Dogs with flattened faces, such as bulldogs, French bulldogs, and pugs, are becoming ever more popular. Yet these breeds are all susceptible to numerous health conditions, to the point where a 2013 survey of veterinarians found that their welfare is too poor to justify continued breeding. To understand the paradoxical popularity of these breeds despite increasing awareness of their compromised welfare, this study explores the beliefs and perceptions of people with flat-faced (or brachycephalic) companion animals.

Surveying over two thousand people with companion pugs, French bulldogs, or bulldogs, this study set out to describe the experiences for guardians, compare them across the three breeds, and explore how health issues impact the human-animal bond. The survey involved six groups of questions, covering demographics, veterinary history, airway problems, guardian perceptions of their dog’s health, guardian expectations, and the relationship between the dog and the human.

Upsettingly, the majority of dogs were less than five years old, and since their health problems are expected to worsen with time, it’s shocking how unhealthy the young dogs already were. Almost one in five guardians reported that their dogs had undergone at least one surgery, most commonly nostril widening (especially among French bulldogs) and eyelid surgery (especially among bulldogs). Clinically-relevant airway problems affected nearly 40% of dogs; such problems can harm their ability to eat, sleep, and to cope with heat in particular. In addition to airway problems, the dogs also commonly suffered from eye, spine, and skin problems.

Despite the evidence of various health conditions, guardians described their dogs as in the “best health possible” (30%) or “very good health” (41%). Over 60% believed their dogs to be much healthier or healthier than average for the breed, but over 20% found the vet bills for their companion animal to be higher than expected.

Noting the contrast between perceived and described health, the study observed that health issues like struggling to breathe seem normalized among guardians of flat-faced dogs. A dog sleeping while sitting upright, for example, may seem like a cute quirk; in reality, it’s a symptom of breathing difficulties. Worryingly, this normalization may cause dogs to suffer more, since their humans may not recognize and seek help for their health problems.

The results of this study are distressing, but it’s not all bad. Many guardians seem to love their dogs. The Monash Dog Owner Relationship Scale was used to score the bond between companion animal and guardian. Generally, scores were high, averaging above 4 on a 5-point scale covering interactions, emotional closeness, and costs of guardianship (where a higher score reflects lower perceived costs). Women and owners without children scored particularly high in emotional closeness to their dogs, which the study suggests may be related to the role that companion animals fill, akin to a child.

We love our companion animals, and want them to be healthy. So we need to overcome the apparent cognitive dissonance between the perceptions and reality of health issues among flat-faced dogs. We can’t help these dogs if we don’t realize that they’re suffering, and if we recognize they’re suffering, we must take corrective steps.