The clinical signs of brachycephalic obstructive airway syndrome by by Steve Dean

Created: 30/05/2012

A PAPER in the Animal Welfare Journal (published by the Universities Federation for Animal Welfare - UFAW) should raise some eyebrows in dog circles. Part titled – ‘Do dog owners perceive the clinical signs related to conformational inherited disorders as normal for the breed?’  the report attempts to quantify owner perception of the clinical signs of brachycephalic obstructive airway syndrome (BOAS) as a veterinary problem.
Through the use of a questionnaire, clients of the Queen Mother Hospital at the Royal Veterinary College were contacted to score their appreciation of breathing problems in their dogs. Just 285 dogs were included in the study, representing 68 breeds. Of these 31 were classed as affected with BOAS either following diagnosis, or by using criteria based upon the owners’ scoring, skull conformation and presence of narrowed nostrils.
The range of scores from the owners for the 31 dogs was 8-30 with the median being 20. The highest score possible is 40. Over half the owners (58 per cent) of these affected dogs reported their dog as not having breathing problems. From this the authors conclude: "This marked disparity between owners’ reports of frequent, severe clinical signs and their perceived lack of a ‘breathing problem’ in their dogs is of concern. Without appreciation of the welfare implications of BOAS, affected but undiagnosed dogs may be negatively affected indefinitely through lack of treatment. Furthermore, affected dogs may continue to be selected in breeding programmes, perpetuating this disorder.”
At the time of writing the full report is not available for further scrutiny so it is not possible to comment on the detail. However, the summary is freely available online. Given the summary of a paper is often used to underpin welfare opinions, the conclusions of the authors are somewhat perplexing.
For example, if approximately 50 per cent of the owners scored their dog’s breathing at less than 20 out of 40 it is entirely understandable if close to 50 per cent considered their dog’s breathing was not unduly abnormal. However the devil may well be in the detail for there is no indication of what a reasonable score would be.
In addition, the conclusions demonstrate a degree of misunderstanding. We can all agree that where dogs are unwell and are not presented for diagnosis and treatment they will suffer poorer health (and therefore welfare) than is optimal. However here is the problem – this paper suggests owners of brachycephalic breeds took clinical signs to be normal. No mention is made of the other owners in the study.
So should we assume it was just the owners of the 31 dogs assumed to have problems who did not recognise clinical symptoms of a disease or would a similar pattern be seen in the owners of other breeds or indeed crossbreeds? Perhaps the complete paper will clarify this.
However it is surely not surprising that dog owners come to accept a level of abnormality when living closely with their dog, brachycephalic or not. Yet it is the second comment in the conclusion that interests me the most. To assume dogs may be at risk from being selected for breeding when they have breathing difficulties assumes the owners of affected dogs are dog breeders. Furthermore it assumes an experienced breeder would exhibit the same inability to recognise abnormal respiratory signs as the less experienced pet owner.
This conclusion appears to go beyond the stated objective of the title, or at least reveals an assumption that all dog owners are equal in their lack of competence to act as veterinary surgeons, it also illustrates a distinct misunderstanding of the way dogs are bred in the UK and is therefore potentially misleading to the reader.
The objective of this study was very laudable for in many areas of life where domesticated animals are kept, appreciation of ‘normality’ is driven by experience and expectation. For example, veterinary surgeons generally appear to assume neutering is a normal event for pet animals. In dogs, there is no doubt that certain breed specific traits are generally accepted as normal for the breed.
Where an accepted norm results in health problems and can be clearly demonstrated, then action is clearly needed. In my experience dog owners and breeders are only too keen to see health preserved in their dog. In the case of the brachycephalic, where a shortened muzzle is accepted as an indicator of risk, the breeders are aware of this and I am sure attempt to breed away from BOAS.
However, in the public arena this risk has rapidly developed into an assumption that any dog with a short muzzle will have breathing difficulties and this is patently not correct. In addition, it is likely there are other less obvious important risk factors that are not the focus of attention.
To reduce the incidence of respiratory disease in brachycephalic dogs we should fully support the presence of clinical signs of BOAS as a true signal. However, the veterinary profession is generally highly protective of its ability to diagnose disease and prescribe treatment for animals.
This published paper would not be the first time that owners have been the subject of inferred criticism for not being skilled in veterinary medicine. If the intent of this paper is to draw attention to lack of veterinary competence of dog owners then this should be clearly stated.
If, alternatively, the intent is to improve the owners’ recognition of signals of BOAS requiring veterinary attention then a list of symptoms for owners to be aware of would have been useful. In situations where owner-education is required it is certainly a better idea to identify the signs to look for rather than focus on an animal owner’s inability to be a veterinary surgeon.
Perhaps the detailed paper will reveal more and once a copy is obtained readers can expect a follow up focused upon the symptoms of BOAS that the authors considered are important indicators of poor health and welfare.
It is a quirk of the scientific publications that many are closed to the public unless paid for through membership. This of course helps to pay for the publication of the journal and acts as a control on copyright. However it is disappointing to see important information with the potential to improve animal health and welfare effectively hidden away from the public gaze.
Some journals now charge the researcher for publishing their scientific papers and make the content freely available. This modern approach increases transparency of science and has much to be said for disseminating information to a wider readership.
Some scientists will argue the public may not understand the technological information reported. However in my view if the science is so complex it cannot be explained to the reasonable intelligent person in the street there is something wrong with the science.