Bulldog Breathing Problems (BOAS) and Heat: Signs, Rules, Emergencies and Surgery

Bulldogs are brachycephalic: a normal amount of airway folded into a very short skull. Narrow nostrils, a soft palate too long for the throat, a small windpipe, and often tonsils and tissue that get sucked into the gap. Together that is brachycephalic obstructive airway syndrome, BOAS, and most Bulldogs have some degree of it. This is the breed's biggest problem and the one that kills, so it is the article to read first. The usual honest line: we are not vets. This is what to watch and when to ask.

What normal should sound like

Quiet breathing at rest, mouth closed, in a cool room. Some snoring asleep is common. Learn what your dog sounds like on a cool day at rest, because everything else is measured against it.

What is not normal: noisy breathing while awake and resting; panting for more than ten minutes after a short walk; gagging, retching or bringing up foam, especially when excited; sleeping sitting up, or with a toy in the mouth to keep the airway open; tiring on walks that used to be fine; nostrils that look like slits rather than open holes. None of these is an emergency today. All of them mean a vet visit and a grade.

Getting a grade

The Respiratory Function Grading Scheme, run by the Kennel Club with Cambridge University, grades BOAS from 0 to 3 after a listen and a short trot. Ask any vet for an assessment, or find a scheme assessor. Grade 0 and 1 need managing; grade 2 and 3 usually need surgery. Breeders should only breed from 0s and 1s, which is why you ask for the parents' certificates.

Surgery

Widening the nostrils and shortening the soft palate, sometimes with the tonsils and the sucked-in tissue removed too, helps most graded dogs enormously. Earlier is better: a young airway that is still firm does far better than a five-year-old's that has been pulled out of shape by years of effort, and surgery often fixes the regurgitation and gagging as well. It is not cheap, which is why insurance comes before the first vet visit. Choose a surgeon who does it routinely.

Heat: the real danger

Dogs cool by panting, and a Bulldog's panting barely works. On a warm day the effort of panting heats the dog further, and the spiral is fast. In a large UK study of heatstroke cases, Bulldogs had about fourteen times a Labrador's risk, and many of the deaths were on ordinary walks and in ordinary gardens. The rules:

• Above about 20°C: no walk. Garden in the shade, cooling mat, fan, indoor games.
• 15 to 20°C: short and slow, early morning or late evening, shade and water, and watch humidity. A humid 22°C is worse than a dry 28°C.
• Stop at the first noisy pant. Noisy panting is the signal to end the walk, at any temperature.
• No hot cars. Not for a minute. A Bulldog has no reserve.
• Overweight, excited or graded 2 or 3: every line above moves down by several degrees.
• Children playing in a warm garden is how heatstroke happens at home. Everyone inside.

Heatstroke: the signs and the first aid

Heavy panting that won't settle in the shade, thick drool, bright red gums, restlessness, wobbling. Then dark or blue gums, vomiting, diarrhoea, collapse. Cool first, drive second: pour cool water over the whole body, put the dog in front of a fan or in the car with the air conditioning on, and go to the nearest vet with the windows down. Ring ahead. Dogs who are cooled on the way and reach a vet quickly often survive; dogs who are left to 'rest in the shade' often don't.

Anaesthesia

Every anaesthetic is riskier for a flat-faced dog: the airway collapses as the muscles relax, and regurgitation on the way in or out can be fatal. Choose a vet who anaesthetises brachycephalic dogs routinely, ask about pre-oxygenation, a rapid intubation and a supervised recovery with the tube left in as long as possible. Don't skip a procedure the dog needs because of the risk; managed well, it is manageable.

Swimming

Bulldogs can't. Heavy front, short legs, short nose. A life jacket and a hand on the dog near any water, and a fence round a pool.

Every other Bulldog decision runs through the airway: the weight, the exercise, the training, the garden. Get the breathing right and the rest of the breed's problems stay small.