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Brachycephalic dogs, otherwise known as dogs with “smushed” faces, are quickly becoming some of the most popular breeds in the world. They include, to name a few, the Pug, Bulldog, Boston Terrier, Boxer, Shih tzu, Pekingese, Lhasa Apso, Brussels Griffon, and Japanese Chin.
Over the last decade in the United States alone, the number of AKC registrations for American and English Bulldogs has gone up 69%, while the French Bulldog, or “Frenchie”, has enjoyed a staggering 476% increase.
So what makes brachycephalic dogs, or “brachys”, so popular?
For one, most are fun-loving, intelligent, happy dogs packed with personality and energy. And then there’s that face! Brachys were specifically bred to have rounder, flatter faces (which makes them appear more human-like), with big eyes that can melt your heart. Most pet parents with brachys are utterly devoted to them, and tend to have several over the course of their lifetime.
However, sharing your life with a brachycephalic dog requires extra skill and a knowledge of what makes them different from most other breeds. These dogs have special needs when it comes to keeping them healthy into old age, and anyone who is considering life with a brachy should be aware of what makes them different, and why.
Brachycephalic Dog Anatomy
The term “brachycephalic” is Greek for “short head”. All brachys were bred to have a shorter, more rounded head with a very short muzzle. Because of this, their lower jaws are normal in size, but their upper jaws are much smaller and more compressed.
This altered facial anatomy has a big impact on the dog’s body, including the respiratory system, teeth, eyes, and skin. Here are the things that make brachys different, along with ways their health can be impacted if certain precautions aren’t taken to protect them.
Brachycephalic Airway Syndrome
This is the most common health issue in brachycephalic dogs. It can result in difficulty breathing, loud snoring, exercise intolerance (due to not being able to take in enough air), and a predisposition to heat stroke. Brachycephalic Airway Syndrome results from the perfect storm of 4 things acting together:
- An Elongated Soft Palate. Although these dogs’ heads were shortened over time, the soft palate (the large flap of skin at the back of the throat) was not. This causes it to periodically flop over the windpipe and obstruct the dog’s airway.
- Stenotic Nares. This is the fancy term for nostrils that are too small and narrow, which makes it harder for the dog to take in air.
- Narrow Trachea. The trachea, or windpipe, in brachycephalic dogs is more narrow. This can cause the dog to be prone to a condition called collapsing trachea.
- Everted Laryngeal Saccules. These are 2 thick clumps of soft tissue located on either side of the trachea. Normally, they stay tucked up out of the way, but if the dog is struggling to breathe, they can temporarily pop out into the throat, further obstructing the airway.
Eyes That Don’t Exactly Fit
Brachycephalic dogs often have shallow eye sockets, which causes their eyeballs to not fit quite right in their heads. Unfortunately, a blow to the back of the head (or any type of head trauma) can actually dislodge an eye, causing it to pop out of the socket. This requires emergency surgery to reposition the eye in the socket.

Pulling too strenuously on a leash attached to a neck collar can also cause an eye to become dislodged. For this reason (and the fact that neck collars place even more stress on their already compromised breathing anatomy), it’s recommended that brachys wear only a harness when on-leash.
Furthermore, due to the fact that their eyes tend to bulge out, brachys often suffer from dry and irritated eyes since their eyelids don’t always close all the way.
Increased Risk Of Skin Infections
Brachys have faces that are pushed in, causing folds and wrinkles in their skin. These facial folds offer the perfect environment for both bacteria and yeast to grow, which can lead to skin infections. The sides of the folds can also rub together, creating irritation and trauma on the surface of the skin, causing redness and irritation.
Daily gentle cleaning of these skin folds with a damp cloth can help prevent irritation and infection.
Difficulty With Anesthesia
Brachys are at a much higher risk of experiencing adverse effects from anesthesia than other dogs. Their compromised airway makes it difficult for them to get enough oxygen, both during the procedure and afterwards while they are waking up.
Their heart and respiratory rates are also notoriously unpredictable while under anesthetic, especially if they also happen to be overweight. I’ve worked with many a veterinarian whose stress level increased greatly when they realized their surgical patient was a brachycephalic dog! Brachys often require much lower doses of anesthetic and very careful monitoring, both during and after surgery. If your brachy needs surgery, make sure that he or she has been carefully examined and is cleared to undergo anesthesia before you give your consent.
Mouths That Are Too Small
Brachys have 42 teeth just like all other dogs, but because of their pushed-in faces and smaller mouths, their teeth get crammed into a much smaller space. This can lead to overlapping teeth, or teeth coming in at odd angles, both of which contribute to dental and gum problems.
Parents of brachycephalic dogs need to be extra diligent about keeping their dogs’ mouths as clean as possible by brushing their teeth several times a week. If necessary, oral rinses can also be used to reduce bacteria. Because brachys are at a much higher risk during anesthetic procedures, it’s important to do everything possible to avoid dental procedures requiring anesthesia.
Prone To Heatstroke
The main way a dog dissipates excess body heat is by panting. Because brachycephalic dogs don’t have an efficient respiratory system due to their anatomy, it makes it much harder for them to dump off excess heat. This makes them a prime target for heat stroke.

This is why it’s particularly important for brachys to stay at a lean, healthy weight. Not only does excess weight place an even greater burden on their already overworked respiratory systems, but the additional fat on an overweight dog adds more insulation that keeps excess body heat in.
Heat stroke in a brachycephalic dog is life-threatening and has resulted in fatalities. Any parent of a brachy should be aware of the signs of heat stroke, and seek veterinary attention immediately if they suspect their dog is experiencing it.
Other Challenges
There are additional challenges that seem to be unique to life with a brachy. Flying can be an issue, since many airlines have restrictions about flying with brachycephalic dogs due to their increased risk of heat stroke and respiratory distress. Brachys are also more prone to loud snoring and reverse sneezing due to their longer soft palates. And they often suffer from exercise intolerance, so they generally don’t make good candidates for running or strenuous hiking.
Also, because their heads are often disproportionately large, labor and delivery in pregnant brachycephalic dogs is difficult, and most require a surgical C-section to deliver the puppies.
Are There Any Solutions To These Issues?
There is a surgical procedure that can be performed to help reduce the symptoms of Brachycephalic Airway Syndrome by widening the nostrils and removing excess tissue from the soft palate. Some brachy parents elect to have this procedure done at the time their dogs are spayed or neutered. However, since every surgery has risk, talk with your veterinarian about whether this procedure may be an option for your brachy.
Of course there is another, more long-term, solution. Many veterinary and pet health care professionals are currently advocating for changes in the breed standards. The Institute of Canine Biology is a strong proponent of breeding longer muzzles back into these bloodlines, stating that “breed standards need to be modified to describe a skull that will accommodate the normal and necessary functions of a dog, and breeders will need to make a commitment to be as diligent about breeding for this as they are for any other trait.”
More Than Just A Pretty Face
If you currently have a brachycephalic dog, or are thinking about adopting one, be aware that Brachycephalic Airway Syndrome can be a progressive condition that may worsen with age. It’s important to familiarize yourself with what are “normal” sounds for your dog and what aren’t – and to get those issues addressed by a veterinarian as soon as they appear, rather than waiting.
With all the potential problems that brachycephalic breeds face, some people wonder why they remain so popular and have their own almost cultish following. Many people who choose to share their lives with a brachy say that, despite all of their issues, brachys have great personalities and make entertaining and loyal companions. Being aware of potential health issues and how to anticipate or prevent them can give many brachys a long and happy life for years to come.
Have you ever shared your life with a brachycephalic dog? If so, what were your biggest joys and challenges? Please share your story with us in the comments below!
Herchel was a pet therapy dog who visited the care facility where I worked. He was a Pug-Boston Terrier mix, black with white feet. He was a darling little guy. He was calm, friendly, gentle and very cute. His pushed-in face gave him a rather comical air. Everyone wanted to see Herchel! They loved holding him or petting him while he lay on their laps. He even performed skits with the assistance of his person. She said he snored when sleeping, but nobody at home minded. He lived a long and happy life well into old age. Cataracts on his eyes eventually dimmed his vision, but that alone did not keep him from his appointed rounds as a Pet Therapy Dog.
What a wonderful story Andrea, thank you for sharing it! Although I’ve never parented a brachy, I hear stories over and over from people recounting how wonderful their personalities are. It sounds like Herchel was perfectly suited for his very special job. <3
Great piece – thank you!
Thanks, Jemima! And thank you for reading! 🙂
We have a Black Pug and she is my world. She is also the boss. We live with her rather than her live with us. Thank you for all of this information. Very good reading and very informative.
Thank you, Quita! I’m glad you found it helpful. 🙂
We have a BT named Lucy. She is a joy but she has most of these issues. She is a small Boston. Just 12 #. She was free. A breeder was going out of business and was giving her dogs away. So far we have about $10000-12000 in her care.
We got her hw+. She got it a second time while on Heartgard. They paid for the second treatment.
Then at 6 yrs she developed sleep apnea. We had the soft palate and onr sacual surgery. 3 months layer had to have 2nd sacual surgery.
During her recovery I noticed she snored badly and would stop breathing. Specialists thought it was neurological until I showed them the video I had taken. Decided it was still respiratory issues. The opening in her sinus bone structure is too small because of her tiny head so she now has a permanent stoma( hole in her neck and treachea. Have to be very careful of water and dirt. No swimming and bathing is tricky.
She has also had eye surgery for a ruptured cornea. Something else BT are prone to happen.
But she is the cutest, most adorable, sweet dog!!! She is our baby girl. Also she is an alpha. Hard headed as they come. She bosses her doxie brother all the time!!!
She is just an example of a bad breeder.
Oh my goodness, poor Lucy!! 🙁 She certainly has had her share of issues! I tend to agree with you that poor breeding and lack of care was likely a big factor, especially since she was heartworm positive when you got her. I think it’s wonderful that you gave her such a great home and have worked so provide her with everything she needs medically to have the best quality of life possible…what you’ve done for her is truly amazing. And it makes me smile that despite all her challenges, she is still so sweet and rules the roost – just like a Boston should! 😉
The only serious problem I had with any of my bulldogs has been entropiatic (?) eyes, where the bottom eyelashes roll inward. I know they call the surgery entropian, but not sure of the condition name.
Hi Joanne! The condition you’re referring to is also called Entropion, where the eyelids fold inward and cause the eyelashes to scratch against the surface of the eye. Not only is it quite painful and irritating, it can also cause permanent damage to the eye. Fortunately, it can be corrected with surgery.
Entropion is very common in brachycephalic dogs, so you’re not alone! Luckily, this surgery is much easier and less invasive than the surgery needed to alleviate Brachycephalic Airway Syndrome.
I received a foundling pug 1 1/2 years ago and she had heart worms, intestinal worms, a tick bite disease and weak hips and a terrible cough. She has no bowel control but has very hard and dry stool. She went through antibiotic, heart worm treatment and numerous other things. Currently she has gone through two antibiotic treatments for UTI’s and she has a mass in her bladder possible from the serious uti. Her main problem now is a chronic cough where she acts like she is trying to cough something up. We have been to the vet two to three times a month since I have had her and I don’t even want to add up the expense, especially since I am on SS with limited income but once you have a pug you are addicted to them. I wonder if anyone else has had this cough problem?
Wow, your poor little girl has certainly been through a lot!! 🙁 Regarding her cough, are you certain that she’s actually coughing and not gagging or reverse sneezing? (I’ve written a post on reverse sneezing that you can read here: https://www.goodpetparent.com/2016/04/26/reverse-sneezing-dogs/ . Coughing can be related to heartworm disease, so depending on how long ago she had heartworm treatment, it could possibly be related to that. But coughing can be a symptom of many different conditions (including asthma and collapsing trachea), so without a chest x-ray and an exam by a vet, it would be hard to diagnose. Has she ever had any chest x-rays to see what might be going on in her lungs? Has the vet seen her for the cough? If not, a quick x-ray of her chest could tell you a lot.
Regarding what you said about “once you have a Pug, you are addicted to them” – I have heard that statement many times from Pug parents. I’ve never had one myself, but the people who share their lives with Pugs seem to be absolutely crazy about them. 🙂
My pug is my world. He is 10 years old now. When he was 7 he suffered a collapsed trachea. We rushed him to University of Illinois at the advise of our vet, and he was given a tracheostomy. He went on to have major scar tissue and the surgery had to be repeated. He also had a large amount of his neck folds removed. He is now easing into his senior years. I hate that he went through all of this, but unfortunately it is a part of being a pug. He is a huge part of our family and we a grateful for each day we have with him.
Oh, those collapsed tracheas can be so scary. 🙁 Although your Pug needed a second surgery, I’m very happy to hear that the last tracheostomy seems to be working! And despite having gone through some rough times, he now has the opportunity to reach senior citizen status with you and your family – all because of the excellent supportive care you’ve given him. And you have a wonderful philosophy…I too am grateful for each day with my boys, and I never take it for granted.
My biggest joy currently is watching our Griffon girl raise her litter of six, she has free whelped both her previous litters. She has no problems with breathing or swallowing, cleaning her pups, running around chasing rabbits here and is as healthy as a horse. Yes, she is brachy – but not so extreme as to have the issues that you have raised. She has had no issue even being anaethetised, which she had to have for her MRI to examine her brain which all ours have done prior to breeding with. I applaud your efforts to make people more aware of the problems that come with extreme brachy heads and noses, but would also like to draw your attention to the great brachy dogs out there – our girl is also a Best in Show winner and champion so despite the fact she is not extreme, she still appeals to dog show judges. Her name is Tabitha and you can see her on the web site below – along with our other fully health proven griffons. regards, Lee
Hello Lee, thank you for writing! I took a look at your website, and Tabitha is indeed a beautiful girl. All the Griffons I’ve ever known have been coal black, so it was interesting to see the lighter coat colors – I think it makes it easier to see their expressive faces! I agree that there is definitely a variation in how extreme the brachy features can be…even within the same breed. Despite the precautions that need to be taken with brachy breeds, personally I think they are some of the most personality-packed dogs out there, and many live long lives without major health complications. As we know, every breed has its issues, so the more knowledge parents of brachy dogs have, the better equipped they will be to identify any potential challenges before they become serious problems. All the best to you and your lovely Griffons! 🙂
My little pug has an elongated pallet, troubles with breathing as she gets older (inflamed lungs and slightly enlarged heart that requires treatment from time to time), epilepsy, and we need to put drops in her eyes (although I’ve found the gel works best) a couple of times a day. Because of the heat in the summer we forgo our ‘after supper’ walks and are now out of the house by 6:30 am to beat the heat and humidity. The brachy’s certainly come with their share of troubles, but a more loving and devoted pet, you will not find. I can’t imagine my life without her now. Nothing compares to the little shadow that is at my side everywhere I go with an endless supply of love and comic relief. Simply put – she’s a gem.
So well put..for people who have never shared life with a brachy, I think you summarized it perfectly! 🙂
My number one boy is a sweet pug named Rupert. I have been fortunate in a lot of ways, in that despite his smush face he still breathes very well (outside of running around in the heat for too long – which makes even me pant and gasp) and he doesn’t snore often or loudly (unless he’s excessively tired – which is also true for my human counterpart). He has had to have teeth removed, and at some point has to have either his remaining teeth removed, or have surgery to cut back his gum line as none of his teeth are properly erupted. He also had terrible, terrible allergies. Several food sensitivities and various airborne allergies (which do not improve even in our Canadian winter). Fortunately, I have a wonderful vet and with lots of patience and trial and error we have figured how what in his diet causes flare ups, and he is now on allergy shots, which are making a huge difference on his quality of life. He unfortunately had to be on steroids for quite a long time because his allergies were so bad that any alternatives (medications, baths, supplements, etc.) would not calm his allergies even a bit, he would go one day without steroids and end up with several large raw spots and secondary yeast and bacterial infections. I was hesitant to go forward with immunotherapy, but I’m so glad I did. He’s still itchy here and there, but it’s not excessive and he hasn’t self-injured since he’s started his allergy shots, which are very easy to give him (he doesn’t even notice when happen).
I’m sure I could have saved a down payment on house on the vet bills I’ve paid, but if my house didn’t have my sweet, pug shaped shadow in it, it just wouldn’t be a home. He’s my best friend, he can just sense when I’m having a hard time and knows when to be silly and play to cheer me up, or when I just need some quite rest and snuggles for comfort. He has the biggest personality I’ve seen not just in dogs, but in all the people and creatures I’ve ever met. I have suffered from chronic pain for many years due to a work injury and twice a year I have to have a procedure done on my spine which results in my being on bed rest for a week, and he is my constant nurse, making sure I don’t get cabin fever while I’m off work. He has saved my life when I was in an extremely and terrifying depression. My quality of life would be so diminished without his companionship. People refer to me as a “Crazy Pug Lady” and I wear that badge with pride. There are two parts of my life, the day I met Rupert and whatever else was before that.
Kelly, from the bottom of my heart, thank you for writing. This story is so very beautiful. As you so eloquently put it, without those sweet shadows in our homes, they are just houses – empty ones at that. No one can place a price or value on the immeasurable joy, comfort, intuitiveness, and love our pets bring to us. They are worth so much more than money could ever buy.
I am so glad the allergy shots are working for Rupert! Allergies can be extremely frustrating, and I’ve heard great things about immunotherapy. Keep flying your “Crazy Pug Lady” flag proudly, and I wish you and Rupert the very best of health and happiness! 🙂
I recently adopted two pugs from the Humane Society, a 9 year old female, Mazie, and 11 year old male, Chunk. They have a variety of health issues, missing teeth, overweight, skin rashes. I have adjusted their diet to accommodate these issues. However I am worried about the exercise since we live in a very warm area. Chunk needs to lose 6-7 pounds, Mazie just 2-3. I have them walking about a quarter mile early in the morning and swimming in the shade about 15 minutes a day, 5 minutes at a time. After a month, there has been no weight loss in either. They both eat about 1 cup of food each day-a mixture of canned and dry kibble-grain free chicken and carrot based.
Hi Sharon…First, it’s wonderful to hear that you opened your heart and home to not just one senior dog who needed a forever home, but two! 🙂 Regarding their weight loss (or apparent lack thereof), have you talked with your vet about their weight loss program? I don’t know what type of food they are eating (other than it sounds from your comments like it might be formulated to help with skin allergies), but is the food a “senior” or “light” formula? Just like us, dogs who are older experience a slowdown in their metabolism, so it’s easier for them to gain weight and harder for them to lose it. I would suggest talking with your veterinarian just to make sure that you are both on the same page with their food – sometimes there can be a fairly significant difference in calories from one brand of food to the next, so you may need to experiment with portion amounts. Also, incorporating fresh veggies like green beans or carrots into their diet can help increase fiber and make them feel more full if they seem to get hungry during the day.
It sounds like you are doing the right things to protect them from the heat while exercising! I don’t know how feasible it would be, but have you ever considered a doggie treadmill so they could walk indoors year-round? Some dogs really seem to enjoy it once they get the hang of it, and you can set the pace. Overall, since both Mazie and Chunk are older AND brachy, working closely with a vet who has good experience with weight loss and exercise programs for overweight pets could be a great help to you. Good luck with your babies, and thank you for writing!
Very informative piece. It is just so sad that so many of these issues are brushed off as just ‘part of being a pug’ when it doesn’t have to be that way. As a vet who see’s these guys struggling everyday, it breaks my heart. Hopefully with continued campaigning people will realise the suffering of these dogs purely for human’s greed and aesthetics and will outcross and breed away from brachycephaly. In a few hundred years i can imagine humans looking back at this time and the popularity of these breeds and shake their heads in disbelief at the cruelty of it all.
Hi Ally, I agree with you. It would be great if all brachy breeds could be outcrossed to reduce their health risks and help them breathe like normal dogs! And there are so many other breeds (like Bulldogs, who, as some may not know, can’t deliver naturally and now require c-sections just to be able to give birth) who would benefit from outcrossing as well. Fortunately the “breeding for aesthetics” debate seems to be getting a lot more attention now…hopefully we will see some positive changes, just like the movement away from ear cropping and tail docking. We can only hope!!
Why these breeds are still being bred is beyond me. A friend has a pug and we sit him sometimes. He’s overweight and he so clearly has issues breathing, when he’s awake and when he’s trying to sleep. It’s like he gets no air at all, he’s constantly struggling. He refuses to walk for more than a few meters, he’s middle-aged and has arthritis. I feel so sorry for these dogs who are constantly in discomfort and who can sometimes not even breathe normally just walking, and can’t be a dog because they can’t run around and play. I really love dogs but will never support the industry for disabled dogs. We wouldn’t want this for humans so why is it ok for dogs?