Flat Chest Syndrome – Flat Chest Puppy French Bulldogs, a Fatal Problem if Left Untreated

By: Danielle Harris

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Understanding Flat Chest Puppy Syndrome: Causes, Symptoms, and Treatment.

As a dog breeder and owner, it is essential to be aware of the various health conditions that can affect your furry friend.

One such condition is Flat Chest Puppy Syndrome.

Flat Chest puppy English Bulldog.     Photo Credit to Owner
Flat Chest English Bulldog. Photo Credit to Owner

What is Flat Chest Puppy Syndrome?


Flat Chest Puppy Syndrome (FCPS) can have 2 causes:

weight of the puppy or a congenital condition also known as Pectus Excavatum.

In both conditions, the chest of the puppy is abnormally flat and narrow, which can lead to respiratory problems and even death.

Causes of Flat Chest Puppy Syndrome

There are a few causes.

  • Laying on flat surfaces without enough traction and bumps (also leads to swimmers- but is a totally separate condition)
  • Weight of a pup (no matter how bumpy the surface)
  • Pectus Excavatum. (pictured below)
Pectus Excavatum. Photo Credit- Frenchi Exoitics
Pectus Excavatum. Photo Credit- Frenchi Exoitics

In normal flat chest, due to flat surfaces and weight, the chest becomes flat like a pancake.

In Pectus Excavatum the chest is concave and the exact cause is still unknown. (pictured above) However, it is believed to be a genetic disorder that is passed down from the parent dogs to their offspring.

The syndrome is more commonly seen in certain breeds, including Bulldogs, Pugs, and Boston Terriers.

This is a serious condition either way. Left untreated, internal organs such as the heart and lungs become affected.

Symptoms of Flat Chest Puppy Syndrome

The symptoms of Flat Chest Puppy Syndrome usually become apparent within the first few weeks of the puppy’s life.

The most common symptoms include:

  • Breathing Problems
  • Puppies with FCPS may struggle to breathe properly, especially during physical activity or when they are excited.
  • The puppy may breathe rapidly, and their breathing may be shallow and labored.
  • Coughing – The puppy may cough frequently, and their cough may sound wet or raspy.
  • Exercise Intolerance
  • Puppies with FCPS may become tired quickly during exercise or physical activity.
  • Failure to Thrive, No desire to nurse or eat

Puppies with severe FCPS may experience failure to thrive, which means they are not gaining weight as expected and may be weaker than their littermates.

This is due to being unable to properly eat, often times with regurgitation from not being able to pass food down through the esophagus.

With every regurgitation, aspiration and pneumonia becomes an increasing risk factor.

Risks of Flat Chest

Flat chest affects many things

Cramping of the internal organs can cause problems with heart and lungs.

They become displaced and improperly develop. This leads to difficulty breathing, low energy levels/exhaustion, poor circulation, heart murmurs, erratic heart rates from compressed heart, and scoliosis.

In addition to heart and lung problems, eating can become a problem as well.

If the chest is misshapen, passing food down through the esophagus can become a problem. This leads to regurgitation and pneumonia.

Diagnosis of Flat Chest Puppy Syndrome

A veterinarian can diagnose Flat Chest Puppy Syndrome through a physical examination of the puppy’s chest. They may also perform X-rays to confirm the diagnosis and assess the severity of the condition.

Treatment of Flat Chest Puppy Syndrome

The treatment of Flat Chest Puppy Syndrome depends on the severity of the condition.

Mild cases may not require any treatment, while severe cases may require surgery. The following are some of the treatment options available for FCPS:

1. Oxygen Therapy

Puppies with breathing difficulties may require supplemental oxygen therapy to help them breathe easier.

2. Medications

The veterinarian may prescribe medications, such as bronchodilators or antibiotics, to help manage the symptoms and prevent complications.

Flat Chest Splint Kit - Frenchi Exotics
Flat Chest Splint Kit – Frenchi Exotics

3. Splint

There are special tools you can purchase for your flat chested puppy. These splints keep your pup from laying flat on the ground and gently reshapes the chest. You can view/purchase them here.

Splint Fitting - Frenchi Exotics
Splint Fitting – Frenchi Exotics

3. Surgery

In severe cases, surgery may be necessary to correct the abnormal shape of the chest. The surgical procedure involves placing a splint or a custom-made brace on the puppy’s chest to support the chest wall and help it grow normally.

Pectus after Correction - Frenchie Exotics
Pectus after Correction – Frenchie Exotics

Prevention of Flat Chest Puppy Syndrome

Keeping your pups on a nice bumpy surface is best.

We use egg carton shaped acoustic panels or rolled up towels/blankets under whelping blankets.

We also put medium size toys in the box for them to cuddle and crawl over to build muscle.

It’s important to monitor eating habits. Overeating can cause a flat chest, as well as other conditions such as swimmers and diarrhea.


Flat Chest Puppy Syndrome is a serious health condition that can affect the quality of life of your puppy.

It is essential to be aware of the causes, symptoms, and treatment options available to manage this condition.

If you suspect that your puppy has FCPS, it is advisable to consult a veterinarian immediately.

The longer the condition is untreated, the less likely it is to reverse the condition, with more problems arising.

Always have the proper tools on hand at all times in case of an emergency!

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