VN October 2021

Vetnews | October 2021 9 Perhaps the most common and arguably the most serious of these health issues is BOAS. Some breeds have approximately 70–75% prevalence of BOAS 2 . The soft tissues of the skull (including soft palate, nasal mucosa and tongue) do not scale down in proportion with the decreased skeletal dimensions of the skull, resulting in mismatched anatomy with soft tissue structures essentially ‘crammed’ into a smaller skull space. This results in compression of the nasal and pharyngeal air passages, amongst other problems 3 . BOAS is characterised by respiratory and thermoregulatory problems. Compromised airway function is highly detrimental to animal welfare, leading to severely reduced physiological function and thus inability to cope with everyday challenges presented to regular pet dogs 1 . Clinical signs include respiratory distress, exercise intolerance, upper respiratory noise (stertor and stridor), and collapse. The ability to breathe is essential for survival, and dogs with BOAS suffer great distress from air starvation, and also fear and anxiety when facing respiratory distress 2 . Heritable diseases like brachycephalism are a frustrating challenge for general practitioners and specialist vets alike when talking with clients 2 . Efforts to combat BOAS may be constrained by a perception that it is ‘normal’ in brachycephalic dogs 4 . Packer, Hendricks and Burn (2012) created a study that quantified owners’ perception of the clinical signs of BOAS as a veterinary problem. Dogs were recruited from a veterinary referral hospital in the United Kingdom and their owners were approached about participating in the survey. Owners were asked to complete a questionnaire about signs commonly associated with BOAS i.e., dyspnoea (shortness of breath), stertor (snoring), stridor (wheezing), exercise intolerance, gagging, regurgitation and vomiting and were asked about whether or not these constituted a ‘breathing problem’ in their pet. The ‘owner-reported breathing score’ obtained from the questionnaire was contrasted against photographic details of their dogs’ phenotype, whereby the dog was assigned a BOAS ‘affected’ status according to specific criteria. Despite reports of high frequency and severe clinical signs of BOAS, 58% of owners of BOAS-affected dogs reported that their dog did not currently have, nor had a history of, breathing problems. This number included the owners of formally affected dogs which were initially referred for respiratory issues. These owners reported no breathing problem despite the official diagnosis of BOAS. When asked to elaborate on their answers, owners stated that: “No to breathing problem— other than being a Bulldog” and “(No,) but he is a Pug!” 4 . This study showed that there is a disparity between the recognition of clinical signs and the perception of these signs as a problem that requires veterinary intervention. Spontaneous comments instead showed that these problems are considered ‘normal’ for certain breeds 4 . The concept of ‘normalisation’ explains the perception change that occurs over time until signs of disease no longer appear abnormal, due to either a large proportion of individual animals within specific breeds showing these clinical signs and/or the animal themselves has always seemed to exhibit that behaviour 2 . However, just because a specific trait (in this case, respiratory difficulty) is commonly associated with certain breeds, it does not mean that the trait should be present at all. ‘Common’ or ‘normal’ does not equate to ‘positive’, ‘beneficial’ or ‘natural’. Unfortunately, normalisation leads to a significant percentage of owners (and even vets) that do not identify these conditions as pathological, nor consider them reasons to seek or recommend therapeutic care. This may also leave these animals in the breeding pool to continue passing undesirable genetic traits to future generations. Therefore, it is essential to continue to educate brachycephalic owners that ‘common’ is not necessarily ‘normal’ 2 . Anotherstudyfoundthatapproximatelyone-thirdofbrachycephalic pet owners did not expect the maintenance and veterinary costs, exercise levels and overall behavioural problems associated with owning such a breed1. It can be assumed that owners who exhibit stronger bonds with their pets are more likely to seek preventative veterinary care, are more likely to visit veterinarians more frequently and will closely follow veterinary recommendations regardless of cost 1 . Owners such as these (while rare in many of our experiences) do exist! The recognition by owners of clinical symptoms as problematic will influence their decision to seek veterinary investigation and treatment for any disease. While these welfare-compromising health concerns often present acutely, it is Article >>> 8