Survey Reveals Divergent Stakeholder Views on Managing Canine Airway Syndrome in Sweden

A nationwide questionnaire study conducted among Swedish dog owners, dog breeders, dog show judges, and practising veterinarians revealed widespread recognition of conformation-related disorders in short-nosed dogs alongside significant polarization regarding corrective measures and breed standards. Investigating stakeholder perspectives surrounding canine brachycephalic obstructive airway syndrome, the researchers gathered structured survey responses from four distinct cohorts across Sweden between October and November 2021. The resulting dataset confirmed that while nearly all professional and non-professional stakeholder groups acknowledge that respiratory and structural health compromises threaten brachycephalic dogs, opinions diverge sharply on how to counteract these issues. A pronounced division emerged between veterinarians, who overwhelmingly endorsed robust structural interventions including bans on breeding affected animals, and show judges, who expressed resistance to further breeding restrictions while emphasizing strict adherence to established breed standards even when physical features are linked to clinical impairment.

Canine brachycephalic obstructive airway syndrome, widely referred to by the acronym BOAS, has gained substantial international attention following the dramatic surge in popularity of short-muzzled dog breeds over the past two decades. The research team noted that despite international collaborative efforts, educational campaigns, and kennel club directives enacted across various jurisdictions since the first Dog Health Workshop was organized in Stockholm in 2012, brachycephalic health problems remain a pervasive canine welfare concern. In Sweden specifically, breed-specific instructions concerning exaggerated features were adopted in 2009, followed in 2017 by a reporting mechanism for surgical corrections of airway obstruction administered through the Swedish Kennel Club. Nevertheless, previous policy proposals frequently relied upon expert opinions from isolated sectors, leaving the broader distribution of awareness and disagreement across the canine community systematically unmeasured.

To rigorously evaluate how different groups perceive conformation-related canine disorders, the questionnaire was developed collaboratively within the Swedish Collaborative Committee on Canine Health and Welfare. This working body incorporated veterinary epidemiologists and institutional representatives from the Swedish Veterinary Association, the Swedish Board of Agriculture, regional County Administrative Boards, the Swedish University of Agricultural Sciences, the Swedish Centre for Animal Welfare, and the Swedish Kennel Club. Questionnaire design was supported by a specialist statistician, and survey clarity was validated through preliminary cognitive pretesting using read-aloud and think-aloud methodologies with dog owners before final deployment. Prior to distribution, the authors executed a statistical power calculation via Epitools, determining that a minimum sample size of 408 participants per stakeholder cohort was required to reliably detect a ten percentage point difference between groups at an error margin of five percent and a statistical power of eighty percent.

The administrative team distributed the survey electronically through the professional survey platform Netigate, issuing 20,116 invitations alongside a single reminder to non-respondents. Sampling frameworks were stratified across the four cohorts, targeting a random sample of 9,571 owners of general dog breeds and 1,947 owners of four specific focus breeds—namely French bulldogs, English bulldogs, pugs, and Boston terriers—drawn directly from the official state-operated dog owner registry. Additionally, the registry of the Swedish Kennel Club provided a random sample of 4,924 breeders of general dog breeds and 557 breeders of the focus breeds. The survey was also dispatched to all 259 licensed Swedish dog show judges, as well as to all 2,858 veterinarians registered with the Swedish Veterinary Association through a dedicated electronic newsletter link. In total, 4,668 submissions were initially received, representing an unadjusted raw response rate of 23.2 percent, before data quality screening removed 840 incomplete submissions, leaving 3,828 fully completed questionnaires yielding a final completion rate of 19.0 percent.

Following verification and demographic adjustments based on multi-role self-identifications, the completed cohort comprised 1,602 dog owners, 1,551 dog breeders, 118 show judges, and 557 veterinarians. Response rates across individual sectors before reclassification were 15.7 percent among owners, 24.8 percent among breeders, 41.7 percent among show judges, and 19.5 percent among veterinarians. Within the validated respondent population, 465 owners and 137 breeders maintained focus breeds, and 64.2 percent of all participating dog owners reported that their animals were registered with the Swedish Kennel Club. Data were compiled and evaluated in R software version 4.2.1, with categorical proportions evaluated across stakeholder classifications using standard Chi-square tests and Fisher exact tests at a predetermined significance threshold of p below 0.05. Participant anonymization was maintained throughout data handling by stripping all identifiable electronic mail addresses prior to analytical processing.

General awareness of health challenges related to short-nosed canine anatomy was exceptionally high across the entire study sample, although measured levels of direct exposure varied considerably. Nearly all surveyed veterinarians, representing 98.4 percent, reported having heard a substantial amount about conformation-related health issues, compared to 69.5 percent of general dog owners, with negligible shares of owners and breeders reporting complete unawareness at 1.69 percent and 1.03 percent respectively. Furthermore, 98.4 percent of veterinarians stated that they had personally examined or treated at least one brachycephalic dog experiencing conformation-related health issues, while equivalent firsthand encounters ranged from 70.2 percent to 78.5 percent among other participant groups. Notably, 60.5 percent of veterinarians perceived that the clinical occurrence of these disorders had increased over time, while only 1.97 percent noted a perceived decrease. Conversely, among dog show judges, 32.3 percent reported an impression that conformational disorders had decreased, whereas only 20.3 percent of judges perceived an increase.

Personal experiences involving canine health complications diverged markedly between clinical practitioners and competitive show rings. Among individuals interacting with the focus breeds during 2019, 94.8 percent of treating veterinarians reported having diagnosed or managed brachycephalic patients exhibiting appearance-related health problems, whereas only 27.4 percent of show judges assessing those breeds encountered clinically affected dogs. Affected breathing was the primary clinical sign identified across all respondent groups, followed by ocular and dermatological complications, which were observed by 94.8 percent of veterinarians, 62.5 percent of focus breed owners, and 32.4 percent of breeders. Moreover, clinical severity was highlighted by veterinary respondents, with 59.1 percent reporting having euthanized at least one brachycephalic dog due to physical appearance complications, and 36.2 percent reporting that they had performed multiple euthanasias for conditions related directly to anatomical conformation.

When questioned on regulatory interventions, over 90 percent of participants across every stakeholder category expressed full or partial approval of historic measures implemented to mitigate conformational health risks. However, prospective strategies generated substantial conflict. Broad majorities ranging between 77.0 percent and 98.0 percent of veterinarians, breeders, and dog owners favoured additional preventative interventions, whereas only 49.2 percent of show judges supported further measures, with 39.8 percent of judges expressing overt opposition. Selective breeding bans on individual dogs predisposed to clinical signs received widespread support from all groups except show judges. A proposal to ban all breeding of brachycephalic dogs was supported by 75.9 percent of veterinarians, 44.7 percent of dog owners, 36.4 percent of breeders, and just 8.5 percent of show judges, underscoring substantial professional tension regarding systemic breeding policies.

Pronounced divisions also emerged over the fundamental role of kennel club breed standards. A substantial majority of show judges, representing 59.3 percent, agreed fully or partly that adhering strictly to the breed standard remains essential even if it entails associated health issues, whereas only 7.4 percent of veterinarians, 37.9 percent of breeders, and 27.5 percent of owners endorsed that view. Among judges specifically evaluating brachycephalic breeds in 2019, 27.4 percent disagreed that conformational health issues threatened canine health, compared to 11.1 percent of non-brachycephalic judges. Furthermore, among focus breed breeders, 35.8 percent opposed additional corrective actions compared to just 8.6 percent of non-brachycephalic breeders. Conversely, owners of dogs showing active clinical signs were significantly more likely to identify conformation as a serious health threat, with 90.1 percent agreeing compared to 69.3 percent among owners of symptom-free dogs.

The study authors highlighted several methodological limitations, noting that lower response rates among veterinarians might reflect recruitment through an organizational newsletter rather than personalized electronic mail invitations, alongside potential self-selection among participants with preexisting interests in canine airway health. Moreover, the risk of owners underestimating clinical impairment through normalisation remained an important interpretive caveat, as earlier investigations indicated that more than half of owners of dogs with impaired breathing failed to recognize the condition as abnormal. Because Swedish pedigree registrations predominate and national import patterns differ from other countries, findings require careful contextualization, yet the authors concluded that these broad multi-stakeholder patterns remain applicable to international breeding systems. Bridging divergent perceptions between show adjudicators, breeders, and veterinary practitioners remains a critical prerequisite for implementing objective breeding criteria and securing sustainable animal welfare improvements.

Subject of Research: Stakeholder awareness and opinions regarding canine brachycephalic obstructive airway syndrome

Article Title: Awareness, experiences, and opinions by owners, breeders, show judges, and veterinarians on canine Brachycephalic Obstructive Airway Syndrome (BOAS)

Article References: Åsbjer, E., Hedhammar, Å., & Engdahl, K. (2024). Awareness, experiences, and opinions by owners, breeders, show judges, and veterinarians on canine Brachycephalic Obstructive Airway Syndrome (BOAS). Canine Medicine and Genetics, 11(1), Article 3. https://doi.org/10.1186/s40575-024-00137-4

Image Credits: AI Generated

DOI: 10.1186/s40575-024-00137-4

Keywords: canine health, brachycephalic obstructive airway syndrome, veterinary medicine, dog breeding, animal welfare, breed standards, show judges, dog conformation, Awareness, experiences, opinions, owners