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Common Painful Conditions Affecting Flat Face and Wrinkly Dog Breeds

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    There are a number of conditions that commonly affect Brachycephalic breeds as well as wrinkly breeds. Brachycephalic breeds of dogs can be identified by their shortened snouts or faces with a flat appearance. As a result of this, they have narrow nostrils and smaller airways. These breeds typically possess wrinkled muzzles. Oftentimes, Brachycephalic breeds overlap with wrinkly dog breeds including Bulldogs, Shar-Peis, And Pugs. Brachycephalic and wrinkly dog breeds are more likely to suffer from a variety of health conditions. If you’re considering adding one of these dogs to your family or already own one, read below to familiarize yourself with the common conditions that may affect these dogs. 

    1. Skin Fold Dermatitis

    Photo Credit: Today’s Veterinary Practice

    What is Skinfold Dermatitis?

    Skinfold dermatitis is a painful condition that’s specific to dogs with skin folds or wrinkles. Any deep skin folds may breed Skin Fold Dermatitis on the dog’s body. Skin folds that are most prone are facial, tail, and vulvar folds. Due to how deep the skin folds are, abnormal rubbing and moisture retention occurs. These folds are warm and not well-aerated which is the perfect environment for yeast and bacteria to grow. This results in inflammation of the skin, known as dermatitis. 

    What Are The Symptoms?

    Skin fold dermatitis can typically be easily identified by hairless, reddened, and odorous skin folds. Additionally, in the deeper facial folds, excessive staining may occur due to the pigment. There are a few common variations of skin fold dermatitis that are observed in brachycephalic and wrinkly breeds. 

    Tail Fold Dermatitis: In those dogs who have corkscrew tails, tail fold dermatitis is common. Deep tail folds that breed skin fold dermatitis may lead inflammation causing deep fistulas or sores. It’s even possible in some cases for these deep fistulas to enter the cavity of the body and lead to deadly systemic infections. 

    Vulvar Dermatitis: Skin fold dermatitis occuring in the vulva can also be very serious and is often overlooked. It commonly occurs in breeds that are prone to having deeply recessed vulvas, often observed in female bulldogs. Urinary tract infections can be a result of vulvar tail fold dermatitis. 

    Lip Fold Dermatitis: Lip fold dermatitis typically occurs when moisture and debris, such as particles of food, become trapped in the folds created by the dog’s sagging lips.

    If your dog is displaying symptoms of skin fold dermatitis, you should speak with your vet to get immediate treatment to avoid a possible painful infection.

    What Are The Treatments?

    No matter what form of skin fold dermatitis is presented, diligent cleaning of the affected areas will be required. The area needs to be cleansed with a medicated skin cleanser, oftentimes chlorhexidine, miconazole, or sulfur/salicylic acid. Antibiotics are often administered in combination with steroids. Steroids may be administered topically, orally or by injection. Mild forms of skin fold dermatitis typically respond well to medical intervention. 


    In severe cases that involve vulvar, lip, or tail fold dermatitis, surgery may be recommended by a veterinarian to remove excess skin. 

    How to Prevent Skin Fold Dermatitis

    1. Watch your dog’s weight. Obesity will only exacerbate skin fold dermatitis. 
    2. Clean any skin folds regularly. 
    3. Only use products that are safe and approved for dogs, especially when cleaning facial folds 
    4. Consult your vet surrounding any other skin issues. 

    2. Hyperkeratosis

    Photo Credit: Great Pet Care

    What is Hyperkeratosis?

    Hyperkeratosis is a condition that affects the hair, nails, and skin. Keratin is the primary protein that makes up these elements of the body. It acts as a protective layer of the skin. However, if too much keratin is produced it can build up and actually cause harm. A rough patch may appear on the dog’s paws, nose, or ears when Hyperkeratosis occurs. This means that the protective layer is now damaged and cracked and can longer protect the skin against bacteria, leading the dog to become more vulnerable to infections. It may be painful for your dog to move, stand, and walk if Hyperkeratosis is left undiagnosed and untreated for too long. 

    What Are The Symptoms?

    There a number of symptoms that point at Hyperkeratosis including: 

    • Dry, crusty layer of skin 
    • Cracks and bleeding in affected area
    • Pain in the affected area 
    • Loss of skin color in the affected area
    • Frequent paw licking 
    • Limping from paiin
    • Lameness 
    • Reduced desire for physical activity 

    In addition to brachycephalic dogs being predisposed to the condition, there are a few other factors that may lead to Hyperkeratosis.  If your dog falls in the below categories, keep a close eye out for the condition and its signs.  

    • Age: Hyperkeratosis is more common in older dogs as the skin tends to get thicker with age 
    • Parasites: If your dog has an existing parasitic condition, Hyperkeratosis is more likely to occur 
    • Auto-immune Diseases: Dogs with some pre-existing auto-immune diseases may cause the dog to produce excess keratin 

    You should notify your vet if there are any signs of Hyperekratosis before it becomes anymore painful.

    What Are The Treatments?

    There are a variety of ways that Hyperkeratosis can be treated in dogs. Many of these treatments are minimally invasive and provide quick relief to your dog. 

    1. Shell Removal: As long as there is no underlying infection, your vet may recommend periodically removing the shell on your dog’s paws or nose. Since keratin will continue to keep growing, removing it will help keep the condition manageable. 
    2. Over-the-Counter Ointments: Some over-the-counter topical ointments may be helpful in softening the keratin and alleviating your dog’s pain. Your vet can recommend ointments that are safe and best suit your pet’s condition. 
    3. Antibiotics/Antifungal Treatment: If there is a skin infection present alongside the hyperkeratosis, an antibiotic or antifungal cream, ointment, or pill may be prescribed by your vet. 
    4. Use booties or protective gear: If hyperkeratosis is present on your dog’s paws, using booties or other protective foot gear may be helpful in alleviating the pain when your dog is on their feet. 

    How to Prevent Hyperkeratosis

    1. Clip Nails: In order to avoid accidents or your dog from scraping himself, clip your dog’s nails on a regular basis. 
    2. Use booties or socks: Protect the skin on your dog’s paws from environmental factors. This will reduce irritation and the likeliness of skin conditions like hyperkeratosis. It is also helpful in defending against parasites. 
    3. Feed a balanced diet: Reduce the risk of hyperkeratosis and other skin conditions by feeding your dog a balanced diet to prevent mineral deficiencies. Zinc deficiency often leads to hyperkeratosis. 

    3. Hemivertebrae

    Photo Credit: Irish Veterinary Journal

    What is Hemivertebrae?

    Hemivertebrae is a disease in which the vertebrae are deformed in either that they are fused or wedge-shaped which causes a twisting of the spine. This congenital condition can happen to either just one or multiple vertebrae and is considered a congenital disease. While it initially sounds like it would be extremely painful to have a spine in that condition, it doesn’t always cause an issue for the affected dog. It is usually dependent on if the spinal cord is being compressed or if there is a weak section of the spinal column. If the abnormality is right at the tail then it doesn’t usually cause a problem but will cause significant problems if located in other parts of the spine. Breeds that have Hemivertebrae of the tail are those breeds with a “curly q tail” or “screw tail” such as Pugs, French Bulldogs, and other brachycephalic breeds. 

    What Are The Symptoms?

    Dogs may not always experience symptoms but if severe, they may experience a variety of clinical signs. Compression of the spinal cord occurs because the impaired vertebrae essentially causes a wedging effect that contorts the spine.This compression leads to serious clinical signs including weakness of hind limbs, pain, urinary incontinence, and fecal incontinence. Signs often present in puppyhood and progressively get worse until they plateau around 9 months of age once the spine has stopped growing. If suspected, a veterinarian will use radiographs as it’s fairly simple to see in an x-ray but they may also use myelograms, CT scans, or MRIs to detect spinal cord compression. Dogs should be seen by a veterinarian as soon as they display symptoms to prevent further problems.

    What Are The Treatments?

    Many dogs with this condition show no clinical signs or pain, and do not require treatment. Rest and anti-inflammatories are typically prescribed for mild cases. In more severe cases, a surgery called a hemilaminectomy may be necessary to relieve compression on the spinal cord. This surgical procedure involves the removal of the intervertebral disc material that is pressing against the spinal cord, followed by stabilization of the spine. 

    How to Prevent Hermivertebrae

    Since hermivertebrae is a genetic trait due to the physical structure of certain breeds, prevention often comes from removing those dogs from the breeding pool.

    For dogs who’s physical structure is not a standard predisposition to hemivertebrae and is inherited as an autosoma recessive trait such as in German Shepherds, best way to prevention is to exclude afflicted dogs and their first degree from the breeding pool.

    4. Entropion

    entropion in dogs
    Photo Credit: Pet Health Network

    What is Entropion?

    Entropion is an ocular, congenital disorder in dogs that can be quite irritating and painful. It causes the eyelids to roll inwards causing the eyelashes and other surrounding hair to brush against the cornea. The rubbing of the hairs on the cornea can lead to corneal ulceration and once that ulcer is present, it will continue to worsen and can eventually cause scarring on the cornea which can affect vision. The damage can be permanent.  It’s most prevalent in dogs with loose, saggy skin such as Shar-Peis and Neopolotin Mastiffs. Other breeds that are predisposed include Boxers, Bulldogs, Chesapeake Bay Retrievers, Great Danes, Chow Chows, Saint Bernard, and Pugs.

    Signs a dog may be suffering from entropion include squinting, eye pain, eye discharge, tearing, swelling around the eyes, eye redness, rubbing eyes, excessive blinking and corneal ulcers. In addition, dogs may experience frequent bouts of conjunctivitis. Quick diagnosis is key before there is permanent damage so if you suspect your dog has entropion or any other eye condition, take them to the vet immediately. Vets diagnose entropion through an eye examination and may perform a fluorescein stain test on the eye to look for corneal damage.

    What Are the Symptoms?

    Signs a dog may be suffering from entropion include squinting, eye pain, eye discharge, tearing, swelling around the eyes, eye redness, rubbing eyes, eye pain, excessive blinking and corneal ulcers. In addition, dogs may experience frequent bouts of conjunctivitis. Quick diagnosis is key before there is permanent damage so if you suspect your dog has entropion or any other eye condition, take them to the vet immediately. Vets diagnose entropion through an eye examination and may perform a fluorescein stain test on the eye to look for corneal damage. Signs of entropion should be evaluated by a vet before permanent damage is done such as blindeness.

    What Are The Treatments?

    Dogs with entropion almost always require surgery to correct their eyelids. The surgical procedure involves removing skin from above or below the eyelid to stop it from turning inwards. If the dog is younger and still growing, the veterinarian may recommend a temporary “tacking procedure” to hold the eyelids in a more natural position until they are a bit older. The dog will likely require eye drops before and following surgery. Eye drops are especially helpful if any additional complications are present, including inflammation or infection. 

    How to Prevent Entropion

    Entropion, unfortunately, cannot always be prevented due to the predisposition as a result of a dog’s physical traits which are a part of their breed. The only thing you can do is attempt to catch it early enough so that the symptoms don’t worsen and the recovery goes as smoothly as possible.

    If your dog is from a breed that has a high risk of developing entropion, you should pay careful attention to his eye care. Keep them clean and take them to the vet on a regular basis for checkups.

    5. Elbow Luxation

    What is Elbow Luxation?

    Elbow luxation, which is the dislocation of the elbow, commonly occurs in smaller breeds and can be a complete dislocation or partial dislocation (radial head with the ulna intact or partially intact). There is speculation on whether congenital luxation of the elbow is inherited, with questions on proper ligament growth being a possible cause. Breeds susceptible to this include Pugs, Afghan Hounds, Dobermans, Yorkies, Boston Terriers, Chihuahuas, and Pomeranians. Nonetheless, congenital luxation of the elbow happens when the bone is displaced from the joint, typically affecting both elbows. Chronic cases typically indicate osteoarthritis as a secondary condition. Classified in three ways, congenital luxation is defined as humeroradial, humeroulnar, and a combination of both. 


    •     Significant limb deformity and dysfunction
    •     Could be partial or full
    •     Observed in Pekinese, Shetland Sheepdog, Dachshund, Yorkshire Terrier, and  English Bulldog breeds


    •     Mainly impacting Dachshunds, the dislocation of the radial head will occur, while the ulna is in a fairly normal position

    Humeroradial and Humeroulnar

    •     Secondary to general joint laxity or skeletal abnormalities and in many cases, occurs along with several congenital issues 
    •     A ligament may be completely missing 
    •     Congenital elbow luxation is typically seen in both dog’s elbows but can occur in only one   

    Diagnosis includes a physical exam where the elbow will be observed along with radiographs to show possible fissures, bowing, and bone growth deformities.

    What Are The Symptoms?

    Symptoms of elbow luxation in dogs begin to show at around 3-4 months of age with dogs experiencing a partially flexed elbow, pain at the elbow with swelling, mild lameness, an inability to bear weight on the limb, pain in the affected leg, pronation of the forelimb, and deviation of the lower leg. A veterinarian will likely take radiographs of the dog to identify any cracks and fissures that are poorly defined in the bones, bowing of the bones, and if interrupted growth in the length of the ulna is present. These factors present in the radiograph point to congenital elbow luxation. Dogs who are presenting these symptoms should be seen by a vet as it can often be extremely painful.

    What Are The Treatments?

    In mild cases of congenital elbow luxation, treatment tends to be minimal and radiographs will be taken frequently to evaluate any progression of the condition. The elbow may also be put back into the correct alignment and put into a splint for 2 weeks. In more severe cases where the dog develops pain and further subluxation of the elbow, surgery may be recommended. The procedure would involve aligning the elbow and stabilization. This allows for radial growth to take place. A pin is placed following reduction of the dislocated joint, restoring movement in the elbow and leading to normal limb function. In the most severe cases, stronger stabilization may be necessary, which may include the use of external plats and fixators. 

    How to Prevent Elbow Luxation

    Because the majority of elbow luxations are caused by considerable trauma, proper fencing and leashing of your pets can assist to limit the risk of this and other traumatic injuries.

    After an elbow luxation, range of motion is typically fair to good. Joint thickening and arthritis are common occurrences. The worse the elbow is before surgery, and the bigger the dog, the worse the prognosis, but satisfactory limb function is typically possible.

    6. Peripheral Odontogenic Fibromas

    Photo Credit: Veterinary Practice News

    What is Peripheral Odontogenic Fibroma?

    Peripheral odontogenic fibromas (sometimes called Epulis) are a benign oral tumor that grows slowly and is the most frequent mass detected in dogs. They’re more frequent in brachycephalic breeds as well. These tumors become exceedingly invasive if left untreated. They are more frequent in dogs over the age of six, although they can happen to any dog. Epulis are hard masses that develop from the gums, especially the ligament of the affected tooth. While there may be numerous masses present, these masses normally exist on their own. They have the ability to grow to extremely large. ligament of the tooth in question. While several masses may be present, these masses usually exist alone. They have the potential to grow very large. 

    What Are The Symptoms?

    Dogs experiencing peripheral odontogenic fibromas may exhibit signs such as excessive drooling, discomfort, and pain while eating, dropping food, decrease in appetite, difficulty closing the jaw, and reluctance to be touched on their head.  You may be able to observe a distinct mass on the dog’s jaw or inside of the mouth. These masses typically start small but continue to grow larger. Swelling in the surrounding region may also be present. Since this causes immense pain and can cause your dog to not eat, it should be seen by a vet immediately. 

    What Are The Treatments?

    Surgery is the preferred method of treatment if the tumor can easily be removed. In some cases, this involves removing a portion of the dog’s jaw and the associated tooth. 

    In cases where the tumor is too large and not preferred, radiation therapy is used as an alternative. 

    How to Prevent Peripheral Odontogenic Fibromas

    While you can’t exactly prevent Peripheral odontogenic fibromas, alveolo-plasty and extraction of the affected tooth can help prevent recurrence. The elimination of the instigating factor, such as plaque and calculus, might be beneficial in cases of Peripheral odontogenic fibromas.

    7. Spina Bifida

    Photo Credit: Veterinary Clinics of North America: Small Animal Practice

    What is Spina Bifida?

    Spina Bifida is a rare congenital abnormality in which the vertebrae of the spinal column is incomplete due to something going wrong with the fusion of the vertebral arches when embryonic development is occurring. This causes an absence of vertebral arches or the presence of a cleft in the middle of the vertebral arch. Breeds can be predisposed to this condition with the most notable being English Bulldogs and other “screw tail breeds”. The disease can be minor and more significant depending on the severity. 

    Spina Bifida is classified into severity levels, ranging from minimal symptoms to complete paralysis of the lower extremities. There are four primary classifications:


    This is the mildest form of Spina Bifida, with no obvious symptoms or indicators. Your pet may be diagnosed with this kind of Spina Bifida if you have x-rays taken on other parts of his or her body and your veterinarian notices it on the radiographs. They might have a little depression on their spine or exhibit no signs at all. It’s possible that you’re not even aware that your dog is sick.

    Closed Neural Tube Defects

    If your dog falls into this category of Spina Bifida, your vet will likely see the signs of it on radiographs. The symptoms are fairly moderate and controllable. Your dog may be partially paralyzed, dragging his or her feet or walking unsteady, but he or she will still be able to walk. They make also experience bowel and urine incontinence and mild nerve injury. It’s also possible that they can also have no problems with movement.


    The spinal cord has grown properly in this case, but the protective membranes that surround it have pushed up into the malformed apertures of the vertebrae. With this variety of Spina Bifida, surgery to remove the membranes pushing through the bone may be an option. Closed neural tube defects have the same clinical signs as open neural tube abnormalities. Although surgery will not heal your pet’s problems, it will make them more comfortable.


    Myelomeningocele is the most severe form of Spina Bifida. In this form, the spinal cord is frequently entirely exposed, or many vertebrae are deformed. Full incontinence is frequently accompanied by complete paralysis of the lower limbs. With nerve injury, there will be a loss of feeling in the skin. Dogs with this severity are frequently euthanized because their spinal cords are exposed at birth. Hydrocephalus can develop as a result of spinal swelling. Although this ailment may be treated, it is a lifelong condition that can lead to a variety of consequences and high medical expenses. If your dog has this kind of Spina Bifida, rescue groups and expert veterinarians may be extremely helpful in determining the best course of treatment.

    What Are The Symptoms?

    Clinical signs for more severe cases include limb weakness, paralysis, incontinence, lack of coordination, and the skin may be dimpled at the location where the defect is present. Affected dogs start showing signs in puppyhood. This spinal disorder can be seen via an x-ray when a dog is laying on their back. In minor cases, symptoms may not even be present and can only be identified by an x-ray.  In more severe cases with significant neurological defects and pain, there is a very poor prognosis for affected dogs.

    In cases where the defect is rather significant, the spinal cord may be exposed and the condition identified at birth. However, if the condition is severe and the spinal cord is not exposed, it may be identified when a puppy starts growing and has difficulty walking. No matter what age they present symptoms, dogs should be seen by a veterinarian at the first sign of symptoms.

    What Are The Treatments?

    Treatment isn’t necessary for dogs that don’t show symptoms. If symptoms do eventually show, seek the help of a veterinarian. Reconstructive surgery may be helpful in mild cases as small repairs can improve the dog’s condition. Unfortunately, there is no effective treatment for dogs with malformations of their spinal cord.  In severe cases of spina bifida, a veterinarian may recommend euthanasia. 

    How to Prevent Spina Bifida

    Due to Spina Bifida being a congenital disorder, the only possible prevention is removing affected dogs from the breeding pool but this does not guarantee prevention.

    8. Discospondylitis

    Photo Credit: VCA Hospitals

    What is Discospondylitis?

    Discospondylitis is a bacterial or fungal infection of the intervertebral disks and the adjacent vertebral bones which can occur in one location of the spinal column or in multiple locations. There are multiple causes for this disease which are either blood-borne spread, direct contamination or migration of a foreign body towards the spinal cord. A dog may be more predisposed if they have chronic infection or immunosuppression through either medication or another underlying condition but it’s more common in large breed dogs with Great Danes, German Shepherds, Boxers, Rottweilers, Doberman Pinschers, and English Bulldogs being the highest risk. 

    What Are The Symptoms?

    Clinical signs of Discospondylitis that are commonly observed are back or neck pain, reluctance to walk, and decreased appetite. Hesitancy to walk upstairs, run, jump, or get up and down may be displayed. 

    Signs a dog may have Discospondylitis often start slowly and continuously progress over time with the first clinical sign usually being back pain. Dogs who suffer may be acting stiff and not wanting to jump on or off furniture and acting like they are in pain while doing certain movements or being touched in certain spots. With the progression of the condition, more signs become apparent such as muscle weakness and in severe cases, paralysis. Most dogs who are affected also show signs of decreased appetite, lethargy, and weight loss. Dogs showing these signs should be seen by a veterinarian immediately.

    What Are The Treatments?

    Depending on the type of infection, Discospondylitis is typically treated with an antibiotic or antifungal treatment. Improvement may show in the dog quickly, but medication needs to continue throughout the whole period in order to ensure the infection is fully cleared.  The treatment period is rather lengthy, ranging from 6-12 months.

    X-rays are often used to monitor the dog’s response to treatment. 6-8 weeks after treatment has begun, x-rays will typically be taken to monitor the progress. Often, this is too early in the treatment to identify clinical improvement, as bony changes take significant time to occur and resolve. Advanced imaging such as CT scans may also be required. If Discospondylitis is suspected, the vet may perform tests to confirm the infection such as blood cultures, urine cultures, and testing for an infection called brucellosis. A cerebrospinal fluid (CSF) tap may also be requested as well as a neurologist, wanting to obtain a culture directly from the infected disk. 

    In cases where dogs do not show improvement on medication, a veterinarian may recommend surgery. The surgery involves exploring and flushing the region to allow for removal of any foreign material, decompress the disk, and alleviate the pressure on the spinal cord. 

    How to Prevent Discospondylitis

    There are no known methods of prevention other than cautious breeding to avoid using animals that may have genetic material that predisposes dogs to this disease. First-degree relatives (parents, siblings, and offspring) should be kept out of the breeding pool for the optimum outcomes.