Health and Welfare of Brachycephalic (Flat-faced) Companion Animals

A Complete Guide for Veterinary and Animal Professionals

Rowena Packer, Dan O'Neill, Rowena Packer, Dan O'Neill

• Publisher: CRC Press
• Year: 2021
• Print ISBN:
  9780367207410
• eBook ISBN:
  9780429558283
• Topic: Medicine
• Subtopic: Epidemiology

Health and welfare issues of brachycephalic (flat-faced) animals are one of the most pressing problems facing companion animals right now. Dogs, in particular, are suffering from a 'brachycephalic crisis' resulting from a perfect storm where predispositions to an array of health issues are amplified by a population boom for certain brachycephalic breeds such as the French Bulldog and Pug. But yet, for many owners, these dogs represent the perfect companion: endearing personas and cute looks in a socially desirable package. So where is the truth in all of this?

This book will equip veterinary professionals, animal welfare scientists, breeders and owners with the fuller story about brachycephalic health and welfare. The first half of the book provides the context of how and why we are in this crisis, offering in-depth historical, social, ethical, communication, nursing, welfare, epidemiological, genetics and international perspectives. The second half shifts towards the clinical arena, with chapters that cover the background, diagnosis, treatment and prevention of the many unique healthcare needs of brachycephalic animals. Cutting-edge knowledge is shared on a range of disciplines including respiratory disease, ophthalmology, dermatology, dentistry, neurology, obesity, reproduction and anesthesia.

With twenty chapters written by world-leading experts, lifetimes of experience and knowledge are condensed into the first book dedicated exclusively to brachycephaly in companion animals. This essential reference resource will inform, challenge and stimulate; it will open your mind to new opportunities for you to improve the welfare of brachycephalic animals by your personal and collective choices and actions. But prepare to be surprised: you may just find that your views on brachycephaly in companion animals will be changed forever.

1     Introduction

How Can a Brachycephalic Boom Cause a Welfare Bust?

Rowena M. A. Packer and Dan G. O’Neill

The Royal Veterinary College

We are in the midst of a brachycephalic dog welfare crisis. And this crisis is not just a UK phenomenon but is unfolding right across the world. But how can this be? Surely the public loves these adorable little flat faces, and surely this unbridled love can only be a good thing for these brachycephalic dogs? With this conundrum, we welcome you, our dear reader, to the complex world of brachycephalic animals. In this world, issues such as conformation, genetics, disease, human perceptions, veterinary care, breeding, social media along with a host of other factors all interact in a complex interplay to impact on the ultimate quality of the lives of these animals. This book will take you on a rollercoaster ride through the highs and lows of brachycephalism in companion animals and will help you to grasp the rich and fuller story of how our human drive to own and love flat-faced animals does not always equate with these animals living good lives, or even ‘lives worth living’. Whether you have picked up this book as a veterinary professional, owner, student or breeder, we urge you to park your current views on brachycephalism at the front cover and to enter this book with an open mind. And we challenge you to have unchanged views by the time you have finished reading.

As the Internet age took hold some decades ago, some people were of the opinion that electronic media would herald the extinction of textbooks as we knew them then. Libraries would become museums. There was a view that the pace of knowledge accrual had become just too rapid and fluid for published books to keep up. But time has shown this view to be very wrong, and today, books are as useful and popular for summarising accumulated knowledge and for learning as ever. With this supportive background, we are pleased to present this book to you, and to share with you the accumulated knowledge and wisdom from 29 world-leading international experts on brachycephalic health and welfare. This book provides an unparalleled resource of factual information, scientific evidence and expert opinion across a range of topics relating to brachycephalism in companion animals, but it also aims to go deeper. In each chapter, the authors go beyond facts to offer their views and insights from their decades of experience working on their topic areas. We want to stimulate you to think deeply and openly about the issues that are raised in these chapters, and to challenge your current views on brachycephalism, with the aim that you move towards new and more considered beliefs.

But why is this book needed right now, given that many popular flat-faced breeds were invented in the 1900s? This book is needed because something odd is happening right now in the twenty-first century to put us in the midst of a brachycephalic crisis that is challenging the well-being of our dogs like never before. This brachycephalic crisis has pushed its way to the top of the global animal welfare agenda over the past decade and garnered the attention of the veterinary profession, welfare charities, government, kennel clubs, academia, media and wider public. Health issues of brachycephalic dog breeds have taken centre stage in such a dramatic fashion because this small group of dog breeds has become so phenomenally popular over a short span of time. Colloquially dubbed ‘the brachy boom’, this rapid popularity increase has magnified the welfare impacts from brachycephalism from affecting just a small proportion of dogs to now affecting huge swathes of the wider dog population. And the process of feeding an insatiable public demand to own some of these popular breeds has generated breeding and supply chains that often prioritise quick sales and large profits with little regard to the welfare of the animals or their future owners. This perfect storm has created the current paradox where a boom in popularity seems to have led to a bust in welfare.

The marked rise in numbers of brachycephalic dogs has been coupled with a rapid expansion in scientific evidence that is identifying more and more health challenges faced by brachycephalic breeds. In order to get a deeper understanding of these complex issues, this book will guide you through many facets of this ‘brachycephalic issue’. Whether you read this book from cover to cover or choose to dip into specific sections that are pertinent to your specialism, profession or breed of interest, we hope this comprehensive guide to brachycephalic health and welfare will consolidate the veritable tsunami of information on brachycephalic breeds generated in recent years into an accessible, engaging and stimulating format. This is, however, no ordinary veterinary text book. The health problems of brachycephalic dogs do not only exist within the veterinary bubble, and acknowledging this, we have structured the book into two sections.

The first section covers important contextual topics that provide a solid grounding on the wider brachycephalic picture. The health and welfare of brachycephalic dogs is fundamentally a human issue; humans initially chose to harness those mutations that cause the flat-faced conformation, have perpetuated this phenotype over generations, and are currently proliferating brachycephalic dogs in numbers like never before. To achieve an understanding about options for the elusive ‘way out’ of the brachycephalic crisis requires a range of perspectives, including the human stories that have driven this trend. Chapter 2 explores over 100 years of historical perspectives on the breeding of brachycephalic dogs, including historical concerns for their health, stakeholder interactions and the roles of the veterinary profession. Such information is key to avoid repeating previously unsuccessful strategies aimed at improving the welfare of brachycephalic dogs that the current generation of veterinary professionals and animal welfare advocates may be unaware of. Despite being perceived as a ‘dog problem’, Chapter 3 explores human attraction and seeming ‘addiction’ to brachycephalic dogs that is fuelling the brachycephalic boom, questions whether humans are instinctually drawn to brachycephalic dogs and considers how owner (mis)perceptions of their dog’s health may perpetuate the popularity of these breeds.

Veterinary professionals are a key stakeholder group in improving the health and welfare of individual brachycephalic dogs under their care and in driving reforms at a population level. Despite this seemingly positive role, the potential for ethical conflict when treating brachycephalic dogs, particularly in relation to veterinary involvement in reproductive procedures, and conformation-altering surgeries represent particular challenges for veterinary professionals. Some frameworks to navigate such issues are discussed in Chapter 4. Whether optimal welfare can be achieved for any individual brachycephalic dog will depend upon a variety of factors related to both their owner(s) (e.g. perception of disease severity and presence, financial constraints) and the veterinary team treating them (e.g. technical and communication skills). The potential for conflict may be high when veterinary surgeons manage brachycephalic cases but where owners do not perceive health problems in their much-loved pet, and therefore this chapter highlights the importance of good communication. Chapter 5 discusses opportunities and challenges for veterinary professionals associated with talking to current and prospective owners about common health issues encountered in brachycephalic dogs. In addition to veterinary surgeons, the role of the registered veterinary nurse (RVN) in welfare‐focused patient care is increasingly recognised. Chapter 6 discusses opportunities for RVNs to help individual brachycephalic dogs by e.g. brachycephalic nurse clinics, as well as also exploring wider nursing educational and advocacy roles.

Understanding the extent of the brachycephalic crisis, and devising strategies to escape from it, requires evidence. The cold hard data of brachycephalic health is explored in Chapter 7, which offers cutting-edge epidemiological data on breed-specific and brachycephalic-wide disorder predispositions, demography and longevity. Chapter 8 explores the genetics of brachycephaly and common health disorders in brachycephalic breeds (termed ‘the brachycephalic syndrome’), including the potential for genetic tests to help select towards healthier brachycephalic breeding stock in the future. Finally, public concern and even outrage concerning brachycephalic welfare have motivated regulators and government agencies to take diverse actions to protect brachycephalic welfare internationally. Chapter 9 describes issues and actions across regions and countries, especially Europe and North America, encompassing kennel and breed clubs, veterinary organisations, research institutions, regulators, humane groups and other non-profits.

The second section of this book moves to a more clinical setting. For the first time, this book brings together international veterinary experts to discuss the latest understanding on the health problems afflicting brachycephalic dogs. Taking a ‘head-to-tail’ approach, this section starts with the ‘poster child’ disorder of brachycephalic health, brachycephalic obstructive airway syndrome (BOAS; Chapters 10 and 11), and explores progressive methods of clinical assessment and surgical management of this complex disorder. Despite the commonly cited appeal of baby-like wide eyes in brachycephalic dogs, Chapter 12 discusses well-recognised common ophthalmic disorders in brachycephalic patients related to their conformation. Chapter 13 then reviews the main dermatological diseases related to brachycephaly in dogs, highlighting where these vary between common brachycephalic dog breeds and exploring how the extreme conformations typical of brachycephalic breeds are associated with complications of common dermatological disorders in dogs. Chapter 14 explores a neglected, but yet extremely important welfare topic, the dental and oral health of brachycephalic patients. Chapters 15 and 16 take us on a journey through the central nervous system of the brachycephalic dog. Chapter 15 explores the impact of brachycephaly on the nervous system, focusing on its disruption effects upon cerebrospinal fluid (CSF) movement and absorption, and the pathophysiology, clinical presentation, diagnosis and management of CSF disorders. Chapter 16 discusses common spinal problems in smaller brachycephalic breeds with an emphasis on vertebral malformations. Breed-specific differences are highlighted together with new insights into the prevalence, clinical relevance, diagnosis and treatment of these congenital malformations.

Obesity and overweight are growing welfare concerns for canine welfare, with even greater significance in brachycephalic animals due to the potentially exacerbating effects of obesity upon pre-existing conformation-related health problems such as respiratory disease and dystocia. Chapter 17 discusses obesity with particular reference to its impacts on brachycephalic animals, focussing on pathophysiology, prevention and treatment. Assisted breeding techniques, such as artificial insemination and caesarean section, are becoming more common in dogs. Increased popularity of some brachycephalic dog breeds has been associated with increased demand for these services. Chapter 18 discusses reproduction principles with special relevance for brachycephalic companion animals, including fertility, gestation, birth and postnatal care. The importance of tailored anaesthesia to facilitate surgical procedures to treat many of the disorders discussed in the second section of this book is increasing as brachycephalic breeds become more popular. Chapter 19 focuses on anaesthetic management during the entire perioperative period, including pre-anaesthetic assessment and stabilisation, induction and maintenance of general anaesthesia and recovery from anaesthesia and postoperative management.

We live at a pivotal moment in time for the future of our brachycephalic companion animals. We know more than ever about their health challenges, and more stakeholders than ever are invested in trying to protect their health and welfare. There is general consensus from many stakeholders in dog welfare that we all need to ‘Stop and think before buying a flat-faced dog’. And yet, paradoxically, the numbers and popularity of brachycephalic animals continue to rise unabated. In a world where supply and demand shape the make-up of the companion animal populations that we own, exerting changes in human behaviour will be central to solving this brachycephalic crisis. In our new world of social media, how we can influence owners to actually stop and think before buying a flat-faced dog? Can hearts and minds be changed, or are brachycephalic dogs here to stay in ever-increasing numbers? If so, is a ‘stick’ rather than a ‘carrot’ approach needed to protect canine welfare by, for example, enacting legislation to enforce change? Can breeders be persuaded of the merits of breeding away from extremes of conformation such that a more moderate version of brachycephalism in these breeds can become compatible with acceptable health and welfare? Or can a dog with a brachycephalic head shape ever be considered healthy? These are just some of the many questions we hope you will be stimulated to reflect upon during your reading of this book. We hope that the combination of cutting-edge literature on key aspects of the brachycephalic crisis summarised by authoritative sources, alongside new and diverse perspectives on brachycephalic dog health and welfare, will encourage open-minded readers to reconsider their own preconceptions of this crisis and also perhaps inspire you to consider your own role in helping to shape a better future for companion animals.

Part 1

Wider Viewpoints

2 A Historical Perspective on Brachycephalic Breed Health and the Role of the Veterinary Profession

Alison Skipper

King’s College London

Contents

Introduction

Note on Terminology and Scope

An Overview of Brachycephalic Health Activism, 1890 Onwards

Early Brachycephalic Reshaping and Activism, c. 1900

Mid-Century Veterinary Intervention, c. 1960

Brachycephalic Activism in the Twenty-First Century

Discussion

Conclusions

References

Introduction

Since the turn of the twenty-first century, certain breeds of brachycephalic dogs, particularly French Bulldogs, Pugs and Bulldogs, have become increasingly fashionable (O’Neill et al., 2018, 2016, 2019). The recent explosion in the popularity of these breeds as pets and in contemporary visual culture has triggered a similarly dramatic increase in general concern for their welfare, in veterinary engagement with their diseases and in ethical debate over their breeding, as the need for this book itself demonstrates. Activists today often compare images of modern dogs with those of the past in an effort to demonstrate an indisputably progressive exaggeration in brachycephalic conformation over time, with an implicit assumption that poor health of brachycephalic breeds is also a new occurrence (Elegans, 2012). But brachycephalic diseases are not, as such comparisons might imply, a new development; the particular ailments of short-faced breeds have been repeatedly recognised and discussed for over a century (Skipper, 2020). The current controversy is actually the third time that these problems have attracted particular attention, with debate previously peaking in the years around 1900 and 1960 (Redwar, 1901b; Singleton, 1962b). Yet, despite this recurring concern, brachycephalic health issues remain a substantial cha...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Dedication1
• Table of Contents
• Foreword
• Editors
• Contributors
• Chapter 1 Introduction: How Can a Brachycephalic Boom Cause a Welfare Bust?
• PART I Wider Viewpoints
• PART 2 Clinical Viewpoints
• Index