title: Epidemiological associations between brachycephaly and upper respiratory tract disorders in dogs attending veterinary practices in England.
abstract: BACKGROUND
  Brachycephalic dog breeds are increasingly common. Canine brachycephaly has been associated with upper respiratory tract (URT) disorders but reliable prevalence data remain lacking. Using primary-care veterinary clinical data, this study aimed to report the prevalence and breed-type risk factors for URT disorders in dogs.
  
  
  RESULTS
  The sampling frame included 170,812 dogs attending 96 primary-care veterinary clinics participating within the VetCompass Programme. Two hundred dogs were randomly selected from each of three extreme brachycephalic breed types (Bulldog, French Bulldog and Pug) and three common small-to medium sized breed types (moderate brachycephalic: Yorkshire Terrier and non-brachycephalic: Border Terrier and West Highland White Terrier). Information on all URT disorders recorded was extracted from individual patient records. Disorder prevalence was compared between groups using the chi-squared test or Fisher's test, as appropriate. Risk factor analysis used multivariable logistic regression modelling. During the study, 83 (6.9 %) study dogs died. Extreme brachycephalic dogs (median longevity: 8.6 years, IQR: 2.4-10.8) were significantly younger at death than the moderate and non-brachycephalic group of dogs (median 12.7 years, IQR 11.1-15.0) (P < 0.001). A higher proportion of deaths in extreme brachycephalic breed types were associated with URT disorders (4/24 deaths, 16.7 %) compared with the moderate and non-brachycephalic group (0/59 deaths, 0.0 %) (P = 0.001). The prevalence of having at least one URT disorder in the extreme brachycephalic group was higher (22.0 %, 95 % confidence interval (CI): 18.0-26.0) than in the moderate and non-brachycephalic group (9.7 %, 95 % CI: 7.1-12.3, P < 0.001). The prevalence of URT disorders varied significantly by breed type: Bulldogs 19.5 %, French Bulldogs 20.0 %, Pugs 26.5 %, Border Terriers 9.0 %, West Highland White Terriers 7.0 % and Yorkshire Terriers 13.0 % (P < 0.001). After accounting for the effects of age, bodyweight, sex, neutering and insurance, extreme brachycephalic dogs had 3.5 times (95 % CI: 2.4-5.0, P < 0.001) the odds of at least one URT disorder compared with the moderate and non-brachycephalic group.
  
  
  CONCLUSIONS
  In summary, this study reports that URT disorders are commonly diagnosed in Bulldog, French Bulldog, Pug, Border Terrier, WHWT and Yorkshire Terrier dogs attending primary-care veterinary practices in England. The three extreme brachycephalic breed types (Bulldog, French Bulldog and Pug) were relatively short-lived and predisposed to URT disorders compared with three other small-to-medium size breed types that are commonly owned (moderate brachycephalic Yorkshire Terrier and non-brachycephalic: Border Terrier and WHWT).
authors.affiliation: The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA, UK.
authors.forename: Dan G
authors.initials: DG
authors.lastname: O'Neill
authors.affiliation: School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Jackson
authors.affiliation: School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Guy
authors.affiliation: The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA, UK.
authors.forename: David B
authors.initials: DB
authors.lastname: Church
authors.affiliation: Gunn Building (B19), Faculty of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Paul D
authors.initials: PD
authors.lastname: McGreevy
authors.affiliation: Gunn Building (B19), Faculty of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Thomson
authors.affiliation: The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA, UK.
authors.forename: Dave C
authors.initials: DC
authors.lastname: Brodbelt
keywords: Breed type; Dog; Extreme brachycephalic; Moderate brachycephalic; Non-brachycephalic; Upper respiratory; VetCompass; primary-care