As climate change causes global temperatures to rise, heat-related illness, a potentially fatal condition in dogs, will become an ever-greater threat. this study aimed to report the incidence, fatality and canine risk factors of heat-related illness in UK dogs under primary veterinary care in 2016. The VetCompass tM programme collects de-identified electronic patient records from UK veterinary practices for research. From the clinical records of 905,543 dogs under veterinary care in 2016, 395 confirmed heat-related illness events were identified. The estimated 2016 incidence of heat-related illness was 0.04% (95% CI 0.04-0.05%), with an event fatality rate of 14.18% (95% CI 11.08-17.96%). Multivariable analysis identified significant risk factors including breed (e.g. Chow Chow, Bulldog and French Bulldog), higher bodyweight relative to the breed/sex mean and being over two years of age. Dogs with a brachycephalic skull shape and dogs weighing over 50 kg were also at greater risk. As we move into an ever-warmer world, veterinary professionals may need to include resistance to heat-related illness amongst their rationales when advising owners on breed selection. Breeding for good respiratory function and maintaining a healthy bodyweight should be considered key welfare priorities for all dogs to limit the risk of heat-related illness. Climate change is listed among the World Health Organisation's top ten threats to Global Health in 2019, with heat-related illness (HRI) predicted to contribute towards an additional 250,000 human deaths annually by 2030 1. HRI is a progressive disorder of animals and man caused by core body temperatures that rise above homeostatic limits, resulting in metabolic disturbances 2. This can lead to decreased cardiac output, fatigue of heat dissipation mechanisms, organ failure and ultimately death 2-4. Animal welfare organisations in the United Kingdom (UK) and Australia have reported increasing numbers of calls about animals trapped in hot environments over recent years 5,6. As the frequency and severity of heat waves is predicted to increase, there is an urgent need for better evidence-based guidance on the risk factors and early recognition of HRI to improve prevention and treatment strategies for both humans and animals 3,7. A deficiency of reliable and current data on the diagnosis, treatment and fatality rate of HRI is a key barrier to mitigating HRI risks in both humans and dogs 8. The classical terminology used to define HRI varies, but typically includes terms that describe progression from heat stress, through heat exhaustion to heatstroke 2. However, these classical terms lack clear explicit definitions and are often used interchangeably as synonyms, leaving their usage open to individual interpretation that creates a confused medical and veterinary literature 3. A novel HRI scoring system has been proposed for use in humans, acknowledging that patients can progress through the stages of disease severity depending on the duration and intensity of heat exposure and effectivenes...