With the increasing popularity of the brachycephalic breeds more and more first-opinion practices are being presented with patients suffering from hereditary diseases. Even though the primary message is to persuade potential puppy owners to choose longer nosed breeds, there are many patients requiring help to alleviate these debilitating conditions for a better quality of life. Jane Ladlow and the BOAS Research Group at the University of Cambridge provide guidance on how to diagnose and treat these patients.