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Short-headed dog breeds like pugs and French bulldogs are very popular. But the “cute” face comes at a very high price: the animals usually suffer from severe respiratory problems and, as a result, regularly from gastrointestinal problems. We have compiled important information about short-headedness in dogs here.

What is brachycephaly?

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The term brachycephaly comes from the Greek and consists of the terms “brachys” for short and “kephale” for head. Brachycephaly means short-headedness. It is innate and has been induced by active breeding in certain breeds of dogs. Which includes:

  • Pug
  • English bulldog
  • French bulldog
  • Pekinese
  • Chihuahua
  • Boxer

The prevalence of brachycephalic dogs has increased significantly in recent years. Reasons include sending out baby signals (round head, big eyes) that appeal to the protective instinct, as well as the friendly and cheerful nature of these dogs.

By the way: pugs didn’t always look like this. Older descriptions show that the “puppy fidele”, very agile little dog, has only lost a lot of its nose in the last 50-80 years. Responsible for this are exaggerated breed standards of dog breeding associations.

Brachycephaly also affects cats of some breeds, e.g. B. Persian or Exotic Shorthair.

What is torment breeding?

The German Animal Welfare Act prohibits breeding from animals that are expected to cause pain, suffering or harm to their offspring. These include missing and / or malformed organs that cannot perform their function adequately, but also behavioral disorders.

If you look at the consequences of breeding for short-headedness in dogs, you quickly understand that they fall under the term torture breeding. Dogs with respiratory syndrome due to brachycephaly should never be used for breeding!

Why is breeding for short-headedness problematic?

The strong selection for a round, short head causes major health problems. These are summarized under the term “brachycephalic syndrome”. The following effects occur:

Narrowed nasal entrance:

The nostrils are too narrow and allow less air to flow in. The directly adjoining nasal vestibule is often too narrow because the nostrils, which are too large, protrude into it.

Compression of the nasal conchae:

In a healthy dog, the head stretches as it grows: the pup’s snub nose becomes longer as it grows up. In the nose are the so-called turbinates, which are multi-twisted bones covered with mucous membrane. These have important functions: they humidify the incoming breathing air, warm it up in winter and cool it down in summer. When the dog pants, moisture is evaporated via the umpteenfold folds of the surface of the nasal conchae. This brings a great cooling effect which is essential for survival as dogs cannot sweat effectively.

In brachycephaly, the turbinates are compressed due to the failure of the nose to grow in length and are unable to perform their functions. They also narrow the channel through which the air can flow towards the lungs. In addition, they show – compared to healthy dogs – a much too large thickness in relation to the size of the animal.

Throat constriction:

The narrowing of the airway continues. In the throat, a soft palate that is too large and too thick and sometimes a tongue that is too large cause a lack of space. Often the tonsils are irritated and inflamed and therefore swollen. They take up more valuable space.


The larynx sits at the entrance to the trachea and can be closed by a kind of lid, the epiglottis. This is done when you swallow so that food gets up your esophagus and doesn’t accidentally end up in your lungs.

Short-headed dog breeds, especially pugs, often have unstable laryngeal cartilage and large amounts of swollen mucosa. As a result, the larynx often collapses, i. i.e. it collapses in on itself. There is then hardly any space for air to flow through – the dog has shortness of breath.

Narrowed trachea:

Two different phenomena often occur in the trachea: Pugs tend to have cartilage that is too soft here, too. These can then not keep the trachea sufficiently open. As a result, the picture is reminiscent of the tracheal collapse of other breeds: the trachea collapses.

French bulldogs, on the other hand, have cartilage braces that are far too narrow, which means that the diameter of the trachea is too small. These problems usually continue in the bronchi of the lungs. The too small diameter significantly impedes the air flow.

Digestive tract:

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The necessary negative pressure when inhaling leads to an expansion of the esophagus and reflux esophagitis (chronic inflammation of the esophagus). It also irritates the vagus nerve, which can also lead to frequent gagging and vomiting. The digestive tract often shows chronic inflammation, similar to IBD (inflammatory bowl disease).

Other limitations of short-headed dogs are the tendency to have difficult births, misaligned teeth and sometimes hydrocephalus. The wrinkles in the nose often rub against the eyes and the tear fluid is deficient, which leads to permanent eye inflammation.

Not all clinical pictures occur equally in all dogs with brachycephaly.

Since dogs usually breathe through their nose, the restrictions in the upper airways hit them so hard. Mouth breathing only comes into play in situations of great stress and is always a sign that the dog is not doing well!

What are the symptoms of Brachycephaly Syndrome and why?

Symptoms usually worsen with age. However, some dogs are affected as puppies.

The most well-known problem of dogs with brachycephaly is shortness of breath. On the one hand, it is caused by the various narrowing of the airways. There is simply not enough air in the lungs. The narrowing of the airways also means that a very large negative pressure has to be built up in order to breathe in air. This is regulated by the respiratory muscles of the chest. However, this strong negative pressure can lead to parts of the airways collapsing, i.e. collapsing. Then even less air flows through, the animal gasps for breath.

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The well-known snoring noises also occur at the various constrictions. External pressure on the throat further aggravates the symptoms, which is why many brachycephalic dogs do not like to sleep in the chest-prone position with their heads flat on the floor. You just don’t get enough air. Some dogs with brachycephaly must sleep sitting up to avoid choking.

And even without physical exertion, many short-headed dogs show a low tolerance for high temperatures. After only minor exertion in hot or humid weather, they need very long periods of recovery to return to normal breathing. As explained above, the turbinates in dogs play an important role in thermoregulation. A lot of heat is given off through the evaporation of plenty of liquid when panting. In dogs with brachycephaly, this ability is severely limited. This explains their increased susceptibility to heat. In case of great heat or sudden exertion, this is life-threatening for the dogs!

Caution: Many brachycephalic dogs show constant mouth breathing. As previously mentioned, this is not to be considered normal and should lead you to the vet immediately!

The permanent undersupply of oxygen caused by brachycephaly affects the entire organism (known from people with sleep apnea): Various metabolic functions and hormone systems are strained, signs of inflammation increase, high blood pressure occurs. In short: the body is under constant stress because it is not supplied with enough oxygen. The enlargement of the esophagus and the often chronic inflammation of the gastrointestinal tract lead to frequent vomiting and diarrhea.

The problems listed can lead to circulatory collapse and death by asphyxiation. Bronchitis, pneumonia and cardiac insufficiency often develop.

Diagnosis of Brachycephaly Syndrome

If you are the owner of a brachycephalic dog and the above symptoms sound familiar to you, please take your darling to a veterinarian as soon as possible!

The expression “pug language”, which some breeders use to gloss over snoring and rattling, completely ignores the suffering of the dogs! They constantly get too little air, often suffer from real shortness of breath and can hardly move, not only in summer. The noises have nothing to do with communication (like the purring of the cat)!

The diagnosis of the cause of the breathing problems is carried out in addition to the physical examination via an endoscopy of the respiratory tract. In this way, the particularly problematic areas can be identified. X-rays and computed tomography (CT) examinations are also helpful in assessing the situation.

Treatment of brachycephaly

When dogs with acute shortness of breath come to the veterinary practice, they are first stabilized. A cool, dark environment, oxygen supply and, if necessary, medication help.

Of course, the original problem, the nose that was too short and the head deformed, cannot be remedied. A comprehensive operation of the nasopharynx promises the greatest success against respiratory problems:

The soft palate that is too long and too thick is shortened and, if necessary, thinned out.
If the nostrils and the nasal vestibule are narrowed, they are widened by removing small pieces of cartilage and flaps of skin.
Inflamed tonsils, which are also taking up space, are removed.
If the turbinates block the airway, they can be made smaller.
It is important – after precise diagnosis – to operate on as many bottlenecks as possible. In this way, optimal success can be achieved. This procedure is also referred to as “multi-level surgery” because several problem areas are addressed at the same time. Gentle laser methods are used: With the help of the laser, very fine, non-bleeding cuts can be made and work can be carried out very precisely in the narrow nose. This procedure ensures the most comprehensive and long-lasting effect possible. Nevertheless, it can happen that after some time the symptoms worsen again. Then another intervention is usually helpful. Sometimes removing scar tissue is enough.

As soon as a dog shows the first symptoms, including constant snoring, surgical intervention should be carried out, otherwise a vicious circle will arise: the symptoms keep getting worse and the intervention bigger and bigger. This only brings relief, not healing. The late effects of permanent poor breathing are so serious that the operation is justified.

Overweight dogs with brachycephaly should definitely lose weight. Because they store fatty tissue in the throat area, which further reduces the available space. At the same time, dogs with permanent irritation of the gastrointestinal tract need adjusted feeding. Temporary medication may also be necessary.

Brachycephaly in dogs: surgical costs and risks

Many brachycephalic dogs bring an increased risk of surgery. This is because they usually already have circulatory problems, a lack of oxygen supply and other diseases. The recovery phase in particular is therefore often difficult. Being overweight is also a problem. Unfortunately, this increases the stress caused by general anesthesia.

However, your veterinarian will inform you about this in advance of the procedure and discuss everything important with you. As these limitations worsen over time, this is another reason to tackle potential brachycephaly surgery early!

Incidentally, the scale of fees for veterinarians specifies billing rates for all veterinary services, which are calculated with a factor of 1-4. The factor is based on the severity of the intervention or, for example, higher rates apply for emergency treatment than for appointment consultations. If you want to know what brachycephaly surgery would cost for your dog, just talk to your vet about it.

Brachycephaly: treatment and animal welfare

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In conclusion, it should be said here: There are now complex surgical procedures that can greatly improve the quality of life of dogs with brachycephaly. Ultimately, however, they do not solve the problem that was caused by breeding, but only help the individual dog to have a more comfortable life.

First breeding an animal sick and then operating on it cannot be the long-term solution! On the other hand, the goal should be to enable these dog breeds to lead a normal life again through appropriate breeding selection. The effects of brachycephaly are so serious that veterinarians have been trying to get exhibition bans for a long time.

It is better not to get a short-headed dog. If it is absolutely necessary, pay attention to a clearly pronounced nose. Especially with pugs, there are first back breeds. Having a fitness test can also be helpful. This has been offered for some time and tests the physical resilience of the dogs.