Is advertising brachycephalic pets a help or a hindrance to their welfare?

Brachycephalic pets (BCPs), particularly dogs, have grown tremendously in popularity over the past 10 years with the crowning of the French bulldog as the No. 1 breed in American Kennel Club (AKC) registration for the past 3 years, displacing the 31-year reign of the Labrador retriever.1 Brachycephalic pets are widely recognized to experience a variety of health problems associated with their anatomic changes, including obstructive airway, and gastrointestinal, cardiac, neurological and orthopedic diseases as well as others.2-6 Many clinicians and researchers have raised concern over the popularity of BCP because of man-made negative effects on the quality of life and concerns for the ethics of extreme breeding.7-10

The popularity of a specific breed or breed type may reflect advertisement and popular culture.11 Certain breeds of dogs, namely French bulldogs are considered status symbols. Flat-faced dogs often have the appearance of human babies, with larger eyes and may trigger nurturing behavior.12 In Europe and Australia there has been a call for limiting or removing BCPs from advertisement to try limiting exposure and inadvertent promotion of BCPs.13 Although a recommendation on the use of BCPs in advertising has not been widely disseminated in the United States, the Canadian Veterinary Medical Association has listed extreme confirmation as a “priority area” of concern without issuing a policy.14 One international website has attempted to draw attention to the risk of brachycephaly.15

To determine the prevalence of images of BCPs on websites used to advertise veterinary specialty and emergency practices, a review was initiated author Elizabeth Rozanski, DVM, DACVIM (SAIM), DACVECC, a professor of clinical sciences at the Cummings School of Veterinary Medicine at Tufts University in Medford, Massachusetts. For this review, Rozanski examined websites from the published list of specialty and emergency practices certified by the Veterinary Emergency and Critical Care Society (VECCS)16 and Veterinary Council on Trauma (VetCOT).17 Additionally, 10 large referral practices, 5 in academia and 5 in private practice, which are not VECCS-certified or VetCOT-verified, were selected at random from a list of practices employing American College of Veterinary Emergency and Critical Care diplomates.

Each website was reviewed by one individual and assessed for the presence of BCP images. BCPs were defined as English and French bulldogs, Boston terriers, boxers, Pekinese, pugs, shih-tzu and Persian cats. Cavalier King Charles spaniels were excluded despite some brachycephalic features because of high incidence of degenerative mitral valve disease leading to their appearance on many cardiology pages. Website landing pages were evaluated as were the individual pages for each specialty (eg. emergency/critical care, oncology, cardiology). Images of individual veterinarians pictured with their own BCPs were excluded, as were “success stories” outlining good outcomes of an individual BCP or information pages about brachycephaly. For veterinary schools, only the pages devoted to the teaching hospital were evaluated.

Practices were divided into VECCS certified or not certified, VetCOT verified or not, academic or private practice, and large corporate or smaller corporate. Using GraphPad software, descriptive statistics were calculated. Fisher’s exact tests were used to compare the prevalence of BCP images between groups.

Fifty-one practice websites were evaluated for the review. Brachycephalic images were identified in 26 (51%) websites. The majority (n=12) were French bulldogs, with the remainder including English bulldogs (n= 5), boxers (n=4), Boston terriers (n=3), pugs (n=2), shih-tzus (n=1), Pekingese (n=1), and a single Persian cat. Three sites had 2 brachycephalic images.

Fifteen academic hospitals and 36 private practices were included. One academic center had an English bulldog as a mascot, while other animals or concepts were the mascot for other schools. Six of 15 (40%) of academic hospitals had images of BCPs, while 22/36 (61%) of private practices had brachycephalic animals (p=0.22). For practices that are VECCS-certified, 12/26 (46%) had brachycephalic images, which was not different than non-VECCS certified practices (14/25 [56%], p=0.26). For VetCOT-verified practices, 8/18 (44%) had brachycephalic images, and for non-VetCOT-verified practices, 18/33 (55%) had brachycephalic images (p=0.56). There was no difference (p=1.0) in large versus small corporate practices.

The results of this review show that BCPs are commonly seen on the websites of emergency and specialty hospitals. There is no difference in the type of practices or the certification of the hospital in their apparent likelihood of having BCPs on their websites.

Brachycephalic pets are thought to appeal to people because of their “kindchenschema,” which is group of physical characteristics that mimic those seen in infants, and subsequently appear to encourage people to find them “cute” and want to care for them.12 Whatever their appeal, there this is no doubt that the popularity of brachycephalic pets has increased exponentially in recent years.1,18

One study documented that the breed winning the Westminster Kennel Club did not affect the popularity in the following 5 years.11 However, movies have been shown to increase the popularity of canine breeds featured in them.13 These movies include 101 Dalmatians, which resulted in a marked increase in dalmatians surrendered to shelters19, and a movie about a Belgian Malinois, Dog, that had a similar impact on interest in that species. Additionally, celebrities often pose with their dogs, and French bulldogs are amongst the most popular in tabloids19,20 In a well-known case, pop star Lady Gaga had 2 of her French bulldogs kidnapped and her dog walker critically injured, before ultimately being returned.21

Takeaway

When a breed is popular, there is an increased likelihood of breeding for profit and less concern about health due to potential for profits. It is important to note that many breeders of brachycephalic dogs value the health of the breed.

One approach to trying to limit consumer exposure to potentially dangerous products, such as alcohol or cigarettes, is to ban advertising of the product, either universally or to certain vulnerable audiences. Banning BCPs from advertising and replacing them with dogs with more normal conformation is one step that might help decrease breed popularity and subsequently limit animals severely affected with clinical signs.

The number of websites that demonstrated images of BCPs in the current study was high. In most large practices, a marketing individual or group is responsible for creation of the website, and this may not have input from any clinical staff. Some of the images from observed from large corporate practices appeared to be the same image, despite purportedly representing different hospitals, suggesting a centralized marketing approach or use of stock images. Other potential limitations include that some images were apparently from the COVID-19 era, suggesting less frequent updates. Often the specialty pages did not clearly appear to represent the specialty being promoted, such as a veterinary criticalist performing an otic exam and a stuffed toy tiger undergoing a CT examination. Veterinary practices concerned about the health issues of BCPs should consider the prudence of displaying images of BCPs on their web pages. Marketing arms of practices should partner with clinicians about images displayed.

REFERENCES

1. Most popular dog breeds. American Kennel Club. Accessed July 17, 2025. https://www.akc.org/most-popular-breeds/
2. Packer RM, Tivers MS. Strategies for the management and prevention of conformation-related respiratory disorders in brachycephalic dogs. Vet Med (Auckl). 2015;6:219-232. doi:10.2147/VMRR.S60475
3. De Decker S, Rohdin C, Gutierrez-Quintana R. Vertebral and spinal malformations in small brachycephalic dog breeds: Current knowledge and remaining questions. Vet J. 2024;304:106095. doi:10.1016/j.tvjl.2024.106095.
4. Foster E, West N, Butterfield S, Rusbridge C, Crawford A. Respiratory compromise in French bulldogs presented with intervertebral disc extrusion. Vet Rec. 2023;193(12):e3603. doi:10.1002/vetr.3603. Epub 2023 Nov 8.
5. Scansen BA. Advances in the treatment of pulmonary valve stenosis. Vet Clin North Am Small Anim Pract. 2023;53(6):1393-1414. doi:10.1016/j.cvsm.2023.05.013
6. Packer RM, Hendricks A, Tivers MS, Burn CC. Impact of facial conformation on canine health: Brachycephalic Obstructive Airway Syndrome. PLoS One. 2015;10(10):e0137496. doi:10.1371’journal.pone.0137496
7. Pound L, Farrow M, O'Neill D, Deane DJ, Packer RMA. 'All I do is fight fires': Qualitative exploration of UK veterinarians' attitudes towards and experiences of pre-purchase consultations regarding brachycephalic dogs. Vet Rec. 2024;194(7):e3897. doi:10.1002/vetr.3897. Epub 2024 Feb 20.
8. Paul ES, Coombe E, McGreevy PD, Packer RMA, Neville V. Are brachycephalic dogs really cute? Evidence from online descriptions. Anthrozoos. 2023;36(4):533-553. doi:10.1080/08927936.2023.2176590
9. Ujfalussy DJ, Bognár Z, Molnár M, Miklósi Á, Kubinyi E. The difference between two brachycephalic and one mesocephalic dog breeds' problem-solving performance suggests evidence for paedomorphism in behaviour. Sci Rep. 2023;13(1):14284. doi:10.1038/s41598-023-41229-8.
10. Help stop ‘pugmania’, brachy group tells Disney. Vet Rec. 2018;182(23):649. doi:10.1136/vr.k2518
11. Herzog HA, Elias SM. Effects of winning the Westminster Kennel Club Dog Show on breed popularity. J Am Vet Med Assoc. 2004;225(3):365-7. doi:10.2460/javma.2004.225.365.
12. Paul ES, Packer RM, McGreevy PD, Coombe E, Mendl E, Neville V. That brachycephalic look: Infant-like facial appearance in short-muzzled dog breeds. Anim Welf. 2023;32:e5. doi:10.1017/awf.2022.6
13. Federation of European Companion Animal Veterinary Associations. Accessed July 17, 2025. https://www.fecava.org/wp-content/uploads/2023/09/Brachycephalics-letter-for-media_2023.pdf
14. Priority areas. Canadian Veterinary Medical Association. April 2023. Accessed September 15, 2025. https://www.canadianveterinarians.net/policy-and-outreach/priority-areas/extreme-conformations/#:~:text=The%20CVMA%20is%20currently%20working,seen%20in%20some%20brachycephalic%20animals
15. Why are we here? Vets Against Brachycephalism. Accessed September 15, 2025. https://vetsagainstbrachycephalism.com
16. Veterinary Emergency and Critical Care Society. Facility certification. Accessed September 15, 2025. https://veccs.org/facility-certification/
17. Veterinary Committee on Trauma website. American College of Veterinary Emergency and Critical Care. Accessed September 15, 2025. https://vetcot.org/
18. Celebrities who love French bulldogs: Lady Gaga, Resse Witherspoon, Megan Thee Stallion and more. US Weekly. January 13, 2022. Accessed October 30, 2025. https://www.usmagazine.com/celebrity-news/pictures/celebrities-and-their-french-bulldogs-w201651/
19. Navarro M. After movies, unwanted Dalmatians. New York Times. September 14, 1997. Accessed October 30, 2025. https://www.nytimes.com/1997/09/14/us/after-movies-unwanted-dalmatians.html
20. Ghirlanda, S., Acerbi, A., & Herzog, H. (2014). Dog Movie Stars and Dog Breed Popularity: A Case Study in Media Influence on Choice. PLOS ONE. 2014;9(9):e106565. doi:10.1371/journal.prone.0106565
21. Martinez GR. Lady Gaga does not have to pay $500,000 reward to woman involved in dognapping case, judge rules. CBS News. October 4, 2023. Accessed October 30, 2025. https://www.cbsnews.com/news/lady-gaga-no-500000-dollar-reward-jennifer-mcbride-dognapping-lawsuit-los-angeles-french-bulldogs-robbery/