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Brachycephalic Airway Health

Six in Ten Owners Did Not Recognise Breathing Trouble in Dogs a Test Showed Had It

When French Bulldogs were assessed objectively for airway obstruction, most of the affected dogs' owners had not identified a problem.

Brachycephalic Airway HealthModerate evidence
Source
PLOS ONE, 2015
Study type
Prospective diagnostic accuracy and instrument development study
PAWai use
EducationalObservation Support
Last reviewed
September 2, 2026
Next scheduled review
September 2, 2027
Version
Topic v1.0 · Knowledge v1.0
⚠ Not for decision-making — for education and visit preparation only

Plain-English summary

Flat-faced breeds snort, snuffle and snore, and that sound is so characteristic that many owners file it under personality rather than health. A 2015 study tested that assumption directly: it measured French Bulldogs' breathing objectively, graded how affected they were, and then compared that grading with what their owners believed.

Among the dogs the grading identified as clinically affected, 60% of owners had not recognised a problem. The noise had been normalised — heard, but not counted as something to raise.

This is not a study about negligent owners. It is a study about how hard it is to notice a problem that has been present for as long as you have known the animal.

What the study found

Eighty-nine French Bulldogs drawn from the pet population, plus twenty non-brachycephalic control dogs, underwent whole-body barometric plethysmography — a non-invasive method that records breathing in an unsedated dog inside a measurement chamber, allowing repeated quantitative readings.

Each dog also received a respiratory functional grade based on observed signs such as respiratory noise and effort, assessed both before and after exercise. Grades 0 and I were treated as having insignificant clinical signs; Grades II and III as having significant signs.

The comparison between owner perception and functional grading is the finding most relevant to anyone living with one of these dogs: 60% of owners failed to recognise the syndrome in dogs that graded as significantly affected.

The airflow measurements themselves separated the groups clearly. Traces differed significantly between affected and unaffected French Bulldogs — and, notably, between non-brachycephalic controls and French Bulldogs graded 0, the least affected grade. The researchers used these parameters to build a classifier and derive a BOAS Index, which reached a sensitivity of 0.97 and specificity of 0.93 in the training group of 69 dogs, and 0.95 accuracy in a separate test group of 20.

What this study cannot tell you

The population was specific and small: 89 French Bulldogs at a single centre. Other flat-faced breeds — Pugs, Bulldogs, Boston Terriers — were not assessed here, and the authors present broader application as a possibility rather than a result.

The 60% figure is a single measurement in a single study group. It is a strong signal that normalisation is widespread; it is not a precise national rate, and it should not be quoted as one.

The classifier's validation set was 20 dogs. Those accuracy figures are promising, not settled.

And the finding that Grade 0 French Bulldogs differed from non-brachycephalic controls needs care in the telling. It says something about the breed's airway as measured on this equipment. It does not mean every French Bulldog is ill, and it is not a basis for concluding anything about your own dog.

What pet owners should track

The useful shift is from hearing the noise to recording it, in terms a veterinarian can act on:

  • Breathing noise at rest, and whether it has changed over months — a phone video captures this far better than a description
  • How your dog breathes after ordinary exertion, and how long it takes to settle back down
  • Whether your dog struggles in heat, or seeks cool surfaces more than it used to
  • How your dog sleeps: position, restlessness, waking, whether it seems to fight for breath
  • Whether it stops or slows on walks it used to complete comfortably

Record these against dates. A slow drift is invisible day to day and obvious across six months of notes.

Breathing difficulty, blue-tinged gums, or collapse are emergencies. Contact a veterinarian immediately — do not observe and record.

What PAWai can help organize

PAWai can hold these observations and videos with their dates, so a change that developed too slowly to notice becomes something you can show. PAWai does not grade airway function, does not diagnose brachycephalic obstructive airway syndrome, and cannot tell you whether your dog's breathing is normal. That assessment is clinical, and in this study it required specialised equipment. What PAWai contributes is a record clear enough that the conversation with your veterinarian starts from evidence rather than from "he's always been a bit snorty."

Disclaimer

PAWai organizes information and educates pet owners. PAWai does not diagnose conditions or recommend treatment. Always consult a licensed veterinarian for medical decisions about your pet.

Citation

Liu, N.-C., Sargan, D. R., Adams, V. J., & Ladlow, J. F. (2015). Characterisation of brachycephalic obstructive airway syndrome in French Bulldogs using whole-body barometric plethysmography. PLOS ONE, 10(6), e0130741. https://doi.org/10.1371/journal.pone.0130741

Frequently asked questions

Isn't snorting just normal for a flat-faced breed?

That belief is exactly what this study measured against an objective test. Sixty percent of owners of dogs that graded as clinically affected had not recognised a problem. Common in a breed is not the same as harmless for an individual dog — and only a veterinary assessment can tell you which one you are looking at.

My dog seems fine at rest. Does that rule it out?

Not necessarily. The functional grading in this study assessed respiratory signs both before and after exercise, because exertion is where restriction tends to show. A dog that is quiet on the sofa can still be affected.

Even dogs graded as unaffected differed from other breeds?

Yes, and it is one of the study's more striking findings. Airflow traces from French Bulldogs graded 0 — the least affected grade — were still significantly different from non-brachycephalic control dogs. That is a measurement finding about the breed's airway, not a diagnosis of illness in those individual dogs.

Can I test this at home?

No. The measurement in this study was whole-body barometric plethysmography, performed in a chamber with specialised equipment. What you can do at home is observe and record — noise, effort, recovery after exercise, sleep — and bring that to a veterinarian.

How strong is this evidence?

Reasonable but narrow. It studied 89 French Bulldogs plus 20 controls at a single centre, and the classifier it developed was validated on only 20 dogs. The 60% owner-recognition figure comes from one breed in one study population and should not be treated as a precise rate for all flat-faced dogs.

Sources

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