Brachycephalic dogs are joyfully wrinkled, round and exuberantly noisy bedfellows. But as much as we love these characteristics, they are often tied to some frustrating health conditions. If you are considering adopting one of these breeds, here are 5 health concerns unique to brachycephalic breeds that most people don’t know about.
Brachycephalic breeds are dog breeds with a characteristic shortened facial skeletal conformation. Although this class of dog is named for their facial conformation, they come with a host of other features that can lead to some specific health concerns. The well known health problems of brachycephalic breeds are related to: trouble breathing, dental disease, spinal problems, skin and eye disease. However, if you have a brachycephalic dog or are considering adopting one, here are five health conditions unique to this class of dog that are not often discussed but still well known to veterinarians.
- Corkscrew tail infection
- Idiopathic head tremor syndrome
- Malformation of the caudal occipital skull with syringomyelia
- Gastrointestinal disease associated with airway obstruction
- Urethral prolapse
Table of Contents
The following dogs are classified as brachycephalic breeds
- French Bulldogs
- Bulldogs (old English, Victorian)
- Cavalier King Charles Spaniels
- Shih tzu
- Boston Terrier
- Mastiffs (Brazilian, Neapolitan, Bull, English, Pyrenean, Tibetan, Spanish)
- Affenpinscher
- Brussels Griffon
- Dogue de Bordeaux
- Japanese Chin
- Lhasa Apso
- Brasileiro
- Pekingese
If you have one of these dogs, here are 5 health conditions that are unique to brachycephalic dogs which are not well discussed but well known in veterinary practice:
Brachycephalic health condition #1: Caudal Occipital Malformation Syndrome of Cavalier King Charles Spaniels (COMS)
While Cavalier King Charles Spaniels do not have as obvious shortened facial features, they are still considered part of the Brachycephalic cohort. An inherited health condition over-represented in this breed is called Caudal Occipital Malformation Syndrome (COMS).
Caudal Occipital Malformation Syndrome is a congenital malformation of the back of the skull. The malformation essentially squishes the base of the brain. Squishing the base of the brain can cause fluid to build up in the spinal cord (syringomyelia). Compression of the back of the brain causes unique symptoms of head and neck pain. Abnormal sensations in this area can cause an unusual symptom: persistent scratching of the head, neck and shoulder region. If your Cavalier is rubbing their face a lot or scratching their head/neck or shoulders a lot, you should have your dog evaluated for this condition!
Other symptoms that can occur include weakness in their front legs and incoordination in their hind legs, facial nerve paralysis, and hearing difficulty. Dogs that present to the veterinarian for COMS are typically between 3 to 6 years of age. Dogs that present younger than 2 years of age tend to have more severe clinical symptoms of the disease.
Diagnosis of COMS is made by imaging the brain with an MRI. There are medical and surgical therapies for this condition depending on the patient and severity of disease symptoms.
Medical Therapy for Caudal Occipital Malformation Syndrome:
Medical therapy for COMS falls into three main categories: medication to address pain/discomfort, medication that reduces cerebral spinal fluid (CSF) formation, and anti-inflammatory medication.
Medication to relieve pain/discomfort:
- To relieve the abnormal spinal sensations that lead to the excessive scratching: gabapentin (10mg/kg orally every 8 hours ) is most often used
- For pain: opioid medication may be selected.
Medication to reduce CSF formation:
- omeprazole (a proton pump inhibitor)
- acetazolamide (a carbonic anhydrase inhibitor)
- furosemide (a loop diuretic) are utilized
Medication to reduce brain swelling:
- Prednisone at a dose of 0.5mg/kg orally every 12 hours and then tapered
Surgical therapy for Caudal Occipital Malformation Syndrome:
Surgery to address COMS is called foramen magnum decompression. It is designed to make more room for the brain by enlarging the hole at the base of the skull where the spinal cord meets the brain. The surgical success rate is 80-90% but as many as 25% of dogs may relapse due to scar tissue formation requiring a second surgery.
Brachycephalic health condition #2: Corkscrew tail infection
Brachycephalic breeds with screw tail conformation include the Pug, French Bulldog, English Bulldog and Boston Terrier. These breeds have congenital malformations of their vertebrae in their spine and shortened tails. Their shortened tails curve into a corkscrew shape which can sometimes cause problems depending on the shape and angle of their tails. Some dogs have tails that corkscrew in a downward direction, resting tightly against the body. These tails cannot be raised during defection. If the tail covers their anus it will cause difficulty with elimination and unsanitary trapping of feces under their tail.
A more common problem with the corkscrew tail is when the tail curves tightly creating pockets under the tail trapping heat and moisture. This leads to secondary infection and irritation. The tail may angle backwards towards their body and cause deep pockets, pain, and discomfort. Dogs may exhibit frantic behavior at times jerking to look at their backside, rubbing their backend or spinning on their bottom.
A tail that angles straight down and covers the anus. This dog is prepped for surgery to shorten the tail.
This dog has a more classic screw tail conformation.
The screw tail sits tight against the skin and often hides pockets of skin that can become very inflamed and moist. This can lead to skin infection.
Corkscrew tail infections can be managed by owners at home with the routine use of antiseptic wipes. More serious infections are treated with topical or oral antibiotic and steroid medications. Neo-Predef is a topical powder that contains a steroid, antibiotic and light numbing medication that can be sprinkled into pockets and skin folds to reduce inflammation, itch and moisture.
In severe cases with recurrent infections and pain, surgery to amputate the tail (caudectomy) is performed.
Brachycephalic health condition #3: Idiopathic head tremor of Bulldogs and Boxers
Bulldogs and Boxers sometimes develop unusual bouts of head tremoring called Idiopathic Head Tremors. Idiopathic head tremors are characterized by a series of involuntary head movements, generally in the horizontal or vertical directions (no or yes movements) that typically last for about 3 minutes. These head tremors occur most often in Bulldogs, but Boxers, Labrador Retrievers and Doberman Pinschers are also represented.
Idiopathic head tremors are diagnosed by excluding other causes. The results of all tests: eye exam, brain scan, bile acids testing and CSF tap) should be normal. Close to 90 percent of dogs develop this tremor before 4 years of age. The episodes are non painful and the dogs are alert and conscious during the tremoring. The frequency is best described as sporadic and often can be interrupted by distracting the dog by moving their head in a different direction. The cause of the trembling is not understood, it is thought to be a type of movement disorder. Interestingly, in the vast majority (67%) of dogs, the intermittent head tremors eventually disappear.
Brachycephalic health condition #4: Gastrointestinal disease associated with brachycephalic obstructive airway syndrome (BOAS):
Most owners of brachycephalic breeds understand that these dogs have increased work with breathing due to several conformational changes: narrowed nostrils, an elongated and thickened soft palate that can obstruct the intake of air into the windpipe (trachea), and narrowed (hypoplastic) windpipe. The resistance to airflow demands increased negative airway pressures to drive air into the lungs. The negative airway pressures not only damage the soft tissues of the throat over time, but they also cause secondary gastrointestinal complications.
Many brachycephalic dogs have symptoms of gagging, regurgitation, vomiting, and trouble keeping food down while eating. Negative airway pressures in the chest leads to esophageal reflux and decreased esophageal motility. Interestingly, dogs with airway obstruction and no GI symptoms still have ulcerative lesions in the esophagus and stomach. If your Pug or Frenchie or other brachycephalic is having frequent bouts of regurgitation or vomiting, ask your vet whether this could be due to increased work of breathing/BOAS.
Luckily, studies have shown good results with medical management of these GI symptoms following airway surgery. Dogs with severe ulcerative lesions in the stomach and esophagus were prescribed an antacid (omeprazole), a prokinetic (cisapride), a surface protector (sucralfate), and an anti inflammatory (prednisone) for 3 months . Dogs with less severe ulcerative lesions were given the same treatment without the use of prednisone for 2 months. After a minimum of 6 months 75% of dogs no longer required treatment for GI symptoms.
Brachycephalic health condition # 5: Urethral prolapse
Urethral prolapse in a Bulldog. The lining of the penis is protruding.
Urethral prolapse is protrusion of the lining of the penis (the urethral mucosa) from the tip of the penis. This condition occurs in male dogs, most commonly young, brachycephalic breeds with English bulldogs being most often affected. The exact cause is not known but is suspected to be self trauma from sexual excitement or straining due to urinary tract inflammation or straining to urinate past a partial urethral obstruction. Another hypothesis is that labored breathing causes increased intra-abdominal pressure. This increased pressure may impair venous return of blood from the pudendal veins causing increased engorgement of the urethral tissues.
Surgery is the treatment of choice for urethral prolapse. The tissue is reduced into the penis with a urethral catheter and then mattress or purse-string sutures are placed. Neutering is recommended to minimize recurrence. A little more than 50% of dogs have a recurrence of urethral prolapse after surgical correction.
If your dog is suffering from urethral prolapse, you should apply vaseline or other lubricant jelly to the area and bring your dog to the veterinarian right away.
Health concerns of brachycephalic breeds summary
Brachycephalic breeds are very popular for a reason! However, it is a good idea to understand some health issues that veterinarians see in these breeds which many owners are not aware of.
For related reading, check out this article about disc disease and back pain in dogs!