Welcome, to another Feature Friday. Have you ever watched a Bulldog or Pug snore like an old generator and thought, “Aww, how cute!” Well… today, let’s pull back the wrinkly curtain to find out why these adorable snorts may not be as harmless as they sound and the truth about brachycephalic syndrome in Bulldogs & Pugs.
But first, let's understand these breeds.
Breed Origins: Where Did Bulldogs and Pugs Come From?
Ancestry & Historical Origins
Bulldogs
- Origins: England, around the 13th century.
- Ancestral Purpose: Developed from ancient mastiff-type dogs for bull-baiting, a brutal sport where dogs latched onto a bull’s nose to immobilise it.
- Physical Selection: Short, strong jaws and a broad, flat face allowed them to grip while breathing. Their stocky build, strong neck and flat skulls were functional adaptations for this blood sport.
After bull-baiting was banned in 1835 (Cruelty to Animals Act), Bulldogs faced extinction. Breed enthusiasts then selectively bred for docility, transforming them from fierce baiting dogs into the gentle, loyal companions we see today but with exaggerated facial flattening for aesthetics rather than function.
Pugs
- Origins: Ancient China, before 400 BCE.
- Ancestral Purpose: Bred as royal companion dogs for Chinese emperors.
- Physical Selection: Their flat face, curled tail and compact body were prized as symbols of status and wealth. Imported to Europe in the 16th century via Dutch traders, they quickly gained popularity among European nobility.
Bottom line: In both breeds, the shortened muzzle (brachycephaly) was gradually intensified through selective breeding for aesthetic traits.
What Necessity Drove Their Mutation? - Natural vs. Artificial Selection
Unlike natural selection where traits improve survival or reproduction, brachycephaly is entirely human-driven artificial selection. Initially:
- Bulldogs: Functional short snouts for bull-baiting.
- Pugs: Purely aesthetic - flat faces were seen as endearing, “baby-like” and regal.
With time, show standards and public preference exaggerated these features, creating extreme brachycephalic anatomy without survival benefit to the dog itself.
So, what exactly is Brachycephalic Syndrome (BOAS)?
Brachycephalic Obstructive Airway Syndrome (BOAS) is a collection of anatomical abnormalities affecting flat-faced (brachycephalic) breeds. It leads to obstructed airflow in the upper respiratory tract, making breathing laborious, especially during exercise, excitement, or heat.
Breeds often affected include: Bulldogs, Pugs, Shih Tzus and Frenchies.
Why and how does this happen?
These dogs were selectively bred to have those adorable short noses and flat faces (a trait called brachycephaly). But here’s the twist: while their skulls shrank, their soft tissues (tongue, soft palate, nostrils) didn’t get the memo to downsize too. The result? A serious mismatch between skull size and airway structures, causing breathing troubles.
Imagine stuffing a large pillow into a small pillowcase, that’s what’s happening inside these dogs’ skulls.
Key Components of BOAS - What’s really going on?
1. Genetics & Anatomy:
Selective breeding for flat faces causes compressed skulls, but their tongue, soft palate and nasal structures remain normal-sized. This leads to overcrowding of tissues in a smaller space.
Here’s what this overcrowding causes:
- Stenotic nares: Their nostrils are so narrow or collapsed that breathing feels like sucking air through a pinched straw.
- Elongated soft palate: Their soft palate (the back of the roof of the mouth) is too long, hanging down into the airway like a curtain dragging on the floor, partially blocking airflow with each breath.
- Hypoplastic trachea: Their windpipe is narrower than normal, meaning less air gets to their lungs, making breathing feel like a constant workout.
- Everted laryngeal saccules: Small tissue pockets in the voice box get sucked into the airway as they struggle to breathe, further blocking airflow.
2. Increased Airway Resistance:
Because their nostrils are narrow and their palate is too long, they have to work extra hard to inhale. This creates strong negative pressure that pulls even more tissue into their airway (like the laryngeal saccules), worsening the obstruction.
3. Progressive Damage:
Over time, the chronic effort needed to breathe inflames and thickens airway tissues, causing swelling and scarring, which makes breathing even more difficult. It’s a vicious cycle: the harder they work to breathe, the worse their airway obstruction becomes.
The Price of Cuteness: Evolutionary Trade-Off
Because humans love cuteness. Over generations, selective breeding for baby-like flat faces led to:
While these features are visually appealing, nature never designed them for efficient breathing. The evolutionary trade-off is severe: impaired thermoregulation, chronic low oxygen (hypoxia), and a high risk of airway diseases.
Their snorts and snores might sound cute, but in reality, they’re signs of a dog struggling to get enough air.
My Personal Story: When Cute Turns Dangerous
I’ll never forget Charlie, a stocky Bulldog patient with the most dramatic snoring I’d ever heard. During consultations, he’d snore so loudly owners would chuckle, saying “He sounds like grandpa!” But on examination, his gums were tinged blue from poor oxygenation. That day, they realised his snoring was not funny - it was a cry for air.
Another time, a sweet Pug named Bella nearly collapsed during a routine walk on a warm afternoon. Her tongue turned purple from heat stress exacerbated by BOAS. We rushed her to oxygen therapy and cooled her down. It was a stark reminder that cute can come at a cost.
These experiences remind me daily: Snoring isn’t cute if it signals suffocation, especially in these breeds.
Why Are People Attracted in Brachycephalic Breeds?
Humans are instinctively attracted to traits resembling infantile features:
- Large, round eyes
- Flat face
- Small snout
- Rounded head
These features trigger nurturing and affection responses in the human brain (Konrad Lorenz’s baby schema theory).
- Bulldogs: Calm, affectionate, loyal and gentle with children.
- Pugs: Playful, sociable, low aggression, adaptable to apartment living.
Historically, these breeds were royal or noble pets, associated with wealth and prestige.
Risks of Keeping Brachycephalic Breeds
Health Risks
- Chronic respiratory distress
- Exercise and heat intolerance
- Collapse and sudden death in severe cases
- Shallow eye sockets - proptosis (eyeball popping out) risk
- Corneal ulcers due to poor eyelid closure
- Short jaws → overcrowded teeth → dental disease
- Dogs pant to cool down. Narrow airways limit heat dissipation → prone to heatstroke.
- Chronic gulping of air can lead to regurgitation and reflux.
- Bulldogs often require C-section deliveries due to disproportionate puppy head sizes relative to dam’s pelvis.
Ethical Risks
- Welfare concerns: Breeding purely for extreme looks over function perpetuates health problems.
- Quality of life: Constant struggle to breathe is distressing.
Benefits of Keeping Brachycephalic Breeds
- Temperament: Generally docile, affectionate, and people-oriented.
- Adaptability: Suit apartment living due to low exercise needs (but exercise restrictions are health-enforced rather than ideal).
- Bonding: Often deeply attached to owners, seeking constant companionship.
However, benefits are human-centric (emotional, social) while health costs are borne by the animal.
However, as a loving pet parent, knowing what to look out for can save your dog from life-threatening complications.
Caring for Your Brachycephalic Breed: What Can Pet Parents Do?
- Loud snoring even when awake
- Difficulty exercising or refusing walks
- Gagging, retching, or vomiting foam
- Sleeping with neck extended or in a sitting position to ease breathing
- Collapsing during excitement or heat exposure
- Bluish gums or tongue (cyanosis)
- Excess fat around the neck further narrows airways. Maintaining an ideal body condition score (BCS) is crucial.
- Walk during cooler parts of the day
- Keep sessions short and gentle
- Avoid excitement-induced exertion
- Never leave them in cars
- Ensure access to shade, fans, or air conditioning during hot weather
- Collars compress the airway. A harness distributes pressure safely across the chest.
- Don’t wait until a crisis. Preventive surgical correction before severe airway collapse significantly improves quality of life.
BOAS Grading Scores: Your First Priority Before Buying
If you’ve decided you want a Bulldog, Pug or any brachycephalic breed and are prepared to bear the financial costs of their care, understanding their BOAS grading score should be your first and most important consideration. This grading assesses how severely a dog is affected by Brachycephalic Obstructive Airway Syndrome and predicts their current and future health risks. Purchasing a puppy with a Grade 0 or I score significantly reduces the chances of lifelong respiratory distress, heat intolerance and costly emergency interventions. By prioritising BOAS grading before purchase, you’re not just ensuring a smoother pet parenting experience, you’re making a compassionate choice that protects your future dog from a lifetime of unnecessary suffering and medical crises.
BOAS grading scores were developed at the University of Cambridge Veterinary School.It is a veterinary assessment system used to evaluate the severity of Brachycephalic Obstructive Airway Syndrome (BOAS) in flat-faced breeds like Bulldogs and Pugs. These scores classify a dog’s breathing function into grades (0 to III) based on clinical examination and mild exercise testing. The grading helps determine how much their airway anatomy is affecting their breathing and overall health, guiding treatment decisions, predicting long-term prognosis and informing ethical breeding or purchasing choices.
Based on:
1. Physical Examination
- Nostril size: Wide and open = better airflow vs Pinched or slit-like = stenotic
- Muzzle Length: A longer muzzle relative to skull length reduces BOAS risk. Avoid dogs with a muzzle nearly flush with the face.
- Respiratory noise at rest: Should be silent and effortless. Snorting, wheezing or open-mouth breathing at rest signals risk.
2. Exercise Tolerance Tests
- Typically a 3-minute brisk walk or treadmill test assessing respiratory noise, breathing effort and recovery time. Should be able to walk briskly without stopping, gagging or collapsing.
- Body Condition: Not overweight. Obesity exacerbates BOAS.
3. Functional Grading
| Grade | Description | Breathing & Signs | Exercise Tolerance | Management Implications |
|---|---|---|---|---|
| 0 | Unaffected | Normal breathing. No abnormal respiratory noise or effort at rest or after mild exercise. | Normal | Dog is clinically unaffected. Routine monitoring advised. |
| I | Mildly Affected | Mild respiratory noise (snoring, snorting), no significant distress. Noise may increase with excitement or exercise but recovers quickly. | Normal | Generally healthy for daily life. Monitor for progression. Maintain ideal weight and avoid overheating. |
| II | Moderately Affected | Moderate respiratory noise with increased breathing effort. May show laboured breathing or prolonged recovery after exercise. Heat intolerance often observed. | Reduced; tires quickly | Veterinary management required. Surgical intervention often recommended to improve airflow and quality of life. |
| III | Severely Affected | Severe respiratory noise with significant breathing effort even at rest. Possible cyanosis (blue gums/tongue) or collapse episodes. | Poor; may collapse with mild activity or heat exposure | Urgent surgical correction needed. Severe BOAS is life-threatening if unmanaged. Breeding not recommended. |
Is Your Pup at Risk?
Does your Bulldog or Pug:
- Gasp for air after mild activity?
- Struggle to sleep comfortably?
- Overheat easily?
If yes, consult your vet ASAP.
Red Flags in Breeder Claims
No written BOAS grading certificate or veterinary health screening available.
What Can The Vet Do?
- Physical Examination: Checking nostril patency, palate length and breathing sounds
- Sedated Oral Exam: Visualising palate and larynx structures
- Radiographs: Assessing tracheal diameter
- Endoscopy: Direct visualisation of airway structures if needed
- Stenotic Nares Resection (Rhinoplasty): Widening the nostrils to ease airflow.
- Soft Palate Resection (Staphylectomy): Trimming excess tissue to clear airway blockage.
- Everted Laryngeal Saccule Removal: Extracting obstructive saccules from the larynx.
- Tonsillectomy or Further Airway Surgeries: In severe cases with extensive tissue obstruction.
- Oxygen therapy during acute respiratory distress
- Anti-inflammatory medications to reduce airway swelling
- Weight management programs to reduce external compression
Prevention
While you can’t change their anatomy, you can:
- Choose responsible breeders who prioritize functional airways over extreme looks. Ask for BOAS grading scores before purchasing.
- Keep them slim
- Avoid overheating
- Seek early surgical intervention before irreversible damage occurs
Prognosis
With early surgical intervention and lifelong management, prognosis improves significantly. However, severely affected dogs may have persistent breathing challenges despite treatment.
Zoonotic Implications
None directly. BOAS is not contagious to humans. But it is a sobering reminder of ethical breeding practices - what we create in animals can affect their health for life.
While BOAS has no zoonotic risks for humans, it raises a far deeper concern about our role in shaping the lives of these animals.
The Ethical Debate
We often talk about the snorts and snores of brachycephalic breeds with affection, but behind every wheeze lies a question we cannot ignore:
"Is it ethical to breed dogs whose very anatomy makes breathing a daily struggle?"
Human preference and demand for these features have led to the emergence of breeds like Bulldogs and Pugs, where appearance is prioritised over functional anatomy, resulting in extreme conformations.
The Moral Dilemma
We, as a society, face a critical question:
"Do we have the right to continue breeding animals for traits that inherently cause suffering, simply because we find them cute?"
As a veterinary professional, I often wonder:
"If a breed’s standard traits inherently compromise its health and wellbeing, should that standard still exist?"
I took an oath to prioritise animal welfare. And welfare is about quality of life, not just length of life. If we truly love these breeds, we must fight for their right to breathe freely.
Where Animal Welfare Organisations Stand
- The British Veterinary Association (BVA) and World Small Animal Veterinary Association (WSAVA) have called for urgent reforms in brachycephalic breeding.
- Campaigns like #BreedToBreathe advocate for redefining breed standards to prioritise health.
Our Responsibility
- Support ethical breeders focused on health over looks
- Educate pet owners about the hidden costs of extreme conformations
- Advocate for revised breed standards that prioritise welfare
Final Thoughts
Every time I see a Bulldog or Pug, I think of their valiant daily struggle to simply breathe. We owe them more than just “aww cute!” - we owe them comfort and health.
Stay tuned for next Feature Friday, where we tackle another pet health truth bomb.
Until then, stay vortexy, curious, empowered and compassionate.
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