Loading health guide
Health Testing Guide
Which tests are mandatory, how to spot responsible breeders — and what it costs when things go wrong.
For the American Bully we have compiled 4 mandatory and 4 recommended health tests, drawn from breed-club regulations, the University of PEI (CIDD), and OMIA — weighted by severity and heritability.
What this grade means
Due to their extreme physical build, the American Bully often struggles with severe joint issues such as hip dysplasia (HD) and elbow dysplasia (ED). Furthermore, many individuals, especially those from more compact lines, suffer from Brachycephalic Obstructive Airway Syndrome (BOAS), which significantly impairs their quality of life. Since reliable, controlled health testing is often lacking across the breed, extreme caution is advised when purchasing a puppy.
Every breed is susceptible to certain inherited conditions. Just like humans, dogs inherit predispositions from their parents. Responsible breeders screen their breeding dogs for these conditions and make informed mating decisions to reduce the risk passed on to puppies.
No — but it's the strongest tool we have. Diet, exercise, environment, and genetics all contribute to whether a dog develops a condition. When breeders use the right tests to identify risk in potential parents, the likelihood of many conditions appearing in the puppies drops significantly.
There's no one-size-fits-all here. For the American Bully we track 4 mandatory tests plus 4 additional recommended ones. The specific tests and passing thresholds are detailed further below.
Keep in mind
Reliable screening tests still don't exist for many hereditary conditions, and tests for complex polygenic conditions are not always predictive of severity in the puppies. Even so, they're a powerful tool used by every responsible breeder.
There are two main types of health tests:
Screen the dog's DNA for known disease-causing mutations. Can be performed from puppyhood and give a binary result (clear / carrier / affected).
Clinical and imaging exams like X-ray, ultrasound, or ophthalmoscopy. They show how a predisposition actually manifests — usually only conclusive after 12–18 months.
We group breeding programs into three levels based on testing depth. Ask your breeder directly which level they meet.
A breeder at the Great level performs all mandatory tests plus 4 additional clinically recommended screenings that reduce risk in this breed.
In addition to mandatory tests:
Brachycephalic obstructive airway syndrome (BOAS)(BOAS)
Atmung
Brachycephalic obstructive airway syndrome (BOAS) is a severe respiratory condition affecting short-muzzled dog breeds, where the physical shortening of the skull leaves insufficient space for the upper airways. This structural compression forces tissues like the soft palate and nasal passages into a restricted area, significantly obstructing the flow of oxygen to the lungs. Over time, the increased effort required to breathe puts chronic strain on the dog's respiratory and cardiovascular systems.
Physisch · Passing: CLEAR
Ichthyosis(ICT)
Haut und Fell
Ichthyosis is an inherited skin disorder where the outer layer of the skin, the epidermis, does not develop or shed properly. This defect in keratinization—the process of forming a protective outer skin barrier—leads to a buildup of dry, thick, and scaly skin. Because this barrier is compromised, the dog's body is more vulnerable to secondary infections.
Passing: CARRIER
Degenerative Myelopathy(DM)
Nervensystem
Degenerative Myelopathy is a progressive disease of the spinal cord where the protective sheath around the nerves slowly breaks down. This deterioration disrupts the vital communication signals between the brain and the muscles of the hind limbs. Over time, this lack of signal transmission leads to a complete loss of muscle control in the back legs.
DNA · Passing: CLEAR
Cystinuria(Cyst-1a)
Nieren
Cystinuria is an inherited metabolic disorder affecting the kidneys, where the body fails to reabsorb an amino acid called cystine. Instead of being filtered back into the bloodstream, cystine builds up in the urine. Over time, this high concentration causes the amino acid to crystallize, forming painful stones in the bladder and urinary tract.
Koerperfluessigkeiten · Passing: Clear/Carrier
These levels are a comparison framework, not an official certification. They help compare breeding programs at a glance.
A complete checklist with every mandatory and recommended test plus identity and rearing questions — take it with you.
Open the full checklistFor breeders
Machine-readable mating rules, minimum ages, scoring schemes, and what's required for HonestDog verification — as a printable guide.
Example rule — Elbow Dysplasia
Both parents must be ED 0 or 1 or better.
We compile mandatory tests from official breed regulations and veterinary databases — and check every uploaded certificate for authenticity.
L1 = mandatory under breed-club regulations. L2 = recommended or clinically indicated. L3 = lower prevalence. Every assignment carries a source and confidence rating.
VDH breeding regulations, CIDD (University of PEI), OMIA (University of Sydney), curated veterinary input.
Uploaded certificates are AI-extracted and reviewed by our team for authenticity, date, and result.
4 tests are currently mandatory under the relevant breed-club regulations. The most common are Elbow Dysplasia (ED), Hip dysplasia (HD), Neuronal Ceroid Lipofuscinosis (NCL). Every test must be completed before mating, and the result must fall within the threshold defined by the regulation.
See breeders who have already uploaded their mandatory tests for verification.
View verified breeders