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Understanding RFG/BOAS

Respiratory Function Grading

Welcome to the French Bulldog Foundation of America's dedicated resource on the Respiratory Function Grading Scheme (RFG/BOAS). This tool is vital for breeders committed to improving airway health in French Bulldogs and other brachycephalic breeds.


But what Exactly IS BOAS? Breath easier... we've got your answers.

What Does BOAS Sound Like?

This snippet featuring Dr. Jane Ladlow, who developed the Respiratory Function Grading Schema for the Kennel Club in the UK, now available in the US via Orthorpedic Foundation of America (OFA), demonstrates the three types of audible BOAS, covers how the RFG/BOAS test is done, what the four ratings are, and which dogs are considered acceptabe to breed to each other.  

 

Credit: Dr. Jane Ladlow, "BOAS: How to diagnose it," Cambridge Veterinary School, 2020. Available at: https://www.youtube.com/wat

Dr. Julia Ziegler, DVM

Grab interest

  

Dr. Julia Ziegler, DVM BOAS & Respiratory Function Grading Scheme (RFGS) Expert Certified OFA RFGS Evaluator

Dr. Julia Ziegler is a dedicated veterinarian and certified evaluator for the Orthopedic Foundation for Animals (OFA) Respiratory Function Grading Scheme (RFGS). Based in North Carolina at Animal Hospital on South Main (and its sister location), she specializes in brachycephalic airway health with a strong focus on improving quality of life for French Bulldogs and other flat-faced breeds.

Her expertise centers on Brachycephalic Obstructive Airway Syndrome (BOAS) — a progressive condition involving multiple anatomical challenges that restrict airflow. Dr. Ziegler provides clear, practical education on how BOAS affects our dogs and how the non-invasive RFGS test offers an objective way to assess respiratory function, guide breeding decisions, support surgical planning, and track improvements through management like weight control.


In her recent in-depth webinar for the French Bulldog Foundation of America, “Inside BOAS: What Every French Bulldog Owner & Breeder Should Know,” Dr. Ziegler delivered over an hour of valuable insight into the disease process, real-world impacts on daily life, and actionable strategies for breeders and owners. The session included an engaging Q&A that addressed common questions from the community.


Dr. Ziegler’s approach is compassionate and solution-oriented. She emphasizes that the goal isn’t perfection, but steady progress toward healthier, happier French Bulldogs through informed, responsible breeding and proactive health management.

We are deeply grateful to Dr. Ziegler for sharing her time, knowledge, and dedication with the FBDFA community. Her contributions directly support our mission: Health Above All Else — through education, advocacy, and promoting responsible, health-focused breeding.


Expertise Areas:

  • Brachycephalic Obstructive Airway Syndrome (BOAS)
  • Respiratory Function Grading Scheme (RFGS) testing & interpretation
  • Breeding recommendations using RFGS grading
  • Airway management and improvement strategies
  • Education for owners, breeders, and enthusiasts


More educational webinars, clinics, and resources featuring experts like Dr. Ziegler are coming soon. Join the FBDFA community to stay informed and help build a healthier future for French Bulldogs.


Understanding RFG/BOAS: Respiratory Function Grading Scheme

What is BOAS?

 Brachycephalic Obstructive Airway Syndrome (BOAS) is a respiratory condition common in flat-faced breeds like French Bulldogs, resulting from anatomical features such as narrowed nostrils (stenotic nares), elongated soft palates, and tracheal narrowing. It causes breathing difficulties, exercise intolerance, heat sensitivity, and potential complications like regurgitation or collapse. While pet owners should monitor symptoms, RFG testing is primarily for evaluating breeding stock to reduce hereditary risks and promote healthier generations.


 

The YouTube video "BOAS: How to diagnose it" by Jane Ladlow includes several audio demonstrations of BOAS-related respiratory sounds, primarily in the latter half. Here's a timeline of the key sound examples based on the video content:

  • 16:17: Demonstration of an "awake snorer" sound (low-pitched rumbling, often linked to soft palate or nasopharynx issues).
  • 16:43: Example of stridor (high-pitched wheezing, typically laryngeal-related).
  • 16:58: Another stridor sound bite (laryngeal focus).
  • 17:05: Nasal stridor example (low-pitched grunting or snuffling from nasal obstruction).
  • 18:20: Mild nasal noise in a one-year-old bulldog (pre-exercise, showing subtle obstruction).
  • 18:28: Post-exercise recovery sound (no noise, for contrast with affected cases).

These clips are short (5-10 seconds each) and accompanied by Dr. Ladlow's explanations. For the full context, watch the video directly.

History and Development

The RFG scheme was pioneered by the BOAS Research Group at the University of Cambridge, led by Dr. Jane Ladlow, a renowned veterinary surgeon specializing in brachycephalic health. Over two decades of research, starting in the early 2000s, Dr. Ladlow's work addressed the rising welfare concerns in breeds like French Bulldogs, Pugs, and Bulldogs. The scheme was developed to provide an objective, evidence-based assessment of BOAS severity, enabling breeders to make informed decisions and reduce the incidence of affected puppies.

Key milestones:


  • Early Research (2000s): Dr. Ladlow's studies at Cambridge highlighted the need for standardized testing amid growing awareness of BOAS as a progressive disorder.
  • Launch (2019): Partnered with The Kennel Club (UK), the scheme was introduced to improve breed health through functional grading.
  • US Adoption (2023): The Orthopedic Foundation for Animals (OFA) implemented the RFG in the United States, adapting it for local breeders and expanding its global impact.

This initiative stems from a commitment to welfare over aesthetics, countering indiscriminate breeding that exacerbates conformational issues.

The RFG Procedure

 Photo Credit: Belinda Neil

The RFG is a non-invasive, standardized exam performed by certified veterinarians, lasting about 15-20 minutes. It's designed specifically for assessing breeding candidates (minimum age: 12 months; preliminary for younger dogs).


Steps:


  1. Pre-Exercise Assessment: A health survey on breathing history, followed by a calm physical exam including auscultation (stethoscope listening) for baseline respiratory sounds and visual grading of nostril openness (0-3 scale).
  2. Exercise Test: A brisk 3-minute walk (4-5 mph) to simulate mild activity, monitoring effort and noise.
  3. Post-Exercise Evaluation: Immediate re-auscultation to assess recovery (should normalize within 5 minutes), checking for distress like cyanosis or excessive panting.


The test occurs in a controlled, calm environment to minimize stress. If severe signs are present pre-exercise, the test may be skipped for safety.

Grading System

Grades are based on respiratory noise, inspiratory effort, and signs of distress, using a scale of 0-3:

  • Grade 0: Clinically unaffected – no BOAS signs; ideal for breeding.
  • Grade 1: Mild signs – unaffected clinically; suitable with caution.
  • Grade 2: Moderate signs – clinically affected; breeding discouraged.
  • Grade 3: Severe signs – clinically affected; exclude from breeding.

The highest category determines the final grade. Results help apply selective pressure to reduce BOAS incidence, though unaffected parents don't guarantee unaffected offspring.

Why It's Important for Breeders

Why It's Important for Breeders

 

BOAS: How to diagnose it" by Jane Ladlow from Cambridge Veterinary School) includes several clear sound bites demonstrating what BOAS (Brachycephalic Obstructive Airway Syndrome) sounds like in affected dogs. These audio examples are used to illustrate different types of respiratory noises associated with the condition, helping to differentiate the sources of obstruction.

Key Sound Bites from the Video:

  • Awake Snoring: A low-pitched, rumbling noise typically caused by issues in the soft palate or nasopharynx. It sounds like a deep, vibrating snort or rattle during normal breathing, even when the dog is awake and relaxed. This is one of the most common indicators of mild to moderate BOAS.
  • Stridor: A high-pitched, whistling or wheezing sound linked to laryngeal collapse (often seen in breeds like Pugs). It resembles a sharp, strained inhale or exhale, similar to a human with a blocked throat, and can become more pronounced during excitement or exercise.
  • Nasal Stridor: Another low-pitched variant, stemming from nasal obstruction (e.g., stenotic nares or narrowed nostrils). This manifests as a grunting or snuffling noise, like labored sniffing through a congested nose, which may include gurgling elements.

These examples are played directly in the video as short clips (5-10 seconds each) captured from real dogs, with Dr. Ladlow explaining the underlying anatomy and how the sounds correlate to specific lesions. The audio is crisp and educational, making it a great resource for breeders or vets learning to identify BOAS symptoms. The video overall emphasizes the RFG scheme for grading these issues objectively.

Find a Certified Evaluator

Why It's Important for Breeders

 OFA-approved RFGS examiners are trained veterinarians who ensure reliable assessments. As of Spring 2024 (check OFA for updates), here's a directory by state (contact via email for appointments; they may host clinics or test at their facilities). 


Note: this  will take you directly to OFA's page on RFG/BOAS where you can scroll to view the latest approved list.


Locate an RFG Evaluator

Respiratory Functional Breathing Demo +

If you'd like to watch a French Bulldog put to a significant test, watch Dirty Martini on the treadmill... then watch his recovery.
https://youtu.be/QcEep82yAgM?si=8R-CBJxurLJF9fYG

This demonstration is NOT what is required to test for RFG/BOAS: that test is only 3 mins at a trotting pace of about 4pmh... no hills... no galloping... but it does a good job of showing what a healthy Frenchie can do... and he's not the only one!

OFA's List of APPROVED RFGS Examiners

RFGS Examiners

FBDFA will update this list quarterly to sync with OFA's published list. 


"The following veterinarians have been approved as OFA RFGS examiners as of Spring 2024.  Email is the preferred method of contact.  RFGS appointments can be made at their hospitals or clinics, or they can be contracted to perform RFGS exams at health screening clinics. "


List Last updated 1-30-2026.

Alabama

  • Robyn Wilborn, DVM, DACT (Auburn CVM, Auburn), therio@auburn.edu

California

  • Lynelle Johnson, DVM, DACVIM (UC Davis, Davis), lrjohnson@ucdavis.edu
  • Bruce Christensen, DVM, DACT (Kokopelli Veterinary Center, Sacramento), kokopellivet@gmail.com
  • Alyssa Shelby, DVM (Kokopelli Veterinary Center, Sacramento), dralyssa@kokopellivet.net
  • Brittany Shumack, DVM (Kokopelli Veterinary Center, Sacramento), brittany.shumack@gmail.com
  • Mary Sebzda, DVM, DACT (Newport Harbor Animal Hospital, Costa Mesa), doctors@newportharborvets.com
  • Sophie Grundy, DVM (Banfield Pet Hospital, Elk Grove), sophie.grundy@usa.net
  •  Janice Cain, DVM, DACVIM (Canine Reproduction Center at Ironhorse VetCare, Dublin), cainrepro@gamil.com

Colorado

  

  • Milan Hess, DVM, DACT (Colorado Veterinary Specialty Group, Littleton), reproduction@cvsg.com
  • Rachel Blankmeyer, DVM (Black Canyton Veterinary Clinic, Montrose), rmblankmeyer@gmail.com
  • Jenna Dockweiler, DVM, DACT (Wheat Ridge Animal Hospital, Wheat Ridge), jenna.dockweiler@gmail.com
  •  Hayley Moore, DVM, DACT (Village Center Veterinary Care, Colorado Springs), dr.hayleymooredvm@gmail.com 

Florida

  •   Carla Barstow, DVM, (Highland Pet Hospital, Tampa), dr.barstow@tampavet.com
  • Kathleen Ham, DVM, DACVS (UFL, Gainesville), hamkat15@yahoo.com
  • Renato Mendez, DVM (Quality Care Animal Hospital, Miramar), qualitycareah@yahoo.com

Iowa

  •   Olivia Stricklin, DVM, MS, DACT (Iowa State University, Ames), stricklo@iastate.edu
  • Tressa Reiner, DVM (Iowa State University, Ames), tkreiner@iastate.edu

Maryland

  • Allan Frank, DVM (Hunt Valley Animal Hospital, Cockeysvile), petvet84@verizon.net
  • Tim Cujdik, DVM (Hunt Valley Animal Hospital, Cockeysville), tjpcujdik@verizon.net
  • Melanie Donis, DVM (Companion Care Veterinary Hospital, Mechanicsville), melmacvet@yahoo.com
  • Kate Withowski, DVM, DACT (East Coast Vets, Easton), sunnysiderepro@gmail.com

Massachusetts

  •  Elizabeth Rozanski, DVM, DACVIM (Tufts, North Grafton), elizabeth.rozanski@tufts.edu
  • MaryAnne Mack, DVM (Feeding Hills Veterinary Hospital, Granby), drmack@feedinghillsvet.com

Michigan

  • Amanda Bolyard, DVM (Heritage Animal Hospital, Dundee), dramanda@hahvet.com
  • Nicole Sugai, DVM, DACT (Heritage Animal Hospital, Dundee), drnicole@hahvet.com
  • Leeah Schwanger, DVM (Wilson Veterinary Hospital, Washington), mbgolds@hotmail.com
  • Robin Elizabeth Krieger, DVM (Clarkston Animal Medical Center, Clarkston),  frenchiedvm@gmail.com
  • Ryan Carpenter, DVM (Family Friends Veterinary Hospital, Grand Rapids), staff@familyfriendsvet.com
  • Katherine Donahue, DVM (Schultz Veterinary Clinic, Okemos), info@schultzvetclinic.com
  • Terrie Malinak, DVM (Schultz Veterinary Clinic, Okemos), info@schultzvetclinic.com
  • Michelle Roth, DVM (Schultz Veterinary Clinic, Okemos), info@schultzvetclinic.com

Nevada

  • Jessica Hagstette, DVM (Camino Al Norte Animal Hospital, North Las Vegas), jhagstette@gmail.com

New Hampshire

  • Dan Kelleher, DVM (Broadview Reproductive Services, Dover), kellehervet@gmail.com

New Jersey

  • Jacob Froelich, DVM, PhD (Cape Veterinary Hospital, Cape May Court House), jfroehlich@capevethospital.com

New York

  •  Christopher Payton, DVM (Harmony Veterinary Clinic, Ballston Spa), chrispayton4@yahoo.com

North Carolina

  • Beth Bauer, DVM (Carolina Ranch Animal Hospital, Garner), tagalongdals@gmail.com
  • Julia Zuercher, DVM (Animal Hospital of Statesville, Statesville), jzdvm21@gmail.com
  • Nichola Gaither, DVM (Animal Hospital of Statesville, Statesville), dr.nicholagaither@gmail.com
  • Ashly LaRoche, DVM (Animal Hospital of Statesville, Statesville), dr.ashlylaroche@gmail.com
  • Amber Talbot, DVM (Animal Hospital of Statesville, Statesville), amber.r.talbot@gmail.com
  • Kristin Christy, DVM (Animal Hospital of Statesville, Statesville), drchristy101@gmail.com
  • Natalie Orner, DVM, DACT (Eastern Carolina Veterinary Referral, Wilmington), natalie.orner@easterncarolinavet.com
  • Amber Nebel-Karp, DVM (Animal Hospital of East Davie, Advance), amber.nebel@gmail.com
  • Lacey Rosenberg, DVM, DACT (Veterinary Hospital at the Lake, Sherrills Ford), drlaceyrosenberg@gmail.com
  • Jane Barber, DVM, MS, DACT (Terrell), drjanebarber@aol.com

Ohio

 

  • Erin Runcan, DVM, DACT (The Ohio State University, Columbus), runcan.1@osu.edu
  • Connor Cashman, DVM (Animal Clinic Northview, North Ridgeville), concash16@gmail.com
  • Lori Hunt, DVM (Cuyahoga Valley Vet Clinic, Richfield), staff.cvvc@gmail.com

Oklahoma

  • Lauren Kinter, DVM (405 Vet Animal Hospital, Oklahoma City), lauren.kinter@svp.vet

Oregon

  • Cheryl Lopate, DVM, DACT (Wilsonville Veterinary Clinic, Wilsonville), lopatec1@gmail.com
  • Eleas Wu, DVM, DACT (Wilsonville Veterinary Clinic, Wilsonville), eleaswu@gmail.com

Tennessee

  • Blair Cornman, VMD (Animal Hospital of Signal Mountain, Signal Mountain), bcornman@nva.com 
  • Julie Adams, DVM (PAWS Tennessee, Gordonsville), vet@pawstn.vet
  • Lily Lewis, DVM, DACT (Blue Pearl Pet Hospital, Franklin), lily.lewis@bluepearlvet.com

Texas

  • Kelley Thieman, DVM, DACVS (TX A&M, College Station), kthieman@cvm.tamu.edu
  • Jessica Cohen, DVM, DACT (McKinney Animal Hospital, McKinney), jessicacohendvm@gmail.com

Utah

  •  Dave Mahoney, DVM, DACT (South Mountain Pet Care, Draper), peligrodave@gmail.com 

Virginia

  • Valeria Rickard, DVM (JVR Veterinary Services, Haymarket), valeria,rickard@jvrveterinaryservices.com
  • Julie Cecere, DVM, DACT (VA/MD Regional CVM, Blacksburg), juliet@vt.edu
  • Kara Kolster, DVM, DACT (Springfield Veterinary Center, Glen Allen), karakolster@gmail.com

Washington

  • Anders Thoreson, DVM (Klahaya Animal Hospital, Snohomish), athoreson@klahayavet.com
  • Cynthia Smith, DVM (The Pet Doctor, N Lakewood), comerrell@comcast.net

Wisconsin

  •  Carrie Stefaniak, DVM, (Sunrise Veterinary Services, Reedsburg), carrietate99@gmail.com
  • Marty Greer, DVM, (Veterinary Village, Lomira), drgreer@k9stork.com

Canada - Ontario

  • Allison Collier, DVM (U of Guelph, Guelph), colliera@uoguelph.ca
  • Ameet Singh, DVM, DACVIM (U of Guelph, Guelph), amsingh@uoguelph.ca
  • Meredith Walker, DVM, (Mississauga Animal Hospital), meredithwalker98@gmail.com
  • Matthew Wittenrich, DVM, (Beattie Pet Hospital), drmattwittenrich@gmail.com
  • Jenn Woods, DVM (Brookville Vet Clinic, Campbellville),  jenn@brookvillevet.com
  • Juan Castillo, DVM (Graham Animal Hospital, Hillsburgh), jmcastilloh@gmail.com
  • Rasa Levstein, DVM, DACT (Graham Animal Hospital, Hillsburgh), rasa.levstein@gmail.com
  • Patricia Lechten, DVM (Allandale Veterinary Hospital, Barrie), patricia.lechten@sympatico.ca
  • Evan Bell, DVM (Vets on Main, Ottawa), evan.bell@vetsonmain.ca
  • Rea Marcelissen, DVM (St. Lawrence College Pet Hospital, Kingston), readvm@gmail.com

Canada - Quebec

  • Raphael St-Pierre, DVM (Hopital Veterinaire Mont St-Hilaire, Otterburn Park), raphaelstp22@gmail.com 

Canada - Alberta

  • Natasha Borowski, DVM (Wetaskiwin Animal Clinic, Wetaskiwin), nborowski1991@gmail.com
  • Erika Duperreault, DVM (Crestwood Veterinary Centre, Edmonton), erikaduperreault@gmail.com
  • Dr. Yanhui Qi (Calgary Holistic Veterinary Clinic, Calgary), holisticvet@telus.net
  • Dr. Cesar Lima (Taber Pet Clinic, Taber), lima@taberpetclinic.ca
  • Alexandra Horner, DVM, DACT (Springbank Pet Hospital, Calgary), alexandra.horner@shaw.ca
  • Marco Bregliano, DVM, DACT (VetDirect, Okotoks), marco@vetdirect.ca

Canada - British Columbia

  • Hebe Lin, DVM (Eastern Pet Integrative Care Vet Hospital, Richmond), epicvetca@gmail.com
  • Irene Mul, DVM (Okanagan Veterinary Hospital, Kelowna), mulirene@hotmail.com

Canada - New Brunswick

  •  Shannon Monteith, DVM (Florenceville Vet Clinic, Florenceville-Bristol), monteithshannon@yahoo.ca 

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