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Surgical Options For Treating Boas In The Pug

BOAS stands for “brachycephalic obstructive airway syndrome,” and this name describes a collection of different anatomical problems that can occur in brachycephalic dogs, and which lead to respiratory problems such as shortness of breath, overheating and associated issues.

The pug is one of the best known brachycephalic dog breeds – and they’re also one of the breeds that are most likely to be affected by BOAS.

All dogs with brachycephalic faces have BOAS to some extent – but in dogs whose faces aren’t overly flat or exaggerated, the condition will have little to no impact on them and they will be able to lead a healthy, normal life. However, in dogs whose faces are particularly flat and highly exaggerated, BOAS in its turn will be very pronounced – which has a huge impact on the quality of life and potentially, longevity of affected dogs.

In dogs that suffer badly from BOAS, your vet might recommend surgical intervention to go some way towards correcting the issue and allowing your dog to breathe more easily, greatly improving their quality of life and general health.

If you own a pug and you are concerned about their ability to breathe freely, or if your vet has let you know that they suffer from BOAS and that this is having a negative impact on their health and wellbeing, you might be considering surgical options to help to correct the issue.

In this article, we will look at BOAS surgery for pugs, and cover some of the issues that surgery can correct and how this may help your dog to lead a healthier, happier life. Read on to learn more.

What problems does BOAS cause for affected pugs?

As mentioned, all dogs with a shortened muzzle will have some degree of BOAS, but this only becomes a problem when it is very acute – which your vet may refer to as “clinically significant.”

In pugs who suffer from clinically significant BOAS, they may suffer from laboured breathing even when at rest, loud snoring, exercise intolerance and a tendency to overheating. In the most pronounced cases of BOAS, affected dogs will commonly struggle to breathe, which can lead to fainting and collapse as well as having a huge impact on the dog’s quality of life.

What conformation issues cause BOAS?

There are four different elements to BOAS, and affected pugs may display anything from one to all of them.

The four conformation issues that cause BOAS are:

  • An overly long soft palate.
  • Very pinched or narrow nostrils (known as “stenotic nares).
  • Laryngeal collapse.
  • Tracheal hypoplasia, or an overly small trachea/wind pipe. However, this fourth issue is reasonably uncommon in pugs.

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How can BOAS in pugs be treated and managed?

Not all pugs with clinically significant BOAS will need surgery, and in some cases, other forms of nonsurgical management may be viable or even preferred.

Keeping the dog at a healthy weight is vital for nonsurgical management of BOAS, as fat around the head and neck worsens the issue. Care must be taken to avoid overexertion through exercise, and overheating in hot weather.

For pugs whose BOAS is not overly acute, this may be enough to retain a good quality of life. However, these steps aren’t enough for severe cases of BOAS, which means that surgery may be required to correct the issue enough to allow the dog to thrive.

No surgery can fully reverse or cure the effects of BOAS in the pug, but they can go a long way towards improving their breathing and quality of life as a whole. However, even after a successful surgery, your dog will need special care for the remainder of their life to protect them from overheating and respiratory distress.

Surgical options for treating BOAS in the pug

Depending on the specific or most acute problem or problems that BOAS causes for your pug, various different surgeries may be necessary. Next, we will look at the different corrective surgeries that can be performed on pugs with BOAS, and how they work.

Soft palate surgery

If your dog’s soft palate is overly long and this has a great impact on their ability to breathe and so, quality of life, they might need surgery to reduce its length and help to ease the obstruction of airflow through the airways into the larynx.

Nostril surgery

For dogs with very pinched or narrow nostrils (stenotic nares) surgery might be required to improve airflow and make it easier for the dog to breathe freely. This involves either removing a small piece of cartilage near the front of the nostrils, or paring off a section of skin alongside of the nose to ease the occlusion.

Larynx surgery

Laryngeal collapse can be eased for some dogs if some of the soft tissue that occludes and slows down the normal flow of air through the respiratory system is removed. However, this is only usually effective in dogs with a mild to moderate collapse, and in very extreme cases the only option for permanent correction is a tracheostomy, or a hole being made in the dog’s throat to allow them to breathe through while bypassing the nose and mouth entirely.

A laryngeal tieback may be indicated in some cases instead, but this procedure often produces only a short-term correction.

Tracheal surgery

Tracheal surgery is often avoided where possible due to the risk of anaesthesia on a dog whose breathing is already impaired. However, if tracheal hypoplasia is having an acute long-term effect on your pug’s quality of life, surgical intervention to expand the trachea itself and/or the nostrils too may be indicated.

Tonsil surgery

For some presentations of BOAS in pugs, removing the dog’s tonsils might help too, in order to clear some of the obstruction in the dog’s overly short respiratory system.

Can my normal vet perform BOAS surgery on my pug?

Many general care small animal veterinary clinics won’t perform their own BOAS surgeries in house, as these are very specialist procedures with a lot of variables that tend to require oversight by a specialist in order to achieve a measure of success.

This means that your pug’s vet might refer them to a specialist referral clinic for further assessment and the surgery itself – and you might also need a referral to get a fully detailed diagnosis and treatment plan too.


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