Many people cannot resist short-nosed (brachycephalic) dog breeds because they are cute, loving, loyal, and even portable. However, they require a high level of maintenance if they are to live long and healthy lives. Janet King and Dr. Alice Novotny Jeromin are joined by Dr. Liesl Bigge, a small animal internal medicine specialist, to discuss how to properly take care of French Bulldogs, Pugs, Cavalier King Charles Spaniels, and all types of brachycephalic dogs. From addressing their breathing issues, dermatology problems, eye problems, to treating their gastrointestinal issues, the doctors suggest the best practices to keep them healthy and active if you own or are planning to adopt one. Dr. Bigge also discusses the true costs of having short-nosed dog breeds and why you need insurance coverage from day one.
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Taking Care Of Short-Nosed Dog Breeds
The Short-Nosed Breeds Of Dogs-We Discuss Their Medical Problems That You Need To Be Aware Of!
Welcome to the show. Janet, do you know what the word brachycephalic means?
No. I can’t even pronounce it.
I know you can’t.
I could be in the spelling bee on that one.
Brachy means short. Cephalic means head. Everybody who’s got one of those cute, smushed-in-face dogs, this show is for you. Those are pugs, cavalier king charles, shih tzu, and the number one breed in America, the French bulldog. They all have a lot of problems because of this smushed-in face. We’ve gotten our favorite internal medicine specialist, and now partial co-host, Dr. Liesl Bigge.
She’s a twofer.
No, she’s a threefer.
We’ve got to come up with a blazer or something.
We’ll get the green blazer. Also, Dr. Bigge is our favorite Buckeye, as you can tell from her studio. In all seriousness, though, as an internist, Dr. Bigge sees a lot of French bulldogs in the other breeds that I mentioned, as do I, a dermatologist. We’re going to talk about their problems, what to watch for, and what to think about if you’re going to adopt one of these dogs, because sometimes, it’s not easy-peasy, right, Dr. Bigge?
Not at all. In fact, if you are thinking about adopting or purchasing one of these dogs, you need to have insurance on day one of adopting or getting them. If they don’t have insurance, they need to have their own bank account or their own little checking account to be able to facilitate the cost of owning one of these guys down the road. It’s a whole lot.
I had a Pug for fifteen years. We bought her because we anticipated moving, and we wanted a smaller dog instead of our pit bull-y things that we normally adopt. I’m well aware of them and their problems. I was well into veterinary medicine by the time we got a pug. She was wonderful. I loved her personality, but she wasn’t without a whole bunch of stuff.
Before we talk about other problems, that whole breed is so cute, loving, loyal, and sweet.
They’re portable.
They’re irresistible. They’re good for the elderly or an apartment dweller because they are the cutest little pint-sized things. We have a Frenchie around the corner. His name is Walter. I love him.
How To Deal With Breathing Issues
Dr. Bigge, let’s start at the top. Name a part of the body in a French Bulldog that isn’t a problem for them. I can’t think of one.
They don’t get a lot of liver disease. I’m going through the systems that I deal with. They don’t get a ton of endocrine diseases. It’s not like they’re overrepresented for Cushing’s that we talked about before. Maybe they don’t live long enough to get those. I hate to say it like that, but it’s the truth.
They have breathing issues. I’m assuming it’s their structure.
We’ll start with the breathing, then.
The vast majority of our smushy-faced breeds, as I lovingly refer to them, have what we call BOAS. It stands for Brachycephalic Obstructive Airway Syndrome. It’s a constellation or a whole group of problems that the majority of these pets have that affect their ability to breathe. The biggest one that we see in pretty much all of them is stenotic nares. What that means is that the little holes that they breathe through, their nasal holes themselves, are too small for them. That’s the most that we can see visually from looking at them.
The rest of them are going down the airway. We’ll see these things in the back of their throat. They’re called laryngeal saccules. These are little things that people think of as tonsils. They’re not tonsils, but they’re these little pouches in the back of their throat. I have no idea. I tried to look up what they’re for from an evolutionary standpoint. I have no idea. I couldn’t figure that out.
Are they lymphoid tissues?
They have some lymphoid in them, but I couldn’t figure it out. Give me a couple more weeks. Maybe I’d be able to find it. These are little pouchy things in the back of their throat that when you have this increased resistance. Imagine breathing through a straw. You’re pulling in that much air. Those little saccules that are supposed to be indented this way become everted. They poke out into the airway. You’ve got these two things that are supposed to be like this, but they’re poking into the airway and then further obstructing the ability to breathe. Those are called everted laryngeal saccules.
Is that a snort?
All of it causes snorting. They do snort. The other thing they have is the soft palate. We have a hard palate. We have a soft palate behind it. They tend to have an elongated soft palate. What we think, rather than being a long soft palate, is that their soft palate is thick. It is thicker than it should be, even more so than longer.
There’s a whole bunch of other stuff. They tend to have big tongues, macroglossia. Depending on the breed, our old English bulldogs tend to have tracheas or windpipes that are about 80% of the size that they should be for their size. All of this stuff leads to difficulty getting air in. That leads to intolerance of heat.
I’m in Florida. I’ll go to the Shark Tooth Festival. You see them at 11:00 in the morning on a leash, and it’s hot. Imagine you close up your nares. Try to breathe in. You’ve got the everted saccules. Try to exhale. You can’t pant. They get overheated.
They don’t have sweat glands. I haven’t watched all your episodes to know about how dogs move heat. Panting is the main way for them to cool themselves off. If you can’t move air, you can’t move heat. They’re way predisposed to heat stroke. Unfortunately, even in Ohio, we’ll see a ton of it. The Georgia Bulldogs are a lot in Georgia just because of that mascot. It’s not a great place to own them because of the heat or the difficulty with the heat.
Dogs do not have sweat glands. They can only cool themselves off through panting. Share on XThat’s BOAS. A lot of them can be dealt with from a surgical perspective. When we elect to do surgery, the sooner it’s done in their lifetime, the better. You want them to be full-size, full-grown. The earlier we do it, the better it is for them for the rest of their life because BOAS syndrome predisposes them to the development of other stuff. A lot of those can be surgically dealt with.
Several of them that can’t would be the stenotic trachea because we can’t make that windpipe bigger. That’s a bad one. Over time, their larynx can also collapse because of that increased stress of breathing. That whole breed category of chondrodystrophic dogs has problems with cartilage. Their cartilage isn’t as great as the cartilage in a non-bulldoggy breed. There’s a lot.
Her husband is a veterinary surgeon. I’ve heard veterinary surgeons say that for French bulldogs, even at a young age, the cartilage is already rupturing.
There are so many things.
We’ve done this to them as humans.
We have selected these characteristics. I don’t agree with it. I was a Pug owner. I had one for fifteen years out of this weakness because they’re so cute. We didn’t have to do anything surgical from an airway perspective. We kept her exceedingly lean. Everybody looks at her and says, “She’s too skinny.” I’m like, “Nope. That’s what a dog is supposed to look like.” It’s because we do need to keep them thin. Think about it. How many people have seen Bulldogs, Pugs, or Frenchies that look like these little rotund sausages?
They look like Sputnik. They look like a big ball with these four legs.
It also predisposes to the airway or makes the airway stuff worse. A lot of people will look at the BOAS, the obstructive airway diseases, like a person with sleep apnea. A lot of the secondary problems that people get, we can see that in our dogs, too. They don’t live long enough to have the super long-term complications with the sleep apnea that people get. They don’t live long enough to have the cardiovascular stuff that goes along with it.
Do these pet owners who have these breeds know about all this?
No.
Dealing with Eye And Ear Problems
They have these breathing problems. They also have eye and ear problems. I read that there’s an 80% more of a chance of Frenchies having eye problems than other breeds of dogs because their folds are scratching the eye. The ears are tight also as far as folds.
Sticking with the face, they will get the facial folds. We do see other breeds. English Bulldogs are probably even worse off than the poor Frenchies are. They get this rope that we call, where they get this big blob of skin. They have prominent eyes. They don’t sit as far back in their sockets. If the dog rubs its head on the ground because its face is itchy or something, and then you’re going to shove that into the eye, they’ll have a tendency towards corneal ulceration.
They also have a propensity towards dry eye. When you have dry eyes, that means there’s not enough tear production. It then lends itself to the cornea not being happy. The watch glass covering over the eye gets matte. It is this perpetual problem with the eyes over time. Some of those can be treated with medications, but my dog was one of the ones that lost her eyeball from having an ulcer and lots of stuff with her.
It’s a lot of maintenance. Some pet owners are like, “They’re so cute.” They have no idea about the maintenance involved. There are so many areas of the body.
How many times can we easily trim a dog’s toenails? It’s not easy in most cases. You have to train a dog to be able to do their feet. If you have a dog, you have to be able to clean the folds if they get yeasty, moist dermatitis, as you’ve seen under their eyes or in the creases in their face. If we have all of that stuff, that develops.
Train your dogs to do their feet. If the folds of their feet remain unclean, they get yeasty. Share on XIt smells. It has to be clean. Did your pug like a toenail trim?
No.
I’ve never met a Pug that liked their toenail trim. Some of them would even pass out.
Why are they passing out?
It’s because of the breathing. They’re stressed out.
They scream. You can train. Even with my goofball dog, it took me a good six years to be able to do her nails without the world ending. I can dremel her without anybody holding her or anything, but it’s a lot.
I go to the vet for that.
I know. You come to us for that. Let me throw my two cents in. These Frenchies, genetically, have the gene for allergy. They usually start at three months of age, much younger than other dogs. At three months of age, you’d think of food allergy as well because those dogs start young. With Frenchies, once they have the gene for environmental allergy, that kicks in, too. They’re going to rub their face more. Those eyeballs are sticking out. Think about it. If you’re a Collie with a long nose, and you’re a dog, you put your nose first for everything. Imagine a Pug or a Frenchie. They’re putting their nose first somewhere. They’re going to get eye trauma. It’s scary.
They get a lot. I remember Dr. Chuck Parshall, who was an ophthalmologist, whom Alice also knows very well. We saw a ton of brachycephalic breeds for eye disease. Also, you figure a lot of times we had to put Elizabethan collars on them as a post-op thing. Dr. Parshall would always joke. He’s like, “They need something to keep themselves from rubbing, but that acts as a telescope to go throwing stuff at the surgery.” He draws it all in. They have a lot of issues with their head and face.
The breeders want them to be even more pushed in. It’s ruining the breed even more.
The responsible breeders are not breeding for that. I’ve seen a couple of breeders where they’re breeding to have good nares. They might have good open nares, but then they still can have the other stuff. Surgically, this is the easiest thing to fix. The trachea is a big issue. You can’t make a tongue smaller, although there is some radio frequency ablation they’re trying to make. I don’t even understand it, but it is to try to make the tongue a little more reasonable. There’s a lot. They need to be kept exceedingly lean.
Understanding Dental Issues And How To Solve Them
They have a lot of dental issues, too.
It’s because the teeth aren’t lined up.
The teeth are in the short jaw. Imagine putting all those teeth into it.
What’s a tail pocket?
They can keep extra change there!
That’s another place where stinky stuff happens, but they can develop something called a screw tail that we’ll see in old English bulldogs and Frenchies. I asked my husband. I’m like, “How many Frenchies have have you done screw tail surgery on?” He’s like, “Too many.” What happens is instead of their tail going up like a normal floppy dog tail, their tail curves around into their back. Since it’s a firm thing in the back, it keeps moisture and overgrowth of yeast. Especially if they get overweight, they’ll get a little fat pad around there. They end up having these chronic, nasty infections. They are bacterial or yeast infections.
It’s all maintenance. You can’t just put them on the antibiotic or anti-yeast pill. You’ve got to get in there.
You resect the tail. Again, it’s a surgical disease. It’s a maintenance disease, or you have to cut it out. You leave them tailless. It takes care of the problem, but it’s another surgical procedure.
Short-Nose Dog Breeds And Their Stomach Problems
What about their stomachs? Don’t they have a lot of stomach problems?
I feel like we’re picking on these breeds.
When Dr. Jeromin asked me to do this, I’m like, “I don’t want to throw my bias towards why are we breeding dogs like this?” There are some specimens of them that are good. Since they’ve gained popularity, you end up with a whole lot of breeders that get a male and get a female. Let me do this part first before we do the GI stuff. They get a male dog and a female dog. Breed them. Guess what? They cannot have babies on their own accord.
They’re like turkeys.
That’s exactly what it is.
Those are AI insemination.
They cannot have their puppies naturally because you’ve got these big old faces that don’t want to fit through a birth canal. I have only heard of one breeding line of Frenchies that has been able to be born naturally.
Do they C-section them?
Every single one.
Is it called the same thing in animals?
Yes. It’s called a C-section.
I got it right.
I do these C-sections. You have C-sections that are being done, especially if it’s people who are not super familiar with the reproductive process of dogs, that you’re not only putting the dam at risk. You’re putting the puppies at risk. You may end up with no dog if you don’t know what you’re doing when you endeavor to breed these breeds.
If you think about it, because they don’t have a neck. They’re not able to help the process.
There’s a lot of it. That’s a big thing, too. Should we be breeding dogs that can’t reproduce naturally? That’s a whole ethical thing.
You’re putting them under anesthesia. It’s a dog with breathing problems. They’re at an anesthetic risk to get their puppies.
They will then have puppies that still have those same problems or may have the same problem.
Are there questions when you’re adopting one of these breeds that you should be asking your breeder?
“Did the sire have airway surgery?” would be number one. They’re going to be C-section puppies. That’s number one. Did the sire or dam require or have surgery? A lot of times, if you meet the sire and the dam, you’re going to know because the ones that haven’t had surgery are so noisy and so loud when they’re breathing that it’s going to be pretty obvious. If they have had surgery and they’re still noisy and loud, that’s an even worse sign for what your dog or your puppy may have.
That’s got to be a scary surgery. With your husband being a surgeon, going in there and doing those arytenoid folds, that’s a bloody area.
The nose is okay. I don’t think it’s that bad. The worst one is if you have a hypoplastic trachea. That’s the windpipe that’s too small, or if the larynx itself wants to collapse. If you feel your larynx in your neck, it’s cartilage, but it’s stiff. They get smushy. The surgery itself I don’t think is that difficult. It’s the recovery.
It’s because they’re stressed out there.
A comical thing is that sometimes, when you do surgery on brachycephalic animals, and I don’t even mean a big surgery. Say if we’re doing some other procedure where they require a tube in their trachea. These dogs don’t want to give up that endotracheal tube when you’re recovering them post-op.
It’s because they can breathe.
Most dogs, as they’re waking up from anesthesia, are like, “What is this thing? Get it out of my mouth.” That’s how we know we can wake them up. These dogs will walk with this tube hanging out of their mouth because they’re like, “I have air.”
“It’s the most oxygen I’ve had.”
That’s another interesting thing. Anesthesia-wise, they are challenging.
Why do they have so many stomach problems?
We’re pretty convinced that the brachycephalic obstructive airway syndrome itself predisposes them to most of their GI things. Pretty much all of them will have GERD or gastroesophageal reflux disease. People have GERD. That’s where the opening between the esophagus or the food tube and the stomach allows acid from the stomach to fly back into the esophagus. The esophagus doesn’t like acid. People get heartburn or acid indigestion. The dogs obviously can’t describe that, but that can lead to decreases in appetite, or they’ll spit up more frequently than another dog would.
The other disease that they get, which is a much bigger deal, is a sliding hiatal hernia. The stomach is supposed to be below the esophagus. What happens with these guys is because of that pressure that they have to pull to breathe, the pressure differential between the esophagus and the stomach forces the stomach up into the esophagus. It doesn’t stay there. It moves back and forth. That in and of itself is a whole other thing. It manifests as vomiting or regurgitation after eating.
A sliding hiatal hernia forces the dog’s stomach up into the esophagus because of the pressure to breathe. Share on XI suspect that even in the action of breathing, they swallow a lot of air. When you swallow air, you get more air into your stomach. That takes up space. When you eat, you’re swallowing air. It makes the stomach even bigger. The dog will expel that. The hiatal hernias that they have can often be a surgical disease. That’s the reason why we talked about trying to get the airways dealt with before the sliding hiatal hernia develops. That may stop that from happening.
There was an interesting study done a couple of years ago that was published at the University of California, Davis. They looked at the dog’s GI stuff, esophageal stomach stuff, before and after doing the brachycephalic airway surgeries to see if the gastrointestinal signs improved after the surgery was done. What they saw was that from the owner’s perspective, there was improvement in regurgitation and vomiting.
What they found from an endoscopy perspective, where we take a fiberoptic scope and look down into the stomach and esophagus afterwards, was that there wasn’t a big improvement. The question is, if the BOAS part is not completely causing this, and it’s not improving after surgery, clinically, why did owners think that things were improving? That’s up for further discussion. That’s the GI stuff. I don’t necessarily think that they’re overrepresented for food intolerance itself, or food allergy stuff, unless it’s derm wise.
It’s more the gastric acid thing.
It’s that whole stomach esophagus relationship that’s not great with them. They’re super gassy. These dogs clear a room.
How To Eliminate Your Dog’s Perpetual Headache
There are the stinky facial folds, the stinky tail fold, and then the gas. You guys, we’re not picking on the breed. We want you guys to know these are the common things that if you adopt one of these brachycephalic breeds, you can get. The other one, Liesl, that we need to talk about is syringomyelia. Jackie, our friend who works for me, adopted a Cavy.
She had to take it to OSU because it was doing that phantom scratching thing at the neck. We’ll talk about that. They ran an MRI on it at Ohio State. They came out and said to her, “We don’t even know how this dog is able to breathe.” The vertebrae were so compressed against the head that the dog had a perpetual headache.
Cavaliers have this thing called a Chiari malformation. It is two different things. We have this Chiari malformation, which is where their head, their brain, is too big for the skull in which it sits. When you have a brain that’s too big and a skull that’s too small, the brain part gets pushed backwards. Where does the brain exit? Push, push, push. It causes discomfort that way. What Dr. Jeromin was talking about is when they’re scratching their neck, when their brain gets smooshed back further in their skull.
It causes changes in the flow of the cerebral spinal fluid, which bathes the brain in the spinal cord. What can happen is that the spinal cord itself develops these things called syrinxes or pockets of cerebral spinal fluid that can push on the spinal cord. Push even further out. It causes not only discomfort, which is where this scratchy thing that they’re doing is, but it does cause neurologic dysfunction, sloppy gait, or difficulty in walking. It can progress and be bad for them.
There are some surgeries that can be done. They can be very expensive, so it’s different than the other diseases that we see further down the spinal cord, which we can talk about with these guys also. The Chiari malformation or syringomyelia is another big deal. It’s primarily the Cavalier King Charles that we see that in. Cavies also get this other interesting disease. I’m going to forget the name of it. They have the tube that connects the inner ear. The Eustachian tube that connects the middle ear to the throat, essentially, is how we’ll say it.
It drains the fluid down the throat.
What is it?
It’s a cholesteatoma. They’re now calling it tympanosteatoma.
That’s not what it is.
It’s a cholesteatoma, but they’ve renamed it to tympanosteatoma.
They get vertigo.
No. It’s a bunch of mucus that develops in the bulla, in the middle ear. It pushes on the tympana. It pushes on the eardrum. It causes pain and discomfort. That’s another reason why they can scratch their head. We see that as primary secretory otitis media.
I knew it. It was on the tip of my tongue.
That’s another thing that we see, primarily in Cavies, but we can see it in other breeds also. That’s a weird one. That’s relatively newly described since Alice and I have been in school.
We have to mention Cavies with their heart disease.
Cavalier King Charles has a lot of mitral valve disease. There are some lines that are better than others. If you have a Cavalier, and it makes it past 5 or 6 years old without getting a heart murmur, that’s good. We do see a whole lot of mitral valves. Which is the valve between the upper and lower chambers of the heart, where that’s dysfunctional and leads to heart failure way earlier than we like to see.
The breeders are doing a little bit better on that, too. They’re trying to breed away from that, but we still see, unfortunately, a bunch more. We still see them a lot. Let’s put it that way. We have better drugs, so the dogs are living longer with those diseases. We definitely have better drugs for it than we did years ago.
Why You Need Insurance From Day One
We want our audience to know that if you are considering taking on one of these breeds, be aware of the insurance costs.
Dr. Bigge has a suggestion to get that insurance ASAP.
I can’t comment on whose insurance to get because that whole industry is changing all the time, but it can be helpful. The problem with insurance, when you go to look for it, is also seeing whether there are pre-existing things that are excluded from the different policies. These companies might be getting smart with all the issues that these guys get. You may not be covered.
When you apply for insurance, they ask you what breed.
They’d have to.
We got insurance because we have a Golden. I compared and contrasted the five companies. It’s like doing your taxes. It’s so confusing.
It’s like human health care, only it’s for your baby.
It’s important that our audience understands that these are issues. We’re not trying to be hard on these breeds. I have no idea, and they’re the cutest things.
They are so adorable.
The average person wouldn’t know that all these body systems are affected. If I say to Dr. Bigge a breed, or she says to me, I immediately tell them. Dachshund, intervertebral dysplasia. Golden Retriever, allergy. Pitbull, which you have, what would you say?
Cruciates. They all tear their cruciates, but they’re itchy dogs, too. It’s their atopy.
As a vet, you know off the top of your head. The normal person doesn’t know that. This is helpful to people. If you travel a lot, and then we need to talk about that, Dr. Bigge, there are some airlines that will not fly brachycephalic dogs.
They will not. There was a lawsuit. That was a dog that was brought in. It was several years ago. It was a Frenchie that they had put up in the compartment above the seats. The dog died because of the stress. When they get stressed out, that’s another thing, too. When you have to work that hard to move air, and then you’re stressed out and breathing hard. The soft tissues in the throat and trachea become swollen. It then further impedes airflow. It’s this spiraling effect.
These dogs essentially develop heat stroke, which is probably what that dog died of, and then respiratory failure, if you’re having to work this hard to move air. It’s awful, so they won’t fly with them. They shouldn’t. You got a dog. If it doesn’t tolerate car rides, then drug it. I hate to say it like that, but speak with your veterinarian about the correct sedatives to use to appropriately keep the dog calm, not comatose. Things that help with anxiety, like a Valium, but that class of drugs, along with some other sedative can help these guys be able to travel.
When a dog has to work hard to move air because of stress, the soft tissues in the throat and the trachea become swollen. This impedes airflow, which leads to heat stroke or respiratory failure. Share on XI always tell people, if you’re going to do that, do it at home first to see the reaction of the dog. I wouldn’t use Benadryl, but Benadryl makes some dogs hyper-excited as opposed to sleepy. You’ve got to try it at home first. You don’t want to give your dog an unknown medication and then fly them or take them in the car.
You’d start all that stuff beforehand.
Short-Nose Dog Breeds And The Butterfly Vertebrae
We have to talk about vertebrae.
The vertebral column is the bones that encase the spinal cord. If you take an X-ray picture of these dogs’ backs, especially Frenchies and bulldogs, they do not look normal in most cases. They have what are called butterfly vertebrae or hemivertebrae. They have a malformation of the vertebrae that surround the spinal cord, which then puts them in a worse position.
If they have a blunt force trauma, slamming into them by something else, it does not allow that vertebral body to protect the cord correctly. We also see the chondrodystrophic breeds, as I said, with their smooshy face. They have problems with their cartilage. They also have issues like dachshunds. Dachshunds are chondrodystrophic. They just don’t have smooshy faces. In between your vertebrae, there is a disc that acts as a cushion.
It is cushioned between those two vertebrae. What happens with these chondrodystrophic dogs is that the center of that cushion becomes hard or firm. When you have this boom, it can cause the central disc to shoot out into the spinal cord and then cause these guys to not be able to walk abruptly. That’s another set of things that we see with bulldogs, some Frenchies, and old English bulldogs. I don’t think I see as many cavaliers with that thing. It’s another layer of neuro-orthopedic disease.
What about cruciates? Is it more luxating patella that they get?
The patella is the kneecap. What we see with the kneecap is that it will slide. It sits in a groove. What happens is it slides out of the groove and then causes the dogs to have a little giddy-up in their gait. That can be surgically corrected. It is another thing that we see with those guys. My surgeon husband abhors doing particularly orthopedic surgery on these guys because most of the dogs are overweight. You’re having to perform an orthopedic surgery on an overweight dog. The owners can’t lift them to take them outside.
The Right Way To Treat GME
They can have more post-op complications because of their typical overweight stature and wanting that to heal. One of the weird things neurologically that we see in these brachies, pugs, and other brachycephalic is a disease called GME, which is a granulomatous meningoencephalitis. It’s an inflammation of the cover of the brain and spinal cord. It also affects the white matter in the brain. It’s a bad disease. It causes a seizure disorder. It’s hard to describe, but they come in because they’re dull, or something’s going on. They can’t be seizuring. It’s a fairly devastating disease.
How do you treat it?
It’s high-dose steroids. There are a couple of other drugs that we can use to treat it, but I don’t know that I’ve ever seen a dog get back to being the same dog they were prior to the diagnosis, or if we can treat them enough to have them be a good pet. It’s something we see a lot of. A lot is relative. We see it more in those breeds than we do in generic Joe Blow breed from non-brachycephalic. That’s another not as common.
I remember having a young gentleman bring his Pug in. I’m not sure why I saw it for derm because I don’t remember it having a horrible derm problem. It was a black pug. It had GME. He held it like a baby because it couldn’t walk. It would throw his head back. I thought, “I know he sees some of his dog still there,” but it was so tragic. I know he was hanging on to him. He was hoping that the dog was going to get better. I didn’t have a lot of background information on it, but what a horrible disease that is.
It’s devastating. I’ve seen that more in Boston’s breed-wise. Pugs are way over-represented. It’s a tough one. I can pick a breed. I haven’t seen a lot of it in cavies, but that doesn’t take them off the table. We can see it in any breed. We just tend to see it more in little terriers and also the smushy-faced ones.
Is GME mostly in small dogs?
Yes, it’s mostly small dogs. I don’t think I’ve ever seen it in a large breed. I have to pull papers and see if there has ever been. That name has changed over time, too. They’ve given it different names. That’s based on us being able to do more examination of the tissues post-mortem and stuff like that. If you look up GME, you’ll see other parts of it.
When you talk about changing the name, what’s sad about that is that it’s great that that part of it has come a long way, but it has nothing to do with improving the therapy. I’d be so much happier if I heard, “They found this about it. We’ll change the therapy to this, and the dog will do so much better.” That step three and four never get there.
Some Poop Issues And How To Deal With Them
I’m circling back to GI stuff. We did the upper GI. The other part about GI that’s unique to Frenchies is this. When I was in school, we learned it as boxer colitis or histiocytic colitis.
We’re going to the poop zone.
There are a lot of Frenchies that have this issue with chronic loose stool to some extent. It is not usually super watery, but at least soft, lots of mucus, straining, and sometimes bloody. It is refractory to a lot of the typical therapies that we would do when we’re working with colitis or what we call large bowel diarrhea in dogs. What we found is that it is caused by an E. coli type that has been able to evade the immune system of the Frenchie’s GI tract.
I’m not going to say it’s that bacteria, because if you took that bacteria and you threw it at another dog, they’d be fine. It has to do specifically with the Frenchie’s gastrointestinal immunity. It’s able to evade the normal immune response, set up shop, and cause this continued inflammation. Should I say how we treat it? People will just want to empirically treat. Diagnosis-wise, you have to do a GI biopsy.
Gastrointestinal biopsies are done with endoscopy, just like a colonoscopy, like a human. We will culture that intestinal tissue to try to find the bacteria and type it, and then say, “What antibiotic is it susceptible to?” It is usually a combination of antibiotic therapy. I hesitate to say what we usually do because it should be diagnosed in order. It’s usually 4 to 6 weeks of antibiotics, and not just any antibiotic. It’s a big deal.
Is it like the old boxer histiocytic colitis, where we put them on Baytril?
Yes.
That’s way back in the day.
It’s very similar.
Janet, aren’t you lucky with Libby that you’re not having any of these problems?
Amen. I love those little guys. They’re so cute, loving, and sweet.
I’ve never met a mean one.
Which one?
Frenchies.
I have met a few mean Frenchies.
I’ve been retired. I never had a nasty one back then.
We are seeing them now. There are old English bulldogs.
As pet owners or pet adopters, you know the risks of the breeds you’re picking.
That is what it is. I would implore that breeders try to breed away from these characteristics that make these dogs. It challenges their lives. They have short lives. They have lives that are not without pain and discomfort. Are we breeding them because it gives us pleasure to have this cute dog? I don’t know. Is that the right thing to be doing?
It is an ethical question.
One Question To Ask Your Dog
On that note, I’m going to ask you our threepeater guest question. Are you ready? If your dog, your cutie patootie right there, could speak, what one question would you ask him or her?
That’s a hard one.
It’s probably what stresses her out the most in life.
She’s so nice.
She’s a Prozac girl. She’s on fluoxetine.
That’s an interesting question.
To help avoid those situations, that would be number one. We want a better life through chemistry.
Dr. Liesl, our favorite Buckeye, I heard for years, Alice would say, “Send me those blood reports, so I can send them to Dr. Liesl.” I never met you.
There’s so many dogs that she’s never met.
All the time. I texted you about that one. It was allergic.
It was chronic rubbing.
It was deep pyoderma and allergic.
That’s the best it could have been.
The dog’s doing great now. I said, “Don’t let her get bad again.” There is lots of blood. Everybody’s like, “My dog started on thyroid.” I’m like, “How about if you send me the lab work to take a peek at?”
Can I tell you about that? I read an article in human medicine where people on thyroid, more than 50%, when they went off, stayed absolutely fine. They’re thinking that thyroid supplementation in all people is not necessarily a permanent thing.
That would be interesting to think through the pathophys of that. Are you giving the thyroid a break?
My first thought was, “Did they need to be on it?” That’s the first one. There are a lot of dogs on thyroid that you and I know shouldn’t.
A very common question that we get all the time is about these obese dogs. The dogs aren’t feeding themselves if they’re fat most of the time. It’s because we’re feeding them. They don’t choose their food.
The dogs are not feeding themselves. If they are fat most of the time, it is because we are feeding them. Share on XDiscussion Wrap-up And Closing Words
Thank you. You small dog pet owners, we love you just as much, but you need to be informed. I had no idea any of this went on with those small ones. I just think they’re so cute.
The three of us get older. When I think about it, the older I get, if my dog were having a seizure and I had to pick a 50, 60, or 70-pound dog up, I couldn’t do it. I probably will get smaller dogs as I get older.
There’s something to be said. As Alice was saying, you talk to a veterinarian and ask him, “What kind of dog should I get?” I especially am not the right person to ask because all I’m going to tell you is everything that they get wrong with them. There’s a lot of great little dogs out there. We need to do better with these poor brachycephalic dogs. There are whole conferences on brachycephalic disease processes. If you can do an entire conference, continuing education for veterinarians, for these guys, there’s something wrong.
Thank you for being a threepeater, so informative, and a Buckeye to boot. Be well. Thank you so much. Thank you all for tuning in. I learned a lot of big words, folks.
There are a lot of words. I was thinking about that. It’s a lot to try to describe. The one thing I didn’t say was the BREATHE center. A little short thing about that is the folks at the University of Missouri have a whole center that looks at the association between breathing and the gastrointestinal effects of it. They will do complete evaluations of these dogs from stem to stern, as they say, front to back. The cost to have it done at the University of Missouri tends to be less expensive than having it done at a lot of the other tertiary institutions. It’s not a slam on those other places. You can go to a hotel and have this whole evaluation done in Columbia, Missouri.
Don’t fly the dog there.
It’s in the middle of the country. It’s the Bringing Respiration and Aerodigestion Toward Health. It’s fantastic. It’s a great resource for these brachies and reaching out potentially for them. There are a lot of places that do the surgeries. This is a comprehensive place that is unique to them. Versus a lot of other places in the country. I give a shout-out to them. I meant to mention that earlier. Thank you.
Thanks for tuning in. Thank you, Dr. Liesl. We appreciate you.
Thank you so much.
Alice, what do you have to say?
Janet, you’re wrapping it up. Dr. Liesl and I could talk for another two hours.
Thanks for tuning in. Don’t forget to share us, like us, and tell your friends about us. By the way, we’re number three this week in our category, animals and pets. We’re creeping up there. Look out. Thanks for tuning in.
Thanks, everybody. Don’t forget to kiss the pets.
Thank you.
Important Links
- Dr. Liesl Bigge on LinkedIn
- BREATHE Clinic
- Brachycephalic Obstructive Airway Syndrome (BOAS) Resources – WSAVA
- The French Bulldog’s Popularity Comes at a Price | ASPCA
About Dr. Liesl Bigge
Bigge is board-certified as a small animal internal medicine specialist by the American College of Veterinary Internal Medicine. She obtained her veterinary degree from The Ohio State University before pursuing further training at Darien Animal Hospital as a medicine and surgery intern. She then completed her 3-year internal medicine residency at the Tufts University Foster Hospital for Small Animals. Dr. Bigge has spoken at local veterinary association meetings. She is co-owner of Cleveland Associated Veterinary Specialists and also an internal medicine consultant for a large veterinary laboratory. In her spare time, she loves to garden and volunteers extensively for community service and arts organizations.