ABSTRACT As brachycephalic dog ownership and breeding gain popularity , nursing involvement in brachycephalic caesarean sections is increasing . Extreme brachycephalic breeds most commonly requiring caesareans include British bulldogs , French bulldogs and pugs . The majority of these patients may not be seen in practice until they come in for surgical intervention . Therefore , veterinary professionals should encourage preoperative testing to minimise perioperative complications and breeding based on extreme conformation features .
Keywords brachycephalic , nursing , c-section , breeding , ethics
Introduction
There are differing attitudes in the veterinary community to treating brachycephalic patients , and a divide in practice policies on treating breeding brachycephalic patients . Negativity towards breeding could be related to the health conditions associated with brachycephalic breeds , and the owners ' lack of awareness of breedrelated health conditions . Veterinary professionals may also consider that brachycephalic breeding does not always comply with the Animal Welfare Act ( 2006 ) as , in some cases , it causes unnecessary suffering ( Royal Veterinary College , 2022 ). However , some professionals may believe it is important to assist with caesarean sections ( c-sections ) to help the pregnant brachycephalic dog from further birthing complications ( British Veterinary Association ( BVA ), 2022 ).
In a recent study of veterinary nurses ' ( VNs ) involvement with brachycephalic patients , most practices ( 51 %) only performed emergency c-sections for these breeds . The majority of practices ( 53 %) allowing elective c-sections did not book them in until days 62 – 63 of pregnancy , due to lower survival rates in litters produced prior to day 60 ( Campbell , 2020 ). Depending on practice location and breeding demographics , c-sections vary from common to rare procedures but , in all cases , good nursing care has a significant impact on the outcome of the bitch and pups .
Ethical considerations
It could be suggested that practices refusing to assist the birthing process are doing so to discourage breeding , to try to prevent the continuation of extreme hereditary brachycephalic conformation . However , it is difficult for veterinary professionals to influence breeding without face-to-face discussions with owners / breeders . Those practices accepting brachycephalic patients may see higher numbers of these breeds , and have greater involvement in c-sections , which allows more opportunities to educate breeders but also allows the breeding process to continue . It is a dilemma challenging all practices .
Breeding that is heavily dependent on c-sections presents ethical challenges . Guidance is provided by DEFRA ( 2020 ) and the Kennel Club ( 2021 ), but challenges remain as not all breeding dogs are registered . This allows breeding strongly reliant on surgical intervention to continue .
However , veterinary surgeons ( VSs ) are able to report a c-section under the RCVS Code of Conduct , as it may impact on animal welfare . As veterinary professionals , we can closely monitor this in practice and ensure the whole team adopts the same approach . This can be achieved by using the BVA ’ s ( 2020 ) 10-point plan to regulate brachycephalic dog health .
It may also be beneficial to refer patients with brachycephalic obstructive airway syndrome ( BOAS ) for grading under the Respiratory Function Grading Scheme produced by the Kennel Club and the University of Cambridge ( Kennel Club , n . d .). This uses a traffic light system to display safer breeding matches and identifies when a bitch should not be bred from , due to the high risk of BOAS being passed on through the genes .
Brachycephalic dogs used for regular breeding should be reassessed every 2 years throughout their breeding life . Although similar to recording c-sections , recording of BOAS grades is low in comparison to brachycephalic ownership , perhaps because the scheme is not compulsory . This further emphasises the need for the veterinary team to work with the breeding community to improve brachycephalic dog health .
Preoperative health checks
It is important to make breeders aware that preoperative checks must be carried out by a veterinary professional . Brachycephalic fertility clinics appear to be gaining popularity in the UK , but not all are monitored and they do not have to adhere to RCVS guidelines ( Loeb , 2020 ). This has allowed many non-professionals to take blood samples and provide diagnostics that come under Schedule 3 of the RCVS Code of Professional Conduct .
Due to the legal uncertainties relating to these fertility clinics , the author suggests it may be more beneficial for veterinary practices interacting with large numbers of members of the breeding community to provide such services , to ensure treatment is carried out legally and can be monitored appropriately . For example , VNs could assist by taking blood samples for progesterone ( PGT ) testing and running the sample in-house or sending it to an external laboratory , and the VS could provide ultrasound scans and preoperative consults to assess pregnant bitches and monitor their health .
Volume 37 ( 5 ) • November 2022
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