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Brachycephalic Dogs & Cats Brachycephalic Dogs & Cats Discussion Paper 1. Background Components of this syndrome include one or Domestic dogs (Canis familiaris) display several of the following: stenotic nares, considerable variation in morphology, undersize nasal chambers with malformed particularly skull shape.1,4 Three overall terms nasal conchae, elongated soft palate, everted are used to broadly designate head shape: laryngeal ventricles (saccules), laryngeal dolichocephalic, mesocephalic and collapse and hypoplastic trachea.11,12 BAS is a brachycephalic. Brachycephalic dogs are those progressive disease and clinical signs tend to dogs with a wide and short head.3 worsen with age. Symptoms include exercise, Brachycephalic breeds include the Pug, French heat and stress intolerance, snoring, stridor, Bulldog, English Bulldog, Boxer, Boston Terrier cyanosis, syncope and collapse.11 and Pekingese. Brachycephalic dogs are Brachycephalic dogs have been found to be 38 increasingly popular, two brachycephalic breeds times more likely to have BAS than non (Pug and Cavalier King Charles Spaniel*) were brachycephalic dogs.5 among the top ten pedigree dog breeds listed in the 2012 Australian National Kennel Club The following is a summary of welfare concerns (ANKC) registration statistics.22 Registrations for associated with BAS:12 (p91) breeds such as the French Bulldog and Boston ‘Has the potential to affect large numbers Terrier have doubled between 2008 and 2012.22 of animals; all brachycephalic dogs may be respiratory compromised to some Brachycephaly is associated with a number of degree, with > 10 breeds reported with medical conditions that can compromise the 1,10 this disorder in case series welfare of affected animals: internationally.’ Respiratory disease – including ‘Has the potential to continue to do so brachycephalic airway syndrome. generation after generation into the Neurological disease – including future due to its inherent link with the syringomyelia. brachycephalic conformation - if dogs Ocular disease – including with at-risk conformations continue to be pigmentary keratitis and corneal bred then this problem will be ulceration. perpetuated.’ Gastrointestinal abnormalities and ‘Can have a severe adverse impact on disease. animals’ feelings; affected dogs are reported to be in chronic respiratory Brachycephalic airway syndrome (BAS) occurs distress, thermal and physical as a result of hereditary anatomical discomfort, and experience behavioural abnormalities associated with this skull shape. restriction due to their impaired physical capabilities.’ * CKCS are not always classified as brachycephalic dogs Brachycephalic dogs & cats discussion paper ‘These effects can be of long duration, II. Skull index potentially affecting the dog for a large part of, or throughout, its life.’ Skull index is calculated in the same way as cephalic index but the measurement definitions ‘Owners of brachycephalic dogs have for skull length differ slightly.3 Brachycephalic been found to underestimate the severity breeds exceed other head shapes in this index. and frequency of breathing problems and Skull index has been measured at between 80- there is a lack of recognition that signs of 100 in brachycephalic dogs and has been brachycephalic airway syndrome are a defined as an index greater than 81 in Miller’s problem requiring veterinary attention. Anatomy of the Dog. Instead owners can perceive signs as Skull width - widest interzygomatic normal for the breed’.12,11 distance. Skull length - inion to prosthion. 2. Potential objective measures for o Inion - most prominent projection brachycephalic animals of the occipital bone (external occipital protuberance). a. Genetics o Prosthion - most forward projecting point of the anterior Dog breeds are defined by a specific surface of the upper jaw. combination of behavioural, morphological and coat colour traits. Many of these traits are shared between breeds of dogs.1 It is likely that III. Craniofacial angle genetic modifiers exist for brachycephaly1and it is thought that brachycephaly is a semi- Craniofacial angle is the angle formed by the dominant trait.19 The exact genes responsible basilar and facial axes. The basilar axis is have not yet been identified20 but are thought to achieved by joining the basioccipital bone to the be located in Cfa1 (canine chromosome 1)1. caudal margin of the chiasmatic groove. The facial axis is determined by the caudal Limitations of genetics: prolongation of the projection of the hard palate. Lateral radiographs are required for this Gene(s) not yet identified, BAS not likely measurement. It has been noted that to be amenable to genetic screening measurements for the basilar axis differ between authors.6 similar to other heritable diseases. b. Skull measurements The craniofacial angle has been defined in Miller’s Anatomy of the Dog as 9-14⁰ in It has been found that skull measurements and brachycephalic dogs, 25-26⁰ in dolichocephalic those on live dog heads correlate well.2 greyhounds and 19-21⁰ in mesocephalic dogs, Measurements reported in the literature include: with no statistically significant differences between genders.6 I. Cephalic index IV. Facial index Cephalic index is obtained by dividing skull width 4 Facial width (widest interzygomatic distance by skull length (skull width/skull length x 100). 3 This requires no specialised equipment. x 100)/ facial length (nasion to prosthion)). Brachycephalic breeds exceed other head shapes in this index. Skull width - widest interzygomatic Nasion - lies at the root of the nose distance. where frontal and nasal bones unite. Skull length - nose to external occipital Prosthion - most forward projecting point protuberance. of the anterior surface of the upper jaw. Brachycephalic dogs & cats discussion paper V. Craniofacial index Limitations of measurements based on clinical examination: A ratio of muzzle length to cranial length has been published.12 No specialised equipment is There is currently a degree of required. It is described as a potential risk factor subjectivity. A comprehensive and for BAS as it reflects the degree of skeletal objective grading system would need to shortening of the muzzle. Dogs affected with BAS had ratios that spanned into those be devised. described as ambiguous for BAS – therefore Inter-observer reliability would need to be there does not appear to be a natural ‘cut-off demonstrated for above grading system. point’. A nares ratio has also been reported, Need for a veterinary examination. using photographs of nares to measure degree Risks of anaesthesia are greater in of narrowing. Dogs affected with BAS had brachycephalic dogs (consensus smaller nares ratios compared to unaffected dogs.12 required that this does not outweigh the benefits). Limitations of skull/head measurements: A measurement scale derived to assess BAS will not address other abnormalities Whilst skull measurements define a dog associated with brachycephalic breeds as brachychephalic, there is no (i.e. ocular disease, GI disease, consensus on which measurements are neurologic disease). 10 standard. Clinical signs do not remain static over Approaches to measurements are the lifetime of the animal. different between schools of thought (e.g. Anglo-Saxon vs. German).9 3. Brachycephalic cats There is no reported correlation between Brachycephalic cat breeds include the Persian degree of brachycephaly in terms of skull and British Shorthair. Brachycephalic cats are measurements and severity of clinical reported to be at higher risk of developing signs. Packer, Hendricks & Burn (2012, respiratory, visual and olfactory disorders as a p91) report that ‘research to quantify the result of their head shape.13 Cats do not risk of brachycephalic airway syndrome generally appear to suffer from BAS in the same across the spectrum of cranio-facial way as dogs do but there have been case reports in the literature.18 indices, and the creation of quantitative limits to these extreme conformations, is Skull Computed Tomography (CT) has been required to help refine breed standards in used to ascertain how brachycephalic head line with health and welfare.’ shape affects nasolacrimal drainage in cats. This study categorised brachycephalic head c. Measures based on clinical examination shapes from one to five (based on position of canine teeth, degree of jaw rotation and Some authors suggest examining neurocranium shape) and demonstrated that the brachycephalic dogs as puppies, evaluating for more severe the brachycephaly the more stenotic nares, signs of stridor or stertor with distorted the nasolacrimal drainage system. The restraint and any evidence of increase authors reported that the degree of rotation of respiratory effort. It is also suggested that an the upper canine teeth can provide a basis for upper airway examination is conducted under classification of brachycephalia in cats and light anaesthesia to examine the soft palate, make breeding recommendations. In Germany it laryngeal ventricles (saccules) and laryngeal is prohibited to breed from brachycephalic cats 10 function. in which the tip of the nose is higher than the level of the lower eyelid, and which show other anomalies of the facial bones. 21 Brachycephalic dogs & cats discussion paper 4. Conclusions 5. Areas for potential further research and development Brachycephalic head shape is associated with several health problems, Development of a brachycephalic airway the most significant being BAS due to its syndrome measurement scale (a system chronicity
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