Smooshy (Flat) Faced Dogs and Cats

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Flat Faced Dogs and Cats | W. Jean Dodds, DVM

Pugs are so darn cute and have charming personalities to match! This adorable, scrunched-up visage actually exacerbates the Brachycephalic (short head) Obstruction Airway Syndrome. One would think that air would travel faster to the lungs because of the shorter distance, but the parts getting the air to the lungs are compressed and distorted, which enables the audible and stereotypical labored breathing.  

Besides Pugs, many brachycephalic breeds such as Cavalier King Charles Spaniel, English Toy Spaniel, Shih Tzu, Boxer, Pekingese, French Bulldog, English Bulldog, Boston Terrier, Himalayan and Persian cats are afflicted with the same respiratory problems and other health conditions because of their flat-faces.

Controversy has surrounded these breeds for quite some time and has questioned whether or not we need to change breeding practices. The debate has ranged from introducing another breed into the lines to alleviate these conditions to not breeding those dogs with severe problems. Don’t misunderstand me, quite a few breeds are prone to congenital conditions (i.e. present at birth) and similar discussions are going on about them. However, the British Veterinary Association and other notable organizations recently asked pet parents not to purchase brachycephalic breeds, specifically because of their health concerns and therefore increased animal suffering. Personally, I agree that something needs to change.  

I am not trying to dissuade you if you are considering making one of these breeds a member of your household. As I said, many brachycephalic breeds are ideal family members due to their affable personalities. However, I want you to realize the amount of healthcare and the associated costs that these pets can entail. A quick comparison of the ASPCA’s insurance plans demonstrated that the monthly premium for a 5-month old English Bulldog was $13.57 greater than that for a Pembroke Welsh Corgi. I also implore you to research and purchase only from responsible breeders or adopt from a rescue.


Due to the narrow passageways, brachycephalic dogs have a higher propensity for heatstroke and exercise intolerance since dogs use their respiration and must breathe to cool down. Clearly, pet caregivers often have a difficult time keeping weight off these pets, which then heightens breathing difficulties.

What exactly is going on? It is usually not just one of the various parts of the respiratory system that carries air to the lungs, but the entire system. Surgery can be performed to alleviate the symptoms in order to optimize breathing. However, anesthesia poses a higher risk to these breeds because of the narrowness of their respiratory anatomy. Additionally, post-anesthetic care requires close observation.    

Nostrils – Stenotic nares refers to the condition of narrow or collapsed nostrils causing many of these dogs to breathe through their mouths. Resection surgery is possible to help breathing.

Elongated Soft Palate – Odd to think of something elongated in a flat-faced companion pet. However, the soft palate – the tissue between the mouth and nasal cavities – has not been modified with their selective breeding. It abnormally extends over the throat because it is longer than what the head can accommodate. Soft palates are where snoring usually originates in brachycephalic breeds and causes panting in hot weather. Surgery is possible.

Everted Laryngeal Saccules – This is a secondary condition from the labored breathing, because the saccules of the larynx can become inflamed and even cause them to flip inside out. Surgery to remove the saccules can be performed.  

Tracheal Stenosis or Hypoplasia – Most commonly found in English Bulldogs, it is an underdeveloped and narrow windpipe. Surgery cannot be performed to rectify this condition.

Face, Eyes and Mouth

The smooshed face also leads to the eyes bulging out. In fact, several brachycephalic dogs that sustain eye/ head trauma could have an eye actually pop out. Clearly, this is would require emergency care.

Chronic eye problems exist, too. Since the eyelids are not long enough to cover the entire eye, the cornea could become irritated and damaged because it is too dry. This can result in ulcers of the eye. Surgery can correct this problem, but please consult with a veterinary ophthalmologist. You can add veterinary eye drops as a preventative measure.  

On the flip side, your dog could have excessively watery eyes due to another type of irritation. The eyelids are still not closing effectively because they are curling into the eye (entropion) and the eyelashes are scraping the eye. Surgery can be performed to correct this.

Moving down the face, the wrinkles (facial folds) require daily cleaning and/or after every meal.

Finally, the overcrowded conditions in the mouth can cause the teeth to grossly overlap or stick out at weird angles. So, daily brushings are critical with brachycephalic dogs or cats since food can easily get stuck and cause periodontal disease. Since anesthesia poses a higher risk to these pets, the goal should be to brush your pet’s teeth daily to extend the length of time between professional cleanings. If you have a veterinary dentist or orthodontist within a 100 mile radius of where you live, I would contact them to do the cleanings for your brachycephalic pets and for routine care.

Preventative Care

While many of the previous conditions listed are inherited, you can help prevent discomfort or emergency care events.

  • Only use harnesses! Collars put pressure on the neck can that exacerbate breathing problems, damage the larynx or trachea, and hurt the eyes.
  • Don’t overly exercise a brachycephalic breed because this can lead to heatstroke or heat exhaustion.
  • On the flip side, keep them at a healthy weight.

I don’t mean to scare you, but want you to realize the potential costs and health considerations when choosing a brachycephalic pet. Regardless, they are truly wonderful companions!

W. Jean Dodds, DVM
Hemopet / NutriScan
11561 Salinaz Avenue
Garden Grove, CA 92843


Boothe, Harry W., DVM. “Brachycephalic Airway Syndrome (Proceedings).” Veterinary Calendar., 01 May 2011. Web. 08 Jan. 2017.

“Vets Warn People against Buying ‘flat-faced’ Dogs.” BBC News. BBC, 21 Sept. 2016. Web. 08 Jan. 2017.

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