Are pet owners in denial when it comes to flat-faced dogs?

Photo by https://pixabay.com/pt/users/kaz-19203/, CC0, via Wikimedia Commons

Earlier this week, I found myself pausing to reflect in the middle of the 6.30pm appointment, which was with Flo, a sweet-natured ten month old English Bulldog who I had not previously met. Flo gazed at me with her big hazelnut eyes, fixated alternately on me, and then determinedly back to the dehydrated chicken treat in my hand. Her tongue lolled out to one side as she panted, such that it looked as though she was grinning at me. Distraction worked wonders, and she sat calmly as I started to examine her.

Her owner had brought her to me because she had been extremely itchy for several months. They had tried various shampoos purchased online, but nothing had seemed to make any difference.

Little Flo’s skin was in an awful state. Her extremely flattened face meant that she had deep folds of skin under her eyes, which were raw and moist due to infection. She tried to yank her leg away in pain as I examined her the very sensitive skin on her feet, which was scarlet red between her pads. Her ear canals were swollen and clogged with thick brown secretions. But by far the worst affected area was her tail; I couldn’t help but reflexively gag at the smell of the pus in the skin folds around her corkscrew tail, which was inverted into her rump. I did my best to clean the ulcerated skin with antiseptic wash as gently as possible, but struggled to get deep into the folds as it was just too uncomfortable for her. Cleaning her ears was a similarly painful affair.

As a reward for being such a cooperative patient, I placed a handful of treats on the floor in front of her. Her underbite was so extreme that, though she tried desperately, she just physically couldn’t pick the treats up, and so I placed them straight into her mouth instead. I felt a pang of despair for her.

‘Hello baby!’, her owner rejoiced as Flo bounded towards her, the sound of her nails scrabbling on the floor. I had to explain that unfortunately we could treat the infections, but not cure Flo of the root problems. Any allergies Flo had developed that were the likely underlying culprit for the sore ears and feet, would probably be a lifelong battle to control, and she would very likely need to be on some form of medication permanently in future. The skin folds would need to be cleaned daily for the rest of her life, but due to the depth of the folds around the tail there would be a high chance it would prove impossible to control the infection and keep Flo comfortable. This could leave no option but to amputate the tail. I could see in her owner’s eyes that she was heartbroken.

I couldn’t help but to continue to dwell on Flo after work that evening; I felt deep sadness for her. But also a profound sense of frustration; because I am sick of seeing dogs like Flo, who are born broken, and need to be fixed.

By the time I see these dogs as puppies, it is too late to tell their adoring owners that these breeds are plagued by health problems; that they should perhaps have thought more carefully before getting one. Because the dog is already part of their family.

Last month, the journal Nature published a study of a population of 22,000 dogs which demonstrated that brachycephalic (flat-faced) dog breeds, including English Bulldogs, French Bulldogs, and Pugs, were on average less healthy their counterparts; they were significantly more likely to suffer from eight of thirty common disorders than non flat-faced breeds. Of course this is just on average – there will be variation within a breed and some individuals will be fortunate and not develop any medical issues that require treatment.

The reason the study is significant, is because it is is the largest study of its kind that shows in black and white that the decision to buy a brachycephalic dog, is a decision to buy a less healthy dog; and that has serious welfare implications.

The popularity of these breeds has soared astronomically in the past decade or so; in the past 2 years the French Bulldog has dropped on and off of the top spot of the list of most popular dog breeds registered with the UK Kennel Club. They are all over YouTube and Instagram; The Beckhams, Lady Gaga, Leo DiCaprio, Dwayne Johnson and Reese Witherspoon all have posted photos of themselves smooching their French Bulldogs, and the net result is that these breeds are considered fashionable.

I can see why they are so popular; they are very sociable dogs, and have great personalities. One just can’t help but be entertained by their variety of facial expressions. As a result of evolution, the human brain is hardwired to be drawn in by round faces and big eyes. These are juvenile features that stimulate the release of hormones such as oxytocin from the brain, which encourage us to be protective of our human offspring. One explanation for the popularity of the flat-faced breeds, is that they hijack these inbuilt pathways. Whether consciously or subconsciously, we treat them like our babies.

But the very features that make us humans find these dogs so adorable, are the ones that make them inherently unhealthy. With selective breeding, over time we have shortened their skulls to the extreme. As a result of having bulging eyes, and often abnormal eyelids, they are 11 times more likely to suffer from corneal ulcers, with pugs being a massive 19 (YES, 19!) times more likely to develop them than the average dog. The most serious of these can result in loss of the eye. As a result of having such shallow eye sockets they can even develop exophthalmos; the eyeball literally pops out.

They are predisposed to spinal disorders, with a high incidence of intervertebral disc disease and they frequently are born with abnormal malformed vertebrae. This list of problems is not exhaustive; this review of insurance claims submitted to an American insurance company shows an increase in claims for a wide variety of health conditions for brachycephalic breeds compared to other breeds.

Their wide skulls mean that many have difficulties giving birth naturally as the puppies’ skulls are too large to pass through the pelvic canal. This is so common that many breeders opt to routinely perform an elective Caesarean section, before the dog has a chance to go into labour.

Many owners consider their noisy snorting to be ‘normal for the breed’. It might be what we have come to expect from these dogs, but that doesn’t mean it should be the norm. The snorting is noise created by resistance in their airways; their nostrils are too narrow, the bones in their nasal cavity are too crowded together and they have excessive tissue in their throats. Exercising is the last thing most you would want to do when you have a completely blocked nose from a cold – imagine having this permanently, as well as a throat which feels closed up; none of us is ever going to experience what it is like being one of these dogs, but that is how I imagine it.

This combination of extreme airway issues can lead to BOAS (Brachycephalic Obstructive Airway Syndrome). Dogs with BOAS cannot exercise normally. They often regurgitate food after eating, as the negative pressure they have to create in their chest just to be able to breathe normally sucks back up out of the stomach. We are increasingly recognising that they can suffer from sleep apnoea as a result, and the worst affected individuals can succumb easily to heat stroke in hot weather, and even develop a complete obstruction of their airways, resulting in death. Many of the most severely affected have to undergo major surgery to open up their airways; and this is just to afford them the luxury of breathing normally.

Broadly speaking, the lifespan of a dog correlates inversely with their body weight; smaller dogs live for longer. But brachycephalics live much shorter lives that other dog breeds of a similar size, with an average lifespan of 8.6 years, far shorter than the average 12.7 years.

The evidence is overwhelming. The majority of vets are on the same page on this, as are most organisations that have a role in animal welfare; the RSPCA, the British Veterinary Association, the Dogs Trust have publicly voiced their concerns about the serious animal welfare implications of the surge in ownership of these dogs. But yet these breeds remain extremely popular, and a study recently found that 93% of the owners of brachycephalic breeds would opt for the same breed again. So it doesn’t look like their popularity is going to reduce any time soon.

I certainly do not judge anyone who chooses to have a brachycephalic dog; I have friends who own them. But their popularity is part of the problem; so many people own these dogs that we have become blind to the issues they have. But we desperately have to improve the awareness of the health issues these breeds suffer from, and the very real implications this has on the dog’s welfare.

There are efforts by breed associations and the Kennel Club, such as the Respiratory Function Grading Scheme, that are aiming to reduce the incidence of health problems in these breeds. But the gene pool within these breeds is small, and there is only so much these sorts of scheme can achieve.

Flo demonstrates that just because a dog looks happy, that does not mean it is not suffering. A dog is not a small human, and is not psychologically impacted in the same way by chronic ill-health. They can’t become depressed contemplating the fact that they may never be able to breath normally, for example. But that does not mean they are not suffering.

In selectively breeding these breeds, we have created dogs who often have wonderful personalities, but unfortunately, on average, poor health. For me as a vet, it is crushing being faced with the health issues these broken dogs have every day, and simply having to patch them up. It is the dog that gets the bum deal – and the owner that gets a big bill.

I hope that most, confronted with the full picture, would think a bit harder before getting brachycephalic dog in the first place.