In addition to presenting with respiratory signs, many dogs with brachycephalic airway obstructive syndrome show digestive tract signs related to the same conformational abnormalities. A detailed diagnostic investigation is usually required, including clinicopathologic analyses, thoracic radiographs, fluoroscopic studies, abdominal ultrasound examinations and both upper airway and gastrointestinal tract endoscopy. In most cases, medical therapies are successful in managing clinical signs, but surgery can occasionally be required to resolve hiatal hernia or pyloric stenosis. In determining prognosis, the features of each individual case should be considered, with the overall prognosis depending on the severity and extent of all the identified lesions.