Common health issues for flat-faced dogs

Pugs, shih-tzus, bulldogs, and other flat-faced dogs are more popular than ever, so there’s no time like the present to become more familiar with their unique health issues. 

A flat-faced dog’s compacted facial anatomy causes increased effort with every breath. Despite the added effort, these dogs often suffer from reduced airflow to the lungs, which can lead to Brachycephalic obstructive airway syndrome (BOAS). Symptoms include:

  • Snorting, grunting sounds
  • Wheezing on inhale
  • Gagging and coughing
  • Snoring
  • Collapsing during or after exercise

Dogs with BOAS may require surgery to shorten the soft palate, which is typically elongated in short-faced dogs. In addition, many of these dogs require surgical resection to open the larynx and nostrils. Even without BOAS, brachycephalic dogs require special anesthesia considerations . This is why most airlines have restrictions against snub-nosed breeds, as flying can bring added health risks.

Heart disease

Facial conformation is often a primary factor when flat-faced dogs present with heart disease. Because the lungs receive less than the optimal amount of air, blood oxygen levels are often chronically low, placing added strain on the heart.


Brachycephalic dogs are prone to overheating and heatstroke, as their facial conformation prohibits effective cooling. Clients with short-faced dogs like French Bulldogs should be advised to keep their pets cool during hot weather, opting for exercise during early mornings and after the sun goes down rather than during the hottest part of the day. Clients can also help their pets by walking them on a harness instead of attaching the leash to the dog’s collar.

Dental problems

All dogs require regular dental cleaning, but flat-faced breeds tend to have more dental problems than their longer-nosed cousins. Check for overcrowded teeth and urge clients to practice good doggie dental hygiene at home between regular visits.

Ocular injuries and eye disease 

Most flat-faced dogs also have protruding eyes. Cherry eye, dry eye, and eye ulcers are common issues for these dogs, and so are ocular injuries, often sustained during everyday activities and play sessions.

Facial skin infections and ear infections

Where there are skin folds, there’s an increased risk of bacterial buildup and infection – and most of these dogs have pronounced facial folds. In addition, their ear canals are often narrower than average, which can lead to a higher frequency of ear infections. Teach clients to conduct routine facial fold and ear cleanings; if they’re unable to do so, advise them to have their dogs professionally groomed on a regular basis.


Obesity is a problem for any dog, but it magnifies many of the common health issues flat-faced dogs tend to suffer from.

Being overweight makes BOAS symptoms worse since fat deposits in the chest and neck restrict breathing further. Obesity intensifies the likelihood of heat stroke in short-nosed dogs, and it greatly increases their risk of suffering heart disease and diabetes. Urge clients to keep their brachy dogs at a healthy weight, focusing on regular exercise and an appropriate diet.

While surgery can help flat-faced dogs with severe BOAS, prevention is key to better health overall.


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