Brachycephalic Obstructive Airway Syndrome (BOAS) in Dogs: Symptoms, Treatment & Cost

By the Pawlee Team

Diagnosis cost

£200–£500

Treatment cost

£1500–£3500

Ongoing cost

N/A

Severity

Serious

Treatable

Yes

Species

Dogs

What is brachycephalic obstructive airway syndrome (boas)?

Brachycephalic obstructive airway syndrome (BOAS) is a condition caused by the shortened skull shape of flat-faced breeds. The soft palate is too long, the nostrils are narrowed (stenotic nares), and the trachea may be undersized, all of which restrict airflow. Affected dogs struggle to breathe normally, especially during exercise, in warm weather, or when excited. BOAS ranges from mild (noisy breathing, occasional snoring) to severe (collapse, cyanosis, heat stroke risk). It is the single most significant health issue in brachycephalic breeds and affects the majority of French Bulldogs, Pugs, and English Bulldogs to some degree.

Symptoms to watch for

See a vet soon

Loud or laboured breathing, even at rest
Excessive snoring when sleeping
Gagging, retching, or regurgitation
Exercise intolerance or reluctance to walk
Overheating quickly in warm weather
Blue-tinged gums or tongue during exertion
Collapse or fainting during exercise or excitement
Sleep apnoea or disturbed sleep

How is brachycephalic obstructive airway syndrome (boas) diagnosed?

Test	Typical cost
Consultation and physical examination	£40–£70
Airway assessment under sedation or anaesthesia	£200–£400

Treatment options and costs

Weight management and lifestyle modification

Minimal ongoing cost

For mild cases, keeping the dog at an ideal weight, avoiding exercise in hot weather, using a harness instead of a collar, and keeping the home cool may be sufficient to manage symptoms without surgery.

BOAS corrective surgery (soft palate resection and widening of nostrils)

£1,500–£3,500

The most common surgical approach combines shortening the elongated soft palate and widening the stenotic nares. Some dogs also need removal of everted laryngeal saccules. Surgery is best performed at a young age (1–2 years) before secondary changes develop. Most dogs see a significant improvement in breathing.

Breeds most at risk

Breed	Risk level
French Bulldog	High
Pug	High
Shih Tzu	Moderate
Cavalier King Charles Spaniel	Low

Does pet insurance cover brachycephalic obstructive airway syndrome (boas)?

Most lifetime pet insurance policies cover BOAS diagnosis and surgery, provided the condition develops after the policy starts and is not classed as pre-existing. However, some insurers exclude brachycephalic airway conditions for flat-faced breeds or impose waiting periods. A few policies specifically exclude BOAS surgery. Always check your policy wording carefully before buying a brachycephalic breed. Claims for BOAS surgery are among the most common for French Bulldogs and Pugs.

Related conditions

Skin Allergies Dogs Cherry Eye Dogs

Frequently asked questions

How much does BOAS surgery cost in the UK?

BOAS corrective surgery typically costs £1,500–£3,500 in the UK, depending on the severity, the number of procedures combined (soft palate, nares, laryngeal saccules), and whether it is performed at a first-opinion practice or a specialist referral centre. London and the South East tend to be at the higher end.

Is BOAS surgery worth the cost?

For dogs with moderate to severe BOAS, surgery can dramatically improve quality of life. Most dogs breathe much more comfortably after recovery, tolerate exercise better, and are at lower risk of heat stroke. The earlier surgery is performed (ideally at 1–2 years of age), the better the outcome, as it prevents secondary airway changes.

Do all flat-faced dogs need BOAS surgery?

No. BOAS severity varies widely even within the same breed. Some flat-faced dogs have mild symptoms manageable with weight control and lifestyle adjustments. Others have severe obstruction that significantly impacts quality of life and requires surgical correction. Your vet can assess the severity with a physical examination and, if needed, an airway assessment under sedation.

Does insurance cover BOAS surgery for French Bulldogs and Pugs?

Many lifetime policies do cover BOAS surgery, but some insurers exclude brachycephalic airway conditions or impose waiting periods for flat-faced breeds. It is essential to check the specific exclusions before taking out a policy. If your dog has shown any breathing symptoms before the policy start date, the condition may be classed as pre-existing and excluded.