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Health

Pug Dog Health

Overview

The majority of the health issues seen with this breed are linked to the Pug's body structure. There are conditions to be aware of and steps you can take to keep your Pug as healthy as possible. 
This section will cover: 

Signs of a Possible Health Issue- Clinical signs and red flags that point to a possible health issue. 
List of Most Reported Health Issues - From a comprehensive study involving 2,693 owners of Pug puppies and dogs, the most reported issues. 
General vs Breed-Specific Health Issues - Why the Pug is prone to certain health conditions and disorders. 
General Health Issues Seen with Pugs - Some of the most common yet troubling health concerns for all breeds including the Pug. This includes allergies, dental issues, ear, eye and skin issues, and stomach problems. 
Pug Breed-Specific Health Issues, Respiratory-related - This includes BOAS, stenotic nares, elongated soft palate, tracheal issues, everted laryngeal saccules, and general breathing problems related to environmental or care aspects. 
Pug Breed-Specific Health Issues, Joint and Bone Related - This includes elbow dysplasia and hip issues. 
Pug Breed-Specific Health Issues, Other - This covers Pug Dog Encephalitis (PDE) which is a neurological brain disorder that strikes 1.2% of Pugs and is always fatal.
Health Tips - A summary of the top 6 things you can do to help your Pug stay healthy and live a long life.  

Signs of a Possible Health Issue

If you are looking at Pug puppies to potentially bring one into your home and are trying to determine if they are healthy or are not sure if your Pug of any age is feeling well, there are some general guidelines that point to good health and warning flags that indicate something may be wrong. 
Fever:
Though a dog can certainly be ill without a fever, checking body temperature is an effective method of helping to determine if Pug is fighting some type of infection or is suffering from heat stress. 

Newborn puppies have lower temperatures than their adult counterparts, ranging from about 96 to 97 degrees Fahrenheit (35.5 to 36 C). By the age of 4-weeks old, body temperature is up to about 100 F (37.8 C). Then, by the age of 8 weeks and for the rest of a dog's life, normal body temperature is between 100 and 102.5 F (37.8 to 39.2 C). 

The most accurate method of taking a dog's temperature is to use a pet rectal thermometer that is first lubricated with petroleum jelly. There are pet digital thermometers, but reliable ones can be quite pricey. 
Discharge: 
If you see unusual and excessive discharge from the ears, nose, or eyes this is a red flag. The most common health issue associated with this is allergies, though there are other possibilities as well. Ear discharge is linked to ear infections and excessive eye discharge is linked to eyelash or eyelid abnormalities and certain eye infections. 

Odor: 

Healthy dogs have a neutral smell and a slight 'doggie odor' if the coat gets wet in a way that does not involve cleansing products, like getting wet from the rain. Any strong odd odor is a red flag. Smells from the mouth can indicate dental issues, smells from the ears can indicate an ear infection, and smells from the facial area (wrinkles) or an all-over body odor can indicate bacterial or skin yeast infections. 
Increased breathing issues: 
It will be normal for your Pug to pant a bit in hot weather or when exercising and some can have a certain level of noisy breathing even when at rest. This is typically due to one or more of the common issues seen with Pugs including elongated soft palate and stenotic nares, both which may need surgical correction and are explored ahead. 
With this breed, there can be a fine line between providing enough activity to promote good health and overexertion. If your Pug is panting very heavy, making loud wheezing noises or is seemingly struggling to breath normally, this should not be overlooked. 
Changes in mobility:
This includes a slower gait, limping, trouble rising up, sitting at an odd angle, or holding a limb in an usual way. These changes can indicate something as simple as a strained ligament to something as serious as hip dysplasia or other joint abnormality. With Pugs over the age of 6 or with those that have had past joint or bone issues, these changes can point to osteoarthritis. 
Changes in behavior:
If a Pug is experiencing pain or is ill, there is often decreased appetite, reluctance to exercise, restlessness, and/or changes in sleep patterns (trouble falling asleep, sleeping more, or sleeping less).

List of Most Reported Health Issues

In a comprehensive study done by PetPugDog, which asked 'Has your Pug had any of these health issues?' to 2,693 Pug owners, respondents reported the following: 

Ear infections 15%
Allergies 13%
Eye problems (irritation, eyelash abnormalities and eye infections) 11%
Dental/tooth issues 8%
Breathing issues (brachycephalic obstructive airway syndrome, stenotic nares, elongated palate, trachea issues, everted laryngeal saccules, and other) 8%
Stomach issues (upset stomach, vomiting, diarrhea, etc.) 7%
Skin issues (not related to allergies) 6%
Joint-related issues (elbow dysplasia, Legg-Calve-Perthes, hip dysplasia, patella luxation, etc.) 6%
Parasites (worms, fleas, mites) 3%
Other 3%
Cancer 1.22%
Coat issues (Alopecia, thinning, etc.) 1%
Organ related (liver, kidneys, etc.) 1%
Diabetes .33% 

Note that the full results of this survey are included in PetPugDog's GIANT Book of Pug Care

General vs Breed-Specific Health Issues

Dogs in general are prone to certain health issues just as humans are; these are often those related to environment, food intake, and care. And, each particular breed is prone to certain breed-specific issues which are often genetic and/or linked to body structure. With Pugs, the main physical traits connected to health issues include:  
  • The Pug is among a group of breeds that are brachycephalic. This refers to a head shape with a compressed jaw, a short muzzle, and a compact skull. This profile consequently causes the upper respiratory system to be compressed which can lead to breathing-related issues.
  • Pugs have a barrel-shaped body with relatively short legs that carry a sturdy 14+ pounds (6.35 kg) with many pet Pugs 20+ pounds (9 kg) which plays a role in joint-related issues. 
  • Loose fur and lots of facial wrinkles make the Pug prone to skin issues including bacterial and yeast skin infections.
Next, we will cover the most common general and breed-specific health issues that owners of Pugs should know about. Of course, this does not mean that your Pug will be affected by these. 

General Health Issues Seen with Pugs

Allergies
Allergies are a common ailment with all dog breeds and as seen in the previous 'List of Most Reported Health Issues', 13% of owners reported that their Pug has struggled with allergies, though certainly issues like coat problems, skin issues, and stomach problems can be related to this and breathing-related problems can be exacerbated by this. 
Pugs can have a variety of allergies including airborne (grasses, pollen, etc.), contact (anything that comes into contact with the body), and food (often a reaction to additives, though dogs can be allergic to any ingredient including a certain protein, like chicken). 

Signs of allergies include itching, rash, hives, hot spots, wheezing, sneezing, coughing, and/or watery eyes. 

Allergies can often be reduced by making changes to a Pug's environment, limiting exposure, and the use of over-the-counter allergy treatments including specialty shampoos and anti-itch topical sprays. In some cases, prescribed medications may need to be given. Read more about Pug Dog Allergies
Dental Issues 
Without proper care and upkeep, Pugs can develop tooth decay and periodontal disease. Infections can be localized or they can travel up to the sinuses or even lead to full-body infection, also known as sepsis, a potentially life-threatening condition. Taking care of the teeth is something that should start when a Pug is a pup and continue on through the dog's entire life. Read more about Pug Dental Care
Ear Infections
Ear infections are one of the most common health issues seen with all dog breeds and with dogs of all ages. As you can see in the previous 'List of Most Reported Health Issues', this was at #1, with 15% of owners stating that their Pug has suffered from an ear infection. 
Breeds like the Pug that have drop ears (rose or button fold-over) in which the ear canal is fully or partial covered are more prone to this than breeds with erect stand-up ears. Keeping the ears clean of excess wax, debris and moisture plays a big role in helping to prevent ear infections. Read more about Pug Dog Ears for information regarding ear set, ear care, and infection prevention. 
Eye Issues
Canines in general can have a wide range of eye-related issues and disorders. In addition to those, breeds like the Pug that have large and somewhat protruding eyes are prone to certain eye issues. As seen earlier under 'List of Most Reported Health Issues', eye problems ranked at #3 with 11% of Pug owners reporting a previous or current problem. 
Top issues that affect Pugs include pigmentary keratitis, cherry eye, inflammation, keratoconjunctivitis sicca (dry eye), corneal abrasions and ulcerations, entropion (inverted or folded-in eyelid), distichiasis (eyelash(es) will grow in an odd place), and cataracts (mostly seen with seniors). Read more about Pug Dog Eye Issues and Care
Skin Issues
Common skin issues seen with Pugs includes itching, hot spots, and rash, sometimes seen alongside a strong odor. The cause behind these problems may be linked to allergies or a skin infection due to bacteria or yeast. In many cases, skin irritations and itching can be remedied at home by making some changes to limit exposure to the trigger and the use of topical anti-itch sprays and/or shampoos. 
Read more about Pug Dog Skin Issues which covers a wide range of signs and symptoms. 
Or, read more about Pug Dog Itching which helps owners determine the cause and covers options for giving a Pug immediate relief. 
Stomach and Intestinal Issues 
There are lots of things that can cause a Pug to have an upset stomach or a disturbance in bowel movements, ranging from ingestion of table scraps with a high fat content to ingestion of toxins, though an acute bacterial issue or virus are also possibilities. Long-term stomach issues are often related to a dog's diet. Bloat, which is a dangerous twisting of the stomach, is linked to rapid ingestion of food and exercising too close to meal time. Read more: 
Pug Dog Bloat - This acute condition, also known as Killer Bloat and medically known as Gastric Dilatation Volvulus, is a serious and sometime fatal issue. Learn how to prevent this, common symptoms, and how to react if you suspect this. 
Pug Dog Constipation - This refers to very hard or very infrequent bowel movements. Most cases can be treated at home but severe cases or those that do not respond to home remedies must be treated by the veterinarian. 
Pug Dog Diarrhea - This refers to very frequent or loose stools and needs to be addressed as soon as possible since it can lead to dangerous dehydration. 
Pug Dog Gas - Excess gas can cause burping or flatulence which may not only be stinky but also uncomfortable for a Pug.  

Pug Breed-Specific Health Issues, Respiratory-related

Brachycephalic Obstructive Airway Syndrome (BOAS)
This is a combination of two or more conditions, and in some cases secondary conditions, that affects the breathing passages and therefore a Pug's ability to breathe. The four main conditions are: 
  1. Stenotic nares. ‘Pinched’ nostrils that are too small, making it difficult to draw air in. 
  2. Elongated soft palate; The palate (flap of skin at the back of the throat) is too long, partially blocking the entrance to the trachea (windpipe). 
  3. Trachea issues. This includes hypoplastic trachea (abnormal growth of the cartilage rings that make up the trachea (windpipe) is which the airway is abnormally narrow and collapsed trachea (a weakening of the cartilage rings which leads to one or more of them collapsing inward) which blocks the trachea (windpipe) to varying extents.
  4. Everted laryngeal saccules. Tissue located in front of the vocal cords is pulled into the trachea (windpipe), causing a partial blockage. This is not seen as often as stenotic nares, elongated soft palate, and trachea issues.
Secondary conditions include laryngeal (voice box) collapse and tonsillar eversion and hypertrophy.

BOAS is very common with Pugs. Some studies show the rate of brachycephalic obstructive airway syndrome with Pugs as being 90+%; however, this does not represent the number that have this condition severe enough to warrant surgery. As seen in the previous 'List of Most Reported Health Issues' just 8% of owners reported this with their Pug, though this certainly and unfortunately does not include those who have this but are not yet diagnosed. 
Read more about Brachycephalic Obstructive Airway Syndrome with Pugs or continue on to learn about each of the conditions seen with this. 
Stenotic Nares
This is a very common health condition seen with Pugs, approximately 50% of all Pugs have this to some degree. Also known as pinched nostrils, stenotic nares involves abnormally narrow nostrils that cause a dog to have trouble breathing. Over time, internal pressure can build up, affecting the larynx and lead to larynx collapse which is a very dangerous and often fatal condition.  

Stenotic nares is a congenital issue, meaning that it is present at birth, but noticeable symptoms may not appear for several years. Signs include noisy breathing, exercise intolerance, and snoring. Severe cases may also include cyanosis (blue gums) and/or fainting. 

Minor cases are treated with the use of a harness as opposed to a collar and careful attention paid to exercise limits. Moderate to severe cases are treated surgically. Read more about Pug Dog Stenotic Nares
Elongated Soft Palate
This is a condition seen with Pugs involving the palate which is a flap of tissue located at the back of the throat. Because Pugs have compressed internal passages, the palate is often too large, comparatively speaking, and therefore partially blocks the entrance to the trachea (windpipe). This means that as a Pug inhales and exhales, the air cannot flow freely as it would otherwise. 

Elongated soft palate is a congenital issue, meaning that it is present at birth and symptoms may not always be noticeable right away but may worsen as a Pug matures. Signs include newborn pups dribbling milk from the nose, excessive panting, gagging or regurgitating food, snoring, excessive saliva, and exercise intolerance. Severe cases may also include cyanosis (blue gums) and/or fainting. 

Minor cases are treated with the use of a harness as opposed to a collar, careful attention paid to exercise limits, and encouraging better sleeping positions. Moderate to severe cases are treated surgically. Read more about Pug Dog Elongated Soft Palate
Tracheal Issues - Hypoplastic and Collapsed Trachea
Hypoplastic trachea (an abnormally narrow trachea) is seen more often with Pugs than collapsed trachea (rings supporting the trachea collapse inward). This breed is at moderate risk and if a Pug suffers from one of these tracheal issues, it may be seen alongside elongated soft palate and/or stenotic nares. 

Hypoplastic trachea is a congenital issue, meaning that it is present at birth and collapsed trachea can be genetic or acquired. 

Signs of either issue includes trouble eating (gagging on or regurgitating food), noisy breathing (gasping, rattling, or wheezing noises), coughing, gasping for breath, and exercise intolerance. With collapsed trachea, there is often a distinctive honking-type cough. Severe cases may also include cyanosis (blue gums) and/or fainting. 

Minor to moderate cases are treated with the use of a harness as opposed to a collar, careful attention paid to exercise limits, anti-inflammatory medication, and cough medication. Moderate to severe cases may be treated surgically, but this is an extensive and risky surgery. Read more about Pug Hypoplastic and Collapsed Trachea
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Everted Laryngeal Saccules
This is a common issue seen with all brachycephalic breeds with studies suggesting a prevalence rate of 54 to 66%, though Pugs are not the breed most prone to this. With this, tissue near the vocal cords becomes everted (inside out). When this occurs, that protruding tissue is drawn into the windpipe, blocking off proper airflow. This abnormality causes internal negative pressure that can put stress on the larynx which can cause eventual collapse, a severe and often fatal condition. 

Signs include very noisy breathing, nasal congestion, gasping for air, gagging on or regurgitating food, coughing and/or exercise intolerance. With severe cases, there can be cyanosis (blue gums) and/or fainting. 

Because everted laryngeal saccules is considered to be the first stage of laryngeal collapse, any moderate to severe cases are almost always treated with surgery. Read more about Pug Dog Everted Laryngeal Saccules.
General Breathing Issues 

Though the issues that fall under the category of BOAS are seen with brachycephalic breeds like the Pug, it is not always the case that any of these are severe enough to be causing problems. And, Pugs can also have noisy or labored breathing that is not connected at all to these abnormalities. In some cases, it is a matter of over-exertion and in other cases it can be linked to environmental elements such as air quality or hot temperatures or care elements including the type of accessories placed on a Pug. 

To make sure you are doing all you can to help your Pug breathe as freely as possible, read more about Pug Breathing Issues

Pug Breed-Specific Health Issues, Joint and Bone Related

Elbow Dysplasia
The elbow refers to the joints in the two front legs (the patella refers to the knee joint in the two hind legs). Elbow dysplasia is an umbrella term that refers to a growth abnormality of cells, tissue, and/or bone in the elbow joint but all involve improperly fitting joint and socket.

This is a very common issue with Pugs, reports show 40+% of Pugs have dysplastic elbows to some degree. It is usually diagnosed by the age of 1 year and signs include abnormal gait, lameness, limping, odd stance, and discomfort. There are many non-surgical treatment options and surgery is reserved for severe cases. Read more about Pug Dog Elbow Dysplasia
Hip Issues - Hip Dysplasia and Legg-Calve-Perthes
Pugs are very prone to hip dysplasia which refers to a malformation that causes an ill-fitting hip joint and socket typically seen with weakened support of connective tissues and muscles that creates instability. Signs include limping, holding the leg in an odd position, and mobility issues. 

Small-sized dog breeds, including the Pug, are prone to Legg-Calve-Perthes which is a degenerative disease of the head of the femur bone on the hind leg (the ball that fits into the socket in the pelvis; which makes up the hip joint). With this, there is deterioration of the bone leading to sometimes serious mobility issues.  

Treatment for these two hip issues can involve certain exercises, OTC medications, supplements, and prescribed medications. Surgery is an option with severe cases. 
Read more about Pug Dog Hip Dysplasia including the high occurrence rate, age of onset, diagnosis, treatment options, and important prevention tips. 
Or, read more about Pug Dog Legg-Calve-Perthes including symptoms, diagnosis, and treatment options.

Breed-Specific Health Issues, Other

Pug Dog Encephalitis
Pug Dog Encephalitis (PDE) falls under the category of necrotizing meningoencephalitis (NME) and is a neurological brain disorder that causes rapid onset swelling of the brain, death of brain cells, and unfortunately is fatal in all cases. 

This strikes approximately 1.2% of Pug dogs, see also: Pug Dog Life Span. This is seen more often with fawn Pugs as opposed to those with black coats and age of onset is usually under the age of 7 years old. The main symptom is severe seizures and unfortunately, there is no treatment. Read more about Pug Dog Encephalitis.

Health Tips

There are things that you can do to help keep your Pug as healthy as possible: 
1. Keep your Pug at a healthy weight. Pugs typically have very hearty appetites while not being built for long duration or high intensity physical activity, so this makes the Pug prone to weight gain. Carrying excess weight puts stress on this breed's short, stocky and barrel-shaped body with wear and tear on the knees, hips, and back and is a contributing factor in a range of health issues.  
2. Feed your Pug a healthy diet. Feeding your Pug all-natural and nutritious meals and snacks will help your dog maintain a healthy weight and will avoid issues commonly seen with substandard dog foods including allergic reactions. 
3. Exercise your Pug on a regular basis. Routine exercise helps helps regulate the metabolism, keeps supporting muscles strong, is great for heart health, and helps strengthen the immune system. In addition, staying physically active is a boost for mental health as well; dogs that are able to release pent-up energy in a positive way are less prone to boredom and negative behaviors such as barking and destructive chewing. Follow exercise guidelines to ensure your Pug is active enough while avoiding heat stress and breathing issues. 
4. Regular grooming. Staying on track in regard to all grooming elements including cleaning the facial wrinkles, eye area, and ears and bathing your Pug on time while using high-quality products can help avoid skin yeast infections which are common with this breed. Keeping your Pug's teeth clean and free from plaque build-up will help avoid painful infections and possible tooth loss. 
5. Make and keep veterinary wellness checks. Starting at age 1, Pugs should be seen by the vet once a year for routine checks which include a physical examination, blood, urine, and stool testing, breathing assessment, and more. Starting around age 8, these checkups are usually needed twice per year. 
6. Always use a harness, not a collar. This brachycephalic breed that is already prone to breathing-related issues should never be walked using a leash and collar which puts pressure on the trachea; always place a harness on your Pug instead which distributes stress over the much stronger shoulders, back, and chest. 
You may also be interested in:

Pug Dog Bad Breath - Reasons why a Pug's breath can get stinky and at-home remedies to fix this. 
Pug Dog Itching Issues - See the top reasons why a Pug may be terribly itching, along with exact steps to fully and quickly resolve this common problem. 
Pug Paw Care - How to keep your Pug's paw in good shape and remedies for the most common issues including itchiness and irritation. 
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