What are brachycephalic dogs – and are they really as unhealthy as vets claim? Veterinary surgeon explains why they often suffer health issues

What are brachycephalic dogs – and are they really as unhealthy as vets claim? Veterinary surgeon explains why they often suffer health issues

Do brachycephalic dogs deserve their unhealthy reputation? We investigate

Published: June 26, 2025 at 12:22 pm

Brachycephalic breeds have had a huge rise in popularity over recent years with dog owners. They are breeds that are often full of life, full of character and can make excellent companions.

However, due to their anatomy, these breeds have several inherent health issues and often means they are frequent flyers at the vets, says veterinary surgeon Graham Lewis.

What is a brachycephalic breed and why are they considered unhealthy?

A brachycephalic breed is a breed that has a shortened, flattened muzzle with a wide skull. Examples include bulldogs, pugs, boxers and cavalier King Charles spaniels.

All these breeds have a lot of variation within them in terms of how flattened their face is, but the majority of these animals will suffer from some degree of Brachycephalic Obstructive Airway Syndrome (BOAS) which is a combination of anatomical issues that can affect their breathing.

In mild cases these animals live happy, healthy lives without any need for intervention, but in a lot of cases it can affect their quality of life and may require specialist surgeries to help.

Their conformation also makes many of these breeds more prone to problems with heat stroke which is still unfortunately a deadly issue when the temperature starts to rise in the UK.

Below, we look at some of the more popular breeds and what problems any potential owners might want to consider before taking on one of these characters.

Brachycephalic dogs

French bulldog

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These have been largely responsible for the current popularity of brachycephalic breeds as they have such great personalities and have become very common. They are well-known for their constant happy bum wiggle!

How healthy are French bulldogs?

They are not often the worst affected of the brachycephalic breeds in terms of BOAS but it's not uncommon for BOAS to cause problems that require treatment.

As well as these issues, they are also more prone to certain eye conditions and problems with the spine.

Like all brachycephalic breeds, I would strongly recommend considering a robust pet insurance policy for these guys.

Brachycephalic health score: 5/10

Pug

Pugs are full of character and they can be very willful (try giving a pug a tablet if it is doesn’t want it!).

How healthy are pugs?

They have a large variation within the breed of how shortened their nose is, but those with very flattened noses do commonly have issues with BOAS and need treatment.

They are also prone to eye issues, including prolapse of the eyeball, as well as other issues such as skin and orthopaedic problems.

Brachycephalic health score: 2/10

Cavalier King Charles spaniel

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Cavies are such sweet dogs and rarely have an aggressive bone in their bodies. However, they suffer with a variety of health issues, some of which are due to the brachycephalic skull.

How healthy are Cavalier King Charles spaniels?

As well as suffering a bit with BOAS, they can have a disease called Syringomyelia which is a fluid-filled cyst in the spinal cord linked to a malformation at the back of the skull. This can cause severe discomfort to affected dogs.

They also very commonly get mitral valve disease in the heart that can lead to heart failure. Expect to get to know your vet well if you own one of these.

Brachycephalic health score: 4/10 (but overall health score 1/10!)

Boxer

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Boxers are either slobbery balls of huge energy or laidback quiet companions – there doesn’t seem to be any middle ground!

How healthy are boxers?

Boxers usually have a bit of a muzzle, especially compared to some of the other brachycephalic breeds, but they can still suffer from some of the same issues including an increased risk of corneal ulcers. They also have several non-brachycephalic health issues associated with them, such as an increased risk of certain types of tumours. From a purely brachycephalic point of view, however, they are relatively low risk!

Brachycephalic health score: 8/10

English bulldog

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Things don’t get more typically British than the English bulldog, alongside Winston Churchill and the Union Jack.

How healthy are English bulldogs?

Unfortunately, in terms of health, they maybe aren’t the best advert for the UK. They regularly suffer with BOAS, as well as other issues to do with their skin folds, orthopaedic problems and eye issues. They are often lovely natured but insurance (or deep pockets) are essential for looking after them properly.

Brachycephalic health score: 1/10

Shih Tzu

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Shih Tzus know who the boss is, and it’s usually them. They can be stubborn and fussy with food.

How healthy are Shih Tzus?

They are affected by breathing issues but not as commonly as some brachycephalic breeds. They do have eye issues; commonly due to their flattened face. Their coat needs a fair bit of maintenance and a top knot can help keep the hair out of their eyes! They can live to their mid teens.

Brachycephalic health score: 7/10

Boston terrier

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This American breed is strong-willed and playful with a short muzzle and pointy, erect ears.

How healthy are Boston terriers?

They have more of a muzzle than many brachycephalic breeds and also live (on average) to early/mid teens, but they can still suffer from BOAS and eye problems due to their brachycephalic conformation.

Brachycephalic health score: 8/10

Dogue de Bordeaux

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This giant of the brachycephalic world are very lovable characters: they are loyal, laidback and just a little bit slobbery!

How healthy are Dogue de Bordeaux?

They rarely suffer from BOAS to the extent of needing treatment. However, they have several other health issues such as dilated cardiomyopathy (that can lead to heart failure), a predisposition to certain cancers and issues with their hips. With a lifespan rarely reaching double digits, I’m afraid they are not around as long as some breeds, but they leave a lasting impression on their owners.

Brachycephalic health score: 9/10 (but overall health score: 4/10!)

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