Is it now time to iron out the wrinkles? Health of Shar Pei dogs under primary veterinary care in the UK.

BACKGROUND: The Shar Pei is a common dog breed with a distinctive appearance caused by hyaluronosis that has been linked with several health conditions. Anonymised primary-care veterinary clinical records were explored to extract data on the demography, common disorders and mortality of Shar Pei in the UK in 2013. RESULTS: The study population of 455,557 dogs included 1913 (0.42%) Shar Pei. The mean adult bodyweight was 22.26 kg. The most prevalent fine-level precision disorders were entropion (prevalence 17.88%, 95% CI: 16.16-19.59), otitis externa (16.36%, 95% CI: 14.70-18.02), ear disorders (6.69%, 95% CI: 5.57-7.81), aggression (5.23%, 95% CI: 4.23-6.22), and pyoderma (4.29%, 95% CI: 3.38-5.19). The most prevalent disorder groups were ophthalmologic (prevalence = 22.27%, 95% CI: 20.40-24.13), dermatological (21.01%, 95% CI: 19.19-22.84), aural (18.66%, 95% CI: 16.92-20.41), traumatic injury (7.53%, 95% CI: 6.35-8.71) and behavioural (7.21%, 95% CI: 6.05-8.37). The median longevity of 190 Shar Pei that died during the study period was 7.28 years (IQR 5.04-10.05, range 0.04-15.04). Of 184 deaths with a recorded method of death, 157 (85.33%) deaths involved euthanasia and 27 (14.67%) deaths were unassisted. Among 136 (71.58%) deaths with a recorded biomedical cause of death, the most common causes of death at group level precision were neoplasia (15.44%, 95% CI: 9.37-21.51), renal disorders (13.24%, 95% CI: 7.54-18.93), and behavioural disorders (11.03%, 95% CI: 5.76-16.29). CONCLUSIONS: Almost one fifth of Shar Pei receive veterinary care each year for entropion, a condition linked strongly with the extreme conformation of thickened and folded skin and bristly hair that characterises the Shar Pei breed. Several other common disorders are also linked to hyaluronosis. Current UK legislation can help support efforts to avoid breeding or acquiring animals with extreme conformations and to promote adequate veterinary care for already-owned animals with extreme conformations.

The Shar Pei dog breed is instantly recognisable by their copious loose folded skin and bristly coat, with Shar Pei translating from Chinese as 'sand paper skin'. Although originally a fighting, hunting and guarding dog in China, the Shar Pei breed was re-invented in the US as a companion animal in the late 1970s where a more wrinkled and heavy-set American 'meat mouth' variety replaced the traditional 'bone mouth' variety originally popular in China. However, the underlying disease of hyaluronosis that causes the characteristic extreme appearance of the Shar Pei has also been linked with several other health problems in the breed such as in-turned eyelids (entropion) and ear disease. Using anonymised veterinary clinical records collected within the VetCompass Programme at the Royal Veterinary College (RVC), Shar Pei made up 0.4% of all dogs in the UK in 2013 and had an average adult bodyweight of 22 kg. The most common specific disorders diagnosed in Shar Pei were in-turned eyelids (17.88%), ear infection (16.36%), ear problems (6.69%), aggression (5.23%), and skin infection (4.29%). Among the 30 most common specific disorders, females were more likely to show in-turned eyelids and conjunctivitis, while males were more likely to show aggression and infected paws. Once the disorders were grouped, the most common disorder groups were eye disorders (22.27%), skin (21.01%), ear (18.66%), traumatic injury (7.53%), and behavioural (7.21%). The average lifespan of Shar Pei was 7.28 years. The most common causes of death were cancer (15.44%,), kidney disorders (13.24%), and behavioural disorders (11.03%). This study highlights that almost one fifth of the breed receive veterinary care each year for in-turned eyelids that can lead to extreme pain and are linked to the thickened and folded skin that humans find so appealing in this breed. Current UK legislation can help support concerted efforts from all animal welfare stakeholders to avoid breeding or acquiring animals with these and other extreme conformations and to promote adequate veterinary care for already-owned animals with extreme conformations.

A Review of Clinical Outcomes, Owner Understanding and Satisfaction following Medial Canthoplasty in Brachycephalic Dogs in a UK Referral Setting (2016-2021).

Brachycephalic breeds have increased in popularity despite growing awareness of their predisposition to a wide range of conformation-related diseases. The extreme facial conformation of many popular brachycephalic breeds compromises their ocular surface health, increasing the risk of painful corneal ulceration. Medial canthoplasty (MC) is a surgical procedure to address ocular abnormalities in brachycephalic dogs, which are collectively referred to as brachycephalic ocular syndrome (BOS). This study retrospectively reviewed the records of dogs recommended MC at a referral hospital between 2016 and 2021. A questionnaire was designed to identify owners' perceptions pre- and post-operatively. From 271 brachycephalic dogs recommended MC, 43.5% (118/271) underwent surgery and 72.0% (85/118) were Pugs. The majority of dogs (73.7%, 87/118) that underwent surgery had current or historical corneal ulceration. Follow-up was available in 104 dogs, of which 5.7% (6/104) had corneal ulceration post-operatively. Sixty-four owners completed the questionnaire and reported post-operative corneal ulceration in 12.5% of dogs (8/64), reduced ocular discharge (70.8%, 34/48), reduced ocular irritation (67.7%, 21/31) and less periocular cleaning (52.5%, 32/61). Owners were satisfied with the clinical (85.9%, 55/64) and cosmetic (87.5%, 56/64) outcome. In conclusion, MC has high clinical relevance for the surgical management of BOS, restoring functional conformation and improving the quality of life of affected dogs.

Demography, common disorders and mortality of Boxer dogs under primary veterinary care in the UK.

BACKGROUND: The Boxer is a popular dog breed with a distinctive appearance. However, the breed has been linked with several health conditions, some of which have been associated with its moderately brachycephalic conformation and its white colouration. Anonymised primary-care veterinary clinical records were explored to extract data on the demography, common disorders and mortality of Boxers in the UK in 2016. RESULTS: The study population of 336,865 dogs included 3,219 (0.96%) Boxers, of which 10.71% were recorded as white. The mean adult bodyweight was 30.43 kg (SD 5.73 kg). Annual disorder counts did not differ statistically between the sexes or between white and non-white Boxers. The most prevalent fine-level precision disorders were otitis externa (n = 230, 7.15%), epulis (188, 5.84%), corneal ulceration (161, 5.00%) and periodontal disease (149, 4.63%). Of the 34 most common fine-level disorders, none differed in prevalence between white and non-white dogs. The most prevalent disorder groups were skin disorder (n = 571, 17.74%), neoplasia (457, 14.20%) and ear disorder (335, 10.41%). White Boxers had higher prevalence than non-white Boxers for two disorder groups: dental disorder and brain disorder. The median longevity of 346 Boxers that died during the study was 10.46 years (IQR 9.00-11.98, range 2.76-18.00). Median longevity did not differ statistically between the sexes or between white and non-white Boxers. The most common grouped causes of death were death - unrecorded cause (n = 73, 21.10%), neoplasia (43, 12.43%) and brain disorder (33, 9.54%). CONCLUSIONS: There was minimal evidence of substantial health differences between white and non-white Boxers. Among the four most common disorders recorded in Boxers, two were typically common across all types of dogs (otitis externa and periodontal disease) while two suggested strong predispositions for the Boxer breed (epulis and corneal ulceration), showing the value of eliciting breed-specific disorder patterns for insights for potential health reforms. The overall longevity of Boxer dogs was consistent with other breeds of similar body size.

The Boxer is a medium-large sized, active dog with a short coat and a moderately flat-faced (brachycephalic) skull shape. Despite many decades of popularity in the UK, there is limited published evidence on the overall health profile of Boxers. White-coloured Boxers are thought to be at higher risk of deafness from birth and as a result, white Boxers have traditionally often been culled at birth by breeders.Using anonymised veterinary clinical records collected within the VetCompass Programme at the Royal Veterinary College (RVC), Boxers made up around 1% of all dogs in the UK in 2016, with an average adult bodyweight around 30 kg. The most common colours were brindle (22.82%), dark red (22.62%) and dark red multi-colour (20.92%), with 10.71% white Boxers. Across the 3,219 Boxers in the study, 73.97% had at least one disorder recorded during 2016. The average number of disorders per year did not differ statistically between female and male Boxers, or between white and non-white Boxers. The most common specific disorders in Boxers were ear infection (7.15%), gum mass (5.84%), eye ulcer (5.00%) and dental disease (4.63%). White and non-white dogs did not differ in their risk for any of the 34 most common specific disorders. Only two dogs in the study were recorded with deafness; one white and one non-white. The average lifespan of Boxers overall was 10.46 years. Lifespan did not differ statistically between female and male Boxers, or between white and non-white Boxers.This study identifies ongoing popularity for the Boxer in the UK, with around 10% of these Boxers being white. There was minimal evidence of health differences between male and female Boxers, or between white and non-white Boxers. Among the four most common disorders recorded in Boxers, two are typically common across all types of dogs (ear and dental disease) while two showed strong predisposition in the Boxer breed (gum mass and eye ulcer), suggesting the value of understanding breed-specific health patterns to prioritise health plans for each breed. The overall longevity of Boxer dogs was typical of other breeds of this body size.

English Bulldogs in the UK: a VetCompass study of their disorder predispositions and protections.

BACKGROUND: The English Bulldog has risen sharply in popularity over the past decade but its distinctive and extreme conformation is linked to several serious health conditions. Using multivariable analysis of anonymised veterinary clinical data from the VetCompass Programme, this study compared the odds of common disorders between English Bulldogs and all remaining dogs in the UK during 2016. RESULTS: From 905,544 dogs under veterinary care during 2016, the analysis included a random sample of 2,662 English Bulldogs and 22,039 dogs that are not English Bulldogs. English Bulldogs had 2.04 times the odds of diagnosis with ≥ 1 disorder than dogs that are not English Bulldogs (95% confidence interval [CI] 1.85 to 2.25). At a specific-level of diagnostic precision, English Bulldogs had increased odds of 24/43 (55.8%) disorders. These included: skin fold dermatitis (odds ratio [OR] 38.12; 95% CI 26.86 to 54.10), prolapsed nictitating membrane gland (OR 26.79; 95% CI 18.61 to 38.58) and mandibular prognathism (OR 24.32; 95% CI 13.59 to 43.53). Conversely, English Bulldogs had significantly reduced odds of 6/43 (14.0%) disorders. These included: retained deciduous tooth (OR 0.02; 95% CI 0.01 to 0.17), lipoma (OR 0.06; 95% CI 0.01 to 0.40) and periodontal disease (OR 0.23; 95% CI 0.18 to 0.30). At a grouped-level of diagnostic precision, English Bulldogs had significantly increased odds of 17/34 (50.0%) disorders. These included: congenital disorder (OR 7.55; 95% CI 5.29 to 10.76), tail disorder (OR 6.01; 95% CI 3.91 to 9.24) and lower respiratory tract disorder (OR 5.50; 95% CI 4.11 to 7.35). Conversely, English Bulldogs had significantly reduced odds of 3/34 (8.8%) disorders. These were: dental disorder (OR 0.25; 95% CI 0.20 to 0.31), spinal cord disorder (OR 0.31; 95% CI 0.14 to 0.71) and appetite disorder (OR 0.43; 95% CI 0.20 to 0.91). CONCLUSIONS: These results suggest that the health of English Bulldogs is substantially lower than dogs that are not English Bulldogs and that many predispositions in the breed are driven by the extreme conformation of these dogs. Consequently, immediate redefinition of the breed towards a moderate conformation is strongly advocated to avoid the UK joining the growing list of countries where breeding of English Bulldogs is banned.

The English Bulldog has risen sharply in popularity over the past decade in the UK. However, its distinctive and extreme conformation has raised concerns because many of these physical features render the breed prone to serious health conditions. There are increasing international efforts to either reform the breed towards a more moderate conformation or, in the absence of such change, to ban the breeding of these dogs on welfare grounds.This VetCompass study explored random samples of anonymised veterinary clinical records from 2,662 English Bulldogs and 22,039 dogs that are not English Bulldogs from an overall population of 905,544 dogs under veterinary care during 2016 in the UK to identify all health disorders recorded for each dog during 2016. The most common disorders in each group were identified and the risks for the most common disorders overall was compared between the English Bulldogs and dogs that are not English Bulldogs.English Bulldogs were younger (2.65 years vs 4.42 years) and heavier (25.55kg vs 13.54kg) than dogs that are not English Bulldogs. English Bulldogs had 2.04 times the risk of diagnosis with at least one disorder during 2016 compared with dogs that are not English Bulldogs. English Bulldogs had increased risk for 24/43 (55.8%) disorders compared to dogs that are not English Bulldogs. The disorders with the highest risk in English Bulldogs included skin fold dermatitis (× 38.12), prolapsed nictitating membrane gland [cherry eye] (× 26.79), protruding lower jaw (× 24.32), brachycephalic obstructive airway syndrome [BOAS] (× 19.20) and interdigital cyst (× 12.96). Conversely, English Bulldogs had significantly reduced risk of 6/43 (14.0%) disorders compared to dogs that are not English Bulldogs. These included: retained deciduous [baby] tooth (× 0.02), lipoma [fatty mass] (× 0.06), dental disease (× 0.23), itchy skin (× 0.25) and flea infestation (× 0.40).The results of this study suggest that the overall health of the English Bulldog is much lower than dogs that are not English Bulldogs. Many of the disorder predispositions reported in this study are intrinsically related to the extreme conformation of English Bulldogs. Redefining the body-shape of the breed away from its current extreme conformation and towards a moderate conformation is advocated for urgent action to avoid the UK joining the growing list of countries where breeding of English Bulldogs is banned.

Health of Pug dogs in the UK: disorder predispositions and protections.

BACKGROUND: Pugs are a brachycephalic dog breed that has become phenomenally popular over recent decades. However, there is growing concern about serious health and welfare issues in the breed. To augment the evidence-base on the comparative health of Pugs, this study aimed to compare the odds of common disorders between Pugs and all remaining dogs under primary veterinary care in the UK during 2016. A cross-sectional study design of VetCompass clinical records was used to estimate the one-year (2016) period prevalence for the disorders most commonly diagnosed in Pugs and non-Pugs. Risk factor analysis applied multivariable logistic regression modelling methods to compare the odds of 40 common disorders between Pugs and non-Pugs. RESULTS: From a study population of 905,544 dogs, the analysis included random samples of 4308 Pugs and 21,835 non-Pugs. Pugs were younger (2.36 years, range 0.07-16.24 vs 4.44 years, range 0.01-20.46, p <  0.001) and lighter (8.95 kg, range 5.00-13.60 vs. 14.07 kg, range 1.41-85.00, p <  0.001) than non-Pugs. Pugs had 1.86 (95% confidence interval [CI] 1.72 to 2.01) times the adjusted odds of diagnosis with ≥1 disorder than non-Pugs. Pugs had significantly increased adjusted odds for 23/40 (57.5%) common disorders. These included: brachycephalic obstructive airway syndrome (odds ratio [OR] 53.92; 95% CI 36.22 to 80.28), stenotic nares (OR 51.25; 95% CI 24.93 to 105.37) and corneal ulceration (OR 13.01; 95% CI 10.50 to 16.11). Conversely, Pugs had significantly reduced adjusted odds of 7/40 (17.5%) common disorders compared to non-Pugs. These included: heart murmur (OR 0.23; 95% 0.13 to 0.14), lipoma (OR 0.24; 95% CI 0.11 to 0.55) and aggression (OR 0.31; 95% CI 0.21 to 0.47). CONCLUSIONS: The current study highlights that predispositions outnumber protections between Pugs and non-Pugs for common disorders, suggesting some critical health welfare challenges to overcome for Pugs. Highly differing heath profiles between Pugs and other dogs in the UK suggest that the Pug has diverged substantially from mainstream dog breeds and can no longer be considered as a typical dog from a health perspective.

Pugs have become phenomenally popular in the UK over recent decades. The breed has a flat-faced look (brachycephalic) that many humans find highly attractive and 'cute' but this flat face is also linked to several serious health problems. Consequently, there is growing concern about the welfare issues associated with the popularity and health issues of Pugs. To get a better overall perspective on the health of Pugs, this study aimed to compare the risks of common disorders between Pugs and all remaining dogs.The study collected clinical information from first opinion veterinary practices in the UK that were participating in VetCompass. Dogs were grouped as either Pugs or non-Pugs. Information was gathered from the clinical records on all disorders diagnosed in each group during 2016 and a list of the most common disorders in each group was generated.From 905,544 dogs in the overall study, there were 16,218 (1.79%) Pugs and 889,326 (98.21%) non-Pugs. Pugs (2.36 years, interquartile range [IQR] 1.16­4.53) were generally younger than non-Pugs (4.44 years, IQR 1.90­8.12). Pugs (8.95 kg, IQR 7.80­10.17) were also generally lower in bodyweight than non-Pugs (14.07 kg, IQR 8.15­25.20). From a combined list of 40 common disorders among both groups of dogs, Pugs had increased risk for 23 (57.5%) but had reduced risk for 7 (17.5%) disorders compared to non-Pugs. The disorders with the highest relative risk in Pugs included brachycephalic obstructive airway syndrome (BOAS) (× 53.92 risk), narrowed nostrils (× 51.25), eye ulceration (× 13.01), and skin fold infection (× 10.98). Disorders with the lowest relative risk in Pugs included heart murmur (× 0.23), fatty lump (× 0.24), aggression (× 0.31), and wounds (× 0.53).The study provides a broad evidence base on the positive and negative aspects of the health of Pugs. Disease predispositions were more common than disease protections, confirming the hypothesis that there are many critical health-related welfare challenges to overcome for Pugs. The widely differing health profiles between Pugs and other dogs in the UK suggest that the Pug has now diverged to such an extent from mainstream dog breeds that it can no longer be considered as a typical dog from a health perspective.

Proportion and risk factors for death by euthanasia in dogs in the UK.

The loss of a pet can be particularly distressing for owners, whether the method of death is euthanasia or is unassisted. Using primary-care clinical data, this study aimed to report the demographic and clinical factors associated with euthanasia, relative to unassisted death, in dogs. Method of death (euthanasia or unassisted) and clinical cause of death were extracted from a random sample of 29,865 dogs within the VetCompass Programme from a sampling frame of 905,544 dogs under UK veterinary care in 2016. Multivariable logistic regression modelling was used to evaluate associations between risk factors and method of death. Of the confirmed deaths, 26,676 (89.3%) were euthanased and 2,487 (8.3%) died unassisted. After accounting for confounding factors, 6 grouped-level disorders had higher odds in euthanased dogs (than dogs that died unassisted), using neoplasia as the baseline. The disorders with greatest odds included: poor quality of life (OR 16.28), undesirable behaviour (OR 11.36) and spinal cord disorder (OR 6.00). Breed, larger bodyweight and increasing age were additional risk factors for euthanasia. The results highlight that a large majority of owners will face euthanasia decisions and these findings can support veterinarians and owners to better prepare for such an eventuality.

Great expectations, inconvenient truths, and the paradoxes of the dog-owner relationship for owners of brachycephalic dogs.

Popularity of brachycephalic (flat-faced) dog breeds is increasing internationally despite well-documented intrinsic health and welfare problems associated with their conformation. Given this apparent paradox, greater understanding of the expectations and reality for brachycephalic dog owners and factors driving the dog-owner bond are needed. This study reports a large-scale online survey with valid responses from 2168 owners of brachycephalic dogs (Pugs: n = 789, median age of dogs 2.5 years; French Bulldog: n = 741, median age 2.0 years; Bulldogs: n = 638, median age 2.5 years). The most common owner-reported disorders in their dogs were allergies, corneal ulcers, skin fold infections and Brachycephalic Obstructive Airway Syndrome (BOAS). One-fifth (19.9%) of owners reported that their dog had undergone at least one conformation-related surgery, 36.5% of dogs were reported with a problem with heat regulation, and 17.9% with problems breathing. Despite awareness of their dog's health issues, 70.9% owners considered their dog to be in very good health or the best health possible. Paradoxically, just 6.8% of owners considered their dog to be less healthy than average for their breed. Dog owner-relationships were extremely strong across all three breeds. Emotional closeness to their dog was highest for owners of Pugs, female owners, and owners with no children in the household. Ownership of brachycephalic dog breeds is a complex phenomenon, characterised by extremely strong dog-owner relationships and unrealistic perceptions of good health set against high levels of disease in relatively young dogs. Perceptual errors in owner beliefs appear to exist between brachycephalic owner perspectives of their own dog's health versus the health of the rest of their breed, which may be fuelled by cognitive dissonance processes. These novel data improve our understanding of the cognitive processes and relationships that facilitate the rising popularity of breeds that paradoxically are affected by high levels of conformation-related morbidity.

Investigating the potential of the anti-epileptic drug imepitoin as a treatment for co-morbid anxiety in dogs with idiopathic epilepsy.

BACKGROUND: Behavioural changes associated with idiopathic epilepsy (IE) have been identified in dogs, with fear and anxiety-related problems seen in both drug-naïve dogs and dogs treated with anti-epileptic drugs (AEDs). Treating anxiety-related behaviour in dogs with IE may be challenging, as seizures are a contraindication for many conventional anxiolytic drugs. In addition, many dogs with IE are already treated with AEDs to reduce their seizure frequency, which may have negative effects if used in polytherapy. Imepitoin is low-affinity partial agonist at the benzodiazepine (BDZ) site of the GABAA receptor, and has been demonstrated to have both anticonvulsant and anxiolytic effects in laboratory rodents. Imepitoin has been developed for the treatment of IE in dogs, with demonstrated anticonvulsant effects and high tolerability and safety. To date, imepitoin's potential to reduce anxiety in dogs with IE has not been investigated. An online survey was conducted to investigate the effect of imepitoin on fear and anxiety-related behaviours in dogs with IE. Eighty-five valid responses were received from owners of dogs with IE currently treated with imepitoin. Anxiety-related behaviour was quantified before and during imepitoin treatment using a validated questionnaire tool (C-BARQ). RESULTS: No differences were observed in the five fear/anxiety-related measures between the two time periods (before vs. during treatment) for dog directed fear, stranger directed fear, non-social fear, pain sensitivity and separation related behaviour. A median 45% reduction in seizure frequency/month was observed following imepitoin treatment; however, imepitoin did not appear effective in reducing seizure frequency in a minority of cases. Polyphagia was the most common chronic side effect, and more side effects were reported in polytherapy cases. CONCLUSIONS: Imepitoin does not appear to improve anxiety-related behaviour in dogs with IE treated with this medication for its anti-epileptic effects. Investigating the effects of imepitoin upon the behaviour of dogs with recognised behavioural anxiety-related problems (e.g. specific fears and phobias, separation related behaviours), in both healthy dogs and dogs with epilepsy is required to further explore any potential anxiolytic effects of this medication.

How long and low can you go? Effect of conformation on the risk of thoracolumbar intervertebral disc extrusion in domestic dogs.

Intervertebral disc extrusion (IVDE) is a common neurological disorder in certain dog breeds, resulting in spinal cord compression and injury that can cause pain and neurological deficits. Most disc extrusions are reported in chondrodystrophic breeds (e.g. Dachshunds, Basset Hounds, Pekingese), where selection for 'long and low' morphologies is linked with intervertebral discs abnormalities that predispose dogs to IVDE. The aim of this study was to quantify the relationship between relative thoracolumbar vertebral column length and IVDE risk in diverse breeds. A 14 month cross-sectional study of dogs entering a UK small animal referral hospital for diverse disorders including IVDE was carried out. Dogs were measured on breed-defining morphometrics, including back length (BL) and height at the withers (HW). Of 700 dogs recruited from this referral population, measured and clinically examined, 79 were diagnosed with thoracolumbar IVDE following diagnostic imaging ± surgery. The BL:HW ratio was positively associated with IVDE risk, indicating that relatively longer dogs were at increased risk, e.g. the probability of IVDE was 0.30 for Miniature Dachshunds when BL:HW ratio equalled 1.1, compared to 0.68 when BL:HW ratio equalled 1.5. Additionally, both being overweight and skeletally smaller significantly increased IVDE risk. Therefore, selection for longer backs and miniaturisation should be discouraged in high-risk breeds to reduce IVDE risk. In higher risk individuals, maintaining a lean body shape is particularly important to reduce the risk of IVDE. Results are reported as probabilities to aid decision-making regarding breed standards and screening programmes reflecting the degree of risk acceptable to stakeholders.