What You Should Know About French Bulldog Breathing Issues

This article is all about french bulldog breathing issues.

It’s no secret that French Bulldogs (affectionately known as “Frenchies”) have stolen our hearts. The breed has taken out the number one spot on the American Kennel Club’s most popular dog breeds of 2022.¹ With their goofy, affectionate, and playful nature, they have fast become a family-favorite.² The French Bulldog has a wide squished face with trademark “bat-ears” and facial wrinkles above the nose. Unfortunately, this characteristic appearance is associated with French Bulldog breathing issues, which many owners may not be aware of prior to bringing home their new family member. Understanding the health conditions of French Bulldogs is very important for potential or new French Bulldog owners.

In this post we’ll discuss:

• Anatomy of French Bulldogs (and how it relates to their breathing issues)
• Brachycephalic Obstructive Airway Syndrome
• Treatment of French Bulldog Breathing Issues
• Prevention of French Bulldog Breathing Issues (what you can do at home)

Anatomy of French Bulldogs

As mentioned previously, the French Bulldog has a characteristic squished face. The medical term for this squished face is “brachycephaly”.⁸ There are many breeds that fall under this brachycephalic category, including Pugs, Boston Terriers, Brussels Griffon, Shih Tzu, English Bulldogs and of course, French Bulldogs.⁸

There are several components of French Bulldog anatomy that can contribute to their breathing issues including a shortened, widened skull, stenotic nares (nostrils), an elongated, thickened soft palate (hyperplasia), and an enlarged tongue (macroglossia)⁸.

Shortened, Widened Skull

The skull of the French Bulldog is markedly shorter than the skull of traditional dog breeds such as the Beagle or Labrador. The bones of the nasal cavity (the nasal conchae) are also abnormal.⁸

Stenotic Nares

The opening of the nostril is abnormally narrowed and, in some individuals, can be reduced to just a small slit. This reduces or obstructs air from flowing into the nostrils and down into the lungs. Frenchie’s will often resort to breathing with their mouths open when they are excited, exercising or stressed due to these narrowed nostrils.⁸

Thickened, Elongated Soft Palate (Hyperplasia)

Several veterinary studies using CT scans have demonstrated that Frenchie’s have elongated and thickened soft palates, which is referred to as soft palate hyperplasia. This enlarged soft palate sits over the entrance to the trachea (the windpipe), causing obstruction of the airway.⁸

Enlarged Tongue (Macroglossia)

Another study in 2020 utilizing CT scans found that brachycephalic breeds such as the French Bulldog, Pug and Boston Terrier have an enlarged and denser tongue compared with non-brachycephalic breeds.⁸ This also contributes to airway narrowing.

Brachycephalic Obstructive Airway Syndrome

So what is Brachycephalic Obstructive Airway Syndrome?

Brachycephalic Obstructive Airway Syndrome is a veterinary term used to describe the respiratory distress seen in brachycephalic dogs caused by their abnormal anatomy. Generations of breeding for a squished face has resulted in dramatic shortening of the skull of brachycephalic dogs.8 Whilst the skull is shortened, the soft tissues such as the tongue, soft palate and nostrils are not reduced in size and are squished into a smaller space. Although this creates their adorable flat faces, the increased proportion of soft tissue in the upper airways makes it harder for Frenchie’s to breath by causing a narrowed airway passage and subsequent increased airflow resistance.^8,9

Understanding BOAS

Another way to understand this by breathing through a straw. When you attempt to take a deep breath through a straw, you will find that it is significantly harder to get the air into your lungs because the straw acts as a narrowed upper airway. This narrowed airway results in you having to increase the effort it takes to suck the air in, which is termed increased inspiratory effort. French Bulldogs, and all brachycephalic breeds, have increased inspiratory effort to overcome the obstruction (blockage) of their upper airway by all the soft tissue. This creates high negative pressure in the lower airway, which sucks the soft tissues towards the opening of the airway, causing further airway obstruction and tissue swelling. This cycle continues over time, resulting in secondary (dynamic) changes such as everted tonsils and laryngeal (voice box) collapse.^8,9

Consequences of BOAS

French Bulldogs experience airway obstruction every day, which can be identified by their noisy breathing and snoring which is commonly mistaken as being “normal” for these dogs. In individuals who are severely affected, stress, exercise and heat can result in an episode of severe respiratory distress where the airway becomes so swollen from excessive panting that they are no longer able to get enough oxygen into their lungs. This can result in fainting (syncopal events) or even respiratory arrest which can be fatal without immediate veterinary intervention.^8,9 Dogs that experience severe respiratory distress may require ventilation or temporary tracheostomy tube placement.⁸

Other French Bulldog Breathing Issues

In addition to airway obstruction, Frenchie’s may also experience:

• Reverse Sneezing: The exact cause is unknown however it is theorized that the elongated soft palate causes irritation in the throat. Episodes of reverse sneezing usually only last a few seconds.⁸
• Heat Intolerance: Dogs are unable to sweat, so rely on panting to keep themselves cool. When dogs pant, air passes over the wet tissues of the mouth and inside the nose, which cools the air that they are inhaling, allowing them to cool their bodies. With the obstructive soft tissues and abnormal bony structures causing reduced and turbulent airflow in the upper airway, Frenchie’s have a reduced ability to cool themselves effectively via panting, making them prone to heat stress.¹⁰
• Sleep disturbances: BOAS affected dogs have been recognized to have sleep apnea and dyspnoea (difficulty breathing). These dogs can be chronically sleep deprived as they cannot breathe effectively with their mouths closed during sleep. You may notice that your Frenchie wakes up several times throughout the night or prefers to sleep with their head elevated on a toy or the ledge of the couch to improve airflow.⁹
• Gastrointestinal Reflux: Due to the increased negative pressure generated in chest to overcome the crowded upper airway, gastric contents from the stomach are sucked into the oesophagus, which is known as reflux. This is commonly observed by French Bulldog owners as white frothy material that comes out of the mouth when exercising. In severely affected individuals, this may occur multiple times a day.⁹
• Aspiration Pneumonia: This refers to when gastric contents, saliva or food is inhaled into the lungs. This can occur in BOAS affected dog’s secondary to reflux and regurgitation.⁸

Treatment

To determine whether your Frenchie could benefit from BOAS surgery, you should start with a consultation with your veterinarian. Signs of BOAS can be subtle or normalized for this breed, and a discussion with your vet can help to identify these. The next step is diagnostic tests, which involves an upper airway examination under sedation, chest (thoracic) x-rays and/or a CT scan.⁸

Surgical techniques to increase the space in the airway include:

1. Widening of the nostrils (alarplasty)
2. Soft palate shortening (staphylectomy)
3. Soft palate thinning (staphylectomy)
4. Removal of everted, enlarged tonsils (tonsillectomy)
5. Removal of everted laryngeal saccules (sacculectomy)⁹

In severely affected individuals, additional surgery to remove additional tissue within the nostrils to further increase airflow can be considered. The LATE procedure, which stands for laser-assisted turbinectomy, involves using a special medical laser to remove abnormal, crowded tissue within the nasal cavity.¹¹ Regrowth of tissue is common post-surgery however it has been demonstrated to be an effective treatment for dogs with intranasal abnormalities and poor response to the common surgical treatments previously discussed.¹¹

Your veterinarian can advise you of French bulldog breathing surgery cost. It is highly recommended to take out pet insurance before bringing your new puppy home.

Prevention

While surgery is the most effective measure for improving quality of life and reducing secondary changes such as laryngeal collapse, there are several things you can do for your Frenchie from home. Simple lifestyle changes may reduce the severity of symptoms.¹²

Weight Management

One of the most important management strategies for brachycephalic breeds is keeping them at an appropriate weight. Obesity has been shown to be associated with worsened symptoms of BOAS. A high-quality, complete, and balanced diet is recommended.¹²

Harness

Reducing pressure on the upper airways is recommended by avoiding walking Frenchie’s on a collar around the neck. Instead, a well-fitted harness is recommended.¹²

Exercise and heat restriction

Avoid excessive heat exposure and vigorous exercise which increase oxygen demand. Walks should be taken during the coolest part of the day e.g. the early morning.¹²

Regular Vet Check-Ups

Brachycephaly is also associated with other health conditions such as spinal disease, patella luxation, ocular and dental disease.⁸ Regular check-ups as recommended by your veterinarian will help to identify and manage these conditions where required.

French Bulldogs are charismatic, affectionate family members who unfortunately suffer breathing issues due to their abnormal anatomy. There have been many advancements in the recognition, treatment, and management of BOAS in recent years. It is important to be aware of these issues so that you can be an advocate for your squishy-faced friend and work with your vet to give them their most comfortable life.

*Disclaimer: This article is not individualized for your pet and is not a substitute for professional veterinary advice. Please see your veterinarian for individualized recommendations.