Brachycephalic obstructive airway syndrome: diagnosis, surgical management and outcomes

Brachycephalic obstructive airway syndrome (BOAS) is a progressive condition predominantly affecting brachycephalic dog breeds, including French Bulldogs, English Bulldogs and Pugs. BOAS is caused by anatomical abnormalities resulting from selective breeding, and leads to upper airway obstruction, which significantly impacts quality of life and poses serious health risks. Accurate diagnosis involves clinical history, physical examination and advanced diagnostic tools such as whole-body barometric plethysmography, imaging and functional grading systems. Surgical intervention remains the cornerstone of treatment, addressing stenotic nares, elongated soft palates and other abnormalities. Anaesthetic management and postoperative care are critical because of the increased risk of complications such as airway swelling and aspiration pneumonia. While surgery improves quality of life and reduces perioperative risks, some clinical signs and complications may persist. This review discusses the pathophysiology, diagnosis, treatment and outcomes associated with BOAS, and emphasises the importance of early intervention and a multidisciplinary approach for optimising long-term welfare in affected dogs.