Ask the Vet: Flat-faced breeds prone to health problems

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Q: My dog Hugo is the cutest, most lovable French bulldog I know. When I submitted a photo of him to a calendar contest, they refused to accept it because he is a brachycephalic dog, and they consider it inhumane to promote unhealthy dogs. I hope you can explain their discriminatory position, because I am mystified.

A: Brachycephalic dogs have short (brachy-, BRAKE’-ee) heads (-cephalic) without a pronounced muzzle. French bulldogs are typical of these flat-faced breeds, along with Boston terriers, boxers, English bulldogs, Pekingese, pugs, Shih Tzus and others.

Sadly, these dogs inherit multiple life-threatening health problems that accompany the short, flat facial conformation. While other dogs typically survive 12.7 years, brachycephalic breeds live an average of only 8.6 years.

Their most common health problem is brachycephalic obstructive airway syndrome, or BOAS, caused by malformation of many structures in the head and neck. BOAS makes it hard to breathe, so their blood is not as well oxygenated as normal dog blood. BOAS also increases the risk of sleep apnea, heat stroke and collapse.

Brachycephalic breeds have an underbite with misalignment and overcrowding of teeth that makes chewing difficult. Most of these dogs develop severe dental disease and premature loss of their teeth.

The flat face of brachycephalic breeds also predisposes them to eye problems that cause pain and reduce vision. For example, these dogs are 11 to 20 times more likely to develop corneal ulcers than normal dogs. Many have eyelashes and facial hair rubbing against the surface of the eye, as well as abnormal tear production and impaired tear drainage.

Brachycephalic dogs also experience gastrointestinal disorders more often than other dogs. Gastroesophageal reflux disease, hiatal hernia and esophagitis cause regurgitation and related problems.

In addition, these dogs inherit skull and spine abnormalities that cause neurologic dysfunction. Intervertebral disc disease, spinal arthritis and scoliosis induce pain and make walking difficult.

Finally, brachycephalic pups have such large heads that most can’t be delivered naturally but require cesarean section.

These medical problems contribute to the dogs’ poor health — and to their families’ high veterinary bills. I suspect that’s why the calendar company refuses to feature brachycephalic breeds.

My advice is to give Hugo the love he deserves, even if he’s not calendar-worthy.

Q: My veterinarian recommended that my indoor-only cat Sydney be treated with a heartworm preventive. If heartworms are transmitted by mosquitos, which live outside, why would an indoor cat like Syd need a heartworm preventive?

A: You are correct that heartworms are transmitted by mosquitos, but it’s not unusual for them to find their way indoors. Research shows that 25% to 30% of heartworm-infected cats spend all their time inside.

Your veterinarian’s advice to start a heartworm preventive could protect Syd from severe breathing problems and premature death.

A single heartworm or even some immature heartworm larvae can cause heartworm-associated respiratory disease, or HARD. This condition is characterized by coughing, wheezing, labored breathing, lethargy, vomiting and decreased appetite.

Diagnosis requires many tests, and even then, accurate diagnosis is difficult. Therefore, HARD is often misdiagnosed as asthma.

Unfortunately, the arsenic treatment that kills heartworms in dogs is toxic to cats, so treatment options for cats are limited. In most cases, HARD kills cats — sometimes suddenly, before the cat develops clinical signs.

Fortunately, many safe, effective, easy-to-use feline heartworm preventives are available. Ask your veterinarian to prescribe one of them to protect Syd.

Lee Pickett, a veterinarian, practices companion animal medicine in North Carolina. Contact her at

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