Association of brachycephaly, sleep-disordered breathing, and inflammatory response in dogs.

Brachycephalic dogs face SDB-driven intermittent hypoxemia and inflammation, warranting better diagnostic tools and breeding reform.

This review article examines the relationship between brachycephaly, sleep-disordered breathing (SDB), and systemic inflammation in dogs. Brachycephalic breeds experience anatomical mismatch between the shortened craniofacial structure and unchanged soft tissue volume of the upper airways, predisposing them to obstructive SDB. During sleep, repeated partial or complete airway blockages cause intermittent hypoxemia, paralleling obstructive sleep apnea (OSA) in humans. In people, OSA is strongly associated with chronic low-grade systemic inflammation, increased morbidity, and elevated mortality rates. The authors propose that similar pathophysiological cascades may occur in affected dogs, with intermittent hypoxemia driving inflammatory responses that compound welfare concerns beyond the mechanical airway obstruction itself. Key risk factors for SDB in dogs include brachycephalic conformation, moderate-to-severe brachycephalic obstructive airway syndrome (BOAS) signs, and excess body weight. Despite growing recognition of SDB as a significant welfare issue, clinical diagnosis remains challenging due to complex and labor-intensive diagnostic methodologies. The authors highlight recent advances in SDB diagnostics and emphasize the urgent need for accessible, practical screening tools to identify individual patients requiring intervention. Both surgical correction of anatomical abnormalities and conservative management strategies (e.g., weight loss) are noted as at least partially effective treatments. The review concludes with a broader call for critical reassessment of selective breeding practices perpetuating extreme brachycephalic phenotypes, framing this as a population-level welfare imperative.

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