French bulldogs are the most popular dog breed in the U.S., dominating American Kennel Club registrations for the past four years. While coveted for cute looks, it’s no secret the breed is prone to health problems, often undergoing surgeries to correct issues with their airways. 

During these and other procedures requiring sedation, members of the University of Minnesota Veterinary Medical Center’s Anesthesia Service team noticed a trend that warranted further investigation.  

When procedures are complex or long, the team uses two methods to monitor the patient’s blood pressure: an oscillometric cuff placed on the leg—similar to those used on people’s arms—and a catheter inserted into a blood vessel. In cases of shorter, stockier breeds like the Frenchie, the readings provided by both devices sometimes didn’t match. 

Of the two methods, the arterial catheter is considered the gold standard, so the issue likely lay with the cuff. The question of why the discrepancy exists sparked a research project led by anesthesia resident Josephine Sindorf. The project focuses on French bulldogs in particular because they are seen often at the VMC, and selecting one breed reduces variability in the research data. 

“No one has looked at whether breed-specific conformation—in this case, the structure of the legs—affects the accuracy of non-invasive blood pressure monitoring in dogs,” Sindorf says. 

“If what we are seeing anecdotally is statistically significant based on our results, it likely applies to other breeds with the same limb conformation such as English bulldogs, pugs, and basset hounds.”

It’s likely the anatomy of the Frenchie and these other breeds that creates difficulty in getting accurate blood pressure readings. The muscles of their front legs give them more of a conical shape compared to the typically cylindrical shape of the front limb of the average dog. 

“Oscillometric cuffs are placed and secured around the limb and then inflate and deflate to determine the blood pressure,” says Colleen Hickey, a veterinary anesthesiologist and assistant professor at the College of Veterinary Medicine. “When the limb is more conical, like with brachycephalic dogs, we have observed that it is harder for the cuff to stay in place and question whether it inflates uniformly across the limb.”

Not having accurate blood pressure readings during procedures increases an already elevated risk faced by brachycephalic breeds when placed under anesthesia. Brachycephalic breeds have been shown to have a higher anesthetic risk—meaning a chance to have an adverse event or side effect while receiving anesthesia—relative to non-brachycephalic breeds. Airway confirmation, which ensures that a tube placed in the patient’s airway to facilitate breathing is oriented and working properly, is challenging in brachycephalic breeds due to the crowding of anatomic structures in their bodies. The added inability to accurately measure blood pressure could contribute to issues such as prolonged or poor anesthetic recovery.

By observing the prevalence and nature of blood pressure reading discrepancies, the research team hopes to prove that breed may play a role in the accuracy of blood pressure monitoring to raise awareness about the issue

“We may be able to identify trends—such as if the oscillometric cuff consistently underestimates or overestimates blood pressure—that may help guide others in interpreting oscillometric blood pressure readings in Frenchies,” Sindorf says.

While the risks of anesthesia in Frenchies can’t be completely eliminated, the team hopes to work toward reducing the risk by improving anesthetic monitoring and patient care before, during, and after an anesthesia event.