Noisy breathing is never normal 

For over a decade, Jane Ladlow has been making the case that breathing problems in flat-faced dogs don’t have to be inevitable. Research she co-authored and was recently released proves she’s right. Behind the data are thousands of dogs and the owners and breeders who chose to do something about it.

Meet Charlie-Carl. He’s a Cavalier King Charles Spaniel who had always been a snorer and his owner – Diane – assumed, as many people do, that this was simply part of having a flat-faced dog. Then a vet commented on his palate and over the following months Diane also noticed he was struggling to sleep. By the time they arrived at Granta’s BOAS Airway Clinic, the noise she had long accepted as normal had become something she could no longer ignore.

It turned out Charlie-Carl had already undergone airway surgery elsewhere and needed further surgery to correct it. The procedure went well and for the first time in a long time, he could sleep without fighting for breath.

“I wish I’d brought him here first,” says Diane. “If your dog’s breathing is noisy, it’s worth looking into before it becomes a bigger problem.”

Charlie-Carl’s story is not unusual, but what’s changing is the evidence behind it.

The scheme, and the science behind it

Jane is a specialist soft tissue surgeon here at Granta and head assessor for The Royal Kennel Club’s Respiratory Function Grading Scheme (RFGS) – a role she has held since helping to develop the tool itself.

The RFGS assessment combines careful auscultation with a short exercise test, placing dogs on a scale from Grade 0 (unaffected) to Grade 3 (clinically significant disease requiring intervention). It was developed and validated using whole-body barometric plethysmography – equipment that measures the mechanics of breathing rather than relying on observation alone. Trained assessors now operate across the UK, so breeders and owners do not need to travel far to have their dog assessed. The scheme has since been adopted by 17 countries.

The new paper, published in PLOS One and co-authored by Jane, draws on data from more than 4,000 dogs assessed through the RFGS. By analysing results across generations, researchers estimated how much of the variation in breathing ability between dogs can be attributed to genetics. For pugs, French bulldogs and bulldogs, the answer was a moderate but meaningful proportion: heritability estimates ranged from 0.21 to 0.49, comparable to traits already successfully selected for in companion animals.

In other words: this isn’t bad luck. It runs in families and it can be bred out.

“Noisy breathing is never normal. If you can hear a dog struggling to breathe, they are affected. That is what the grading scheme is built on, and it is what this research confirms. We can test these dogs, we can identify the ones that should not be bred from, and we can show that it works.”

Professor Jane Ladlow

A problem broader than most people realise

Brachycephalic Obstructive Airway Syndrome (BOAS) affects the flat-faced dog breeds that have become some of the most popular pets in the country. The structural changes that give French Bulldogs, Pugs, Bulldogs and others their distinctive faces also compress the soft tissue around the airway, making it harder to breathe normally. The most familiar sign is noisy breathing – the snoring, snuffling and rasping that many owners have come to accept as part of the deal. It isn’t. “We have just been told it is for so long that people stop hearing it,” Jane says.

Research published earlier this year, from a study Jane supervised, assessed 898 dogs across 14 brachycephalic breeds and found that almost every single one showed some detectable level of breathing abnormality. The Pekingese and Japanese Chin were found to be as severely affected as Pugs and French Bulldogs. The disease is present across a far wider range of breeds than most people realise.

A further study in The Veterinary Journal, co-authored by Jane, used CT imaging to map the specific airway problems driving BOAS in the three most commonly affected breeds. One finding stands out: in Bulldogs, a hypoplastic trachea – a windpipe that is simply too narrow – cannot be corrected surgically. It has to be bred out. That is a clinical argument, grounded in evidence, for why the grading scheme matters beyond any individual dog.

Which brings us back to the breeders – because that is where the real changes can happen.

A breeder’s perspective

Vicky Collins-Nattrass has been breeding Bulldogs for over 30 years, following in the footsteps of her mother, a farmer’s wife who kept the breed throughout Vicky’s childhood. When researchers from Cambridge first approached Bulldog breeders about taking part in early trials, she was cautious. The idea of putting a dog in a chamber worried her but what she found changed her mind. The dogs were fine and, as the research evolved into the non-invasive listening-based scheme used today, she became one of its advocates.

“The Bulldog, if not extreme in conformation, is just as fit and energetic as any dog,” she says. “I saw this as a chance to prove that – both to breeders and to our critics.” She had long been selective about the dogs she bred from – looking for balance, for neck length, for room to breathe. What the scheme gave her was scientific backing and, crucially, a way of reaching breeders who were less experienced. Over the years, she has seen the difference in the show ring – dogs that used to be found by their noise are now breathing quietly, which she says is a “vast improvement from the early days.”

The new research feels like vindication. “Having devoted 18 years to improving the health of the Bulldog, it means everything to know that people are taking on board that we can selectively breed from the best.” Her advice to anyone thinking of buying a flat-faced dog is direct: research the breed, look carefully at the source, and ask to see the parents’ paperwork.

“Ask a lot of questions. Buying on a whim can be very costly. Even if you are never going to breed, it’s worth having your dog tested. It gives you peace of mind, and the data helps everyone.”

Vicky Collins-Nattrass

What this means for you

If you own or are thinking of buying a brachycephalic dog, the most useful thing you can do is find a breeder who health-tests. Ask to see RFGS results for both parents and if your dog already shows signs – laboured snoring, difficulty in the heat, reluctance to exercise, disturbed sleep – speak to your vet about a referral for assessment. Many dogs with clinically significant BOAS can be helped with surgery, and earlier intervention gives better outcomes.

If you are a breeder, the research is unambiguous: testing works, and the data shows it.

“If you want to breed your dog, you must always get it tested, so the puppies you produce are going to have a healthy, long life – and the families who love them are going to enjoy them for years to come.”

Professor Jane Ladlow

The Kennel Club’s RFG scheme has trained assessors across the country – you can find your nearest one here.

Speak to Granta Veterinary Specialists

Granta’s BOAS airway clinic is led by Jane and her colleague Jackie Demetriou and Kate Price the BOAS nurse. If you have a patient who may benefit from specialist assessment – whether they’re showing signs of grade 2 BOAS or above, have concurrent GI symptoms, have had previous airway surgery, or are breeding stock requiring objective grading – we’re here to help. Referrals are straightforward and every case is reviewed with the same care we’d want for our own animals.