BOAS assessment: what we look for and when surgery is recommended

BOAS assessment: what we look for during a BOAS assessment

If you share your life with a flat-faced dog, it is not always easy to tell the difference between typical breed traits and signs that breathing has become more of a struggle than it should be. Many dogs with BOAS adapt quietly, so owners often only realise later that what seemed normal was actually a sign their dog had been working too hard to breathe.
At Rock House Vets, a BOAS assessment is designed to answer an important question with care and clarity: is your dog coping well, or has the airway reached the point where surgery is likely to help? We look at how much effort your dog is using to breathe, how those signs affect everyday life, and whether the balance has shifted from monitoring to treatment.
This is not a page about the operation itself. It is about the decision behind it. For many owners, that is the part that feels most uncertain.

Why a BOAS assessment matters

Brachycephalic obstructive airway syndrome, often shortened to BOAS, affects dogs with a shortened skull shape and crowded upper airway anatomy. That commonly includes French Bulldogs, English Bulldogs and Pugs, although other flat-faced breeds can be affected too.
The difficulty is that BOAS does not always announce itself dramatically at first. It often shows up in ways owners have come to accept, such as noisy breathing, getting tired quickly, struggling in warm weather, needing longer to recover after excitement, or sleeping in odd positions to keep the airway open. Because these signs can seem familiar, they are often underestimated.
At Rock House Vets, we use BOAS assessment to look beyond whether a dog is simply noisy. We want to understand whether breathing is comfortable, sustainable and appropriate for normal daily life. That is what guides the next step.

What Rock House Vets looks for during a BOAS assessment

When we assess a dog for BOAS, we begin with the whole picture. We ask what you are noticing at home, on walks, during exercise, in the car, at bedtime and in warmer weather. We want to know whether your dog seems settled and comfortable, or whether normal life is starting to demand too much from the airway.
We also look closely at how your dog breathes during the consultation. That includes the sound of breathing, the effort involved, whether the nostrils are narrowed, how easily your dog becomes open-mouthed, and whether excitement quickly makes the breathing noisier or more laboured.
Some dogs show clear signs the moment they enter the room. Others are more subtle until we piece together the story with their owner. In many cases, the dog has been compensating for quite some time, and it is only once everything is viewed together that the true level of airway compromise becomes clearer.

The signs that help us judge severity

One of the most important parts of a BOAS assessment is judging where a dog sits on the spectrum between mild signs and a more significant welfare problem.
A dog with mild signs may be a little noisy at times, but still able to exercise reasonably, settle well, sleep comfortably and cope in day-to-day life. Those dogs may not need surgery immediately, although they still benefit from proper monitoring and sensible advice.
A dog with more significant BOAS often presents differently. We may hear persistent airway noise even at rest. Owners may describe exercise intolerance, difficulty coping in warm weather, restless sleep, disturbed breathing overnight, gagging, retching, regurgitation or a tendency to become distressed more quickly than expected. Some dogs recover slowly after activity. Some seem reluctant to walk far, not because they are lazy, but because breathing is harder work than it should be.
At Rock House Vets, we also pay attention to the dogs who have subtly changed their lifestyle around their breathing. These are the dogs who seem calmer than expected, prefer short bursts of activity, dislike heat, or avoid exertion because their airway has quietly taught them to.

Could my dog have BOAS even if they have always breathed noisily?

Yes, and this is one of the most common reasons owners book a consultation with Rock House Vets.
A dog that has always snored, snorted or breathed noisily may still have clinically important airway restriction. Familiar does not always mean normal. In flat-faced breeds, it is easy for chronic signs to fade into the background until they begin to affect exercise, sleep, temperature tolerance or general comfort more noticeably.
A BOAS assessment helps distinguish between a dog who is noisy but coping and a dog whose airway is placing them under ongoing strain.

When BOAS surgery is recommended

At Rock House Vets, surgery is recommended when the airway restriction is affecting quality of life strongly enough that monitoring alone is no longer the kindest plan.
That recommendation is not based on one isolated sign. It comes from the overall clinical picture. If a dog is regularly struggling with breathing effort, activity, heat, sleep or recovery, and the airway anatomy suggests the problem is unlikely to improve without intervention, surgery may offer the best chance of making breathing easier and more sustainable.
This is why a BOAS assessment matters so much. It helps us judge whether your dog is still coping adequately, whether the signs are progressing, and whether delaying treatment risks allowing the airway to remain under unnecessary strain.
We do not approach surgery as an automatic answer for every brachycephalic dog. We recommend it when the evidence suggests it is likely to improve comfort, reduce effort and support a better day-to-day quality of life.
If you would like to understand more about the procedure itself, recovery and treatment planning, please visit our BOAS surgery page.

Can a dog be coping at home but still need BOAS surgery?

Yes. In fact, this is very often the grey area that prompts owners to seek advice.
Dogs are remarkably good at adapting. A dog may still be eating, walking and behaving affectionately, yet still be using far too much effort to breathe. Owners sometimes tell us their dog seems mostly fine, but is noisier than other dogs, overheats easily, tires faster than expected or does not sleep as peacefully as they would like. Those details matter.
At Rock House Vets, we look carefully at whether your dog is truly comfortable or simply managing around a restricted airway. Sometimes the signs are subtle, but still enough to support a recommendation for treatment.

Do all flat-faced dogs need surgery?

No. Not every French Bulldog, Bulldog or Pug seen at Rock House Vets will need BOAS surgery.
Some dogs have mild signs and remain comfortable with monitoring, sensible weight management and a good understanding of what to watch for over time. In those cases, the most appropriate recommendation may be continued review rather than immediate treatment.
The purpose of the assessment is not to steer every dog towards surgery. It is to make a balanced clinical judgement about what your dog needs now, and what may need revisiting in the future.

Is BOAS likely to get worse over time?

It can do. BOAS is not always static, and ongoing effortful breathing can place repeated strain on the airway. For some dogs, that means signs become more obvious with age, heat, exertion or changes in body condition.
That is one reason why owners often feel relieved after a BOAS assessment. Even if surgery is not needed straight away, it is helpful to understand where your dog stands now and what changes would suggest it is time to reassess.

When to book a BOAS assessment

You do not have to wait until your dog is in obvious distress to seek advice. In many cases, the best time to arrange a BOAS assessment is when you start wondering whether your dog is breathing as comfortably as they should.

That might be because your dog snores heavily, seems louder than other dogs of the same breed, struggles in warmer weather, pants excessively after mild exertion or simply does not seem able to enjoy exercise as easily as expected. It might also be because you have always had a quiet concern in the back of your mind and want a clearer clinical opinion.

At Rock House Vets, we see these consultations as a way of giving owners reassurance, clarity and a sensible plan. Sometimes that means continued monitoring. Sometimes it means recognising that surgery has become the right next step. Either way, the value lies in understanding your dog properly.

FAQs about BOAS Assessment

What does Rock House Vets look for during a BOAS assessment?

We look at how your dog breathes at rest and with mild excitement, how much effort breathing appears to take, how open the nostrils are, and how signs at home fit with what we see clinically. We also consider exercise tolerance, sleep quality, heat sensitivity and overall comfort.

How do you tell whether BOAS is mild or more serious?

We look at the whole picture rather than relying on one sign alone. A dog with mild BOAS may be noisy but otherwise comfortable. A dog with more significant BOAS is more likely to show exercise intolerance, poor heat tolerance, disturbed sleep, laboured breathing or slower recovery after activity.

When is BOAS surgery recommended rather than monitoring?

Surgery is usually recommended when airway restriction is affecting quality of life enough that monitoring alone is unlikely to be sufficient. That may be because breathing effort is too high, everyday activities are being limited, or the airway changes are significant enough to justify treatment.

Can a dog seem normal at home and still need BOAS surgery?

Yes. Some dogs adapt very well, which can make the signs seem less serious than they really are. A dog can appear settled at home while still struggling with airflow, heat, exercise or sleep more than they should.

Should I wait until symptoms become severe before booking?

No. It is often better to assess BOAS before signs become more advanced. A consultation gives you a clearer understanding of whether your dog is coping well, whether the airway needs monitoring, or whether surgery is likely to help.

Do all French Bulldogs, Bulldogs and Pugs need BOAS surgery?

No. Some dogs have mild signs and do not need surgery straight away. The aim of a BOAS assessment at Rock House Vets is to decide what is appropriate for the individual dog in front of us.

Book a BOAS assessment at Rock House Vets

Arrange a BOAS assessment with Rock House Vets if your dog is noisy, heat-sensitive, tiring too quickly or working harder to breathe than you feel comfortable with. We will take the time to assess your dog carefully, explain what we find in plain English, and help you decide whether monitoring or BOAS surgery is the right next step.

If you would like advice about your pet’s condition or need to arrange an appointment, book a BOAS assessment with Rock House Vets.