Surgical options for treating BOAS in Pugs: 2025 UK Guide

Brachycephalic Obstructive Airway Syndrome (BOAS) presents a range of anatomical challenges in brachycephalic dog breeds like the pug puppies, which can lead to significant respiratory difficulties such as laboured breathing, overheating, and exercise intolerance.

While all dogs with flat faces exhibit some degree of BOAS, it becomes clinically significant only in breeds like the pug with highly exaggerated skull shapes. In these cases, the syndrome greatly impacts the dog's welfare and longevity. When conservative management fails, surgery is often recommended to ease airway obstruction and improve breathing, thus enhancing the dog’s quality of life.

Understanding BOAS and Its Impact on Pugs

Clinically significant BOAS in pugs manifests in symptoms including loud snoring, difficulty breathing even at rest, overheating, and reduced exercise capacity. In severe instances, this may lead to fainting or collapse. Recognising these signs early is vital to seeking timely veterinary advice and potential intervention.

BOAS arises from several conformational issues common in pugs, primarily:

• An excessively long soft palate that obstructs airflow.
• Narrowed nostrils (stenotic nares) reducing air intake.
• Laryngeal collapse, affecting the airway's structural integrity.
• Tracheal hypoplasia, a smaller than normal windpipe, which is less common but can worsen symptoms.

Managing BOAS Without Surgery

Not all pugs require surgical treatment. Weight management is critical since excess fat around the neck exacerbates breathing issues. Owners should avoid stressing or overheating their dogs and monitor activity intensity. For mild cases, such management can sustain good health and comfort. However, severe or worsening symptoms usually necessitate surgical options.

Key Surgical Treatments for BOAS in Pugs

BOAS surgery targets the anatomical abnormalities that obstruct airways. Veterinary specialists typically tailor the approach based on the dog’s specific problems, often combining procedures as needed.

Soft Palate Resection

Reducing the length or bulk of the soft palate helps clear the airway, allowing easier airflow into the larynx. Techniques now include minimally invasive radiofrequency methods that limit bleeding and promote quicker recovery.

Nostril Surgery (Stenotic Nares Correction)

This procedure widens the nostrils by removing small tissue wedges or cartilage sections to improve airflow. It is a highly effective surgery to enhance breathing in pugs.

Laryngeal Surgery

When laryngeal collapse is mild to moderate, removal of obstructing laryngeal saccules can improve airflow. Severe collapse cases may require tracheostomy, creating a surgical airway bypassing upper obstructions. A laryngeal tieback is another option but often offers only temporary relief.

Tracheal Surgery

Due to anaesthetic risks, tracheal surgery is sparingly used, reserved only for severe tracheal hypoplasia significantly impacting breathing and life quality.

Tonsil Removal

In some cases, tonsillectomy may be needed to clear additional airway obstruction.

The Importance of Specialist Vet Care

BOAS surgeries are complex and best performed in referral clinics by surgical specialists. Your veterinary surgeon may recommend referral for detailed assessment and surgical planning. This specialised care improves surgical success and long-term outcomes.

Post-operative Care and Lifelong Management

Post-surgery, pugs require a calm, cool environment and attentive care to minimise stress and overheating risks. Their diet should be soft and given in small portions to ease swallowing. Owners must monitor for breathing difficulties, regurgitation, or other complications and maintain scheduled veterinary follow-ups.

Pain management and weight control remain vital to ongoing comfort. Surgery significantly improves symptoms but does not cure BOAS entirely. Lifelong vigilance to prevent overheating and respiratory distress is essential.

Latest UK Veterinary Consensus and Welfare Initiatives

In 2025, the UK introduced mandatory Respiratory Function Grading (RFG) for pug, English Bulldog, and French Bulldog show entrants, underscoring commitment to respiratory health. Dogs with severe BOAS are barred from competition, encouraging responsible breeding and early health intervention.

Prospective pug owners should seek out breeders prioritising BOAS screening and consider RFG assessments to select healthier puppies, fostering better breed health long term.

Summary and Responsible Ownership

BOAS is a challenging condition for brachycephalic dogs like pugs, but modern surgical techniques offer meaningful relief and quality of life improvements for affected pets. Early veterinary assessment, specialist surgical care, and comprehensive post-operative management underpin the best outcomes.

As BOAS cannot be fully cured, owners must commit to ongoing care and prevention strategies, including weight management and avoiding heat stress. Responsible ownership and ethical breeding are key pillars in addressing this breed-specific health issue.

For those considering a pug, use tools such as the reputable pug breeders and RFG screenings to support healthier puppy selection and improved welfare.