Is it normal for my Pug or Frenchie to snore?

While snoring is common in these breeds, it is not "normal" from a medical perspective. Snoring is a sign of airway obstruction, usually caused by an elongated soft palate vibrating against the back of the throat.

What is the best age for BOAS surgery?

Early intervention is key. Most veterinarians recommend performing corrective surgery, such as widening the nostrils or shortening the soft palate, when the pet is young - often between 6 to 24 months of age. Operating early helps prevent secondary, permanent complications like laryngeal collapse, which is much harder to treat later in life.

Can cats get BOAS too?

Yes. While often discussed in dogs, "flat-faced" cat breeds like Persians, Himalayans, and Exotic Shorthairs can also suffer from brachycephalic syndrome. They may exhibit narrowed nostrils and noisy breathing, and they face the same risks regarding heatstroke and anaesthesia as their canine counterparts.

Why is weight so important for brachycephalic pets?

Obesity is particularly dangerous for these breeds because excess body fat isn't just external; it also accumulates around the throat and airway. This internal fat further narrows an already crowded space, making it significantly harder for the pet to breathe and regulate their body temperature. Even a small weight loss can lead to a significant improvement in breathing ease.

Why should I use a harness instead of a collar?

Brachycephalic breeds often have malformed or "hypoplastic" tracheas (windpipes). A collar puts direct pressure on the neck and windpipe, which can cause the airway to collapse or trigger a coughing fit. A Y-shaped harness distributes pressure across the chest, keeping the neck free and the airway open.

Last Updated: 15/01/2026

Brachycephalic Airway Syndrome in Dogs & Cats: Signs, Surgery, and Management

Is your flat-faced pet snoring or struggling in the heat? This guide to Brachycephalic Obstructive Airway Syndrome (BOAS) covers everything from narrowed nostrils to life-saving surgery, helping Australian pet parents provide the best respiratory care.

Author: Dr Teagan Lever BVSc (Hons)

Reading Time: 6 minutes - short read

Brachycephalic Airway Obstruction Syndrome (BAOS), also known as Brachycephalic Obstructive Airway Syndrome (BOAS), is a critical health concern for "flat-faced" breeds. While their pushed-in faces are a defining characteristic of breeds like French Bulldogs and Pugs, the underlying skeletal structure often results in severe respiratory distress.

In this comprehensive guide, we explore the anatomical causes of BOAS, secondary health complications, and the life-saving surgical options available.

What is Brachycephalic Airway Syndrome?

The term "Brachycephalic" comes from the Greek words brachy (short) and cephalic (head). In these pets, the skull bones are shortened, but the soft tissues inside the mouth and nose are not. This results in a "crowded" airway where excess tissue obstructs the flow of oxygen. These anatomical defects are a result of years of selective breeding for the brachycephalic appearance.

Common Brachycephalic Breeds

While most commonly associated with dogs, this syndrome also affects specific cat breeds:

Dogs: French Bulldogs, English Bulldogs, Pugs, Boston Terriers, Boxers, Cavalier King Charles Spaniels, Shih Tzus, and Mastiffs.
Cats: Persian, Himalayan, and Exotic Shorthair.

The 4 Primary Anatomical Defects of BOAS

Brachycephalic Syndrome is rarely just one issue; it is typically a combination of several physical abnormalities:

Stenotic Nares (Narrowed Nostrils): The nostrils are malformed and pinched inward. This increases airway resistance, making every breath through the nose feel like breathing through a pinched straw.
Elongated Soft Palate: The roof of the mouth is too long for the shortened skull. The end of the palate hangs down into the throat, partially blocking the entrance to the trachea (windpipe) and causing the classic "snoring" sound.
Hypoplastic Trachea: The trachea or "windpipe" has a dangerously small diameter. This is common in English Bulldogs and significantly complicates anaesthesia.
Everted Laryngeal Saccules: These are small pouches located just inside the larynx (voice box). Due to the high pressure of struggling to breathe, these pouches get sucked into the airway, further narrowing the space.

What are the Signs of BOAS?

brachcephalic dog planting, lying on grass

Signs often progress as a pet ages. What may seem like "cute" snoring in a puppy can become a life-threatening obstruction in an adult.

Noisy Breathing: Snorting, wheezing, or "stertor" (a low-pitched snoring sound).
Exercise Intolerance: Tiring quickly or refusing to walk in mild weather.
Heat Sensitivity: Rapid panting that does not result in cooling (high risk of heatstroke).
Digestive Distress: Frequent gagging, retching, or regurgitation of white foam, often worsened by the effort of breathing.
Cyanosis: A bluish tint to the tongue or gums due to lack of oxygen.
Syncopal Episodes: Fainting or collapsing after excitement or exertion.

Secondary Health Complications

Veterinary research has linked BOAS to systemic issues beyond the lungs:

Gastrointestinal Disease: The negative pressure created by struggling to breathe can cause Gastroesophageal Reflux (GERD) and hiatal hernias.
Sleep Apnoea: Many brachycephalic dogs cannot reach deep sleep because their airways collapse when they relax, leading to chronic exhaustion.
Heart Strain: Chronic low oxygen levels put immense pressure on the right side of the heart, potentially leading to heart failure.

Diagnosis and Veterinary Assessment

Because BOAS is an internal structural issue, a physical exam in a consult room is only the first step.

Visual Exam: A vet can diagnose Stenotic Nares immediately.
Pharyngeal Exam: To see an Elongated Soft Palate or Everted Saccules, the pet must be under heavy sedation or general anaesthesia.
Imaging: X-rays or CT scans are required to measure the diameter of the Hypoplastic Trachea and check for secondary heart or lung changes.

Treatment: Is Surgery Necessary?

For pets with moderate to severe BOAS, surgery is the "gold standard" of treatment. Early intervention (ideally before 2 years of age) prevents the permanent collapse of the larynx.

Surgical Procedures:

Alapasty/Alapexy: Widening the nostrils/nares by removing a wedge of tissue, or anchoring the nasal alae (nostril wings) to the adjacent skin in an abducted (open) position.
Staphylectomy: Shortening the elongated soft palate to prevent it from blocking the windpipe.
Sacculectomy: Removing everted laryngeal saccules to clear the airway.

Prognosis: Surgery significantly improves quality of life. Most owners report that their dogs have more energy, quieter breathing, and better sleep post-operatively.

At-Home Management and Prevention

If your dog or cat has BOAS, lifestyle changes are essential for their safety:

Weight Management: Being overweight can make breathing even more difficult, so it is especially important that brachycephalic breeds are kept at a lean bodyweight.
Harness Over Collars: Never use a neck collar on a brachycephalic breed. Use a Y-shaped harness that puts zero pressure on the trachea.
Climate Control: These breeds cannot cool themselves effectively. On warm days, they should remain indoors in air conditioning and avoid exercise.
Stress Reduction: High excitement leads to faster breathing, which can trigger an airway crisis.

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The Future of the Breeds: Ethical Breeding

Sadly, brachycephalic airway syndrome has arisen from humans selectively breeding for a physical trait which we find appealing. While there is no doubt brachycephalic breeds are adorable, have wonderful personalities and make great pets, it does pay to stop and think about the consequences of continuing to breed and pass on damaging anatomical defects.

Dogs with even mild brachycephalic airway syndrome are likely to have interrupted sleep, with more severely affected dogs experiencing lethargy, weakness, fainting and distress as the condition worsens.

Organisations like the RSPCA and the Australian Veterinary Association (AVA) advocate for "health over looks." If you are looking for a puppy or kitten, choose reputable breeders who breed away from anatomical defects.

For more information on supporting healthy breeding practices, visit Love Is Blind.

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FAQs

Managing a brachycephalic pet requires a proactive approach and a keen eye for respiratory distress. While their snoring might seem like a "normal" breed trait, it is often a sign of significant airway resistance. By combining weight management, environmental cooling, and timely surgical intervention, the quality of life for these pets can be transformed. If there are concerns about a pet's breathing or tolerance for exercise, a consultation with a veterinarian is the best way to ensure they continue to thrive for years to come.

References

Poncet CM, Dupre GP, Freiche VG, Estrada MM, Poubanne YA, Bouvy BM. Prevalence of gastrointestinal tract lesions in 73 brachycephalic dogs with upper respiratory syndrome. J Small Anim Pract. 2005 Jun;46(6):273-9. doi: 10.1111/j.1748-5827.2005.tb00320.x. PMID: 15971897.
Hendricks JC, Kline LR, Kovalski RJ, O'Brien JA, Morrison AR, Pack AI.. 1987. The English bulldog: a natural model of sleep-disordered breathing. J Appl Physiol (1985). 63(4):1344–1350.
Mitze S, Barrs VR, Beatty JA, Hobi S, Bęczkowski PM. Brachycephalic obstructive airway syndrome: much more than a surgical problem. Vet Q. 2022 Dec;42(1):213-223.

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History

Our experts continually monitor the health and wellness space and we update our articles when new information becomes available.

Thu 15 Jan 2026

Edited by Dr Gillian Hill BVSc (Hons)

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About the Author

Dr Teagan Lever BVSc (Hons)

Head Veterinarian, BVSc (Hons)

Pet Circle's Head Veterinarian, Dr Teagan graduated from the University of Queensland in 2010 and went on to work in small animal and mixed practice in various locations around QLD & ACT before joining Pet Circle in early 2016. Dr Teagan has special interests in dermatology, nutrition and preventative health care. She feels privileged to witness the special bond people share with their pets on a daily basis and enjoys forming lasting relationships with pet parents and their fur children.