Background: Dogs are the most popular mammal kept as a companion animal globally. Positive human-dog relationships can benefit both the human owners as well as the dogs. However, popularity as a companion animal species does not universally benefit dogs in reverse. Breed-related health problems in dogs have received increasing attention over the last decade, sparking increased concerns for dog welfare across many stakeholders. Progress towards improved welfare requires meaningful collaboration between all those working in dog health, science and welfare. The International Partnership for Dogs (IPFD), together with an alternating host organisation, holds biennial meetings called the International Dog Health Workshops (IDHW). The IPFD 4th IDHW was hosted by the UK Kennel Club in Windsor, UK in May 2019. With the aim of encouraging international and multi-stakeholder collaborations that are effective and ongoing, the 4th IDHW 2019 provided a forum to identify specific needs and actions that could improve health, well-being and welfare in dogs, building on outcomes and evaluating actions of previous IDHWs. Results: The workshop included 126 decision-leaders from 16 countries and was structured around five key themes identified as needing international, multi-stakeholder attention. These included the concept of "breed", supply and demand, breed-specific strategies for health and breeding, genetic testing and extreme conformations. The review of progress made since the 3rd IDHW 2017 and the comprehensive lists of actions agreed upon during the current meeting suggest that movement from information and collaboration to action has been achieved. Working groups with specific tasks were identified and many plan to continue to communicate through forum communities on DogWellNet.com.