Boston Terrier "Boston Terriers are generally healthy little dogs." You’ve probably read that somewhere. Maybe on a breeder’s website, maybe in a care guide. And while it’s not entirely false, it glosses over something important: this breed comes loaded with a specific set of health quirks that can blindside you if you’re not paying attention.
This isn’t about scaring you. It’s about making sure you actually know what you signed up for.
1. Brachycephalic Obstructive Airway Syndrome (BOAS)
That flat face you fell in love with? It comes with baggage.
BOAS is the umbrella term for a cluster of airway abnormalities that affect flat-faced breeds. Boston Terriers are right at the top of that list. Narrowed nostrils, an elongated soft palate, and a trachea that can be too small for the dog’s body size, these all add up to one thing: your dog is working harder than they should just to breathe.
"Breathing shouldn’t be a workout. When it is, everything else suffers too."
The signs are easy to miss early on. Loud breathing, snoring, and a tendency to overheat faster than other dogs often get written off as "normal Boston stuff." Sometimes it is mild. But in more serious cases, BOAS can cause exercise intolerance, sleep apnea, and genuine respiratory distress.
The good news is that surgical correction works well when it’s caught early. Talk to your vet about evaluating your dog’s airway before symptoms become serious.
What to Watch For
Excessive snoring is fine. Labored breathing after minimal activity is not. If your dog sounds like they just ran a 5K after a short walk around the block, that’s a conversation for your vet.
2. Eye Problems
Boston Terriers have big, round, beautiful eyes. They’re also extremely vulnerable because of it.
Those prominent eyes sit shallower in the socket than most breeds. That means less protection, more exposure, and a much higher chance of injury or irritation. Corneal ulcers are one of the most common issues, and they can escalate fast.
Dry eye (keratoconjunctivitis sicca) is another one to know. It happens when the tear glands don’t produce enough moisture. Left untreated, it causes chronic inflammation and can eventually affect vision.
"The eyes are one of the first places a Boston Terrier’s genetics can get complicated."
Watch for squinting, cloudiness, discharge, or any visible irritation. A dog pawing at their face repeatedly is also a red flag.
Cherry Eye
This one looks alarming but is fairly common. The gland in the third eyelid prolapse and pops out, showing as a red, fleshy mass in the corner of the eye.
It’s not immediately dangerous, but it does require surgical correction. And Boston Terriers are prone to it, sometimes in both eyes at different times.
3. Allergies
Boston Terriers itch. A lot. More than most people expect.
Skin allergies are extremely common in the breed. Food allergies, environmental allergies, contact allergies, this dog can seemingly react to just about anything. The result is usually the same: relentless scratching, red or irritated skin, recurring ear infections, and paws that get licked raw.
The tricky part is that diagnosing allergies takes time. There’s no single test that tells you everything. Food trials can take weeks or months. Environmental allergens often require veterinary dermatology work to properly identify.
Ear Infections as a Secondary Symptom
Here’s something a lot of new Boston owners don’t connect at first. Recurring ear infections aren’t always just bad luck. They’re often a symptom of underlying allergies driving inflammation in the ear canal.
If your dog gets ear infections more than once or twice a year, dig deeper. Treating the infection without addressing the root cause is just spinning your wheels.
4. Luxating Patella
This one sounds complicated. It’s really not.
A luxating patella is a kneecap that slips out of place. It can happen in one or both back legs, and it ranges from Grade 1 (barely noticeable, slips back on its own) to Grade 4 (permanently displaced, surgery is necessary).
Boston Terriers are genetically predisposed to this condition. Some dogs live their whole lives with a mild luxating patella and barely show symptoms. Others show a characteristic skip in their stride, suddenly lifting one back leg for a few steps before putting it back down.
"A dog that skips a step occasionally might look cute. It might also be telling you something."
Grade 3 and 4 cases typically require surgery to prevent long-term joint damage and arthritis. Even if your dog is currently at Grade 1 or 2, it’s worth monitoring closely because it can progress.
How to Catch It Early
Your vet can feel for patellar laxity during a routine physical exam. If you have a Boston Terrier puppy, ask your vet to check it specifically. Early detection means more options.
5. Hemivertebrae
This is the one that surprises people most.
Hemivertebrae is a spinal malformation where one or more vertebrae develop in a wedge or butterfly shape instead of a normal block shape. It’s directly linked to the genetics that produce the screw tail Boston Terriers are known for. The same mutation that creates that cute little corkscrew tail can affect vertebrae further up the spine as well.
Mild hemivertebrae often causes no symptoms at all. The dog lives a completely normal life and the owner never even knows it’s there.
But in more severe cases, the abnormal vertebrae put pressure on the spinal cord. That can cause weakness in the back legs, loss of coordination, difficulty walking, or even incontinence.
Severity Varies Widely
This is genuinely one of those conditions where two dogs with the same diagnosis can have completely different lives. One dog has an incidental finding on an x-ray and trots around perfectly fine for fifteen years. Another dog develops progressive neurological symptoms that require intervention.
The key is knowing it’s a possibility and watching for it. If your Boston starts showing any changes in their gait, stumbling, or weakness in the hind end, that’s an urgent vet visit.
Staying Ahead of the Problems
None of this means your Boston Terrier is destined for a hard life. Most of them are wildly happy, energetic, and ridiculously entertaining companions.
But they do need owners who pay attention.
Routine vet visits matter more with this breed than with many others. Finding a vet who has experience with brachycephalic breeds specifically is worth the effort. And building a relationship with a veterinary ophthalmologist isn’t a bad idea either, given how common eye issues are.
The Bigger Picture
Boston Terriers have a devoted following for a reason. They’re adaptable, affectionate, and genuinely funny to live with. The health issues are real, but they’re manageable when you know what to look for.
Knowledge is the actual first step in keeping these dogs healthy, not just a vague promise that they’ll "probably be fine."