Abstract

Brachycephalic Obstructive Airway Syndrome (BOAS) is known to occur as a common condition in short-skulled (brachycephalic) dogs, but has been intensively studied only in three breeds: the Bulldog, French Bulldog and Pug. This study investigates the frequency and severity of BOAS in a further 14 breeds in the UK pet population: Affenpinscher, Boston Terrier, Boxer, Cavalier King Charles Spaniel, Chihuahua, Dogue de Bordeaux, Griffon Bruxellois, Japanese Chin, King Charles Spaniel, Maltese, Pekingese, Pomeranian, Shih Tzu and Staffordshire Bull Terrier. The respiratory functional grading (RFG) assessment was adapted for use in these breeds, noting respiratory characteristics for 898 dogs in this study. Conformational parameters were measured to analyse the association with BOAS risk. Statistical analysis was performed both comparatively across the 14 breeds and within each breed. Almost every breed in this study had some detectable level of breathing abnormality. Only the Maltese and Pomeranian had no dogs with clinically significant disease. The Pekingese and Japanese Chin, had the highest rates of BOAS with only 10.9% and 17.4% being Grade 0 respectively. Across the whole study population, three factors were significantly correlated with BOAS: higher body condition score, nostril stenosis, and lower craniofacial ratio (more extreme facial hypoplasia). These parameters accounted for 20% of the variation in BOAS status when modelled in multiple logistic regression. It was noted that some extremely flat-faced breeds, for example the King Charles Spaniel, had lower rates of BOAS than expected based on their conformation. Overall, the frequency of BOAS varies considerably by breed. Broadly speaking, more extreme brachycephaly, nostril stenosis and high body condition score are associated with increased BOAS risk. However, with variation of phenotype between the breeds, the findings of this study advocate for a breed-specific approach when tackling the reduction of the disease on a population level.

Citation: Tomlinson F, Liu N-C, Sargan DR, Ladlow JF (2026) A cross-sectional study into the prevalence and conformational risk factors of BOAS across fourteen brachycephalic dog breeds. PLoS One 21(2): e0340604. https://doi.org/10.1371/journal.pone.0340604