What is Brachycephalic Syndrome?

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Based on an article that first appeared at

You would be hard pressed to find someone who could resist the sweet, short face of a Persian or the excited snorts of a Boston Terrier, but if your pet is one of the many breeds with a “pushed in” face, you should also be aware of the health risks associated with these characteristics.

The term brachycephalic comes from the Greek roots brachy, meaning short and cephalic, meaning head. Many breeds, such as Pugs, Boston terriers, Pekingese, French Bulldogs, Japanese Chins, Boxers, Shih Tzus, English Dulldogs, Persians, Scottish Folds and Exotic Shorthairs, are characterized by Brachycephalic Syndrome, a set of conditions that affect different areas of the respiratory tract.

These include a hypoplastic trachea, stenotic nares, everted laryngeal saccules and an elongated soft palate, all of which can contribute to increased respiratory effort and noise.

All brachycephalic breeds have some degree of this syndrome and can have any combination of these conditions. These problems are due to their facial anatomy and the fact that they simply do not have enough space for all their “parts.” The more conditions of brachycephalic syndrome a pet has, the more important it is to detect problems early and prevent them from becoming more serious.

Signs of Brachycephalic Syndrome include inspiratory stridor (a very noisy wheezing sound), exercise intolerance, gagging or vomiting, coughing and reverse sneezing.

  • Hypoplastic trachea or tracheal stenosis: This is the medical term for a narrowed trachea or windpipe. This condition can put the pet at risk during anesthesia and should be ruled out before any surgical procedures.

  • Stenotic nares: This is the medical term for narrowed nostrils. Many brachycephalic breeds have small nasal openings, which can make breathing difficult. When a pet has such tiny nostrils, he/she creates so much negative pressure trying to breathe that everted saccules or even tracheal or laryngeal collapse can occur. This condition may also lead to lower airway disease later in life. If this problem is severe, surgical correction is recommended and is ideally performed at a young age.

  • Everted laryngeal saccules: A normal larynx features two small pockets called saccules. Occasionally, the increased effort in breathing by brachycephalic breeds can actually cause the saccules to turn inside out. When this happens, surgery is needed to correct it.

  • Elongated soft palate: Because it is so difficult to fit the soft tissues of the mouth and throat into a brachycephalic breed’s short face, the soft palate (which separates the nasal passage from the oral cavity), can hang loosely down into the throat. This causes the snorting sounds that are so characteristic of brachycephalic breeds. If this problem is severe, surgical correction is possible.

Upper respiratory obstructions like the ones listed above also cause brachycephalic breeds to pant inefficiently. Because so much effort is required, the pet’s airways often become inflamed and swollen, which can lead to severe respiratory distress and overheating. Brachycephalic dogs, in particular, are at the greatest risk for heat stroke.

Additionally, brachycephalic breeds are often at greater risk for eye problems, dental disease and skin fold infections.

While there is no cure for Brachycephalic Syndrome, its symptoms can be easily managed. The most important thing is to recognize severe symptoms early and have them corrected, if necessary. Surgical intervention is best at a young age to prevent progression of these problems.

Effective management of these conditions also includes keeping the pet lean, avoiding heat stress and using a harness instead of a collar, which may put unnecessary pressure on the neck.