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What is BOAS?

BOAS stands for Brachycephalic Obstructive Airway Syndrome. This syndrome is a pathological condition affecting short-nosed dogs and cats can lead to severe respiratory distress.

What does it mean if a dog is brachycephalic?

Brachy means shortened and cephalic means head. Meaning if a dog is brachycephalic they have skull bones that are shortened in length, giving their face and nose a pushed-in appearance.

Breeds with flat faces pack a normal amount of tissue into a head that is significantly shorter. This indicates that their windpipe, nasal passageways and nostrils are frequently constricted. They frequently have a soft palate that is too lengthy. Breathing disorders, or Brachycephalic Obstructive Airway Syndrome (BOAS), are often the result of these problems.

Brachycephalic dog breeds and life expectancy

Examples of brachycephalic dog breedsBecause of the flat-faced and shorter-nosed nature that causes BOAS, specific breeds suffer from this syndrome. Popular brachycephalic dogs include:

  • Pugs
  • Pekingese
  • French Bulldogs
  • English Bulldogs
  • Boston Terriers
  • Boxers
  • Shih tzus
  • Cavalier King Charles Spaniels

Due to the health conditions that these breeds experience because of their short-nosed appearance, their life expectancy is reported as shorter than other breeds.

In a study, researchers found brachycephalic dogs, like popular French Bulldogs (9.8 years) have a 40% increased risk of shorter lives than the typical face-shaped dogs. Results showed medium-sized brachycephalic dogs had the lowest average life expectancies – 9.1 years for males and 9.6 years for females.

Study from Dogs Trust, 2024

Dr Dan O’Neill, Chair of the Brachycephalic Working Group (BWG) said: “This new research underlines these major health issues by revealing that flat-faced dogs live 1.5 years shorter lives than typical dogs”

BOAS symptoms

The following signs can be indicators of whether your dog has BOAS:

  • Loud breathing
  • Labored breathing (dyspnea) - even when resting
  • Difficulty coping with exercise
  • Disrupted sleep
  • Poor heat tolerance
  • Gagging when swallowing - difficulty eating
  • Collapse
  • Cyanosis (blue-coloured skin)
  • Narrow nostrils
  • Regurgitation or vomiting — from the pressure created in the abdomen (tummy) from struggling to breathe
  • Protruding masses that can interfere with breathing and eating (called everted laryngeal saccules)
  • Airway obstruction
  • Abnormal growth of the rings of the trachea.

While BOAS symptoms can sometimes not emerge until a dog is between two and four years old, they can occur in puppies as well. If your dog is showing any of these symptoms at any age, make sure to get in touch with your vet at Oak Barn Vets to receive a professional diagnosis.

Noticing these signs? Book a health check for your dog today!

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BOAS diagnosis and treatment

A diagnosis for BOAS is built up from the findings of an examination and the signs mentioned above in a breed with a flat face. During your appointment to determine if exercise causes your dog's symptoms or exacerbates them, your vet may also urge you to take your dog for a short walk to observe the effect.

Your vet might recommend using an endoscope, a specialised camera, to examine your dog's airways while unconscious. However, this is typically done in conjunction with a surgical procedure to address the issues at hand if you have been advised to see a specialist. Additionally, a specialist may perform further tests such as an MRI scan.

When it comes to treating BOAS, a surgical procedure is the main option to resolve any problems, however, other things can be put in place to help as well.

BOAS Surgery

The surgical route involves procedures such as making their soft palate shorter and their noses wider. For optimal results, surgery should be performed sooner rather than later. Surgery carries several risks, which will be reviewed and discussed with your vet. The procedure will, however, significantly enhance your dog's quality of life.

FIG 1 - Widening the nostrilsFIG 1 FIG 2 - Shortening an elongated soft palateFIG 2 FIG 3 - Removing saccules in the larynxFIG 3

The operation involves all or some of the following:

  1. Widening the nostrils (Fig. 1 above)
  2. Shortening an elongated soft palate – excessive soft tissue that hangs down from the roof of the mouth at the back of the throat (Fig. 2 above)
  3. Removing saccules in the larynx – excessive soft tissue in the opening of the windpipe – if they are causing an obstruction (Fig. 3 above)

Monitoring weight

Flat-faced dogs are prone to gaining weight because of their struggle with exercise. When a dog has excess weight, the tissue surrounding their neck and face gets thicker, which affects their airways even more, making breathing more difficult for the dog.

For more guidance on your dog's weight, please see Oak Barns weight management advice.

Keeping up with exercise

Maintaining the highest level of fitness for your dog and increasing it gradually can be beneficial for them. If they aren't used to it, resist the urge to take them for a lengthy walk. Dogs with flat faces typically find it difficult to keep up with other breeds. If your dog is having trouble chasing another dog, put them on a lead or harness (preferred) to prevent this. Excessive exertion can inflate your dog's airways, making it difficult for them to breathe and can even lead them to collapse.

Top tip:

Instead of using a collar, attach your dog's lead to a harness; this will relieve pressure on the neck and improve respiration. While out for a walk in Guildford, if you notice your dog panting or breathing heavily, let them rest for a while before bringing them home gradually.

Hot weather preparation

Because panting causes loss of heat and is less successful in cooling off dogs with flat faces, it is challenging for breeds with flat faces to stay cool on hot days. As a result, they may be particularly vulnerable to heatstroke, which can be dangerous and potentially fatal. Only take your dog for brief walks in the early morning and late evening on hot days when the weather is cool. It is preferable to postpone taking your dog for a walk and wait for the temperature to cool down.

When going for walks, keep an eye on your dog and just walk as far as they feel comfortable, don’t forget, you still need to walk back again!

BOAS Prevention

A Pug - An example of BOAS dogResponsible breeding will help reduce the prevention of this condition in dogs and cats, as BOAS is an inherited condition.

Also, make sure you are aware of any health issues a flat-faced dog breed may have if you're thinking about purchasing or rehoming a dog. Consider whether the breed will fit into your lifestyle by reading up on the breed of dog and condition.

If you're still interested in purchasing a brachycephalic puppy, a professionally qualified vet can evaluate Bulldogs, French Bulldogs and Pugs for breathing issues using the Kennel Club and University of Cambridge's Respiratory Function Grading Scheme. A sire and dam's (mother and father dog) combined grades can assist predict the possible health of their offspring. Make sure the parents of the puppy you are looking for have a low BOAS grade from this scheme if you are looking for a puppy from one of these breeds. But keep in mind that since genetics can be highly complex, a low score does not necessarily translate into a healthy puppy. 

Frequently Asked Questions about BOAS

How much is brachycephalic surgery for dogs?

Treating a dog with BOAS can incur significant expenses, particularly if they require specialised surgery. It's crucial to have an open discussion with your vet regarding your financial situation, the treatment costs, and what course of action you believe is best for your dog.

It's advisable to purchase pet insurance for your dog as soon as you acquire them, ideally before any signs of illness manifest. This ensures you have the necessary support to provide for their care.

Do all brachycephalic dogs need surgery?

While all brachycephalic dogs exhibit some level of BOAS, not all will necessitate complete BOAS surgery. Some may only require specific components of the procedure, while others may not require surgery at all. It's advisable all brachycephalic dogs undergo evaluation by your trusted vet at Oak Barn Vets to assess their risk of BOAS-related complications and determine if BOAS surgery is necessary.

Are brachycephalic dogs in pain?

If certain conditions have developed, then dogs with BOAS may experience pain. Certainly, as your dogs age, their bodily structures may restrict their quality of life. Exercising could become painful due to inflammation, and issues with their eyes can be irritating and sore. Skin allergies around the face are also irritating and could lead to infections if your pet doesn’t stop scratching. If BOAS isn’t treated, it can produce further long-term problems which will cause discomfort and pain later in life.

Do flat-faced dogs experience any other health issues?

Some dogs may also experience symptoms such as gastric reflux, gagging, drooling, and regurgitation. In severe cases, BOAS can escalate the risk of heatstroke, oxygen deprivation, collapse, seizures, and even death. While all brachycephalic dogs have BOAS, the severity of symptoms can vary.

In addition to BOAS, brachycephalic breeds are prone to other serious health issues associated with their facial structures and specific deformities. These include protruding eyes susceptible to injury, dryness, and prolapse; spinal abnormalities; dental issues; difficulties during mating and birthing; skin conditions; diaphragmatic hernias; ear problems; and various other ailments.

Are brachycephalic dogs healthy?

Notably, flat-faced dogs exhibited a higher risk for eight disorders, whereas non-flat-faced dogs showed a higher risk for only two disorders. Corneal ulceration, a painful eye condition, emerged as the disorder with the highest risk in flat-faced dogs, who were found to be eight times more likely to develop the disease.*

*Royal Veterinary College

What other animals are affected by BOAS?

Flat-faced cats including Persians and British Shorthairs can experience health issues related to BOAS and Netherland dwarf rabbits, lop-eared rabbits and lionhead rabbits are also at risk of developing conditions associated with BOAS.

If you are concerned about your pet, consult your local Oak Barn Vets in Guildford today.


Need to book a health check? Contact Oak Barn Vets today!

Struggling to breathe can affect your dog’s quality of life; as a pet owner, it’s important to get help for your dog, even if they only have mild signs of BOAS. Earlier treatment for BOAS is also likely to have a better outcome.


Book a health check with Oak Barn Vets in Guildford online.