We believe little has been achieved in brachycephalic breed improvement for the following reasons:

– There is no specific professional guide for breed improvement for the breeders to use.

– There is no incentive for breeders to change as flatter faces command higher prices.

– There is a complete lack of public awareness as to the problem.

– There is a complete lack of understanding of these breeds by almost all first opinion veterinarians.

We believe the following will potentially solve these problems:

1) A clearly defined set of professional veterinary breeding standards that is endorsed by the AVA, RSPCA, ASAVA and state veterinary boards +/- other relevant groups .

2) An incentive for breeders to adopt these new standards by those who agree to them being endorsed by professional veterinary bodies and other relevant groups, and those not adopting them not being endorsed. The endorsed breeders will be publicly promoted as breeding for health. An official website list of veterinary profession endorsed breeders agreeing to breed for health needs to be established, publicised and accepted. This is the only way change will occur.

3) A consistent and relevant and well planned public education campaign.

4) A complete overhaul of veterinary education as to both the problems that currently exist, and the correct advice at initial presentation. (One very relevant topic to discuss is the fact that almost no veterinarians understand intermittent regurgitation is almost always restricted airway related. How has our profession allowed this to happen and why does it continue to do nothing to address this most basic of concepts?).

Addressing each of these four points above is the only way to achieve progress. Anything less will not achieve change.

The above is not difficult to achieve. But it will require a dedicated group of concerned professionals to work together in an efficient manner, using both logic and relevant studies to make some common sense recommendations.

To initiate a start on some of the basics to put up for discussion to achieve the above we recommend giving consideration to discussing the following on each of these four main points:

1) Veterinary recommended breeding standards: We cannot fix everything at once, and must start with some of the basics to ensure we do not dilute the current available gene pool too much. We put up the following for discussion:

– Nares: Exclude moderate to severe stenosis. Leniency has to be applied here initially. Grey area moderates should be included.

– Minimum CFR: Whether this be specific for each breed, or consistent across all breeds, but look to Holland for what they are doing and decide on an initial ratio. Interestingly in recent conversations with Nai-Chieh from Cambridge, they have studies that are less convincing that this is relevant. We would like to look at those studies first before discounting this. But an extreme, say 0.3 or less, should be excluded. Nai-Chieh has recommended we look more at neck girth and skull index ratios instead. So let’s look into that and see if we can combine help from Cambridge to devise a plan that may have eventual international merit.

– Screening x-ray for hypoplastic trachea and hemivertebrae: A current scheme that exists grades hemivertebrae as level 1,2 or 3 depending on severity. An overall score of 15 is considered acceptable. This allows for 5 severe hemivertebrae to be advertised by breeders doing this program as healthy spines that will never cause a problem. We have a different view. We believe this current scheme is exacerbating the spinal problems and needs to be addressed. We believe any spine with a single grade 3 should be excluded and a score of 5 rather than 15 should be the standard of acceptability. This should come with a certificate explaining the potential for spinal disease is still significant. Breeders must give their own paperwork explaining this. Hypoplastic trachea can be measured in the same screening xrays

The above should be bare minimum to be passed as a level one veterinary endorsed dog selected for greater potential health.

The following could be considered for people wanting to advertise level 2 health:

– At 1 year a GA and rhinoscopy for turbinates, and physical pharyngeal assessment to assess degree of length of palate entering larynx, and presence and degree of oedematous laryngeal ventricles and swollen tonsils.

– Of course a rough grading system will need to be decided, and only endorsed brachycephalic veterinarians that have been trained as part of this group can be assessors for all the above. We need a few in each city.

2) Breeder Incentive: Regardless of developing a professional recommended standard for breed improvement, this will achieve nothing once presented to kennel clubs, as a few will say, great, wonderful idea, and maybe even adopt it. But the vast majority will just say get stuffed (subtly or otherwise). So an incentive needs to be put in place. This is achieved by making public a very specific endorsement of breeders choosing to breed for health over the show ring by adopting the recommendations of the veterinary profession. So long as our profession is consistent and persistent with only endorsing breeders who agree to these standards, and not endorse breeders who don’t, slowly public pressure will effect change, as the public does want health.

3) Public Awareness Campaign: Social Media is currently used effectively by the breeders to push their agenda. The same medium needs to be used to explain the veterinary professions advice and endorsement. Nothing will be achieved without an effective public awareness campaign. This will involve a very specific set of explanations, and endorsements that can be made visible via the following:

– A large number of professional bodies having very clear websites explaining all the above. We would suggest multiple reputable specialists centres, select general practices, the AVA, the RSPCA , ASAVA etc, and other relevant groups.

– Social Media Facebook groups and platforms dedicated to professional advice and help. Social Media must be used to spread awareness in this day and age and we need to plan how best to go about this. For a start we suggest starting BAHA: Brachycephalic Australia Health Awareness: We are calling on professionals to help to have input here.

4) Educate the Profession: The repetitive message we get from every post desexed dog that comes to our clinic for airway assessment is the same: “We were told nothing, or told at desexing that there were no concerns”. We have disagreed with this advice every time. As explained above, the fact that almost no general practitioners understand restricted airway related gastric reflux and sliding hiatal hernia is a good example of the diffuse lack of understanding of these breeds. This is possibly the most important problem to address if change is to occur. Hence we urge consideration to the following:

– There is general consensus amongst Australian brachycephalic experts that 90-100% of these dogs would benefit from early airway correction (which in itself is enough to give rise to this forum). Given this consensus, does the profession have an obligation to address the concern that the vast majority of first opinion vets giving no or incorrect advice upon initial presentation and desexing assessment? There is a significant disconnect here that we feel the profession has a need to address.

– We would like every vet clinic to be given an information package regarding these problems and solutions, put together by this group, for their own education.

– We would call for a 2-4 year program of re education.

– We would call for discussion on a minimum owner information booklet to be produced and made available for all practices to give to each new brachycephalic presented to their clinic. This booklet will explain the problems, the options, the breed standards the veterinary profession is calling for, and the breeders who have agreed to breed for health.

– We call for a revamp of the student curriculum to better educate students as to the options that must be given to presenting brachycephalics, especially pre-desexing, so that they can educate their first employers. This needs to include a clear understanding of the new breed standards recommended by our own profession.

Basically, general practitioner ignorance is the biggest battle we have as currently they are endorsing current breed standards by advising people snoring, gurgling, exercise intolerance, reflux and regurgitation is normal and of no concern because they are brachys. They then back this up by advising there are no concerns at desexing, when almost always this advice is incorrect. All this indirectly endorses the current breeding standards, and reinforces the breeder’s assertions, strongly publicly communicated, that any vet recommending airway correction is deliberately doing unnecessary procedures to make money. Hence the owner believes their long time trusted (but wrong) personal vet, and increases suspicion in society of brachycephalic vets recommending airway correction and a change of breed standards.

The biggest safeguard for this however, is regardless of incorrectly assessing and advising on an individual patient, every single vet must be encouraged upon presentation to explain professionally endorsed breeders of health, ask the client for their registered breeder, and then inform them, and document whether they have chosen a health breeder or show ring breeder. If they have bought from a show ring breeder, spend some time explaining the increased risks they have chosen to take for their dog. They then need to give the information booklet explaining the professions stance, recommendations and advice.

The above will take some time to work through but is reasonably easily achievable. We call for interested parties to start these discussions. We particularly ask for VSS lead by Professor Philip Moses to help guide and advise a set of improved breed standards that can be the basis of all further achievements. We ask for the RSPCA , AVA and ASAVA to be significantly involved.

TOPIC OF DISCUSSION:

There is a lot of debate and noise regarding how to assess for BOAS, including the use of exercise tolerance tests and WBBP. We have one question we would like to put up for discussion:

Regardless of clinical signs, if under examination at 6-12 months, usually at desexing, if a palate obviously extends extensively into the larynx, would the best advice for the dog at that time be to resect it or leave it? Our belief is to resect it on the following basis:

– The downside at that time is almost negligible

– The upside for protecting a dog from going on to develop debilitating secondary changes such as redundant pharyngeal mucosa and laryngeal collapse is significantly higher that any potential downside.

– The reality in practice is that well over 90% of owners notice obvious improvement in their dogs lifestyle, even when pre-surgical signs were subtle, or exercise tolerance tests had been passed. We’re currently putting together data of every dog we correct, and would like to call on other clinics to do the same. We feel the proof of what we need to suggest revised breeding standards lies in such information. We wonder if we are not documenting responses enough. We are happy to share our post surgery questionnaire’s and data. As such we ask:

Is it reasonable or not reasonable to bypass BOAS testing (which we are concerned can give a false impression of no concerns when concerns may in fact exist due to the subjective and ongoing developmental nature of these tests) and just recommend correction as appropriate under anaesthetic examination prior to 12 months of age, especially if being desexed?

We believe this is a really important topic for discussion, and is relevant to the need to encourage a change of current breed standards. We have asked multiple professionals this question of which we have had two reputable surgeons and a medico answer it should be resected, with other experts choosing not to answer at this time.