Laws and consequences: Texas legal changes in excruciating detail

On the face of it, the recent changes to Texas state law appear to be a good idea, aimed at preventing non-veterinarians from practicing veterinary medicine. But as is often the case with legislation, digging in to the situation a little deeper uncovers a load of unintended consequences, in this case in animal shelters. The whole story makes a great teaching case for how population medicine differs from individual medicine. There's a lot to cover, so let's get going.

The body of law in question is the Veterinary Practice Act. This Act covers, you guessed it, the practice of veterinary medicine. Among the basic rules that the Act lays out is the rule that in order for veterinary medicine to be legally practiced on an animal, there must exist a valid veterinary-client-patient relationship. That statement takes quite a lot of unpacking, so here you go:

  • Veterinary medicine: in this case, giving a vaccination
  • Valid veterinary-client-patient relationship: the relationship between the veterinarian, the client, and the patient. The veterinarian must have actually met both the client and the patient. Usually this must be renewed yearly -- so if you call your veterinarian and ask for a refill on your pet's medication, but you haven't had your pet in to the clinic for more than a year, the veterinarian must ask you to bring your pet back in for a checkup, or the veterinarian is at risk of losing their license. (Seriously. That's why they won't refill over the phone after a particular period of time.)
  • But there is an exception made for herd health. If the veterinarian is treating a herd of animals (commonly livestock such as cows) then the relationship is with the herd, not the individual animal. So the vet can prescribe treatments over the phone for a herd member that they haven't ever seen, if they have recent experience with that herd as a whole.
In the case of an animal shelter, some states treat animals in a single shelter as a herd. This is entirely appropriate. In a shelter, medicine should be practiced with the good of the population at heart, not the individual animal. I promise that this is not as heartless as it sounds, and ends up actually being better for the individual in the end. If you let parvovirus get a hold in your shelter, it is the herd that is sick, but it is individuals that die. It is best for individuals to be in a healthy herd.

Until recently, the situation in Texas was that it was legal for a non-veterinarian shelter employee to give vaccines to animals in the shelter because they were members of a herd, so the veterinarian could write general herd health protocols ("give the core vaccines to all animals at intake") without having to see each individual animal. Now that's changed.

The problem is with stray animals. Shelters don't own stray animals for the first few days that they are in the shelter. This is called the animal's "stray hold," and is intended to give the owner a chance to reclaim their animal before it is put up for adoption. The number of reclaimed stray animals is typically low, especially for cats; often only 2% of stray cats are ever reclaimed. The majority of stray animals go on to be owned by the shelter.

Texas has changed the wording of their Animal Practice Act to specify that dogs and cats cannot be considered herd animals. Yes, it has really taken me this much explanation to get to the actual change in wording, but here it is: in the middle of a definition of the veterinary-patient-client relationship, the Act states (newly added text in italics):

A veterinarian possesses sufficient knowledge of the animal for purposes of Subsection (a)(2) [having a valid veterinary-patient-client relationship] if the veterinarian has recently seen, or is personally acquainted with, the keeping and care of the animal by:
(1) examining the animal; or
(2) making medically appropriate and timely visits to the premises on which the animal is kept. (NOTE: Per TAC 573.20(b) and 573.80(14), this section only applies to herd animals not including cats and dogs.)

On the one hand, it does seem silly to think of a "herd" of dogs and cats. But if you forget about the fact that the word "herd" has other meanings in other contexts, the real question that this change in wording is addressing is: Should shelters be allowed to practice population medicine on their animals?

In this particular instance, the fallout goes like this:

  • By default, shelter animals in Texas cannot be treated as "herd" animals.
  • Animals which are owned by the shelter are exempt from the Veterinary Practice Act, and therefore may still be treated as a herd.
  • Stray animals which are still in their stray holding period, however, are not yet owned by the shelter and therefore are not part of the shelter's herd.
  • Therefore, stray animals in their stray hold period must be examined by a veterinarian before receiving any treatment, including initial vaccines.

Not a big deal. Surely all shelter animals are examined by a veterinarian, right?

Actually, in quite a few shelters, veterinarians are only called in to treat sick animals, and the healthy animals are managed by technicians. Even in shelters which have a veterinarian, it is common for the veterinarian to only see sick animals. Of course, it is in the best interest of the animals for a veterinarian to see all of them as they come in the door, to establish a baseline of health status and to identify any problems that a technician might miss. But even in shelters with this policy, an animal may not be seen by a veterinarian for several days. Shelters are chronically understaffed and the vets are often behind on performing physical exams, as they have to prioritize treating sick animals more highly than checking on healthy ones.

Even in shelters which are fully staffed, it may be the next day before an animal is seen. If an animal comes in at the end of the day, the veterinarian may be in surgery the next morning and not get to physical exams until the following afternoon, so that the animal isn't seen for about 24 hours.

So the animal isn't seen by a vet for a day or three. If it's healthy, that shouldn't be a problem.

In the case of a shelter animal, one thing must happen the minute it comes in the door to the shelter: it must receive its vaccines. Prompt vaccination, right at the time of intake, is crucial in keeping animals healthy in shelters. Vaccination takes several weeks to bring the immune system up to its full efficiency in dealing with a pathogen, but there does seem to be an effect much earlier than that. Just a few hours one way or the other can actually make a difference, most critically in the very young and susceptible animals (did I mention in any previous posts how crazy kitten season can be in some areas?) and in the very dangerous diseases (such as parvovirus, which often simply manifests as dead animals with no warning). But don't take my word for it. The bible of shelter medicine, the Guidelines for Standards of Care in Animal Shelters, has this to say about prompt vaccination:
Because risk of disease exposure is often high in shelters, animals must be vaccinated at or prior to intake with core vaccines... Shelters that do not vaccinate with core vaccines immediately on entry, or do not vaccinate all animals, are much more likely to experience deadly outbreaks of vaccine preventable disease (Larson 2009).
This is how it works: the animal comes in to the shelter, either as a stray or surrendered by an owner. It gets processed, minimally receiving an identifying number, and is placed in a cage or run. Whoever performs this processing can either stick the animal with vaccines (and give it dewormers) at that time, or call a technician to do it. Giving vaccines isn't hard and you can train just about anyone to do it: it's technically easy (though it's nice to have someone else around to hold the animal still), and no decisions are really necessary. If the animal is too sick to receive its core vaccines against the most dangerous shelter diseases, it is too sick to be in the shelter and should get transferred to a hospital or other off-site care. Period. They all need their vaccines.

I'm saying this as someone who vaccinates her own animals much less often than conventional veterinary wisdom would have me do it. Shelters are full of disease and stress, and decisions about when and how to vaccinate there are going to be very different from decisions about animals in a home environment. I can't say it too often: without prompt vaccination, animals in shelters will die. The first question a shelter medicine specialist asks upon being confronted with an outbreak of parvovirus or distemper is "Are your animals vaccinated on intake?"

So, finally, on to this recent legal change in Texas. What shelter specialists see coming like an impending train wreck is lots of stray animals in Texas not getting seen by a veterinarian as soon as they are brought in to the shelter (it is not reasonable to expect that the vet could see them immediately); therefore, those animals not getting prompt vaccination; therefore, sick animals in shelters. Lots of them.

There is legal recourse at the city or county level: each city or county with a municipal shelter can change its ordinances to appoint the shelter the "designated caretaker" of stray animals during their hold periods. This allows the shelter to once again consider stray animals as part of the shelter herd, so that the veterinarian may ask someone else to give the vaccines before a physical exam has been performed. I have no real idea how likely it is that cities and counties will pass such ordinances, but I am guessing that the rate of adoption won't be anywhere near complete, and that the speed of adoption won't be blinding.

What's the moral of this story? I'm not really sure, but I think it has something to do with how complicated the consequences of legal wording can be, and how important it is to take the advice of specialists into account. I send my sympathies to Texas shelter veterinarians, who now will be faced with the scramble to still vaccinate stray animals on intake despite the change in laws.

Kennel Club is praised in sequel to "German Pedigree Dogs Exposed"

The first "German PDE" aired in Germany in August 2011 - a film by Phillip Hampl. Rather memorably, it kicked off with the mating of a Nova Scotia Duck Tolling Retriever to an Australian Shepherd, triggering swathes of German breeders to hyperventilate in horror.

Last night, Hampl returned to German screens with his sequel, which ended with a gathering of the now-adult offspring of that union trotting attractively around a beautiful field of wild-flowers - the not-so subliminal message: crossbreeding is one way out of the mess.

Hampl's original film did not provoke the reform in Germany that Pedigree Dogs Exposed triggered here in the UK.  In his sequel, Hampl urges the German Kennel Club - the VDH - to do more, and holds up the UK Kennel Club as something of an exemplar.

You can watch Hampl's sequel here. It features a fair bit of Crufts footage, including the ghastly-looking guppy-Pug above and something I had missed when I was there - which is that the Best of Breed Bulldog was wheeled to her vet check. I mean, really!

Hopefully Hampl's film will increase pressure on the VDH to do more - and the timing is pretty good. The 2nd International Workshop on Enhancement of Genetic Health in Pedigree Dogs is being held in Düsseldorf next year. If Hampl is right in his assessment of the situation in Germany, there's a very real danger of it being a whitewash - despite the Swedes' best efforts to secure reform.

The 1st workshop, in Sweden last year, managed to get a lot of Kennel Clubs - and other key stakeholders in canine genetic health - round the table for the first time. Progress report on that to come shortly...

How f****d is that doggy in the window?

Well, would you buy it? 


And yet on sale at Harrods in London this week:

Click to enlarge

Of course, many people reading this will express horror at the price - or that Harrods are selling puppies at all (with Kennel Club registration I might add). 

But, for me, the interesting part is the refreshing honesty displayed on this notice at Harrods - a great deal more honest, as it happens, than the Kennel Club is on its breed information health pages. (Don't believe me? Check it out for yourself here... not a single mention of respiratory problems for any of the brachycephalic breeds). Now I know this is likely due to Harrods' need to cover its commercial arse, but still... what a shame that the Kennel Club isn't similarly obliged.

Here's what it says on the Harrods notice:
"Health: Can be prone to joint diseases, spinal disorders, heart defects and eye problems. They can also have respiratory problems and tend to wheeze and snore and have trouble in hot weather. An overweight Frenchie may have trouble breathing, because of a swollen abdomen."
And still they buy!

PS: anyone want to have a bash at illustrating a Borsche Pugster for me...?

Five years on - is the Kennel Club no longer the enemy?

Prof Steve Dean used his "state of the nation" speech at last week's Welsh Kennel Club annual dinner as an opportunity to say that the Kennel Club is no longer seen as "the enemy" but as part of the solution.

This is half-true. Putting right the mess that Kennel Club breeding has made of purebred dogs does, indeed, lie at least partly in the Kennel Club's gift. And there's no doubt that most of the establishment stakeholders - the vets, welfare groups, Dog Advisory Council etc - have made the decision to work with the Kennel Club to improve dog health.

That's simply what the Establishment does. So having decided not to drive the Kennel Club out of town (one option that was considered, and at a very high level, post-Pedigree Dogs Exposed), the only other option was to agree to get round a table and talk.

You can't do that by treating people as the enemy - actually one of the reasons the RSPCA's Mark ("a parade of mutants") Evans was so unwelcome at stakeholder meetings after PDE. Mark continued to speak his mind.

So, five years on from Pedigree Dogs Exposed, which premiered in the UK five years ago this week, where are we now?

Significant reform introduced by the UK Kennel Club since Pedigree Dogs Exposed - and the three major reports into dog breeding that followed - includes:

• a review of breed standards, leading to (mostly minor) changes being made to around a third.
• the banning of first-degree-relative matings
• better training for - and monitoring of - judges
Mate Select
• the expansion of the high-profile breed list
• funding of the Kennel Club Genetics Centre at the Animal Health Trust
• vet checks at Crufts for the high-profile breeds
• a limit of two C-sections per bitch
• a considerably-improved Assured Breeder Scheme
• independent experts added to the KC's Dog Health Group

Other key non-KC progress includes:

•  the establishment of VetCompass, which is gathering vital epidemiological data (and which has just secured funding for a further three years' work thanks to Dogs Trust)

• the Dog Advisory Council (funding of which is on rather shakier ground)

• a new Puppy Contract setting out a minimum standard for breeders and buyers. This was launched last year without much publicity and without Kennel Club endorsement. The KC is now, however, collaborating with the other stakeholders and the hope that it will result in a revised, universal puppy contract with buy-in from all stakeholders. The simple message -  do not buy or sell a dog without one - has considerable potential.

The KC is also now collaborating with stakeholders (via a working party chaired by Professor Patrick Bateson) on an initiative from the Dog Advisory Council to produce a universal breeding standard  with all-party buy-in. (The DAC's current draft can be downloaded here).

All this is  helpful.

But the core problem remains a much more fundamental one - and that is that the Kennel Club system stinks. Kennel Club shows continue to reward the appearance of health/and the show world is, in the main, driven by distorted sense of what is correct.

The Kennel Club also continues to peddle the lie that DNA tests are the answer to purebred dog health (when they can only ever be a small part of any solution) and despite more general awareness about the perils of inbreeding, the KC is still not addressing genetic diversity in any meaningful way.

There is still no sign of the effective population size figures for individual breeds promised by the KC months ago - and I fear that if I (and others) don't continue to nag, that they will never see the light of day. This will be for the obvious reason that they are concrete proof of the dire straits many breeds are in genetically. I understand the reluctance to let people like me shout "I told you so!", but believe me it would give me no pleasure other than that it would be, I hope, a call to arms to address the fact that many breeds are heading for the genetic scrap heap.

This week, to mark the 5th anniversary of PDE, the RSPCA has called for the Kennel Club to do more - including an independent review of breed standards, further limits on inbreeding, a limit on popular sires and the opening of the stud books (see here).

Being seen to agree with anything that the RSPCA says or does is an invitation to be pissed on from a great height by many dog breeders for whom the RSPCA has become Public Enemy No One. But the RSPCA is right on this issue and I am glad it is still rattling the KC's cage.

I gave them the following quote - an abridged version of which appears in a press release supporting this week's statement:

Five years on from Pedigree Dogs Exposed, the Kennel Club is still in denial about the extent of the problems   
The Kennel Club continues to embrace scientifically and morally bankrupt breeding practices which condemn some dogs to enormous suffering.  By any measure, it is unethical to continue to breed dogs like Pugs and Bulldogs which have such flat faces that they cannot breathe - and yet the Kennel Club registers these breeds in their growing thousands and these dogs continue to be celebrated at Kennel Club shows.   

The same goes for Dachshunds who have such long backs and such short legs that their spines crumble; for Cavalier King Charles Spaniels who are blighted by a skull/brain-size mismatch that predisposes them to horrific pain. Then there are German Shepherds who are quite simply crippled by the warped ideal imposed on them by breeders and Shar-pei bred to a Kennel Club breed standard that demands wrinkles that we now know are linked to a horrific condition that destroys their livers.  The KC has done too little to tackle the suffering these dogs endure, despite an increasing amount of science which both articulates the issues and offers solutions.   

It is also unethical that the Kennel Club continues to endorse inbreeding. You can still, for instance, mate grandfathers to grand-daughters and then mate the offspring back to their great-grandfather. It's a mess genetically and if it isn't addressed many breeds will go to the wall, bred to oblivion. I find it a particular tragedy that breeders who do see the problems and want change are often dismissed as cranks and trouble-makers by those clinging to the status quo. 

If the Kennel Club was the welfare organisation that its glossy PR would have you believe, it would be doing so much more to put this right. The problem is that, at its heart it is a trade organisation that represents those who don't want change.  The dogs continue to pay a huge price."

The Chairman's speech at the WKC dinner last week contained a classic piece of Kennel Club PR. As reported in this week's Dog World, Professor Dean talked of "the increasing acceptance that the source of much of the poor health and welfare of recognised breeds lay outside the KC registration system."

Pure misdirection.

Dean added that "......microchips will help us demonstrate how the vast majority of those who register dogs with the KC are the people to be cherished and encouraged."

There is nothing more than anecdote and wishful thinking to support the implication that KC registered dogs are - overall - in some way healthier, and many reasons to believe that it may not be true.

That there are major problems outside of the KC registrations system is of course evident - and, conversely, many KC breeders go the extra mile for their dogs. But there are likely to be shining examples of robust health outside of the KC system, particularly in our working terriers, collies, lurchers and hounds. I suspect there is less inbreeding in the pet market, too  - while puppy farmers (for all their ills) are probably less likely to tolerate dogs than can't mate or birth without assistance because it's too expensive.

Meanwhile, only 13 per cent of dogs registered with the KC are bred under the Accredited Breeder Scheme and they are the only dogs subject to any husbandry/welfare/health requirements (and even then many breeds - even some of the sickest - are not subject to any health-testing requirements whatsoever). The rest? We simply don't know how well or badly bred they are.

VetCompass is looking at this, as it happens - funded by the Kennel Club, I am sure in its conviction that KC registered dogs truly are healthier.

But we don't know yet, and Prof Dean has no basis for claiming it.

Meanwhile, to the question in the title... is the Kennel Club still the enemy?

Tell me what you think.

Stop brachycephalism, now!

That's the title of a hard-hitting article in the Canadian Veterinary Journal by veterinary dentist Dr Fraser Hale in which he says that breeding brachycephalic dogs is unethical. 

Critics of Pugs, Bulldogs, Pekes, Boston Terriers and other short-faced breeds often focus on the dogs' inability to breathe - but as Dr Hale spells out, in pursuit of "cute" we have created dogs with hideously deformed mouths that often condemn the dogs to a lifetime of pain.

A typical pug mouth
"... the maxilla is too short compared to the mandibles. The upper incisors are in traumatic contact with the floor of the mouth and lower canine teeth. The maxillary premolars are so crowded that there may be no gingiva between and little or no bone support and the teeth may be rotated 90° or more.  
"Some teeth may be under-erupted due to crowding and impaction against adjacent or opposing teeth. The result is that the animal effectively bites itself every time it closes its mouth and there is an extreme predisposition to early onset and rapid progression of periodontal disease.  
"The traumatic contact between the maxillary incisors and the mandibular structures will often lead to traumatic pulpitis and pulp necrosis in the maxillary incisors. There is also often severe bunching-up of the palatal rugae with entrapment of hair, food, and bacteria leading to chronic, painful palatitis hidden from view at the bottom of the deep, closed folds.  
"Some of the dental/oral liabilities associated with brachycephalism can be mitigated by proactive surgery (selective extraction), but many animals do not get to benefit from these procedures and so live with chronic dental pain and infection." 
Dr Fraser points out how illogical it is that veterinarians have campaigned for and, in many cases, achieved bans for cosmetic procedures such as ear-cropping, tail-docking and removal of dew claws which cause only temporary pain and yet have remained silent on this issue. He concludes:
I believe that as protectors of animal welfare, veterinarians should start a public awareness campaign to inform people of the serious, life-long negative impacts of brachycephalism. I believe we must stop referring to these conditions as “normal for the breed” and refer to them as “grossly abnormal in accordance with breed standards” because there is nothing remotely normal or desirable from the animal’s perspective. I believe we must stop using photographs of these deformed but comical breeds in advertising and promotional materials as this just increases public demand because they are “so cute.”
"I am sure these words are going to stimulate some lively, possibly acrimonious response. I am effectively saying that it is unethical to purposely reproduce animals that are specifically designed to have serious structural deformities. The extension of this thinking would be to ban a great number of breeds. Oh, the backlash! My word! But when one looks at it strictly from the animal’s perspective, there is no valid, logical justification for brachycephalism. Its only positive is that many people find brachycephalic breeds esthetically pleasing (cute) and that is not a valid excuse for wilful perpetuation of these mutations." 

Read the whole article here:

Dr Hale, 54, runs a small-animal dental and oral practice in Guelph, Ontario ( I emailed him some questions:

• was there a specific incident that prompted you to write the article?      

This is something that has been bothering me for some years, and I always half joked that after I retire, when I do not care what people think of me (because it would not hurt my business), I would launch this campaign. I do not plan to retire for another 5-6 years at the earliest but I just could not keep silent any longer. The tipping point came when the newsletter of the Ontario Veterinary Medical Association bore this cover. 

On the one hand the cover talked about preventative care and on the other featured a montage of photos of a bulldog pup. The irony was too much to bear. So I wrote the editor a letter [which then formed the basis for the CVJ article]

• what response have you had to the article?

I have had no response and seen no replies to the piece in the CVJ. The Focus letter did spark some replies, most in support and a few taking a defensive stance. The Focus printed one positive and one negative letter. The negative letter was so full of logical holes that I did not bother responding to it. I have also mentioned this issue at a number of conferences and on an internet discussion board and I get lots of positive and supportive feedback from veterinarians. Aside from the one letter in the Focus, I cannot think of a single incident in which a veterinarian has given me any negative feedback so those that disagree with me are just keeping quiet about it.

• what do you think prevents veterinarians from speaking out more often?

Veterinarians are in a tough spot here. Imagine a new client shows up with their brand new pug puppy for first examination and vaccines. They have never had a dog before, have no idea what they have gotten themselves into and are just so happy and proud of their new bundle of joy. The veterinarian wants to keep this new client rather than scaring them away, so they are going to avoid all the negative and scary talk about all the problems that their pup is going to have with its mouth, its breathing, its eyes because it is a hideously deformed genetic mutation. So, they oh and ah over the cute little puppy and give it hugs and treats and send the owners home none-the-wiser about all the problems that are just around the corner. It is a bit of a conflict of interest. I am guilty of this too. I am concerned that if I get the reputation of being a brachy-hater, all of those clients with brachycephalics will go elsewhere and I lose 50% of my business. But if I am not part of the solution, I am part of the problem and I am getting tired of treating so much pathology that could be prevented simply by not creating deformed dogs and cats.

• do you share your frustration with the owners of the brachycephalic breeds you treat?

I try as diplomatically as I can to let them know that the reason their pet has so much pathology in the mouth is because of a serious craniofacial deformity. I have to judge each clients ability/willingness to hear this message and tailor my approach to that assessment. Some have said “If I had only known, I would never have gotten this breed”. I just wish people would research a breed thoroughly before they get their pet.

• which breeds are your main brachy clients?  

There could easily be a geographic bias with this, some breeds being more popular in one area than another, but I see all sorts. Pugs, Boston terriers, French Bulldogs, shih tzus, boxers, lhasa apsos and all sorts of mixed breeds. Then as well as brachycephalic dogs, highly miniaturized ones also have terrible mouths, so add Yorkies, toy and teacup poodles, Chihuahuas, Maltese, Havanese, Bichons… and any crosses of these breeds. And that is just a partial list. Of course, the small brachycephalics are the worst of the bunch. Oh yes, add CKCSs to the list.

• which breed/s in your view are the worst affected?

That is like asking which ocean is the wettest. All brachycephalic breeds are a mess and there is no valid rational or medical justification for the perpetuation of any of them.
Dr Hale with his mixed-breed adoptee Molly

All hail Dr Hale!

Stick an ice cube up his bum

This week's Dog World reports that the Kennel Club has approved the use of ramps in the Bulldog rings to assist with the judging of this blighted British breed.

The reasoning?
"As the Bulldog is one of the 14 Kennel Club high profile breeds, there is a particular emphasis on judges to look for any visible signs of exaggerations that may be causing the dogs pain or discomfort. It was agreed that the ramps allowed for a clearer examination of the dogs’ eyes and skin and would therefore assist judges in their assessment of the dogs.”
Tsk. Why not just make 'em run 10 times round the ring without stopping and exclude the ones that keel over?

I went searching for an official view - but am afraid got sidetracked by this piece of advice on the Bulldog Breed Council's website:

Click to enlarge
Now, the Breed Council has built their website so that you can't copy and paste from it (can't think why not) and the above is a near-unreadable screen-grab. So I hope you'll appreciate that I have gone to the considerable effort to re-type the whole thing for you (and, moreover, resisted the strong temptation to improve the grammar/syntax/sentence construction/punctuation/mistakes).

During hot weather make sure you folow these simple rules - it could save your bulldogs life. 
DON'T take your dog outside during the day! Shut him in a room with a cool floor and draw the curtains to keep the sunlight out, if you do this early enough it will prevent the room from becoming warm as the sun comes into the room. Have an electric fan running in the room to keep the air circulating and make sure there is fresh water available at all times, put a dribble of apple cider vinegar in the water, it will kelp keep the phlegm levels down. 
If he needs to go outside - GO WITH HIM, don't ket him lay out in the sun and bring him straight back in again when he's been tot the toilet. Spray him with cold water if necessary to keep his skin cool. 
If you are not home DON'T let him have free access to the garden, he WILL sun bathe and you will not be there to see when he's been out for too long. 
DON'T walk your dog in this weather, it's still very hot at 8 or 9pm, wait until its very late or walk very early in the morning - remember that tarmac also takes a while to cool off and even after the sun has gone down the roads can be very hot still. 
DON'T force an overheating dog to drink water, offer water, but if refused don't force this issue. HE WILL DRINK IF HE WANTS TO - the worst thing you can do is force him to drink, he could vomit and choke. You can make some ice cubes with glucose powder in the water to feed to him so he takes in fluid without guzzling too much water at once. 
MAKE sure NOW that you have in your cupboard a squizy Jiff lemon, use this FIRST if your dog is overheating, squirt it into the back of the dogs throat - it will break up the foam/phlegm in the throat. (Your dog will hate it but who cares) 
LISTEN to your dog, panting is fine, this is the only way your dog can lose body heat, but listen for a roar - best described as sounding like an asthma attack. If your dog start to roar IMMEDIATELY stand him in cold water, dogs only sweat through the pads of their feet and standing him in cold water has the same effect as putting a cold flannel on your head when you are hot. 
IF HE'S ALREADY TOO HOT - Keep him stook in a bath of cold water, pour water over his head and especially around his neck, you need to cool the bloom going to the brain, in several cases of o verheating there is a risk of brain damage from hot blood going to the brain. (Don't turn the hose pipe on him, it may panic him and make him worse). 
Place ice under his tail (Just inside his bottom if you can), keep pouring cold water over him and KEEP CALM, if you panic your dog will panic - if you suffer from asthma you will understan what I mean. 
Your dog will go very pale as the circulation system struggles to cope. 
Keep going with the water - don't take him out of the bath unit the breathing has calmed down, talk calmly to your dog - you will be soaked, your bathroom will be soaked, but you will save his life!!!!! 
Once the breathing is calmer, remove him from the bath but don't dry him, he will shape up your walls and over you WHO CARES!!!! He will still be very pale (Inside mouth, gums and inner eyes). 
Don't let him wander, don't make a fuss of him, your fussing may panic him and it could start over again. Still don't force him to drink, but make up a rehydration mix and place it in a bowl for him to drink from if he wants to. You can make up your own rehydration mix. 
• 500ml of water
• 2 1/2 teaspoons of glucose powder
• 1/4 teaspoon of salt
• a pinch of bicarbonate of soda 
The mixture will keep in the fridge for 24 hours, or make into ice cubes to use as needed. 
If you cannot calm the dog int he bath GO STRAIGHT TO THE VET!!! Soak a towel in cold water and lay the dog on top of it for the journey, take packets of frozen veggies and lay them on the back of his neck and on each side of his body. If the dog will lay upside down it will help him cool faster through his belly which has less fur on it but bakes sure that someone is with him to ensure he doesn't swallow his tongue! 
If you have air conditioning in the car blast it full cold at the dog, this cool air will help start the cooling process. Remember if you have air conditioning you must keep your car windows SHUT. 
IF YOU ARE AWAY FROM HOME: Find a river, pond, cow trough or knock a door, 7UP will do the same as lemon juice in an emergency. Get in the river with your dog if necessary (many bulldogs cannot swim). but don't take him out until the breathing is calmer, unless his is obviously passing out in which case risk a speeking ticket and get to the nearest vet. 
BE SAFE!!!! Your bulldog won't mind if he doesn't get a walk for a few days!!!!
Hat-tip to Joe Inglis at Vets Klinic in Swindon for this video.