BVA position on brachycephalic dogs
Executive summary
1.

BVA is concerned that the rapid rise in the number of brachycephalic dogs in the UK isleading to a population-based increase of ill health and compromised welfare in these breed
types.

2.

Society as a whole, including the veterinary professions, dog owners, breeders, registeringbodies, breed clubs, academics, animal charities and those with a commercial interest in theuse of dogs and their images, have a social and moral responsibility to work together
towards:3.

•ensuring healthier future generations of dogs with brachycephalic conformation•

reducing the negative health and welfare impacts of brachycephaly on the current
generation of brachycephalic dogs•

increasing awareness of the health and welfare issues associated with brachycephaly
amongst current and prospective owners•

encouraging research in order to better understand and address the prevalence of, andtrends in, conformation-related ill-health in brachycephalic dogs•

encouraging research in order to better understand and address the prevalence of thewelfare impacts resulting from brachycephaly•

the development of objective, robust measures to contribute to the assessment ofproblematic conformation

In order to achieve this, BVA is advocating a three-strand approach whereby all stakeholders
play a role in:•Driving healthier standards amongst brachycephalic dogs•

Avoiding imagery of brachycephalic dogs in advertising, marketing materials and social
media campaigns to reduce demand and prevent the normalisation of their associatedhealth issues•

Supporting and harnessing the influence of the veterinary professions

4.

The BVA policy position sets out key actions for stakeholders across dog health and welfare,including the veterinary professions, registering bodies, breeders, the show sector, academia
and marketers and advertisers.

5.

BVA recognises the need for professional veterinary associations to support their respective
memberships to take action by:

6.

•

developing resources and guidance•

producing targeted communications and consistent messaging•

providing CPD and engaging with key stakeholders to promote collaborative working
across the sector.

BVA has developed a 10-point plan for veterinary practices to support vets to further improve
the health and welfare of brachycephalic dogs and promote responsible ownership.7.

Introduction
In the ten years to 2017 there has been a rapid rise in ownership and number of brachycephalic dogs
in the UK (both those that are Kennel Club-registered and in the wider dog population1). According toKennel Club figures, registration of these breed types has risen dramatically of the past ten years,
with a 3104% increase in French Bulldog registrations, a 193% increase in Pug regis trations and a
96% increase in Bulldog registrations. 2 BVA is concerned that this rise in numbers is leading to apopulation-based increase of ill health and compromised welfare in these breed types. Figure 1
visually illustrates the rise in proportional annual birth rates amongst some brachycephalic breed
types over the 2004-2016 period.
Figure 1: Graph demonstrating the rise in proportional annual birth rates amongst
brachycephalic breeds
Brachycephalic Breeds - Proportional Annual Birth Rates

5.00

Percentage

4.00
3.00
2.00

1.00
0.00
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Year of Birth

Boxer

Bulldog

French Bulldog

PugShih-tzu

Image credit: Dan O’Neill, VetCompass
Brachycephaly refers to a short skull shape, which gives the appearance of a flattened face. Figure 2
shows a comparison of two CT scans, demonstrating the difference in skull shapes between abrachycephalic dog - a dog with a shortened skull shape - (left) and a non-brachycephalic dog - a dog
with a skull of a proportionate size for their breed type without any abnormality - (right).
Figure 2: CT scans of a brachycephalic dog skull (left) and a non-brachycephalic dog skull(right)

1 O’Neill, D.G., Darwent, E.C., Church, D.B. & Brodbelt, D.C. (2016) Demography and health of Pugs underprimary veterinary care in England, Canine Genetics and Epidemiology. Canine Genetics and Epidemiology, 3,1-12. Available at: https://link.springer.com/article/10.1186/s40575-016-0035-z
2Kennel Club (2017) 10 Yearly Breed Statistics. Available at:https://www.thekennelclub.org.uk/media/129029/10yrstatsutility.pdf
BVA brachycephalic dogs policy position January 2018
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Image credit: Cambridge BOAS Research Group

Health and welfare issues associated with brachycephaly
As a consequence of selective breeding for their appearance and to cater for their high demand, asubstantial proportion of dogs with brachycephalic conformation are predisposed to suffer from arange of health problems associated with their extreme conformation. These probl ems include:•Anatomical defects of the upper airway causing breathing difficulties oft en associated withoverheating, sleep apnoea and regurgitation (eg. Brachycephalic Obstructive Airway Syndrome(BOAS))3,4,5 Figure 3 illustrates an example of open nostrils (A) compared against mild (B),moderate (C) and severe (D) stenotic nares or narrowed nostrils that are commonly seen inbrachycephalic breeds. Stenotic nares make it difficult for dogs to breathe and are a risk factor ofBOAS.

•Eye disease6,7,8, 9•Inability to mate or give birth naturally (requiring Caesarean section) 10Figure 3: An example of open nostrils (A) compared against mild (B), moderate (C) and severe(D) stenosis of narrowed nostrils that are commonly seen in brachycephalic breeds and are arisk factor of BOAS.

3 Dupré and Heidenreich (2016) Brachycephalic syndrome. Vet Clin Small Anim 46 (2016) 691–707 Available at:

http://www.vetsmall.theclinics.com/article/S0195-5616(16)00008-5/abstract
4 Packer RMA, Hendricks A, Tivers MS, Burn CC (2015) Impact of Facial Conformation on Canine Health:
Brachycephalic Obstructive Airway Syndrome. PLoS ONE 10(10): e0137496. Available at:
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0137496
5 O'Neill DG, Jackson C, Guy JH, Church DB, McGreevy PD, Thomson PC, Brodbelt DC: Epidemiologicalassociations between brachycephaly and upper respiratory tract disorders in dogs attending veterinary practicesin England. Canine Genetics and Epidemiology 2015, 2(1):10.
6 Maggs D, Miller P, Ofri R and Slatter D (2008) Slatter’s Fundamentals of Veterinary Opthamology. 4th Ed.
Elsevier Health Sciences: Edinburgh, UK
7 Bedford P and Jones G (2001) Abnormal appearance in R Pieffer and S Peterson Jones (Eds) Small animal
ophthalmology: a problem oriented approach. 3rd Ed. Saunders: Philadelphia. pp 59
8 Mould J (1993) Conditions of the Orbit and Globe in S. Petersen-Jones and S. Crispin’s Manual of small animal
ophthalmology. BSAVA: Cheltenham p 45
9 O'Neill, D. G., Lee, M. M., Brodbelt, D. C., Church, D. B. & Sanchez, R. F. (2017) Corneal ulcerative disease indogs under primary veterinary care in England: epidemiology and clinical management. Canine Genetics andEpidemiology, 4, 5.
10 O'Neill, DG., O'Sullivan, AM., Manson, EA., Church, DB., Boag, AK., McGreevy, PD., Brodbelt, DC. (2017)
Canine dystocia in 50 UK first-opinion emergency-care veterinary practices: prevalence and risk factors
Veterinary Record 181, 88.

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A – Open nostrils

B – Mild stenosis

C – Moderate stenosis

D – Severe stenosis

Image credit: Cambridge BOAS Research GroupIn these breed types, veterinary surgeons also regularly treat:•

Repeated skin infections associated with conformational abnormalities seen in dog s withbrachycephalic conformation eg. intertrigo•

Dental problems•

ObesitySocietal responsibility
Society as a whole, including the veterinary professions, dog owners, breeders, registering bodies,
breed clubs, academics, animal charities and those with a commercial interest in the use of dogs andtheir images, have a social and moral responsibility to work together towards:•ensuring healthier future generations of dogs with brachycephalic conformation•

reducing the negative health and welfare impacts of brachycephaly on the current generation ofbrachycephalic dogs•

increasing awareness of the health and welfare issues associated with brachycephaly amongst
current and prospective owners•

encouraging research in order to better understand and address the prevalence of, and trends in,conformation-related ill-health in brachycephalic dogs•

encouraging research in order to better understand and address the prevalence of the welfare
impacts resulting from brachycephaly

BVA brachycephalic dogs policy position January 2018
(Page 4 of 8)•the development of objective, robust measures to contribute to the assessment of problematic
conformation

Driving healthy standards
BVA recognises that there are different populations of brachycephalic dogs in the UK: those Kennel
Club-registered dogs bred to Kennel Club Breed Standards, which may be shown or sold as pets;
those dogs bred to be sold as pets by breeders who are part of the Kennel Club Assured Breeder
Scheme (ABS); those dogs bred to be sold as pets, either purebred or cross-bred, that have noaffiliation with a kennel club, breed society or breeder assurance scheme. At present, we are notaware of any strong evidence to indicate that these different populations suffer the health and welfare
problems that are associated with brachycephaly to a lesser or greater extent.
BVA recognises that there are important interrelationships between these populations. For example,
by setting healthier standards and rewarding positive examples of dogs in the show population, theshow sector has the potential to drive demand for healthier dog conformations amongst the pet buying public and incentivise breeders to emulate these standards through the selection of healthierbreeding lines. The position of influence of the show population should therefore be harnessed toimprove health and welfare outcomes across all populations of dogs, including brachycephalic breed
types. This can be achieved through:Breed Standards
Breed Standards should be reviewed according to evidence and be clear in their definitions of healthy
conformations. This could be achieved using diagrams, quantitative ratios and conformational
limits 11,12,13 14 and developed in consultation with expert veterinary input. Show judges have a role inensuring that only dogs that meet these standards are placed, encouraging improvements tobrachycephalic breed health and incentivising the selection of healthy parents as part of the breeding
process.

Breed health and conservation plans
BVA supports the Kennel Club’s project to develop Breed Health and Conservation Plans for different
breeds and welcomes the Kennel Club’s intention to formulate these for dogs with brachycephalicconformation. In cases where brachycephaly is linked to serious and persisting health problems, orwhere other genetic approaches are not available (eg. through insufficient genetic variability), there isa potential role for evidence-backed outcrossing 15,16 of pedigree brachycephalic dogs with dogs thatwill confer healthier traits.

11 Liu NC, Troconis EL, Kalmar L, Price DJ, Wright HE, Adams VJ, Sargan DR, Ladlow JF. Conformational risk

factors of brachycephalic obstructive airway syndrome (BOAS) in pugs, French bulldogs, and bulldogs. PLoSOne. 2017 Aug 1;12(8):e0181928.
12 Liu NC, Oechtering GU, Adams VJ, Kalmar L, Sargan DR, Ladlow JF. (2017) Outcomes and prognostic factorsof surgical treatments for brachycephalic obstructive airway syndrome in 3 breeds. Vet Surg. 2017
Feb;46(2):271-280
13 Liu NC, Sargan DR, Adams VJ , Ladlow JF. (2015) Characterisation of Brachycephalic Obstructive Airway
Syndrome in French Bulldogs Using Whole-Body Barometric Plethysmography. PLoS One. Jun
16;10(6):e0130741.
14 Bateson, P. 2010. Independent inquiry into dog breeding. Cambridge: University of Cambridge.
15 Farrell, L, Schoenebeck, J, Wiener, P, Clements, D & Summers, K 2015, 'The challenges of pedigree dog
health: approaches to combating inherited disease' Canine Genetics and Epidemiology, vol 2, no. 3. DOI:
10.1186/s40575-015-0014-9
16 Knowler, S. P., v/d Berg, H., McFadyen, A., La Ragione, R. M., & Rusbridge, C. (2016). Inheritance of ChiariLike Malformation: Can a Mixed Breeding Reduce the Risk of Syringomyelia? PLoS ONE, 11(3), e0151280.

http://doi.org/10.1371/journal.pone.0151280
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Brachycephalic health assessments
BVA supports the development of brachycephalic health assessments and their use in both breed
shows and veterinary consultations to improve the health and welfare of the current population ofbrachycephalic dogs and encourage the selection of healthier breeding lines.
Once developed, BVA recommends that all brachycephalic dogs receive an annual brachycephalichealth assessment undertaken by their vet to assess any potential difficulties in breathing and otherconformational-related health issues.
Further, in order to help judges assess the current Breed Watch point of concern for ‘Dogs showing
respiratory distress including difficulty in breathing or laboured breathing’ in Brachycephalic Category
3 breeds, we would support the use of a standardised exercise tolerance test (ETT) and functional
grading by show judges and veterinary professionals - such as the functional grading systemdeveloped by the Cambridge Veterinary School BOAS Research Group. 17
Robust training and support programmes should also be developed to assist both show judges andveterinary professionals to successfully implement and carry out such health assessments.

Marketing and advertising
The prominent use of brachycephalic dogs in marketing campaigns and on various products has thepotential to perpetuate the desirability of these breeds.
BVA urges advertisers, designers and veterinary practices to avoid using imagery depicting dogs withbrachycephalic conformation to reduce their demand and prevent the normalisation of theirassociated health issues.
BVA encourages advertisers and designers to consult with a veterinary surgeon before
commissioning and using animals in marketing materials.
BVA does, however, recognise that the use of brachycephalic breed-types in imagery may benecessary for purposes of health and welfare education and the advertisement of breed-specificservices that seek to improve the health and wellbeing of dogs with brachycephalic conformation.

The role of the veterinary professions
BVA believes that as credible and trusted leaders in animal health and welfare, the veterinary
professions should take action collaboratively to influence the reduction of unhealthy dogs withbrachycephalic conformation and improve health and wellbeing outcomes for the current generationof brachycephalic dogs through consistent messaging.
BVA recognises the need for professional veterinary associations to support their respective
memberships to take action by developing resources and guidance; producing targetedcommunications and consistent messaging; providing CPD and engaging with key stakeholders topromote collaborative working across the sector.
We know that individual veterinary professionals improve the welfare of many brachycephalic dogs on
a day-to-day basis through the diagnosis and treatment of problems linked to brachycephaly. Other
actions that they can undertake to improve the welfare of dogs with brachycephalic conformation
include:•Promoting and undertaking annual brachycephalic health assessments•Raising awareness amongst owners of the role of obesity in exacerbating other health problems
linked to brachycephaly (eg. respiratory disease18) and conveying that frequent respiratory sounds

17 Liu NC, Adams VJ, Kalmar L, Ladlow JF, Sargan DR. (2016) Whole-body barometric plethysmography

characterizes upper airway obstructions in 3 brachycephalic breeds of dogs. Journal of Veterinary Internal
Medicine May;30(3):853-65
18 Liu NC, Adams VJ, Kalmar L, Ladlow JF, Sargan DR. (2016) Whole-body barometric plethysmography

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by their dog such as snorting and snoring are not normal, but instead are clinical signs ofcompromised breathing•

Reporting conformation-altering surgery and Caesarian sections, in Kennel Club-registered dogs,
to the Kennel Club

10-point plan for veterinary practices
There are also actions veterinary practices can undertake to improve the welfare of brachycephalicdogs and promote responsible ownership, including:
8.

Offer pre-purchase consultations, such as the PDSA “Which pet?” consultation framework,with prospective dog owners. The potential health problems of brachycephalic conformation
can be clearly outlined in these consultations

9.

Strongly advise against breeding if a dog is suffering from BOAS or requires conformation
altering surgery – consider neutering (where best practice allows) to prevent further litterswith extremes of conformation that negatively impact on their health and welfare

10. Promote the Puppy Contract (comprising the Puppy Information Pack and contract for sale)through the practice communication channels, eg. website, social media, waiting room
displays, newsletters and in local print and broadcast media
11. Promote and actively participate in available health schemes (eg. BVA/KC Health Schemes),
including those for brachycephalic breeds that currently exist amongst Bulldog, French
bulldog and Pug breed clubs
12. Carry out exercise tolerance tests (ETT) and functional grading for brachycephalic breeds aspart of their annual health assessment
13. Enrol the practice in clinical surveillance programmes such as VetCompass and SAVSNET,
to contribute to data gathering and evidence generation
14. Develop a practice communication strategy to repeatedly, clearly and consistently
communicate the health problems experienced by dogs with brachycephalic conformation
through the practice communication channels
15. Develop practice policy to ensure that practice communication channels (particularly social
media and advertising materials) do not portray dogs with brachycephalic conformation ascute, humorous or appealing
16. Ensure practice policy supports staff to appropriately convey evidence-based information
and advice to owners of dogs with brachycephalic conformation
17. Support local breed clubs and representatives to develop and implement plans to improve
the health of dogs with brachycephalic conformation

ResearchBVA recognises the need for funded research and extended data gathering to better understand andaddress the prevalence of, and trends in, conformation-related ill-health in brachycephalic dogs andthe welfare impacts resulting from brachycephaly.
BVA would welcome the development of breed specific objective assessment measurements, ratios
or indices to contribute to the assessment of problematic brachycephalic conformations leading tonegative health and welfare impacts, as well as the further development of non-invasive functional
health testing eg. exercise tolerance tests (ETT)s or accurate genetic tests.

characterizes upper airway obstructions in 3 brachycephalic breeds of dogs. Journal of Veterinary InternalMedicine May;30(3):853-65

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In addition, we would welcome extended gathering of surveillance data on all dogs withbrachycephalic conformation, including Kennel Club and non-Kennel Club registered dogs, andencourage veterinary practices to enrol in clinical surveillance programmes such as VetCompass andSAVSNET to contribute to improved data gathering and evidence generation.
Equally, BVA believes it is important to carry out enhanced research to measure the welfare impactsof brachycephaly and better understand the social influences that drive breed demand in order todevelop targeted educational strategies that will influence purchasing behaviours.

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