Breathing Problems in Frenchies and Other Flat-Faced Pups: What to Know, How to Help

BOAS can affect any flat-faced dogs, not just Frenchies. photo: AdobeStock

French Bulldogs are beloved for their playful personalities and signature squishy faces. But those same short snouts can cause serious breathing difficulties. 

This condition, called Brachycephalic Obstructive Airway Syndrome (BOAS), happens when the skull is shortened but the soft tissues inside - such as the tongue, soft palate, and nasal structures - are still too large. The result: restricted airflow, noisy breathing, and in severe cases, a reduced quality of life or shortened lifespan. 

And it’s not just Frenchies. BOAS can affect any flat-faced dogs, including Bulldogs, Shih Tzus, Boxers, Pugs, Boston Terriers, Cavalier King Charles Spaniels, Pekingese, and Affenpinschers. 

Surgery can sometimes provide relief, but prevention is better. Thanks to the Orthopedic Foundation for Animals and its use of the Respiratory Function Grading Scheme (RFGS), owners now have a tool to better protect their dogs’ health. 

What Is BOAS?

Brachycephalic Obstructive Airway Syndrome (BOAS) is a collection of breathing problems that affect French Bulldogs and other flat-faced breeds. Because the skulls of these breeds are shortened, the soft tissues inside don’t fit properly. This mismatch causes airway obstruction and makes normal breathing more difficult.

Key features of BOAS include:

• Stenotic nares. Narrowed nostrils make it harder for air to move in and out.

• Elongated soft palate. This excess tissue at the back of the mouth can flip into the airway, blocking airflow.

• Enlarged tongue and tonsils. These can take up extra space in the throat, leaving less room for breathing.

• Everted laryngeal saccules.  Small tissues near the voice box can get pulled into the airway over time, adding to the obstruction.

BOAS symptoms can range from mild snoring to life-threatening airway obstruction. Dogs with moderate to severe BOAS often struggle in hot weather, during exercise, or even while eating and sleeping.

What to Look For

Many of these breathing issues show up in ways owners can notice every day. If your Frenchie snores loudly, pants heavily after a short walk, struggles to cool down in warm weather, or seems easily tired during play, these may be signs of BOAS. Some dogs may even struggle to breathe while eating or sleeping. Recognizing these signs early can help you take action with your veterinarian.

What Is the Respiratory Function Grading Scheme?

The Respiratory Function Grading Scheme (RFGS) was developed by Dr. Jane Ladlow at the University of Cambridge and was later adopted by The Kennel Club in the United Kingdom. In 2023, the Orthopedic Foundation for Animals (OFA) introduced the RFGS in the United States, giving owners, breeders, and veterinarians a reliable way to evaluate airway health in brachycephalic breeds like French Bulldogs, English Bulldogs, Pugs, and others.

Dogs are first examined by an OFA-trained veterinarian after light exercise. The veterinarian then assigns a grade from 0 (no clinical signs) to III (severe breathing issues). The results of this exam help breeders and owners make informed, health-first decisions.

By expanding beyond orthopedic screenings to include this respiratory function test, OFA has provided Frenchie lovers and owners of other flat-faced breeds with a practical tool to promote healthier generations of dogs.

Why RFGS Matters 

This respiratory grading scheme benefits flat-faced dogs and their humans in a number of ways.

• Smarter breeding and buying. Reviewing RFGS grades of puppies and their parents helps families choose dogs with stronger breathing health.

• Early detection.  If your dog already shows signs of BOAS, an RFGS assessment can guide appropriate treatment and lifestyle adjustments.

• Advocacy. Informed owners can ask breeders tough questions and encourage practices that put health before appearance.

What If My Dog Shows Signs of BOAS?

If you’re concerned your dog may have BOAS, watch for labored breathing, noisy panting, exercise or heat intolerance, or fainting episodes. For example, if your dog struggles to catch their breath after climbing stairs, wheezes after a short play session, or collapses in hot weather, these could all be red flags of BOAS. Even small changes like louder snoring, less stamina on walks, or unusual eating habits are worth noting and discussing with your vet. 

Treatment for BOAS may include surgery, but there are risks. These include anesthesia challenges because brachycephalic breeds are at higher risk during and immediately after anesthesia. Specialized care will be needed so if surgery is necessary be sure to  choose a veterinarian experienced in anesthesia and post-operative monitoring for these breeds.

Beyond BOAS: Other Health Issues in French Bulldogs

French Bulldogs are now the most popular breed in the U.S. Unfortunately, high demand has led to more indiscriminate breeding and a surge of medical issues. At Sage Compassion for Animals, many emergency grants help cover urgent care for French Bulldogs, especially C-sections, since many cannot give birth naturally. Spaying and neutering can prevent some hereditary conditions and reduce pregnancy-related risks.

Other common medical conditions in Frenchies include:

• Orthopedic issues such as luxating patella, hip and elbow dysplasia, and spinal disease.

• Ear infections with chronic or severe cases sometimes requiring surgery.

• Skin allergies leading to itching, infections, or discomfort.

• Eye problems including ulcers, cherry eye, cataracts, and trauma risks.

• Digestive concerns and chronic GI issues requiring special diets.

• Urinary stones, especially in males, sometimes leading to dangerous blockages.

• Tracheal collapse further complicating airway function.

Responsible French Bulldog Ownership

Thinking about adding a Frenchie to your family? Consider these steps:

• Ask breeders about RFGS results and full medical histories of the parents.

• Watch for red flags if a breeder is unaware of the RFGS.

• Plan financially with a veterinary budget or pet insurance.

• Support nonprofits like Sage Compassion for Animals, which provide grants to keep pets and families together during unexpected veterinary crises.

French Bulldogs bring endless love and joy, but they require informed and proactive care. Tools like the OFA’s Respiratory Function Grading Scheme empower owners and breeders to make decisions that protect this popular breed’s long-term health. With greater awareness, stronger advocacy, and support for organizations like Sage Compassion for Animals, we can ensure that French Bulldogs - and their flat-faced brethren - not only make us smile but also live longer, healthier lives.