AVMA News

Health screening test rolled out for brachycephalic dog breeds

Respiratory Function Grading Scheme provides assessment for brachycephalic obstructive airway syndrome

A few years ago, the University of Cambridge and The Kennel Club in the U.K. developed the Respiratory Function Grading Scheme as a way to objectively measure the severity of brachycephalic obstructive airway syndrome in dogs and help make a clinical diagnosis. The intent of the scheme is also to improve understanding of the condition, increase awareness, and ultimately reduce the incidence of BOAS.

Now the Orthopedic Foundation for Animals, a U.S.-based nonprofit dedicated to promoting the health and welfare of companion animals through a reduction in the incidence of genetic disease, has joined this international effort and has licensed the RFGS for use in the U.S. and Canada. The OFA is instituting respiratory function grading of brachycephalic breeds as one of its health screening tests.

BOAS Functional Grading Matrix
Researchers at the University of Cambridge in the U.K. have developed the Respiratory Function Grading Scheme as a way to objectively measure the severity of brachycephalic obstructive airway syndrome in dogs and help make a clinical diagnosis. (Images courtesy of the Orthopedic Foundation for Animals) [Enlarge]

The foundation launched the program at the Rose City Classic dog show, Jan. 20-21 in Portland, Oregon. There were representatives from the American Kennel Club, OFA, Bulldog Club of America, French Bull Dog Club of America, and Pug Dog Club of America at the event. In all, about 60 dogs were tested.

The Bulldog Club of America, French Bull Dog Club of America, and Pug Dog Club of America approached the OFA in light of the public discourse around brachycephalic breeds because of their tendency to have respiratory issues and asked whether the OFA could put something in place to help identify healthy dogs.

Various registries exist for health records, including the Canine Health Information Center from the OFA. A purebred dog “achieves CHIC Certification if it has been screened for every disease recommended by the parent club for that breed and those results are publicly available in the database,” according to the OFA website.

How to assess

The popularity of the snub-nosed Pug, French Bulldog, and English Bulldog breeds has grown exponentially in the past few years, explained Eddie Dziuk, chief operating officer of the OFA. “The public finds these breeds extremely endearing,” he said.

As a result, more people have taken to breeding these dogs without carefully considering—or being aware of—the health and welfare consequences of certain physical characteristics. Many of these dogs go on to develop brachycephalic obstructive airway syndrome, which is a condition that causes breathing difficulties. BOAS results when the shortened snout makes the soft tissue in the nose and throat too large for the available space, causing obstruction of the airway from the nostrils to the trachea. This interferes with a dog’s ability to breathe normally. BOAS is a progressive disorder and can impair a dog’s ability to exercise, play, eat, and even sleep.

“There has been a lot of public outcry and concern voiced against these breeds and some of their health conditions,” Dziuk said. “Some of it probably warranted, some of it exaggerated.”

Brachycephalic breeds such as the French bulldog tend to have respiratory issues, which is why the OFA is seeking to identify healthy dogs among the most-affected breeds.

Dzuik said there’s a normalization around symptoms of these breeds, and any kind of respiratory issue shouldn’t be normalized just because a dog is brachycephalic. There’s no reason a Pug shouldn’t be able to run around and breath easily, for example.

He explained that the RFGS program intends to identify the dogs that are healthy, while segregating them out from dogs that have more severe cases.

The examination is conducted by a specially trained veterinarian and consists of four steps: a short health survey, a brief physical examination while the dog is calm, a brisk 3-minute walk, and a post-exercise auscultation.

The RFGS uses a scale of 0 to 3 to objectively diagnose BOAS. Dogs with a grade of 0 or 1 are normal, while dogs with a grade of 2 or 3 are abnormal and symptomatic of the condition.

The program helps conscientious breeders set themselves apart and offers the opportunity to have a veterinarian examine their dogs and certify whether they have normal respiratory function. If the dog has a certain level of respiratory difficulties, the dog should be bred with caution or even excluded from the breeding pool.

According to the OFA, using the RFGS grades and the guidelines, concerned responsible breeders can apply selective genetic pressure to reduce the chances of producing puppies affected by BOAS.

The goal is to use this data to make more-informed breeding decisions. “With smarter breeding decisions, you could hopefully begin to minimize the incidence of the disease,” Dziuk said.

BOAS Breeding Recommendations
Using the RFGS grades and the guidelines, conscientious breeders can apply selective genetic pressure to reduce the chances of producing dogs affected by BOAS.

Preparing veterinarians for the assessment

The RFGS program was developed by Dr. Jane Ladlow at the University of Cambridge. She trained the original core examiner team of two veterinarians. There was an extensive debrief with Dr. Ladlow after each pilot examination to ensure consistency in examination protocol, examination administration, and grading.

All veterinarians have the skills to perform the assessment, but Dzuik stressed that the OFA doesn’t want veterinarians doing the examinations solely on the basis of reading the grading matrix.

Inter-veterinarian reliability is a key concern, and that’s why the OFA is taking a top-down approach by having the trainees work closely with mentors by shadowing.

“The same dog under similar conditions on the same day should achieve the same grade,” Dzuik said.

A veterinarian performs a Respiratory Function Grading Scheme examination on a pug at a 2022 OFA pilot event for the assessment of brachycephalic breeds.

Four additional veterinarians have been trained, and four more attended the dog show in Portland for training. The OFA hopes to gradually increase the pool of available approved veterinarian examiners so that they can perform the testing more readily in different parts of the U.S. and Canada.

Dr. Ladlow trained the first two U.S.-based examiners, who in turn trained the next two. The OFA will continue to follow that reverse pyramid training model. Currently, there are no plans for virtual training, as it requires an in-person shadowing experience. Veterinarians interested in becoming examiners should contact Eddie Dziuk at edziukatoffa [dot] org (edziuk[at]offa[dot]org).

The RFGS is licensed from The Kennel Club, meaning the OFA will use the same grading scheme and program materials. The OFA is also under an obligation to share the results with The Kennel Club as part of the international collaboration.

“It’s an international effort to collect data from all over the world, to allow for better breeding decisions across the world, across borders,” Dzuik said. “And hopefully there’s data that may lead to better therapeutics and better treatment programs.”

AVMA advocates for responsible breeding practices

In January, the AVMA House of Delegates adopted an updated policy on “Inherited Disorders in Responsible Breeding of Companion Animals” that supersedes the existing policy of the same name and continues to emphasize the importance of responsibly managing inherited disorders in companion animals. The policy states, “To improve quality of life of companion animals, the American Veterinary Medical Association discourages breeding companion animals with deleterious characteristics, since these features often require surgical correction or life-long medical or behavioral management. The AVMA supports research in genetic traits and deleterious physical and behavioral features to better educate the profession and breeders so as to optimize the health and welfare of companion animals.”

The World Small Animal Veterinary Association recently issued a warning about an emerging “canine welfare crisis” caused by the popularity of short-nosed breeds. WSAVA’s Hereditary Disease Committee just launched an educational video to highlight the health issues these dogs face, the most serious of which is brachycephalic obstructive airway syndrome.