Fact Sheet Dog Breed Cavalier King Charles Spaniel

 3. Problems/syndromes that may occur in the breed

Of the health problems and possible diseases that occur in this breed, only the most important are listed here.

The Cavalier King Charles Spaniel is known to have the following hereditary defects as well as a high incidence of health problems and dispositions:

(Please also refer to the fact sheets already available on individual defects, especially brachycephaly).

• Brachycephaly
• BOAS (brachycephalic obstructive airway syndrome)
• Chiari-like malformation / syringomyelia
• Mitral valve diseases
• Ocular diseases
• Congenital keratoconjunctivitis sicca and ichthyosiform dermatosis (CKCSID) – Dry Eye Curly Coat Syndrome 
• Chondrodystrophy and chondrodysplasia incl. intervertebral disc diseases
• Degenerative myelopathy
• Primary secretory otitis media (PSOM)
• Dental diseases and diseases of the periodontium
• Episodic Falling Syndrome

4. Other problems that may occur frequently

In addition to the breed-typical defects listed under point 3, there are indications in the veterinary literature of the occurrence of the following problems, which are not discussed further below, as no definitive conclusions can yet be drawn from the known prevalences and breeders, breeding clubs and associations do not state any prevalences collected under scientific conditions. However, the following statement by Hale (2021) applies to these cases: „The absence of evidence is not the evidence of absence“.

Important note: The veterinary literature does not always make a clear distinction between the King Charles Spaniel and the Cavalier King Charles Spaniel.

• Diabetes mellitus
• Urolithiasis 
• Exocrine pancreatic insufficiency
• Liver diseases
• Patellar luxation
• Pyometra
• Dystocia
• Occlusion of the femoral artery 
• Orofacial clefts
• Giant platelet syndrome and thrombocytopenia 
• Anal sac carcinoma 
• Pneumocystis pneumonia/immunoglobulin deficiency 
• Temporomandibular joint dysplasia 
• Chronic kidney disease
• Pancreatitis
• Idiopathic epilepsy
• Corneal squamous cell carcinoma
• Duchenne muscular dystrophy (DMD-C)
• Hip dysplasia

5. Symptoms and pathological value of the most important defects mentioned above: Significance/impact on the physical/psychological well-being (burden) of the defect in the individual animal and classification in burden category*

*The individual breeding-related defects are assigned to different burden categories (BC) depending on their severity. The overall burden category is based on the most severe defect found in the individual animal.

The BC- system, which is designed as a further development of the Swiss model, is still under construction. The BC values given here should therefore be regarded as provisional. This is primarily because the German Animal Welfare Act does not contain a justiciable basis for the classification of burden categories. In contrast to Switzerland, the legal standards in Germany do not quantify pain, suffering or harm or assess their quality, but take them into account if they affect the animal more than insignificantly.

The burdens caused by breeding characteristics are divided into four categories in accordance with Art. 3 of the Ordinance on Animal Welfare in Breeding (TSchZV, Switzerland). The most burdenful trait or symptom is decisive for the assignment of an animal to a burden category (Art. 4 TSchZV, Switzerland).

Category 0 (no burden): These animals are approved for breeding.

Category 1 (mild burden): Mild burden is present if burdenful characteristics or symptoms in pets and farm animals can be compensated for by appropriate care, husbandry or feeding without veterinary intervention or regular medical measures.

Category 2 (medium burden): These animals may only be used for breeding if the breeding objective is to reduce the burden level of the offspring compared to the parent animals.

Category 3 (severe burden): These animals may not be used for breeding.

Brachycephaly (see also Fact Sheet No. 8 Dog Brachycephaly)

Physical:
Brachycephaly describes a shortened skull shape, including a greatly reduced snout-vent length. A detailed overview by Geiger et al. (2021) describes the anatomical changes associated with this head shape. The skull is shorter and rounder overall, with a flat snout and shortened nose.

Various diseases are directly associated with brachycephaly and the extreme shape of the skull or promote its development, including diseases of the upper respiratory tract (BOAS, see there) and corneal ulcers. A study from Great Britain with over 22,000 dogs identified the Cavalier King Charles Spaniel as one of the most common brachycephalic breeds presented in veterinary practice with a proportion of 10.43%. In general, brachycephalic dogs show poorer overall health compared to other breeds.

Other health restrictions include narrow nasal passages. Cavalier King Charles Spaniels appear to have a poorer sense of smell than non-brachycephalic breeds.

Because of the changes in the shape of the brachycephalic skull, it is likely that each brachycephalic mouth has different dental anomalies that vary in severity and expression. These may include malocclusion, inadequate eruption of permanent teeth, crowding and tooth rotation with risk of periodontal disease and trauma to the oral soft tissues.
Another common problem concerns the nasolacrimal duct. Due to the change in the facial skull caused by breeding, it is often misshapen, shortened or has a steep slope. This can significantly impair the outflow of tear fluid.  As a result, the tear fluid drains outwards over the eye, which manifests itself as a so-called „tear duct“ with brownish fur discoloration. If this also runs in a fold, dermatitis can occur. 

Psychological:
Brachycephalic breeds are significantly more frequently affected by various diseases compared to non-brachycephalic dogs. Their life expectancy is reduced compared to meso- and dolichocephalic breeds. This is attributed to the health problems associated with brachycephaly, such as BOAS, spinal diseases and other predispositions.

Brachycephaly impairs essential areas of life such as breathing, sleep, food intake, play behavior, temperature regulation and general resilience. This leads to a considerable reduction in the quality of life of affected dogs.

Burden category: 3

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BOAS (brachycephalic obstructive airway syndrome)

Physical:
Brachycephalic obstructive airway syndrome (BOAS) describes a combination of upper airway abnormalities that lead to partial or complete obstruction in dogs. The shape of the skull plays a central role here: the more pronounced the brachycephaly, the higher the risk of developing BOAS. Although the Cavalier King Charles Spaniel has a lower prevalence than breeds with severe brachycephaly, a variety of primary and secondary changes still occur.

Primary anatomical components include congenital features such as stenotic nostrils, an elongated soft palate, a hypoplastic trachea and nasopharyngeal turbinates. Increased air turbulence and increased airway resistance can subsequently lead to secondary changes such as palatal and laryngeal edema, swelling, eversion of the laryngeal sacs and tonsils, and laryngeal collapse. These changes can lead to life-threatening respiratory problems. Affected dogs can have any combination of the above defects, resulting in varying degrees of upper airway obstruction.

The lower respiratory tract can also be affected. Changes and collapse of the bronchi as well as aspiration pneumonia occur more frequently in brachycephalic breeds.
Typical symptoms include snoring, coughing, noisy breathing (stertor/stridor), shortness of breath, belching, vomiting, reduced resilience, blue coloration of the mucous membranes (cyanosis) and fainting spells (syncope). Effective thermoregulation via evaporation from the nasal mucosa is hardly possible due to the anatomical changes, which in combination with disturbed panting can lead to overheating. If the clinical symptoms are severe, treatment by intubation, oxygen administration, cooling and/or sedation is required.

The Cavalier King Charles Spaniel is significantly overrepresented in dogs with respiratory distress. The median age of this breed at the onset of symptoms is often well below the l average of over nine years observed in other brachycephalic breeds. In addition to the respiratory tract, the gastrointestinal tract can also be affected, for example due to changes in the oesophagus or intestines.
Various surgical procedures are recommended to correct the airway obstructions and thus improve the quality of life of the dogs. The post-operative (recovery) phase is particularly critical and requires intensive observation and care. However, complete resolution of the problems is not necessarily achieved.

Psychological:
The primary and secondary changes associated with BOAS can lead to life-threatening respiratory impairment. Affected dogs suffer from chronic respiratory distress and have to breathe mainly with their mouths open, although they are obligate nose breathers. Particularly at high outside temperatures, their activity is severely restricted due to impaired thermoregulation.

In addition, exercise and heat stress intolerance – which can already become a danger with any form of excitement, whether positive or negative – leads to a massive restriction of species-typical behavior and increases susceptibility to further stress.

Burden category: 3

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Chiari-like malformation (Syringomyelia)

Predisposed to Chiari-like malformation with or without syringomyelia are small-bred breeds, the so-called toy breeds (social dogs) with a shortened muzzle and pronounced stop. Such changes are most frequently reported in the Cavalier King Charles Spaniel, King Charles Spaniel, Griffon Bruxellois, Affenpinscher, Chihuahua, Yorkshire Terrier, Maltese and Pomeranian (Miniature Spitz). Less frequently affected breeds are French Bulldogs, Boston Terriers and Pugs.

A Chiari malformation is not necessarily associated with syringomyelia, but can itself lead to clinical symptoms (pain) that are relevant to animal welfare.

Physical:

Etiology
Chiari-like malformation (CM) is a condition in which the brain is too large in relation to the skull, resulting in a blockage of the opening between the skull and the spinal column. This impairs the flow of cerebrospinal fluid around and within the spinal cord, leading to the formation of fluid-filled cavities in the spinal cord known as syringomyelia. These cavities can either surround the central canal of the spinal cord or separate from it.
In the Cavalier King Charles Spaniel, CM is characterized by an abnormal shape of the occipital bone (Os occipitale). This structural anomaly leads to a reduced volume of the caudal cranial fossa, causing the cerebellum and often the brain stem to be displaced caudally into or through the foramen magnum into the spinal canal (cerebellar herniation).

In one study, 92% of Cavalier King Charles Spaniels showed at least one morphological abnormality consistent with a Chiari-like malformation.

The affected areas are not limited to the cranial cervical region, but can also affect more caudal regions of the spinal cord.
Clinical symptoms usually appear between 6 months and 2 years of age. In addition, dwarfism and brachycephaly are considered risk factors for the development of this malformation. 

The exact cause has not yet been conclusively clarified. The most likely theory assumes that a blockage of the normal flow of cerebrospinal fluid (CSF) in the spinal cord leads to a pressure imbalance. If the CSF pressure is not properly synchronized with the increase in pressure from the heart, the fluid can flow into the perivascular space around the blood vessels and ultimately lead to the formation of a syrinx. The condition often occurs later in life and can often only be clearly diagnosed after the age of five.

Risk factors
Possible risk factors in the Cavalier King Charles Spaniel could be the smaller cranial fossa compared to other breeds, the early closure of the spheno-occipital cranial sutures and possibly other sutures. In addition, these dogs show more frequent cerebellar deformities due to the supraoccipital bone and a protrusion of the vermiform process. These findings, combined with the co-occurrence of occipital dysplasia and hypoplasia, suggest that the Cavalier King Charles Spaniel may have additional predisposing factors for the development of syringomyelia.

Small or absent frontal sinuses and a reduced jugular foramen (the opening at the base of the skull for nerves and blood vessels) have also been documented as possible factors for the development. These factors can impair venous drainage and lead to an increase in intracranial pressure. An increased volume of a certain part of the brain (hindbrain, rhomboid brain) and abnormal development of the occipital bone are also discussed as causes.

There is evidence that hypoplasia of the occipital bone is not necessarily the cause of syringomyelia in this breed. Since Cavalier King Charles Spaniels with and without syringomyelia have similar occipital bone volumes, this could indicate that other factors are involved in the development of the disease. Abnormalities in the transition area between the skull and spine do not appear to have any influence on the future clinical course and development of syringomyelia.
In the broadest sense, Chiari malformation (CM) can be described as any deformity of the skull and skull-spine junction that affects the nerve parenchyma and cerebrospinal fluid circulation and causes pain and/or syringomyelia. The causes of CM are diverse and could include genetic, breed-specific abnormalities of both skeletal and neural structures. Since the causal relationship between certain morphologic changes and syringomyelia or clinical signs has not been established, Knowler et al. (2018) suggest that Chiari malformation should be considered a brachycephalic obstructive cerebrospinal fluid canal syndrome (BOCCS) rather than an isolated malformation.

In 2011, the British Veterinary Association (BVA) and Kennel Club (KC) defined three grades of CM (CM 0-2) as part of the CM/SM health screening program, using cerebellar morphology as a measure of crowding of the caudal fossa. However, this historical scoring system defined by the cerebellum does not relate to the severity of SM, nor does it take into account dogs without CM but with SM.

Prevalence and research situation
Further research is needed to better understand the relationship between Chiari malformation (CM) and syringomyelia (SM). The prevalence of these diseases is significantly increased in Cavalier King Charles Spaniels. The Cavalier King Charles Spaniel has a significantly higher risk of CM/SM diagnosis compared to mixed breed dogs. The variation in the prevalence of CM and SM is large and the prevalence rates for CM/SM in the Cavalier King Charles Spaniel range from 25% to 70% and in some studies as high as 92% to 100%, depending on the source.

In Denmark, a study found a prevalence of 15.4% for the occurrence of symptomatic syringomyelia in Cavalier King Charles Spaniels. In dogs from the Netherlands and Denmark, it was found that MRI-based screening and adapted breeding reduced the prevalence of syringomyelia from 38% to 27%.

With regard to other anatomical abnormalities associated with CM, such as atlanto-occipital overlap, a prevalence of 86% was found in Cavalier King Charles Spaniels.

Clinical symptoms and effects
The most common clinical signs of chiari-like malformation (CM) and syringomyelia (SM) in Cavalier King Charles Spaniels are:

• Pain during movement
• Pain during scratching of the ears or head
• Phantom scratching in the shoulder and neck area (without skin contact)
• Visible symptoms and pain on touch in the neck, limb and ear area
• Uncharacteristic aggression when touched
• Neurological deficits, including:
  • Deficits of the lower motor neurons in the forelimbs
  • Proprioceptive deficits
  • Ataxia
  • Facial paralysis

In clinically conspicuous syringomyelia, so-called phantom scratching in the direction of the neck or sternum is often described, but the skin is not touched. Depending on the extent of the syringomyelia, weakness, muscle atrophy and proprioceptive deficits of the limbs may occur.

Clinical signs of neuropathic pain associated with CM/SM worsen in the majority of affected dogs if not treated surgically.

The increasing size of the syrinxes leads to progressive neurological damage due to direct pressure on the neuronal tissue and ischemia. Functional impairment depends on the exact location of the neuronal damage and may include scoliosis, gait disturbances and other symptoms.

Psychological:
Pain is described in the literature as the most common and important clinical sign of syringomyelia. The neuropathic pain caused by the chiari-like malformation increases anxiety and fear-based behavior and significantly reduces the quality of life of affected dogs.

In addition, the neurological symptoms (proprioceptive deficits, ataxia, facial paralysis) further impair the animals‘ well-being and ability to move.

Burden category: 3 

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Mitral valve diseases

Physical:
The Cavalier King Charles Spaniel is predisposed to degenerative changes in the heart valves. In a retrospective study in a clinic in the UK, the Cavalier King Charles Spaniel was the most common breed diagnosed with degenerative mitral valve insufficiency at 32.4%. Compared to mixed breed dogs, the risk of degenerative mitral valve insufficiency was more than 40 times higher. From the age of 10 years, up to 90 % of CKCS are affected. Cavalier King Charles Spaniels with mitral valve insufficiency also have an increased incidence of chordae tendineae rupture (9.6%). It was found that Cavalier King Charles Spaniels with degenerative mitral valve insufficiency have a 2.78-fold increased risk of mortality compared to mongrel dogs. The results of the study suggest that CKCS may be more susceptible to severe consequences of the disease and therefore require more intensive medical care.

One third of the Cavalier King Charles Spaniels examined exhibit heart murmurs. These indicate existing or developing heart disease. Heart failure is characterized by increasing dyspnoea, syncope, coughing, exercise intolerance and nocturnal restlessness.
In the Breed Report of the Swedish animal health insurance company AGRIA, Cavalier King Charles Spaniels had a more than 7-fold increased relative risk of developing heart disease between 2016 and 2021 compared to the average of all other breeds. 

In an investigation of the relationship between mitral valve disease and the presence of SM in the Cavalier King Carles Spaniel, significantly smaller left ventricles and atria were observed in animals with symptomatic SM compared to those with asymptomatic SM.

Psychological:
Cavalier King Charles Spaniels are thought to be more susceptible to severe effects of mitral valve disease and therefore require more intensive medical care. In addition, affected dogs may be behaviorally impaired due to dyspnea and exercise intolerance.

Burden category 3

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Ocular diseases 

Physical:
Brachycephalic ocular syndrome (BOS) encompasses anatomical and physiological features that occur in brachycephalic dogs and are associated with an increased susceptibility to ocular surface disease. A narrow but shallow eye socket leads to protruding eyes (exophthalmos), which means that the eyeball is less protected. In addition, some brachycephalic dogs exhibit a slight outward deviation of the visual axis (lateral strabismus/exotropia), which further exposes the inside of the eyeball.

Macroblepharon
Another predisposing change is macroblepharon – an enlarged palpebral fissure between the upper and lower eyelid. In combination with exophthalmos, trichiasis of the nasal fold (hair rubbing against the eyes) and abnormalities of the nasolacrimal apparatus, this significantly increases the risk of corneal ulcers and traumatic proptosis. The prevalence of corneal ulcers in the Cavalier King Charles Spaniel is between 2.49% and 11.5% . Since most corneal nerve fibers are pain receptors, damage to the cornea causes severe pain.

Other common eye diseases in this breed are keratitis and keratoconjunctivitis sicca. Lack of tear film, malformation of the eyelids, chronic exposure and superficial trauma can lead to chronic keratitis characterized by neovascularization, inflammatory infiltrates, epithelial hyperplasia and pigmentation. This may increase the risk of corneal squamous cell carcinoma. Deeper corneal layers appear to be more frequently affected in brachycephalic dogs.
The prevalence of keratoconjunctivitis sicca in CKCS is between 1.91 % and 3.5 %, depending on the study. Typical clinical signs are a viscous, mucopurulent eye discharge, sticky eyelids and considerable pain.

Cataracts also occur more frequently in this breed. The prevalence was highest in the age group between 10 and 15 years at 6.56%.

According to ACVO (2023), the Cavalier King Charles Spaniel is affected by distichiasis with a prevalence of approx. 9%. Distichiasis refers to extra eyelashes in dogs that emerge from the meibomian glands at the edge of the eyelid and grow towards the eyeball. These cilia can lead to irritation of the cornea.

Epithelial dystrophy of the cornea: Epithelial-stromal corneal dystrophy is characterized by the accumulation of white to gray opacities, usually composed of lipids, in one or more layers of the cornea. As a rule, this disease rarely leads to pain or blindness. The Cavalier King Charles Spaniel is predisposed to this eye disease. The ACVO (2023) puts the prevalence of the disease at approx. 8%.

Eye problems are the third most common disease in Cavalier King Charles Spaniels with a prevalence of approx. 20%. Of these, corneal diseases account for the largest proportion at approx. 42%, followed by conjunctivitis (29.5%), cataracts (9.7%) and uveitis (3.4%). In the Breed Report of the Swedish animal health insurance company AGRIA, the Cavalier King Charles Spaniel had a 2.5-fold increased relative risk of developing eye diseases between 2016 and 2021 compared to the average of all other breeds insured there. In its test statistics for the Cavalier King Charles Spaniel, the OFA states a prevalence of eye diseases of approx. 5%. 

Psychological:
The cornea is innervated by nociceptive afferent nerve cells, which is why damage to the eye can cause severe pain. Ulcerative changes to the cornea can significantly impair the well-being of affected dogs. These diseases can not only cause severe pain, but can also lead to uveitis, perforation of the cornea, loss of the eyeball and a significant reduction in vision. In addition to the impairment of vision, the possible loss of the eye is a considerable burden for the affected dogs.

Burden category: 2-3 depending on the disease and degree of severity

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Congenital keratoconjunctivitis sicca and ichthyosiform dermatosis (CKCSID) – Dry Eye Curly Coat Syndrome

Some Cavalier King Charles Spaniels suffer from a combination of keratoconjunctivitis sicca and ichthyosis, a genetic disorder that leads to rough, scaly coats and skin lesions. Also known as „Dry Eye Curly Coat Syndrome“, this condition is unique to the Cavalier King Charles Spaniel and consists of a combination of two primary disease processes:  

1. Keratoconjunctivitis sicca: Reduced tear production leads to dryness of the surface of the eye. The most common symptoms include redness in one or both eyes and a thick, mucous discharge. Chronically dry eye surfaces are prone to corneal ulcers and can also cause painful secondary bacterial conjunctivitis.
2. Ichthyosiform dermatosis: The disease is typically characterized by a rough and curly coat, which may be accompanied by multifocal alopecia. The skin is usually dry, scaly and prone to flaking, especially on the dorsal spine and lateral flanks. The abdomen may have a hyperpigmented appearance, while the pads of the feet often show signs of hyperkeratinization. In addition, the nails may show conspicuous growth abnormalities.

Physical:
In 2015, around 3.5% of animals were diagnosed with the syndrome. According to the ACVO test statistics, 3% of the animals tested are carriers of the gene mutation.

Affected puppies are born with an atypical, curly coat. Over time, the dog’s coat becomes increasingly greasy and begins to fall out. The skin begins to flake, which leads to itching and irritation. In addition to the skin, the soles of the feet are also affected, which thicken and harden. Finally, the soles of the feet can burst open. The nails also suffer from the disease, resulting in brittle nails and cracked paw pads, which are very painful and cause the dog to limp.

As soon as the puppy’s eyes open between the 10th and 14th day of life, it has to contend with extremely dry, sticky and painful eyes, which later also show eye discharge. A lack of tear fluid leads to damage to the cornea, which is extremely painful. Over time, the cornea becomes opaque, which can lead to blindness in the animal. Many affected dogs have to be euthanized due to the poor prognosis and the lack of successful treatment.

Psychological:
The cornea is innervated by nociceptive afferent nerve cells, which is why damage to the eye can cause severe pain. Depending on their severity, eye diseases can impair a dog’s ability to see. Dogs with severely impaired vision or blindness have difficulty using body signals such as posture, tail carriage and eye, head and mouth signals or recognizing them in other dogs. This can lead to changes in behavior, anxiety and insecurity. Impaired or absent vision therefore significantly restricts the animal’s typical behavior and well-being.

Burden category: 3

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Chondrodystrophy and Chondrodysplasia incl. Intervertebral Disc Disease (IVDD)*

*see also Fact Sheet No. 31  Breed Basset Hound

Physical:
Chondrodystrophy and chondrodysplasia are developmental disorders of the cartilage and bone that lead to shortened limbs. Chondrodystrophic breeds also show chondroid metaplasia of the nucleus pulposus, which favors premature degeneration and calcification of the intervertebral discs. This change from the originally gelatinous, semi-liquid nucleus pulposus to a drier, firmer structure can occur as early as 3-4 months of age. In the majority of chondrodystrophic dogs, the nucleus pulposus is largely replaced by chondroid tissue by the age of two years.
Chondrodystrophy includes not only skeletal dysplasia with short limbs, but also progressive degeneration of the intervertebral discs (Intervertebral Disc Disease, IVDD) after birth. The thoracolumbar region of the spine is particularly frequently affected. Clinically, the disease manifests itself in varying degrees of pain and neurological deficits. The symptoms usually occur acutely and range from mild pain without neurological deficits to severe myelopathy with paralysis and complete loss of pain sensation.

Psychological:
Disc disease is often accompanied by spinal cord injuries, which can significantly impair quality of life. Affected dogs often suffer from severe pain. Chronic cases, especially dogs with paraplegia, require intensive, time-consuming and costly care from the pet owner due to their limited mobility and incontinence.

Burden category 3

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Degenerative Myelopathy

Physical:
According to the Orthopedic Foundation for Animals (OFA), degenerative myelopathy in Cavalier King Charles Spaniels is present in 24.4% of the animals tested and 33.4% were carriers of the gene.

Approximately 70% of the Cavalier King Charles Spaniels tested in a study on the frequency of the disease in different breeds were carriers of the mutation and 49.3% of the animals had a high risk of developing degenerative myelopathy. 

In its Breed Report (2016-2021), the Swedish animal insurance company AGRIA reports an approx. 12-fold increased relative risk of spinal cord disease compared to the average of all other dog breeds insured there, based on the data it has collected for the breed.

Degenerative myelopathy is a disease of the spinal cord in which the nerve fibers gradually break down. The symptoms often occur between the ages of five and eight, but can also appear at a younger age with varying degrees of intensity. Typical signs are an unsteady gait and muscle weakness in the hind legs. The condition worsens steadily, and within a few months to a year the function of the hind legs can be severely restricted, so that they can hardly be used. In addition, the dog may become incontinent due to the loss of nerves responsible for bladder and bowel control. This disease has been linked to amyotrophic lateral sclerosis (ALS) in humans, with similar mutations in the SOD1 gene identified as possible causes.

Psychological:
Myelopathies are often accompanied not only by signs of paralysis, but also by severe pain, which significantly impairs the animal’s well-being.

Burden category: 3

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Primary Secretory Otitis Media (PSOM)

Physical:
Primary secretory otitis media (PSOM) is a non-infectious effusion that occurs in the middle ear. In the Cavalier King Charles Spaniel, material is frequently found in the middle ear during imaging procedures. The prevalence is between 50 and 54 %, depending on the source. The cause is probably an increased production of viscous mucus (mucus) or a disturbed drainage from the middle ear, although a combination of both phenomena is also possible. The eardrum is usually intact and the middle ear is filled with highly viscous, opaque, grayish or yellowish material (plug). There is no involvement of pathogens, indicating a non-infectious effusion. In brachycephalic dogs, which include the Cavalier King Charles Spaniel, the incidence is significantly higher. This is explained by the altered cranial anatomy, which includes a thickened soft palate and a reduced nasopharyngeal space. Some studies have identified changes in the skull and its structures that are associated with brachycephaly and may contribute to the development of PSOM. The Cavalier King Charles Spaniel has also been shown to have structural differences in the middle ear compared to other dog breeds that may have an influence on the development of PSOM, although other studies have failed to establish a link between changes in the bulla tympanica and middle ear effusions. 

Potential clinical symptoms include hearing loss, neurological abnormalities such as facial nerve palsy, nystagmus, head tilting and ataxia, head and neck scratching, ear itching, abnormal yawning, yowling, head shaking, neck pain and painful ears. The connection between an effusion in the middle ear and hearing loss has been scientifically proven. The breed statistics of the Swedish animal insurance company AGRIA showed that between 2016 and 2021, Cavalier King Charles Spaniels were significantly more likely to present to a veterinary practice with otitis and had an approximately 14-fold increased relative risk of hearing loss or deafness compared to the average of all other insured breeds.
Hearing loss can also be detected even if owners had not noticed any abnormalities beforehand. In one study, 70% of dogs were affected bilaterally and 30% unilaterally.  In other studies, the frequency of unilateral and bilateral effusions was evenly distributed. However, dogs can also be asymptomatic. Affected dogs are often diagnosed with other conditions such as chiari-like malformation or syringomyelia, or with all three conditions.

Psychological:
Possible symptoms such as itching and ataxia affect the dogs‘ typical behavior and well-being. The accumulation of secretions in the middle ear leads to a feeling of pressure, which is very painful for the dogs. Reduced activity and impaired movement, such as difficulty running downhill or climbing and jumping, restrict the dogs‘ typical behavior. The reduced hearing impairs the species-typical communication with other dogs and humans as caregivers, their sensory performance and behavior.  The disease can recur, meaning that the dogs can suffer from the symptoms several times and have to be treated repeatedly.

Burden category: 3

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Dental diseases and diseases of the periodontium

Physical:
The altered and compressed anatomy of the facial skull in brachycephalic animals often leads to deviations from normal dentition and associated periodontal disease, albeit to varying degrees.
Periodontal disease is one of the most common diagnoses made in dogs in veterinary practice. Some prospective studies show prevalence rates of 44 % to 63.6 %. 

Periodontitis is considered irreversible and leads to damage to the periodontal ligament, cementum and alveolar bone, often resulting in tooth loss.

Cavalier King Charles Spaniels ranked fourth out of all breeds analyzed in a comprehensive British study of canine periodontal disease with a period prevalence of 25.29%. In previous studies, the breed’s prevalence of dental/periodontal disease ranged from approximately 15% to approximately 25%.

According to the Breed Report from the Swedish pet health insurance company AGRIA, the Cavalier King Charles Spaniel had a 3-4 times higher relative risk of developing dental disease between 2016 and 2021 compared to the average of all other insured breeds. 

Chronic Ulcerative Periodontal Stomatitis (CUPS)

Chronic ulcerative periodontal stomatitis (CUPS) is a special form of periodontal disease. This is characterized by painful oral ulcers that mainly occur in the buccal mucosa (mucositis), but can also occur on the tongue (glossitis) or the palatal mucosa. It is an immune-mediated disease of the oral cavity of small dog breeds, which is probably due to hypersensitivity to plaque formation. A recent study of the microbiome of affected dogs showed that in dogs with CUPS, the mucosal ulceration is colonized by a specific, species-specific bacterial flora and that there are significant differences between the oral mucosa of healthy dogs and that of dogs with severe periodontal disease. The Cavalier King Charles Spaniel appears to be predisposed to CUPS.

Chronic ulcers result in significant morbidity as dogs may refuse to eat, lose weight and suffer from persistent pain in the mouth. Clinically, affected animals exhibit a variety of symptoms, including unpleasant, sometimes strong odor from the mouth, inappetence or anorexia, excessive salivation with thick and occasionally bloody saliva, and pain in the mouth (e.g. paws in the mouth or chattering jaw movements). Other possible symptoms include unusual chewing movements, eating problems and bleeding in the mouth. Affected dogs often tend to stop chewing on their toys and reject the hard parts of their food.

Conservative therapy with plaque removal, antibacterial, anti-inflammatory or immunosuppressive medication combined with strict oral hygiene (tooth brushing) can be attempted, but is often unsuccessful. As a rule, animals can only be cured by partial or complete extraction of the tooth.

Psychological:
In a study that analyzed the effects of common diseases on the well-being of dogs, it was found that dental diseases and painful diseases of the oral mucosa have a serious impact on the well-being of the affected animals. 

In animals with CUPS, even milder forms of this inflammatory disease in the mouth can lead to severe pain, which significantly restricts the animal’s quality of life. Depending on the degree of severity, the animals are no longer able to fulfill their basic needs of food and water intake, or only to a limited extent, due to the pain. The disease can lead to lethargy and depression-like behavior.

It should be noted that dogs – like cats – often do not show pain in this area. Even with significant defects or illnesses, they sometimes don´t refuse to eat because their hunger is a strong survival instinct. This means that pain and suffering can be present without the dog’s owners noticing immediately.

Burden category: 2-3 depending on the degree of severity

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Episodic Falling Syndrome

Physical:
Episodic Falling Syndrome (EFS) is an inherited disease that predominantly affects Cavalier King Charles Spaniels. The disease is classified as a dyskinesia (movement disorder) and mainly occurs when the dog is excited (e.g. play, visitors, unfamiliar surroundings). In a 2016 study, 12.3% of the animals tested were identified as carriers of the responsible mutation. According to the Orthopedic Foundation for Animals (OFA), Episodic Falling Syndrome in Cavalier King Charles Spaniels is present in 0.3% of the animals tested, while 5.1% of the animals tested were carriers of the gene. In another study, 39 of the 48 CKCS tested were homozygous for the responsible BCAN genotype. 

EFS is a muscle disorder that causes increased muscle tone and muscle spasticity (especially of the limbs), resulting in the limbs appearing „locked“ in an extended position. This muscle spasticity leads to a characteristic „praying“ position and/or collapse. Episodes usually last from a few seconds to several minutes and resolve on their own. Affected dogs appear neurologically normal between episodes. The severity and number of episodes vary throughout the dog’s life and do not follow a specific pattern.
Episodes usually begin between 14 weeks and four years of age and often occur in conjunction with exercise, excitement or frustration. However, these episodes can occur at any time and under any circumstances. 

Psychological:
Affected animals are exposed to an increased risk of injury during the „seizures“ and there is a considerable impairment of the species‘ own behavior.

Burden category: 3

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Life expectancy and mortality

Although small breeds usually live longer than large breeds, the Cavalier King Charles Spaniel, with an average life expectancy of around 10 years, is roughly in the range of large dog breeds (for comparison: the larger King Charles Spaniel has an average life expectancy of 12 years). The shorter life expectancy is attributed to the predisposition to degenerative mitral valve disease and syringomyelia. Heart disease is therefore expected to be the main cause of premature death in the Cavalier King Charles Spaniel.

Recent data from AGRIA also shows that between 2016 and 2021, the Cavalier King Charles Spaniel had an 8-fold increased relative risk of death (or euthanasia) due to heart problems, followed by a 3-fold increased risk due to respiratory problems compared to the average mortality rate of all dog breeds insured there. Mortality due to neurological disease was more than double that of the other breeds. 

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Conclusion

The very high probability of defects and damage in Cavalier King Charles Spaniels justifies the statement that further breeding should be viewed critically and, if at all, can only take place with fully examined and tested (both breeding partners) and an imaging procedure to exclude Chiari malformation/syringomyelia. 

On the subject of the admissibility of an outcross procedure, see point 9 „General assessment under animal welfare law. Germany.“

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Animal ethics evaluation of the torture breeding problem in the Cavalier King Charles Spaniel

Based on the facts stated in QUEN Fact Sheet No. 34, which lists the probability of a number of breeding-related defects in burden categories 2-3 (moderate to severe burden) and 3 (severe burden), it must be stated from an animal ethics perspective that continued breeding with affected animals of this breed is to be classified as highly problematic, as a breeder must assume that animals that he brings into the world through his breeding will have to endure or suffer considerable and continuous pain. This is already unacceptable if at least one of the breeding-related defects in burden categories 2-3 mentioned in this information sheet occurs in a foreseeable manner in at least one of the animals bred by him, whereby „foreseeable“ hereditary changes in the offspring are also present if they are only expected to occur after a generation jump in later generations.

6. Heredity, genetics, known genetic tests if applicable, average genomic inbreeding coefficient (COI) and average heterozygosity value for the breed if applicable

Brachycephaly

The genetic causes of brachycephaly are not yet fully understood. Due to the genetic complexity, it is assumed that several chromosomes are involved. The development of this skull anomaly is influenced by a complex interplay of different gene regulatory networks, signaling interactions and hierarchical control mechanisms. Several studies have identified a link with the CFA1 gene.

Chiari-like malformation/syringomyelia

SM is a complex trait with moderate heritability. CM and SM have a polygenic mode of inheritance with variable penetrance. The responsible locus appears to be PCDH17 on the CFA22 gene.
A genetic test is not available.

Mitral valve diseases

The genetic background of mitral valve disease has not yet been fully researched. However, studies show that various genes and microRNAs are expressed differently between healthy and diseased dogs, indicating a possible involvement in the development of the disease. No single gene appears to be responsible for the disease. Studies suggest that regions on chromosomes CFA13 and CFA14 are associated with the development of mitral valve disease in Cavalier King Charles Spaniels. The CFA13 region may harbor the HEPACAM2 gene, which may play a role in pathogenesis alongside CDK6 and FAH. Recent studies have also identified other potentially involved genes.
A genetic test is available.

Congenital keratoconjunctivitis sicca and ichthyosiform dermatosis (CKCSID) – Dry Eye Curly Coat Syndrome

Inheritance of the disease is autosomal recessive. It is a base mutation (deletion) on the FAM83H gene on chromosome CFA 13.
A genetic test is available.

Chondrodystrophy and Chondrodysplasia incl. Intervertebral Disc Disease (IVDD)

A link between chondrodysplasia and the FGF4 retrogene on chromosome 18 (CFA18) has been demonstrated. Genome studies also showed that chondrodysplasia is associated with an FGF4 retrogene on chromosome 12 (CFA12). Inheritance is dominant.

Premature degeneration of the intervertebral discs (intervertebral disc degeneration, IVDD) is caused by overexpression of the FGF4 retrogene on CFA12. This retrogene occurs with high frequency in many IVDD-prone dog breeds and leads to a 20-fold increase in FGF4 expression in the intervertebral disc. Affected dogs show the first signs of chondroid metaplasia and degeneration of the nucleus pulposus as early as ten weeks of age.

Another FGF4 retrogene on CFA18 is associated with skeletal dysplasia and disproportionate dwarfism, but does not appear to have a direct effect on the development of IVDD. Because many IVDD-prone breeds carry both the CFA12 and CFA18 FGF4 retrogenes, it is difficult to determine the exact contribution of each to the clinical picture. However, it is believed that the CFA12-FGF4 retrogene alone is sufficient to cause premature disc degeneration.
A genetic test is available.

Degenerative Myelopathy

Degenerative myelopathy, which is caused by a mutation in the SOD1 gene, is an inherited neurological disorder in dogs. This mutation occurs in many dog breeds, including the Cavalier King Charles Spaniel. The inheritance of degenerative myelopathy is autosomal recessive with incomplete penetrance.
A genetic test is available.

Primary Secretory Otitis Media (PSOM)

The disease is probably hereditary, but so far there is no definitive evidence of a genetic component, apart from the increased incidence in the breed.

Chronic Ulcerative Periodontal Stomatitis (CUPS)

A genetic predisposition of small and short-headed breeds to the disease is suspected, but has not yet been proven, as there are no systematic studies on this. Maltese and Cavalier King Charles Spaniels in particular appear to be over-represented.

Episodic Falling Syndrome

Inheritance is probably autosomal recessive. The mutation in the BCAN gene associated with episodic fall syndrome has been identified in the Cavalier King Charles Spaniel. Although the exact frequency in the entire CKCS population is not known, 12.9% of 155 clinically normal Cavalier King Charles Spaniels from the United States were carriers of the mutation.
A genetic test is available.

Genetic tests available for the breed

• Chondrodysplasia and Chondrodystrophy (IVDD risk)
• Degenerative Myelopathy (DM), exon 2
• Dry Eye Curly Coat Syndrome (CKCSID)
• Episodic Falling (EF)
• Hyperuricosuria
• Macrothrombocytopenia
• Malignant hyperthermia
• MCAD deficiency (medium-chain acyl-CoA dehydrogenase deficiency)
• Mitral valve endocardiosis
• Duchenne muscular dystrophy
• Progressive Retinal Atrophy (prcd-PRA)
• Xanthinuria type II

7. Diagnosis – necessary examinations before breeding or exhibitions

Caution: Invasive examinations that are stressful for the animal should only be carried out in justified cases of suspicion in breeding animals and not if visible defects already lead to a ban on breeding and showing.

Brachycephaly
In addition to the medical history, typical appearance, measurement of proportions if necessary and general examination, various imaging procedures and functional tests can be used to diagnose brachycephaly. The brachycephalic syndrome can be diagnosed using imaging techniques. X-rays provide craniometric measurements, while CT and endoscopy provide a detailed view of the upper airway.
A practical method of measuring the skull was developed in the Netherlands with the traffic light system. Breeding is prohibited there if the relative nasal shortening has a craniofacial ratio of less than 0.3. This means that the nose length must be at least ⅓ of the total head length.

BOAS (Brachycephalic Obstructive Airway Syndrome)
Clinical symptoms and the dog’s previous history should be taken into account when taking a medical history. An initial assessment can be made by clinical examination before and after exercise. The nostrils and any forced breathing can be assessed visually.
In stable patients, lung function should also be checked by means of auscultation, pulse oximetry and blood gas analysis. Any pneumonia and pulmonary edema can be diagnosed radiographically.
To assess the severity of BOAS, a stress test (Cambridge test) can be performed, which is indicated in all animals in which the craniofacial ratio (CFR) shows abnormal deviations – can be calculated by dividing the nasal length (cm) by the skull length (cm). A more detailed examination of the anatomical structures is carried out using imaging techniques such as X-ray, CT or endoscopy under anesthesia.

Chiari Malformation/Syringomyelia
Pain can be identified by clinical signs and information from the medical history. Dog owners report that affected dogs show increased symptoms especially at night, when they first get up, in extreme heat or cold, when they are excited or in certain postures.
The pain symptoms range from mild hypersensitivity in the head and neck area (head and neck hyperesthesia) to sudden screaming when the head is moved. An MRI is essential for the diagnosis.
Additional imaging procedures such as myelography, electromyography, peripheral nerve conduction and amplitude studies and technetium-99m bone scintigraphy can further support the diagnosis if necessary.
For certain questions, a functional MRI or functional Cine MRI can contribute to the diagnosis. As with a cinematographic film („cine“), sectional images are generated in rapid succession at the same location.

Mitral valve disease
An initial suspected diagnosis can be made by auscultation of the heart. Echocardiography is the most important procedure for diagnosing heart and vascular diseases. In addition, a blood pressure measurement and X-rays can be carried out to assess the heart shadow and possible lung changes.

Depending on the risk of heart disease, staging can be performed. Speckle tracking echocardiography (STE) enables a more precise assessment of heart function and provides information on whether existing mitral valve insufficiency is progressing and the heart is overloaded.

Ocular diseases
Initial indications of an existing impairment/change, e.g. of the nasolacrimal canal, may be noticeable through brownish discoloration of the coat. A complete ophthalmological examination is carried out, including a Schirmer Tear Test, tonometry, ophthalmoscopy and other diagnostic procedures depending on the suspected diagnosis.

Congenital keratoconjunctivitis sicca and ichthyosiform dermatosis (CKCSID) – Dry Eye Curly Coat Syndrome
Suspected diagnosis based on the typical appearance (in puppies from birth) and the breed. The diagnosis is confirmed by carrying out a thorough ophthalmologic and dermatologic examination and by genetic testing. Lack of evidence of another pathogenesis (e.g. endocrine disease) also supports the diagnosis.

Chondrodystrophy and Chondrodysplasia including Intervertebral Disc Disease
The external appearance and observation of the animals in motion can be assessed by inspection. In addition to a neurological examination and classification of the clinic, imaging procedures such as CT (and myelography) should be used to assess frequently occurring intervertebral disc diseases.

Degenerative Myelopathy
The suspected diagnosis can be made on the basis of the symptoms and findings of the physical examination, supplemented by X-rays, MRI scan and/or CT scan to rule out other diseases. However, a definitive diagnosis can only be made by post-mortem histological examinations and/or a genetic test.

Primary Secretory Otitis Media (PSOM)
An otoscopic examination makes it possible to assess the ear canal and the eardrum. For confirmation and in the case of abnormal findings, sample material from the ear canal can be examined cytologically and microbiologically. If neurological symptoms are present, a neurological examination should be performed to rule out other diseases. The gold standard and necessary for a definitive diagnosis is a CT scan to assess the ear canals and potential effusions. An MRI can also be used for imaging. For a definitive diagnosis, a myringotomy (puncture of the eardrum) should be performed to view and remove the characteristic material from the bulla tympanica.   Due to the similar clinical picture, the differential diagnosis should primarily exclude disc diseases, inflammatory ear diseases, inflammatory diseases of the CNS, syringomyelia and Chiari-like Malformation.

Chronic Ulcerative Periodontal Stomatitis (CUPS)
A comprehensive examination of the oral cavity is necessary. This is often difficult without general anesthesia, as most affected dogs experience considerable pain when the oral mucosa is touched. The diagnosis can be made by inspection if the mucosal lesions are in direct contact with plaque and tartar deposits on the exposed surfaces of the tooth roots. As a rule, however, only the histological analysis of a biopsy can confirm the suspected diagnosis. Plasmatic and lymphocytic infiltrates are typically found in the mucosal lesions. X-rays should be taken to assess the periodontal status.

Episodic Falling Syndrome
The diagnosis can be made by breed identification during the „seizures“, as the animals show characteristic symptoms: Progressive hypertonization of the forelimbs and hind limbs causes the dogs to eventually become immobilized in a typical „prayer position“. The stiffening of all four limbs during physical activity can lead to a fall without loss of consciousness or cyanosis. Other clinical signs may include stiffness of the facial muscles, stumbling, arching of the back or vocalizations. A genetic test can be carried out to confirm the diagnosis.

8. Necessary or possible orders from an animal welfare perspective

Decisions on breeding or exhibition bans should be made in connection with the burden category (BC).

Depending on the severity and type of findings, the decisive factor for a breeding ban may be the most severe finding, i.e. the one that affects the animal the most, and its classification in one of the burden categories (BC), or the correlation assessment if there are many individual breeding-related defects or predispositions typical of the breed. 

In addition, the individual inbreeding coefficient of the animal and its carrier trait for risk genes should also be included in the decision-making process.

In general, care should also be taken when breeding Cavalier King Charles Spaniels:
In addition to external, anatomical and functional characteristics as well as the behavior of both breeding partners, the possibilities of breeding hygiene advice at the molecular genetic level should be used and in particular the genetic inbreeding coefficient, the heterozygosity value and the dog leukocyte antigens (DLA) for the breed should be determined. Increasingly, so-called matching tools/scores can also facilitate the selection of suitable breeding partners.

a) Orders that appear necessary

A breeding ban in accordance with Section 11b TierSchG must be imposed on animals with hereditary or breeding-related defects, in particular in the following cases

• Presence of Brachycephalic Obstructive Airway Syndrome (BOAS)
• Syringomyelia/Chiari-like malformation
• Heart diseases
• Eye diseases
• Changes in the skeletal system with negative consequences for the animal: (head, spine, limbs)

An exhibition ban in accordance with § 10 TierSchHuV must be ordered if one of the above-mentioned defects is present.

b) Possible orders

• Order for further examinations or genetic tests
• Order for permanent sterilization (castration) in accordance with § 11b (2) TierSchG. Note: Only surgical castration (removal of the gonads (testicles or ovaries)) is to be used as an animal welfare measure. Sterilization or long-term infertility treatment with medication can have significant side effects.

    

Please note:

Measures taken by the competent authority must be recognizably suitable to prevent long-term damage to the affected animals and their offspring.
Decisions on orders and breeding bans must always be made on a case-by-case basis. They are at the discretion of the competent authority and must take into account the current legal requirements and the circumstances found on site.

9. General animal welfare assessment

a) Germany

From a legal point of view, dogs with the defects/syndromes described above are classified as torture breeding in accordance with § 11b TierSchG.

Justification:

According to § 11b TierSchG, it is prohibited to breed vertebrates if breeding knowledge indicates that, as a result of breeding, the offspring or progeny will have, among other things

• body parts or organs are congenitally missing or unsuitable or deformed for use in accordance with the species and this results in pain, suffering or damage (§ 11b Para. 1 No. 1 TierSchG) or
• the keeping is only possible with pain or avoidable suffering or leads to damage (§ 11b Para. 1 No. 2 c TierSchG).

Pain in animals is defined as an unpleasant sensory perception caused by actual or potential injury that triggers motor or vegetative reactions, results in learned avoidance behavior or can potentially change specific behaviors (Hirt/Maisack/Moritz/Felde, § 1 Rn. 12 mwN; basically also Lorz/Metzger TierSchG, § 1 Rn. 20). Or, more briefly, the International Association for the Study of Pain (IASP) as: „an unpleasant sensory and emotional experience associated with or resembling actual or potential tissue damage“ (https://www.iasp-pain.org/wp-content/uploads/2022/04/revised-definition-flysheet_R2-1-1-1.pdf).

Suffering is any impairment of well-being not already covered by the concept of pain, which goes beyond simple discomfort and lasts for a not insignificant period of time (Hirt/Maisack/Moritz/Felde, § 1 para. 19 with further references; Lorz/Metzger, § 1 para. 33 with further references)[110,111]. Suffering can also be physically and psychologically impairing; fear in particular is classified as suffering in the commentary and case law (Hirt/Maisack/Moritz/Felde, § 1 para. 24 mwN; Lorz/Metzger, § 1 para. 37).

Damage exists if the physical or mental state of an animal is temporarily or permanently altered for the worse (Hirt/Maisack/Moriz/Felde, § 1 para. 27 mwN; Lorz/Metzger, § 1 para. 52 mwN), whereby completely minor impairments based on a physical or mental basis are not taken into account. „The target condition of the animal is assessed on the basis of animals of the same species. The absence of body parts is regularly assessed as damage in the commentary literature“ (VG Hamburg decision of 4.4.2018, 11 E 1067/18 para. 47, also Lorz/Metzger TierSchG Komm. § 1 para. 52).

Breeding Cavalier King Charles Spaniels with the defects described above constitutes torture breeding. This results from the damage, pain and suffering described in detail under point 5, in particular through

• Brachycephaly and possibly Brachycephalic Obstructive Airway Syndrome (BOAS)
• Heart diseases
• Syringomyelia/Chiari-like malformation
• Damage to the skeletal system (head, spine, limbs) and any associated pain and suffering
• Episodic Falling Syndrome
• Eye diseases and associated pain, suffering or damage

It should be noted that a breeding ban applies not only when breeding is carried out with animals that themselves exhibit traits relevant to cruelty (trait carriers), but also when it is known or must be known that an animal used for breeding can pass on traits that can lead to one of the adverse changes in the offspring (carriers; in particular animals that have already produced damaged offspring; Lorz/Metzger, Kommentar zum TierSchG § 11b Rn. 6 with further evidence).

 – An important indication of a hereditary defect is that a disease or behavioral deviation occurs more frequently in related animals than in the overall population of the dog species. The fact that the breed or population has proven to be viable over a longer period of time is not an argument against damage (see Lorz/Metzger Kommentar zum TierSchG § 11b Rn. 9).

 – The prohibition applies regardless of the subjective facts, i.e. regardless of whether the breeder himself recognized or should have recognized the possibility of harmful consequences. Due to this objective standard of care, the breeder cannot invoke a lack of subjective knowledge or experience if the respective knowledge and experience can be expected from a careful breeder of the respective animal species (see Hirt/Maisack/Moritz, Tierschutzgesetz, Kommentar, § 11b TierSchG Rn. 6).

– Inheritance-related changes in the descendants are also foreseeable if it is uncertain whether they will only occur in later generations after a generational leap (cf. Goetschel in Kluge § 11b para. 14).

Attention: According to German legislation (§11bTierSchG), further breeding of animals with the defects described above is not permitted, not even with the aim of breeding out these defects (outcross procedure)!

b) Austria

Dogs with the defects/syndromes described above are classified as torture breeding in Austria in accordance with § 5 TSchG

In particular, anyone who “ breeds in a way that is foreseeable to cause pain, suffering, harm or fear to the animal or its offspring (torture breeding), so that as a result of genetic abnormalities, in particular one or more of the following clinical symptoms occur in the offspring not only temporarily with significant effects on their health or significantly impair physiological life courses or cause an increased risk of injury“ is in breach of Section 5 of the Austrian Animal Welfare Act.

*The word „in particular“ means that the list is not exhaustive, but exemplary. This means that traits and symptoms other than those listed in §5, if they lead to breeding-related changes that may be associated with pain, suffering or damage, are also considered to be torture breeding traits.

Shortening of the facial skull: Breeding with dogs that suffer from a massive shortening of the facial skull and the associated problems or are genetically predestined for this is to be qualified as torture breeding if the following symptoms listed in § 5 are realized: Respiratory distress, malformation of the teeth. 

In the explanations to the TSCHG (amendment 2008), the listed characteristics/symptoms and their possible consequences are mentioned in an explanatory way:

– to lit a) Respiratory distress („Brachycephalic syndrome in dogs 

– lit d) Inflammation of the skin („as a result of skin folds (…, brachycephalic breeds) …“)

– lit f) Inflammation of the conjunctiva and/or the cornea („… as a result of eyelid anomalies in brachycephalic breeds …“)

– to lit j) Neurological symptoms: („as a result of anomalies … of the spinal column (… block vertebrae in brachycephalic breeds …“)

– to lit k) malformations of the dentition („in connection with cranial anomalies in brachycephalic breeds“)

– lit m) Body shapes for which it must be assumed with high probability that natural births are not possible („widening of the base of the skull with simultaneous narrowing of the pelvic canal in brachycephalic breeds …“)

Syringomyelia/Chiari-like malformation: Breeding with dogs that have a malformation of the skull in the form of a Chiari-like malformation and/or syringomyelia, or that are genetically predestined for this, is to be qualified as torture breeding if one of the following symptoms listed in § 5 is realized: neurological symptoms.

Ocular diseases: Breeding with dogs that suffer from pathological changes of the eyes or that are genetically predestined to do so is to be qualified as torture breeding if one of the following symptoms listed in § 5 is realized: inflammation of the conjunctiva and/or the cornea, blindness.

Spinal disorders: Breeding with dogs that suffer from or are genetically predisposed to changes in the spinal column is to be qualified as torture breeding if the following symptom listed in § 5 is realized: movement abnormalities.

Heart disease: Breeding with dogs that suffer from heart disease or are genetically predisposed to it is to be qualified as torture breeding, as significant effects on health or physiological life courses are realized.

c) Switzerland

Anyone wishing to breed with an animal that exhibits a trait or symptom that may lead to moderate or severe stress in connection with the breeding objective must first have a burden assessment carried out. Only hereditary burdens are taken into account in the stress assessment (see Art. 5 of the FSVO Ordinance on Animal Welfare in Breeding (TSchZV)). Dogs with defects that can be assigned to burden category 3 are subject to a breeding ban in accordance with Art. 9 TSchZV. It is also prohibited to breed with animals if the breeding objective results in category 3 defects in the offspring. Animals in category 2 may be bred if the breeding objective is for the offspring to be less affected than the parents (Art. 6 TSchZV). Annex 2 of the TSchZV lists characteristics and symptoms that can lead to moderate or severe burden in connection with the breeding objective. Skeletal deformities or malformations, such as movement anomalies or paralysis, degenerative joint changes, herniated discs, skull deformities with disabling effects on the ability to breathe, the position of the eyes, the position of the teeth, malfunctions and malformations of the eyes, cataracts, progressive retinal atrophy (PRA), displacement of the eyeball, malfunctions of the auditory system, loss of orientation due to inner ear defects and coordination or movement disorders are explicitly mentioned.

In addition, individual breeding forms are expressly prohibited in accordance with Art. 10 TSchZV. In other cases, however, a breeding ban is only imposed on a case-by-case basis. Animals that have been bred on the basis of impermissible breeding objectives may not be exhibited (Art. 30a para. 4 let. b TSchV).

d) Netherlands

According to Article 3.4 „Breeding with domestic animals“ of the Animal Keeper Decree, it is prohibited in the Netherlands to breed with domestic animals in a way that is detrimental to the welfare and health of the parent animals or their offspring.

In any case, breeding must prevent as far as possible that

1. serious genetic defects and diseases are passed on to the offspring or can occur in them;
2. external characteristics are passed on to the offspring or can develop in them that have harmful consequences for the welfare or health of the animals.

It is forbidden in the Netherlands to breed dogs with a muzzle shorter than one third of the length of the skull in accordance with Article 3.4 „Breeding with domestic animals“ and Article 2 „Breeding with brachycephalic dogs“ of the Animal Keeper Decree.

The following hereditary diseases or abnormalities according to Article 3.4. are realized in the Cavalier King Charles Spaniel: brachycephaly, diseases of the eye, abnormalities of the spinal column, heart diseases, Chiari-type malformation of the head.

e) Norway

Restriction of breeding through specifications and ordered evaluation of the effectiveness of the measures. According to a ruling by the Supreme Court in Norway, the breeding of purebred Cavalier King Charles Spaniels is prohibited in its current form due to disease and inbreeding. This does not yet apply to crossbreeding.
The Supreme Court did not consider the English Toy Spaniel/King Charles Spaniel, so the ruling relates to the Cavalier King Charles Spaniel breed.

Initial evaluations after one year have shown that the breeding ban on purebred Cavalier King Carles Spaniels has not yet had any impact on the rest of the dog breeding industry in Norway.

Detailed legal assessments and/or expert opinions, if already available, can be made available to veterinary offices for official use on request.

10. Relevant jurisdiction

1. Germany: Not for Cavalier King Charles Spaniels, but for brachycephaly in French Bulldogs: VG Stade, decision of 07.07. 2022, 10 B 481/22 and OVG Lüneburg, decision of 25.10.2022, 11 ME 221722
2. Austria: LVwG Upper Austria of 06.11.23 – LVwG-000544/100/SB, penalty order with context to brachycephaly 
3. Switzerland: Not known.
4. Netherlands: Amsterdam Court, June 4th 2025,  rule: issuing of pedigrees to brachycephalic dogs is illegal
5. Sweden: Not known
6. Norway: On October 10, 2023, the Dom Høyesterett, as the highest court of appeal, determined that the Cavalier King Charles Spaniel is to be classified as torture breeding due to the large number of serious diseases – due to the Chiari-like malformation (CM) and syringomyelia (SM) alone (HR-2023-1901-A AZ 23-004643SIV-HRET).

11. Order example available?

No.

Examples of orders are only made available to veterinary offices for official use on request.

12. Grants and Funding

13.  Bibliography/ References/ Links

Only a selection of sources on the defects described above and, where applicable, general literature on breed-related defects in dogs is given here. More comprehensive literature lists on the scientific background will be sent exclusively to veterinary offices on request.

Note: The description of health problems associated with the trait, for which there is not yet sufficient scientific evidence, is based on the experience of experts from veterinary practice and/or university institutions as well as publicly accessible databases or publications from animal insurance companies and therefore originates from different evidence classes.

As breeding and showing are international nowadays, the information does not usually only refer to the prevalence of defects or traits in individual associations, clubs or countries.

Sources:

An dieser Stelle wird nur eine Auswahl an Quellen zu den oben beschriebenen Defekten und ggf. allgemeine Literatur zu zuchtbedingten Defekten bei Hunden angegeben. Umfangreichere Literaturlisten zum wissenschaftlichen Hintergrund werden auf Anfrage von Veterinärämtern ausschließlich an diese versendet.

Hinweis: Die Beschreibung von mit dem Merkmal verbundenen Gesundheitsproblemen, für die bisher  keine ausreichenden wissenschaftlichen Erkenntnisse vorliegen, erfolgen vor dem Hintergrund entsprechender Erfahrungen der Experten und Expertinnen aus der tierärztlichen Praxis, und/oder universitären Einrichtungen, sowie öffentlich frei einsehbaren Datenbanken oder Veröffentlichungen von Tier-Versicherungen und entstammen daher unterschiedlichen Evidenzklassen.

Da Zucht und Ausstellungswesen heutzutage international sind, beziehen sich die Angaben in der Regel nicht nur auf Prävalenzen von Defekten oder Merkmalen in einzelnen Verbänden, Vereinen oder Ländern.

Quellen:

AGRIA Pet Insurance Sweden. (2021). Cavalier King Charles Spaniel Agria Breed Profiles Veterinary Care 2016-2021.

Anderson, J. G., Peralta, S., Kol, A., Kass, P. H., & Murphy, B. (2017). Clinical and Histopathologic Characterization of Canine Chronic Ulcerative Stomatitis. Veterinary Pathology, 54(3), 511–519. https://doi.org/10.1177/0300985816688754

Anderson, J. G., Paster, B. J., Korakas, A., Chen, T., & New England Bio Labs, England. (2021). Characterization of the Oral Microbiome in Canine Chronic Ulcerative Stomatitis. Journal of Immune Research, 7(1). https://doi.org/10.26420/jimmunres.2021.1037

Beckers, E., Van Poucke, M., Ronsyn, L., & Peelman, L. (2016). Frequency estimation of disease-causing mutations in the Belgian population of some dog breeds—Part 2: Retrievers and other breed types. Vlaams Diergeneeskundig Tijdschrift, 85(4). https://doi.org/10.21825/vdt.v85i4.16328

Borgarelli, M., & Haggstrom, J. (2010). Canine Degenerative Myxomatous Mitral Valve Disease: Natural History, Clinical Presentation and Therapy. Veterinary Clinics of North America: Small Animal Practice, 40(4), 651–663. https://doi.org/10.1016/j.cvsm.2010.03.008

British Veterinary Association and The Kennel Club. (2019). Chiari Malformation /  Syringomyelia Scheme. Canine Health Schemes. https://www.bva.co.uk/media/2800/20190710-chs-cmsm-leaflet-0719-v1-web.pdf

Bundesamt für Lebensmittelsicherheit. (2015). Verordnung des BLV über den Tierschutz beim Züchten. https://www.fedlex.admin.ch/eli/cc/2014/747/de

Bundesgesetz über den Schutz der Tiere (TSchG) Österreich (2005).
https://www.ris.bka.gv.at/GeltendeFassung.wxe?Abfrage=Bundesnormen&Gesetzesnummer=20003541

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