Texas A&M Researchers Explore Telehealth Options for Diagnosing Canine Respiratory Conditions

Story by Ainsley Treesh, VMBS Marketing & Communications

April 16, 2025

The Respiratory Function Grading scheme offers a safe diagnostic for brachycephalic obstructive airway syndrome.

French bulldogs, English bulldogs, pugs, and other brachycephalic dog breeds have seen a rise in popularity in recent years. However, these breeds are also prone to health problems, including brachycephalic obstructive airway syndrome (BOAS), which occurs when soft tissue in the nose and throat partially obstruct the airway, making it difficult for the dog to breathe normally.

Currently, BOAS is primarily diagnosed through a dog’s history and invasive procedures that come with a risk for these breeds of dogs.

However, researchers at the Texas A&M College of Veterinary Medicine & Biomedical Sciences (VMBS) are looking at increasing the implementation of telehealth exams to diagnose BOAS.

In a study recently published in the journal Veterinary Surgery, the team — including Dr. Kelley Thieman and Dr. Zong Peng, both from the VMBS’ Department of Small Animal Clinical Sciences (VSCS) — compared the reliability of a BOAS evaluation system when performed in person and remotely.

While remote assessment fared poorer than the team had hoped, the researchers believe their study provided valuable insight on ways to continue developing future virtual examinations that will offer an alternative for diagnosing BOAS in brachycephalic breeds.

A Non-Invasive Option

The research team’s study centered on the Respiratory Function Grading (RFG) scheme, a non-invasive tool developed in the United Kingdom to diagnose BOAS.

The RFG scheme clinically grades dogs on a scale from zero to three – where a grade-zero dog is breathing normally and a grade-three dog would have severe clinical signs that affect quality of life.

This scheme also was used to develop a database of RFG scores that allows breeders to use the data to decrease the likelihood of BOAS in litters. The Orthopedic Foundation for Animals (OFA) has started approving assessors in the U.S., working to add to the current database.

However, there are currently only 12 states in the U.S. with assessors approved by the OFA to administer the RFG exam, and Thieman is the only approved assessor in the state of Texas. As a result, access to the RFG scheme can be difficult for the roughly 126,000 veterinarians currently practicing in the U.S.

“We’re working on ways to allow this grading scheme to be more widely adopted in clinics and increase access to the database, where breeders and owners can look at the grades of different dogs,” said Thieman, VSCS associate professor of soft tissue surgery and associate department head.  

“We want to increase the usage and accessibility of this respiratory scheme by doing it remotely,” said Peng, a second-year resident. “If a telehealth option is available, breeders don’t have to drive across multiple states just to have this exam done.”

Improving Telehealth Exams

In addition to increasing access to a valuable diagnostic tool, implementing the RFG scheme, also would provide a lower-risk option for diagnosing BOAS in brachycephalic breeds.

Veterinarians in the U.S. commonly diagnose BOAS by evaluating the dog’s history, using CT scans, or anesthetizing the dog for airway exams.

“Airway exams and CT scans, they’re not without risk because we’re having to either sedate them or put them under general anesthesia. Sedation and anesthesia come with inherent risks, such as adverse drug reactions or rough recoveries, and this is compounded by the fact that dogs with airway disease are poorer anesthetic candidates,” Peng said.

In the study, seven assessors performed in-person examinations on a select group of dogs and scored them using the RFG scheme.

Several months after the initial exam, the same assessors evaluated the same dogs using audio and video recordings and assigned a new RFG score.

When Peng and his team compared the grades of the in-person and remote evaluations, they found there was not a high level of agreement, leaving the team to determine that, as performed in the study, telehealth was not a reliable mechanism for evaluating these dogs for BOAS.

However, the study did provide the team with insight on ways to continue developing future virtual examinations.

“We have to fine-tune the ways we make the recordings, because everything we’re looking for in the respiratory grading function scheme are things that we should be able to evaluate remotely,” Peng said. “In the future, we can fine-tune things like controlling the volume level during recording and standardizing the type of videos we take.”

With so many benefits to the RFG scheme, Peng is optimistic that with further development, telehealth evaluations will become a common resource for breeders and pet owners.

“I think the availability of this exam could raise awareness to breeders and owners,” Peng said. “Even new owners that are wanting a brachycephalic puppy could talk to a breeder that seems to have a lot of grade zero dogs or get a puppy from a litter that’s bred from two grade zero dogs.”

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For more information about the Texas A&M College of Veterinary Medicine & Biomedical Sciences, please visit our website at vetmed.tamu.edu or join us on Facebook, Instagram, and Twitter.

Contact Information: Jennifer Gauntt, Director of VMBS Communications, Texas A&M College of Veterinary Medicine & Biomedical Sciences, jgauntt@cvm.tamu.edu, 979-862-4216

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