Pug Dog Stenotic Nares

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Overview

Stenotic Nares is the medical term for pinched nostrils and is common with brachycephalic breeds including the Pug. While this can be seen on its own, this is one of several components that make up brachycephalic airway obstructive syndrome.

Stenotic nares is a congenital condition, meaning that it is present at birth. With this, there is a malformation of the cartilage in the nose which makes the nostrils too narrow. These narrow breathing passages cause a dog to have trouble drawing in enough air.

Occurrence Rate

Approximately 50% of Pugs have stenotic nares to some degree and with those that do, approximately 50% also have elongated palate.

Age of Onset

Although stenotic nares are present at birth, associated breathing issues may not be apparent until a Pug is several years old.

Symptoms

Signs include one or more of the following:

Noisy breathing, especially when drawing in air. You may notice the noise occurs as the nostrils flare.
Snoring; this may vary depending on a Pug’s positioning when sleeping.
Exercise intolerance; a Pug may tire out quickly and/or struggle to catch their breath during physical activity.
Cyanosis (this is a blue appearance of the gums due to lack of oxygen) is seen in severe cases.
Fainting is seen in severe cases.

How this is Diagnosed

This is fairly straightforward; the veterinarian will able to clearly see the issue, though additional observations may be done such as assessing breathing both when a Pug is at rest and during a short session of activity.

Since there may be other issues that go along with this such as elongated soft palate or tracheal abnormalities that are less obvious, testing may be performed for those as well and this may include x-rays, an MRI and/or a CT scan.

Treatment, Non-Surgical

If a Pug has only mild signs and does not have any other breathing-related conditions, this may be able to be managed with non-surgical treatment.

This includes:

1. Excess weight gain prevention/weight loss. With puppies, a plan will be put in place to prevent future issues of possible excess weight gain. With older dogs, the vet will speak to you about any excess weight that your dog may be carrying and devise a weight loss plan, if needed. This generally includes offering the same amount of food, but with a lower calorie count, and, only if the Pug is able, a slight increase in physical activity.

2. Immediate discontinuation of a collar. Collars place pressure on the neck and breathing passages, so this will never be used again and a harness will be used instead, any time that the Pug in on a leash. Note that harnesses are always recommended at any rate to help prevent breathing issues which are common with this breed.

3. Limit over-excitement. A new approach should be taken in regard to anything that may excite a Pug such as meeting dogs, greeting visitors to the home, or being given a new toy. Introductions should be done gradually and exposure to certain elements should be handled in a casual, low-key manner.

4. Avoidance of exercise during hot, humid weather; follow exercise restrictions year-round. During the summer, outdoor activity will be limited and year-round regular exercise should be timed with plenty of breaks given, to help prevent a Pug from overexerting themselves.

5. Careful monitoring and regular checkups are important since mild cases can turn severe at any time.

Treatment, Surgical

Overview:

The surgical procedure for this condition is considered relatively minor. A small piece of the inner wall of each nostril is removed to widen the openings. Though this used to primarily be done with scalpel, many veterinary surgeons are now using a CO2 surgical laser. With the laser option, there is little to no bleeding, no need for sutures, and very little post-operative discomfort, though general anesthesia is administered in either case.

If a Pug is going to be spayed or neutered and also requires surgery for stenotic nares, these two procedures are often done at the same time so that general anesthesia is only needed once.

Prognosis:

When treated surgically, prognosis is very good.

Recovery:

Most Pugs recover from surgery fairly quickly. Anti-inflammatory medications and/or antibiotics may be given afterward. A soft or liquid diet may be given for 24 to 48 hours and exercise can usually be reintroduced after one week.

The argument for delaying surgery:

Stenotic nares may be very pronounced during the teething phase but then the nostrils may widen to a certain extent once this phase is complete which means that any associated breathing problems may decrease or completely resolve. Therefore, with minor cases, surgery may be delayed until a puppy is passed the teething stage.

The argument for having surgery performed ASAP:

Moderate to severe cases of stenotic nares can cause a dog to put extreme effort into inhaling. Over time, this can put stress on the larynx which can ultimately lead to collapse; this is an extremely serious issue that can cause suffocation and can be fatal.

Note: If a Pug has both stenotic nares and elongated palate and these conditions are severe enough to cause difficulty breathing, surgery is almost always the answer.

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