Brachycephalic Syndrome in Small Dogs
Reviewed and updated by Janice Jones, former veterinary technician
Last updated: January 2026
The term "brachycephalic syndrome in dogs" is not a disease per se, but a set of characteristics that can cause breathing problems. Any dog with a short nose is considered brachycephalic.
These characteristics can affect breathing and heat regulation, with severity ranging from mild to more serious, depending on the dog and the degree of anatomical change.
Brachycephalic dog breeds have a shorter snout, which shortens the dog’s airway. Some have such short noses as to have little or no muzzle at all.
The skull bones of brachycephalic dogs are short, which changes the structures of the soft tissues, creating breathing and other problems
There are quite a few small dogs that considered to be brachycephalic. Some have shorter snouts than others.
King Charles Spaniel (English Toy Spaniel)
Brachy means shortened, and cephalic refers to the head. The syndrome is also called brachycephalic respiratory syndrome, brachycelpalic airway syndrome, and congenital obstructive upper airway disease.
Four distinct anatomical anomalies contribute to the syndrome, and a brachycephalic dog may be affected by one or more of them.
Elongated Soft Palate
The soft palate is the soft portion of the dog’s mouth. In brachycephalic dogs, this part is too long for the length of their smaller mouths. The excessive amount of soft palate can partially block the entrance to the trachea (windpipe) at the back of their throat.
Stenotic Nares
Dogs with stenotic nares have an abnormally small opening that restricts the amount of air that can enter and exit the nostrils. Some puppies born with small nares grow out of it with age.
Hypoplastic Trachea
A hypoplastic trachea has a smaller diameter than a normal trachea.
Everted Laryngeal Saccules
These are small sacs or pouches that are located inside the larynx or voice box. If these pouches turn outward or evert, they will further obstruct airflow.
Brachycephalic Syndrome Symptoms
If one or more of these abnormalities are present, inhaling requires more effort. Often, these dogs end up breathing through their mouths rather than their noses. As a general rule, the more abnormalities present, the worse the symptoms become.
Dogs with fewer problems might have noisy breathing, snort when excited, and may snore when they sleep.
Some dogs may show exercise intolerance or signs of respiratory distress, particularly during heat or excitement.
Other symptoms can include coughing, gagging, retching, and vomiting. Hot, humid weather brings out the worst symptoms in these dogs. Heat stroke is a major possibility in brachycephalic syndrome dogs who cannot escape the heat. Obesity seems to worsen the symptoms.
As the dog ages, the increased effort to breathe strains the heart. Dogs with many different problems show symptoms early in life.
Selective breeding for these cute little noses has resulted in many of these respiratory difficulties. Many breed standards specify that the snout be short. People often find these little noses irresistible, so breeders will continually breed for smaller and smaller noses.
But not all brachycephalic dogs have severe problems. One of the biggest problems these dogs face is overheating, because when they overheat, they pant to cool off, and that panting can lead to swelling and narrowing of an already constricted airway.
Even gastrointestinal problems can occur because these little dogs work so hard to breathe; they may swallow too much air.
Problems present at birth make nursing difficult.
In rare cases, puppies with severe airway obstruction may show symptoms early in life and require close veterinary monitoring. Early assessment helps determine appropriate care and management.
Other severely affected puppies show symptoms when they are just learning to swallow food while breathing. Sadly, there is little that can be done to help these pups, and most die shortly after trying to eat on their own.
Treatment for Brachycephalic Syndrome
Mildly affected dogs can be managed with simple common-sense measures:
- Avoid hot and humid conditions
- Avoid stress
- Reduced amount of exercise
If the dog is showing more symptoms, the veterinarian may prescribe Corticosteroids, non-steroidal anti-inflammatory medications, and oxygen therapy. These are all short-term solutions that will relieve stress and improve airflow.
Since the symptoms are due to anatomical abnormalities, the only way to correct them is through surgery.
Surgical correction may be recommended in dogs with significant breathing difficulty. A veterinarian can determine whether surgery is appropriate based on the dog’s anatomy and symptoms.
If stenotic nares are the cause of the difficulty, a veterinarian can remove a small amount of tissue from the nostrils, thereby widening the opening and allowing more air to pass through.
If it has been determined that an elongated soft palate is the major culprit of the problem, vets can surgically shorten it to a more appropriate length.
The everted laryngeal saccules can be removed to reduce the laryngeal blockade. The prognosis is usually good, especially if surgery is done at a young age.
Other Problems Associated with Brachycephalic Syndrome
Respiratory problems are the most obvious life threatening symptoms, but the dog’s anatomy poses other problems, especially with their eyes and skin.
Skin Issues
As the skull becomes shorter and flatter, more skin covers the bones. This skin tends to form tiny folds, especially on the
front of the face. The English Bulldog and Pug are two examples of this.
Folds create crevices, creating the perfect warm, moist environment where bacteria and yeasts can thrive.
Sometimes this can lead to infection and inflammation. Dogs with light-colored hair often have severe facial and ocular stains due to yeast and bacteria.
Antibiotics may help a little, and daily cleaning and drying will reduce the symptoms, but not cure the underlying problem.
Eye Problems
In addition to breathing difficulties and skin conditions, many of these brachycephalic dogs have protruding eyes due to their skull structure.
The flattening of the skull causes the eye sockets to become shallow. The result is that bulging eyes increase the likelihood of eye injuries because the eye is more exposed.
Dry eyes, corneal ulcers, and even direct trauma occur when a dog has such bulging eyes.
Because of shallow eye sockets, some brachycephalic dogs are more prone to eye injuries. Prompt veterinary care is essential if trauma occurs.
Eye
Injuries and Dislocation in
Brachycephalic Syndrome Dogs
Teeth and Tongue
All dogs have the same number of teeth, but when the head is smaller, there is less room for the teeth. They can be prone to dental problems. Some dogs end up with tongues that are too big for their mouth.
Anesthesia Risks
There is an additional risk for anesthetizing brachycephalic dogs. Most vets recommend pre-op blood work. If you can avoid unnecessary surgeries, your dog will thank you.
Airline Travel with a Brachycephalic Syndrome Dog
Airline policies regarding brachycephalic dogs have changed significantly over time, with many airlines now restricting or prohibiting air travel for these breeds due to safety concerns.
If these dogs must fly, it's best to heed airlines' advice: they require dogs, especially those shipped as baggage or in pressurized cargo areas, to be kenneled in larger crates with ventilation on all four sides.
Each airline has specific requirements.
Protect Your Brachycephalic Syndrome Dog
Brachycephalic syndrome cannot be cured, but symptoms can often be managed and, in some cases, improved with lifestyle adjustments and surgical intervention.
You cannot change your dog’s anatomy, but you can reduce airway stress and help prevent complications.
Here are a few suggestions.
- Provide mild exercise.
- Keep dogs indoors in cool conditions. These dogs cannot live outdoors.
- Provide plenty of cool, fresh water.
- Maintain a healthy weight. Obesity exacerbates the problem.
- Provide sleeping crates that allow air circulation on all sides.
- If the dog travels by air, arrange for a larger-than-average travel crate that has ventilation on all four sides.
- Provide regular veterinary care.
- Use a harness rather than a collar when you walk your dog. Collars put pressure on the throat, increasing the likelihood that your dog will cough and have breathing difficulties.
- Provide an environment that reduces stress. Stress can exacerbate breathing problems.
More About Janice (author and voice behind this site)
Janice Jones has lived with dogs and cats for most of her life and worked as a veterinary technician for over a decade.
She has also been a small-breed dog breeder and rescue advocate and holds academic degrees in psychology, biology, nursing, and mental health counseling.
Her work focuses on helping dog owners make informed, responsible decisions rooted in experience, education, and compassion.
When not writing, reading, or researching dog-related topics, she likes to spend time with her six Shih Tzu dogs, her husband, and her family, as well as knitting and crocheting.
She is also the voice behind Miracle Shih Tzu and Smart-Knit-Crocheting
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