Brachycephalic Obstructive Airway Syndrome (BOAS) in French Bulldogs
Brachycephalic Obstructive Airway Syndrome (BOAS) is the single most important health condition for French Bulldog owners to understand. It affects the upper airway and is caused by the anatomical features that give Frenchies their flat face — narrowed nostrils (stenotic nares), elongated soft palate, and sometimes everted laryngeal saccules. Nearly all French Bulldogs have some degree of BOAS, though severity ranges from mild snoring to life-threatening respiratory distress. The condition is progressive and often worsens with age, heat, and obesity. Early recognition and treatment can dramatically improve quality of life.
Symptoms to Watch For
- Loud snoring and noisy breathing, even at rest
- Snorting, gagging, or reverse sneezing episodes
- Exercise intolerance — tiring quickly during walks or play
- Difficulty breathing in hot or humid weather
- Blue-tinged gums or tongue (cyanosis) during exertion
- Sleep apnea or pausing breathing during sleep
- Vomiting or regurgitating after eating or excitement
- Fainting or collapsing during exercise
Treatment Options
Treatment depends on severity. Mild cases may be managed with weight control, avoiding heat and overexertion, and using a harness instead of a collar. Moderate to severe cases typically require surgical intervention. The most common procedures are soft palate resection (shortening the elongated palate), stenotic nares correction (widening the nostrils), and laryngeal saccule removal. Surgery is usually performed all at once under general anesthesia. Recovery takes 2-3 weeks, and most dogs show significant improvement in breathing within days. Post-surgical care includes soft food, restricted activity, and monitoring for swelling.
Treatment Costs
| Procedure | Cost Range | Notes |
|---|---|---|
| Initial diagnosis & evaluation | $300 - $800 | Includes physical exam, potential sedated exam, and imaging |
| Stenotic nares correction | $500 - $1,500 | Widening of narrowed nostrils; often done with palate surgery |
| Soft palate resection | $1,500 - $3,500 | Shortening of elongated soft palate; most common BOAS surgery |
| Full BOAS correction surgery | $3,000 - $6,000 | Combined nares + palate + saccule removal; varies by location and surgeon |
| Emergency airway intervention | $2,000 - $5,000 | Emergency stabilization for acute respiratory distress; may include temporary tracheostomy |
| Post-surgical follow-up care | $200 - $500 | Follow-up exams, medications, and potential complication management |
Insurance Coverage
BOAS surgery is covered by all major pet insurance providers as long as it is not a pre-existing condition. This is the single most important reason to insure your French Bulldog early — if BOAS symptoms are documented before your policy starts, the condition will be permanently excluded. Most providers classify BOAS treatment under hereditary/congenital conditions, which are covered under standard accident and illness plans. Waiting periods vary: typically 14-15 days for illness coverage, though some providers have longer orthopedic-specific waiting periods that do not affect BOAS coverage.
Top Providers for BOAS Coverage
Unlimited coverage with no annual cap means even the most expensive BOAS surgery is fully covered after your deductible
Direct vet pay at Express clinics means you never front the $3,000-$6,000 surgery cost; per-condition deductible paid once
Strong hereditary condition coverage with wellness add-ons that cover preventive breathing assessments
Unlimited coverage option with wellness add-ons for routine monitoring; available in all 50 states
Prevention & Management
While BOAS cannot be completely prevented due to the breed's anatomy, you can significantly reduce severity and complications. Keep your French Bulldog at a healthy weight — even a few extra pounds worsen breathing obstruction. Use a harness instead of a neck collar to avoid pressure on the airway. Avoid exercising in hot or humid weather, and never leave your Frenchie in a car. Keep living spaces cool and well-ventilated. Avoid stressful situations that cause heavy panting. Feed smaller, more frequent meals to reduce regurgitation risk. Schedule regular vet checkups to monitor airway changes over time. If your vet identifies moderate to severe BOAS, early surgical correction (ideally before age 2) typically produces better outcomes than waiting until the condition worsens.
Frequently Asked Questions
Most French Bulldogs show some BOAS symptoms from birth (noisy breathing, snoring), but clinically significant symptoms typically become apparent between 1-3 years of age. Symptoms often worsen progressively, especially in dogs that are overweight or live in warm climates. Some dogs require surgical intervention as early as 6-12 months if symptoms are severe.
For moderate to severe cases, absolutely. Dogs that undergo BOAS correction surgery typically show dramatic improvement in breathing, exercise tolerance, sleep quality, and overall comfort. The surgery has a high success rate (85-90% of owners report significant improvement) and recovery is usually straightforward. The $3,000-$6,000 cost is significant, but it dramatically improves quality of life for the remaining 8-10+ years.
Yes, all major pet insurance providers cover BOAS surgery as long as it was not a pre-existing condition when you enrolled. This means you need to get insurance before any breathing symptoms are documented by a vet. Ideally, enroll your Frenchie as a puppy before the first comprehensive vet exam. After the waiting period (typically 14-15 days), BOAS treatment is covered under hereditary/congenital condition coverage.
Most French Bulldogs recover within 2-3 weeks. The first 48-72 hours are the most critical, as swelling in the airway can temporarily worsen breathing. Your vet may keep your dog overnight for monitoring. At home, expect soft food for 1-2 weeks, restricted activity for 2-3 weeks, and anti-inflammatory medications. Most dogs breathe noticeably better within days of surgery, with full improvement seen at 4-6 weeks.
You cannot prevent BOAS entirely because it is caused by the breed's anatomy. However, you can reduce severity by keeping your Frenchie at a healthy weight, avoiding heat exposure, using a harness instead of a collar, and scheduling early veterinary assessments. Choosing a responsible breeder who prioritizes open airways and performs BOAS screening can also reduce risk. Early surgical intervention for moderate cases prevents the condition from worsening over time.