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Nationwide® analysis of 50,000 dogs confirms brachycephalic breeds face increased health risks

Columbus, OH - While veterinary healthcare teams across the country have seen that brachycephalic dogs like French Bulldogs, English Bulldogs, Pugs, and Boxers face health challenges more often than longer-nosed breeds, the newest pair of white papers from Nationwide® prove that anecdotal evidence is now founded in facts.

The Nationwide Pet Health Analytics and Insights Team analyzed data from more than 50,000 brachycephalic dogs and more than 450,000 dog years of canine claims from their database of dogs protected by Nationwide pet insurance. The analysis reveals insights into diseases representing increased risks for brachycephalic dogs and “extreme” brachycephalic dogs (French Bulldogs, English Bulldogs, and Pugs) and recommends clinical action to improve the care provided for these pets.

While veterinary researchers have investigated many of these conditions, most were single-site evaluations, often including groups of fewer than 100 dogs,” says Nationwide Chief Veterinary Officer Jules Benson, BVSc, MRCVS. “To our knowledge, this analysis represents the largest single-study cohort of brachycephalic dogs ever conducted. The sheer volume of claims our team at Nationwide was able to analyze provides a major advantage in identifying health risks.”

Key takeaways included:

  • Brachycephalic dogs are among the most popular: The two-part analysis included 15 purebred brachycephalic dog breeds that met the inclusion criteria for the study. Three breeds (Pugs, French Bulldogs, and English Bulldogs) met the criterion for extreme brachycephalic breeds. Those three breeds were ranked 3rd, 7th, and 16th in the overall Nationwide purebred population, and 1st, 3rd, and 5th among brachycephalic dog breeds.

Table 1 - Brachycephalic dogs by Nationwide® purebred breed rank


Breed Rank

French Bulldog


Shih Tzu


English Bulldog






Boston Terrier


Cavalier King Charles Spaniel


Lhasa Apso


Bull Mastiff


Chinese Shar-Pei




Chow Chow


Brussels Griffon


Dogue De Bordeaux


Japanese Chin


  • Breathing problems abound: The risk of brachycephalic dogs submitting a claim for any breathing problem, including brachycephalic obstructive airway syndrome (BOAS), was almost three times higher than for non-brachycephalic dogs.
  • “Extreme” dogs are at increased risk: French Bulldogs, English Bulldogs, and Pugs have a dramatically higher risk of having claims for BOAS, even compared with other brachycephalic breeds. The French Bulldog is more than 17 times more likely to have a claim submitted for BOAS, the English Bulldog nearly 12 times more likely, and the Pug almost 10 times more likely. 
  • BOAS contributes to additional problems: According to Nationwide data, a BOAS diagnosis may be considered an effective sentinel disease for other conditions (e.g., pneumonia, spinal disease, esophageal and gastrointestinal disease) that are exacerbated by extreme brachycephalic morphology.

“The goal of our brachycephalic research is to provide veterinary healthcare teams and pet-owning families with objective, data-informed personalized pet health guidance,” says Dr. Benson. Our results highlight the need for careful counseling of brachycephalic dog owners, especially those with extreme conformations. We aim to facilitate close collaboration, early disease recognition, appropriate interventions, and better health outcomes for pets. As part of that effort, Nationwide is creating communication tools to help clinics start those conversations with owners and build those protocols, which we plan to release later this year.”

To read more about Nationwide’s findings on brachycephalic breeds compared to non-brachy breeds, as well as additional risks facing extreme brachycephalic dogs, visit www.PetInsurance.com/petdata

With Nationwide pet health insurance, many veterinary expenses associated with brachycephalic treatments are eligible for reimbursement based on the member’s chosen coverage. To explore pet health insurance coverage for any kind of dog, cat, and many avian or exotic pets, visit PetInsurance.com.

About Nationwide

Nationwide, a Fortune 100 company based in Columbus, Ohio, is one of the largest and strongest diversified insurance and financial services organizations in the United States. Nationwide is rated A+ by both A.M. Best and Standard & Poor’s. An industry leader in driving customer-focused innovation, Nationwide provides a full range of insurance and financial services products including auto, business, homeowners, farm and life insurance; public and private sector retirement plans, annuities, mutual funds and ETFs; excess & surplus, specialty and surety; pet, motorcycle and boat insurance. For more information, visit www.nationwide.com. Follow us on Facebook and Twitter.

About Nationwide pet insurance
With more than 1.2 million insured pets, Nationwide is the first and largest provider of pet health insurance in the United States. Nationwide pet health insurance plans cover dogs, cats, birds and exotic pets for multiple medical problems and conditions relating to accidents, illnesses and injuries. Medical plans are available in all 50 states and the District of Columbia. Products underwritten by Veterinary Pet Insurance Company (CA), Columbus, OH; National Casualty Company (all other states), Columbus, OH. Agency of Record: DVM Insurance Agency. All are subsidiaries of Nationwide Mutual Insurance Company. Pet owners can find Nationwide pet insurance on Facebook or follow on Twitter. For more information about Nationwide pet insurance, call 800-USA-PETS (800-872-7387) or visit petinsurance.com.