The technical term for breeds like pugs, French bulldogs (“Frenchies”), Boxers, Cavalier King Charles spaniels, Shih Tzus and others is “brachycephalic.” The structure of their bodies means that these breeds often suffer from health problems like breathing issues, skin fold infections, eye issues, back and joint issues, mobility issues and heatstroke.

Veterinarian Sean Wensley compares living with their shortened skulls to breathing through a straw—for your entire life. Many owners consider huffing, snorting and other signs of labored breathing as a cute quirk of the breeds, but these dogs are suffering. In some cases, the dogs’ quality of life can be improved through surgeries correcting anatomical abnormalities, but they may cost thousands of dollars.

Diagram depicting the health issues brachycephalic dogs can face

Why do pugs, bulldogs, etc. have health issues?

With shortened skulls and bulging eyes, brachycephalic dogs look the most like human infants and are therefore popular with human owners. Breeders looking to make money off the most appealing dogs may breed dogs for the flattest faces and the biggest eyes without regard for health or temperament.

Unfortunately, breeding with the goal of “ultimate cuteness” also breeds for health and welfare problems. Tissues from the mouth, windpipe and lungs are squashed into a smaller, enclosed space, so dogs struggle to breath sufficient air and oxygen and their airways are narrow and twisted abnormally. This can cause:

  • Allergies
  • Breathing problems (brachycephalic obstructive airway syndrome or BOAS)
  • Eye issues
  • Difficulty exercising
  • Heatstroke

In addition, the short, stocky bodies and frequent inbreeding of these breeds can cause:

  • Back and joint issues
  • Digestion issues
  • Difficulty giving birth (most brachycephalic breeds are born via C-section)
  • Mobility issues 
  • Skin fold infections

What is brachycephalic obstructive airway syndrome?

Objective measurements have determined that 50% of pugs and French bulldogs and 45% of bulldogs have clinically significant signs of brachycephalic obstructive airway syndrome (BOAS). The Humane Society Veterinary Medical Association notes that upper respiratory disorders were the cause of death for 17% of dogs with extreme brachycephalic conformation (like pugs, bulldogs and French bulldogs) compared to 0% for all other breeds of dogs. The lifespan of dogs with extreme brachycephalic conformation is shorter (8.6 years) than all other breeds of dogs (12.7 years).

BOAS is a consequence of the shortened noses and skulls of these dogs and includes:

  • Elongated and thickened soft palate (a long palate that extends into the throat and interferes with breathing)
  • Stenotic nares (malformed nostrils that do not allow dogs to breathe freely)
  • Everted laryngeal saccules/laryngeal collapse (tissues in the airway that obstruct airflow)

Clinical signs of BOAS can include:

  • Dyspnea (difficulty breathing)
  • Dtertor (noisy breathing)
  • Exercise intolerance (often leading to obesity, which shortens dogs’ lifespans further)
  • Regurgitation/vomiting
  • Overheating
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What should I know before getting a pug, French bulldog, etc.?

If you’re set on a flat face breed, check shelters and breed-specific rescues for your preferred breed first. If you’re set on purchasing the breed, learn how to find a responsible dog breeder and take our checklist with you as you visit different breeders. If the breeder you're working with doesn't meet all the minimum criteria listed, we advise you to walk away. 

Remember that your chosen flat face breed will require special care above and beyond regular dog care, including:

  • Daily/weekly wrinkle and skin fold cleaning.
  • Extra veterinary costs and visits for the most common health problems.
  • Short, gentle walks and cooling products to avoid heatstroke.
  • Help with stairs and jumping on and off furniture.