Does My French Bulldog Need BOAS Surgery? Signs to Look For

French Bulldogs, Pugs and English Bulldogs are among the most popular dogs in Leeds and Wakefield, and we see a lot of them at Paws & Co. We also hear the same sentence from their owners almost every week: "He's always snored, that's just the breed." Sometimes it is. Often it is the first sign of a condition called BOAS, and it is one of the most treatable problems we deal with.

This guide from our vet team explains what BOAS is, how to tell whether your dog might have it, how we assess it, and what surgery involves.

What BOAS Is

BOAS stands for Brachycephalic Obstructive Airway Syndrome. "Brachycephalic" simply means short skulled. When a dog is bred to have a flat face, the soft tissues inside the head do not shrink to match the bone. The result is an airway that is narrowed at several points at once: nostrils that are pinched or slit like, a soft palate that is too long and hangs into the back of the throat, and, in many dogs, small pouches of tissue in the larynx (the laryngeal saccules) that get sucked outwards by the effort of breathing and narrow the airway further.

Every breath has to be pulled through those narrow points. At rest, a dog may cope. Add heat, excitement, exercise or stress and the effort climbs, the tissues swell, and the dog can go from noisy to struggling very quickly. Over the years that constant effort also strains the heart and causes changes further down the airway that cannot be reversed, which is why we would rather see a flat-faced dog early than wait for a crisis.

Signs Your Dog May Have BOAS

Not every flat-faced dog has BOAS that needs treating, but the following are the signs we ask owners to look out for.

• Snoring and noisy breathing at rest. Snorting, rattling or a raspy sound when the dog is simply lying on the sofa, not only when it is asleep.
• Poor tolerance of heat. Struggling on warm days when other dogs are fine, or needing to stop and recover in weather that is not really hot.
• Tiring quickly on walks. Lagging behind, sitting down, or open mouthed breathing after modest exercise.
• Regurgitation, gagging or retching, particularly after eating or when excited. The pressure changes in a narrowed airway affect the gullet too, and many BOAS dogs have digestive signs as well.
• Sleeping in odd positions. Sleeping sitting up, with the head propped on something, or with a toy in the mouth to keep the airway open.

Which Breeds Are Affected

French Bulldogs, Pugs and English Bulldogs are the three most affected breeds, and the majority of dogs of these breeds have some degree of airway obstruction. Boston Terriers, Shih Tzus, Cavalier King Charles Spaniels, Boxers, Pekingese and Lhasa Apsos can also be affected. Any dog with a shortened muzzle is at some risk, including crosses. The shorter the face and the narrower the nostrils, the higher the risk tends to be.

"He's Always Been Like That": Why Normal for the Breed Isn't Normal

The hardest part of BOAS is that the signs are so common within these breeds that owners stop seeing them. A snoring Frenchie is a joke on social media. A Pug that cannot manage a summer walk is "just a Pug". Because the dog has never breathed any other way, it does not look distressed to the people who love it.

A dog with moderate BOAS is working for every breath, all day, every day. Owners who go ahead with surgery often tell us afterwards that they had no idea how much their dog was struggling until they saw it breathe properly. If your dog does any of the things on the list above, it is worth a proper assessment, even if it has been that way since it was a puppy.

How We Assess BOAS

An airway assessment at Paws & Co starts with a full physical examination and a careful listen to the dog breathing at rest. We then watch the dog breathe after a short period of gentle exercise, because that is when obstruction shows itself. We grade the nostrils, check weight and body condition, and ask about the signs you have noticed at home. This builds a picture of how much the airway is affecting the dog and whether surgery is likely to help.

If surgery is recommended, we take pre-operative blood tests and plan the anaesthetic carefully, because flat-faced dogs need particular attention around anaesthesia. We are also happy to give a second opinion if your dog has been assessed elsewhere.

What BOAS Surgery Involves

The aim of surgery is to open the airway at the points where it is narrowed. At Paws & Co, the three problems are dealt with in a single procedure under one anaesthetic.

Doing all three together means one anaesthetic and one recovery. The procedure is usually carried out around twelve months of age, ideally between one and two years, once the dog has finished growing but before long-term changes to the airway have set in. Older dogs can still benefit.

Recovery After BOAS Surgery

Dogs are monitored closely by our nurses on the day of surgery and often stay overnight, because the airway can swell in the first hours. For the first few days at home your dog needs pain relief as prescribed, soft food and strict rest. For two weeks, walks are short and on a harness only, with as little excitement as you can manage. We check the dog at ten to fourteen days, and most are back to normal within about a month.

Long term, the things that protect the airway are the same things we recommend for every flat-faced dog: keep the dog lean, avoid exercise in hot weather, and walk on a harness rather than a collar so nothing presses on the throat. If you are also working with a trainer, mention that your dog has had airway surgery so they can plan around it.

Living Well With a Flat-Faced Dog

Whether or not your dog needs surgery, a few habits make a big difference. Weight is the biggest one: extra fat around the neck and chest narrows the airway further, and many dogs improve noticeably just from losing weight. Avoid walks in the middle of a warm day and stop early if the dog is struggling. And keep an eye on the teeth: a short jaw with a full set of teeth means crowding, which makes dental disease more likely in these breeds. Dental checks for dogs are free at Paws & Co, so it costs nothing to have them looked at.

If you are thinking about getting a flat-faced puppy, ask the breeder whether the parents have been assessed under the Kennel Club and University of Cambridge Respiratory Function Grading Scheme.

Frequently Asked Questions

At what age should a French Bulldog have BOAS surgery?

Most dogs are operated on at around twelve months, ideally between one and two years of age, once the dog has finished growing but before years of laboured breathing have caused long-term changes. Older dogs with clear signs can still benefit, and the only way to know is an assessment.

Will my pet insurance cover BOAS surgery?

Sometimes. Some insurers cover BOAS surgery, while others treat it as a hereditary or pre-existing condition and exclude it, particularly if snoring or breathing problems were noted before the policy started. Check your policy wording or ring your insurer before the assessment, and we can provide a written estimate and clinical notes to support a claim.

Can BOAS be managed without surgery?

Mild cases can sometimes be managed with weight control, avoiding heat and exercise stress, and using a harness instead of a collar. These steps help every flat-faced dog and we recommend them regardless. But they do not change the shape of the airway, and for dogs with moderate or severe obstruction, surgery is the only treatment that addresses the cause. Our assessment will tell you which category your dog falls into.