6 Common Health Problems in Pugs (Vet Answer)

Pugs are one of the most instantly recognizable and beloved dog breeds, known for their wrinkled faces, curly tails, and big personalities in small packages. However, the exaggerated features that give pugs their signature look also make them prone to a number of health issues. As a veterinarian, I feel it‘s important for any current or prospective pug owner to be aware of these breed-specific concerns. By understanding the challenges pugs face, you‘ll be better prepared to prevent problems when possible and get your pug prompt treatment when needed.

Brachycephalic Airway Syndrome
The pug‘s flat face and short muzzle, while endearing to many, is an unnatural canine head shape known as brachycephalic. Brachycephalic breeds like pugs, French bulldogs, and Boston terriers have a compressed upper jaw and a normal-sized lower jaw, leading to anatomical abnormalities that obstruct their airways. These anomalies include:

• Stenotic nares: Abnormally narrow or collapsed nostrils that restrict airflow
• Elongated soft palate: Excess soft tissue at the back of the throat that partially blocks the trachea
• Everted laryngeal saccules: Small pouches inside the voicebox that get pulled into the airway

Pugs with these malformed respiratory structures, a condition known as brachycephalic airway syndrome, have to work harder to breathe. You may notice your pug snorting, snoring, gagging, or struggling to breathe, especially when excited, after exercise, and in hot/humid weather. Left untreated, brachycephalic airway syndrome can lead to potentially life-threatening complications like laryngeal collapse, heatstroke, and heart failure.

If your vet determines your pug‘s breathing is significantly compromised, surgery may be recommended to widen the nostrils, shorten the soft palate, and/or remove the everted saccules. Even after surgery, you‘ll need to take precautions to avoid overtaxing your pug‘s respiratory system. Keep your pug at a healthy weight, use a harness instead of a neck collar, limit strenuous exercise, and NEVER leave your pug outdoors in the heat.

Eye Problems
Those big, bulging pug eyes are certainly cute, but they‘re also prone to injury and irritation. Because their eyes protrude and may not close completely, pugs often experience dry eye and are at higher risk for corneal ulcers. They may also develop eye conditions like:

• Entropion: Eyelids that roll inward, allowing eyelashes to rub against the cornea
• Distichiasis: Extra eyelashes that grow from the eyelid margin and touch the eye
• Proptosis: Dislocation of the eyeball from the socket, usually due to trauma

Watch for signs your pug is having eye trouble, including redness, discharge, excessive blinking, rubbing/pawing at the eyes, cloudiness, and visible third eyelid. See your vet right away if you notice these symptoms, as many eye issues can lead to permanent scarring, vision loss, or even loss of the eye itself without prompt treatment. Your vet may prescribe lubricating drops, antibiotics, and/or anti-inflammatory medications. Surgery could be needed for conditions like entropion and proptosis.

To help protect your pug‘s eyes, keep facial skin folds clean and dry, trim long facial hair, use an eye-safe pet sunscreen, and discourage rough play that could lead to eye injury.

Skin Problems
Those signature pug wrinkles may be adorable, but they‘re also a recipe for skin troubles. Pugs are prone to bacterial and yeast infections in their skin folds, a condition known as skin fold dermatitis. Allergies to things like pollen, mold, dust mites, and fleas are also common in pugs and can cause itchy skin and recurrent ear infections.

Prevent skin fold infections by cleaning your pug‘s wrinkles daily with a damp cloth or pet wipe, then thoroughly drying the areas. If your pug is itchy or smelly or if you notice redness, hair loss, and/or discharge in the skin folds or ears, have your vet take a look. Medicated shampoos, oral antibiotics/antifungals, and/or anti-itch medications like Apoquel or Cytopoint are often needed to treat underlying skin infections and allergies. Year-round flea prevention is also a must for pugs.

Orthopedic Problems
Besides breathing issues and skin problems, pugs face a few musculoskeletal challenges. Luxating patellas, where the kneecap slips out of its groove, and hip dysplasia, where the hip joints are malformed, are both heritable conditions known to affect pugs. Pugs are also prone to intervertebral disc disease (IVDD), likely in part due to their corkscrew tails and short legs. In IVDD, the cushioning discs between vertebrae harden and bulge, pressing painfully on the spinal cord.

If your pug starts limping, walking stiffly, showing reluctance to jump or climb stairs, or is suddenly dragging their back legs, get them evaluated by your vet immediately. Depending on the orthopedic issue and its severity, your pug may need x-rays, surgery, joint supplements, pain medications, weight management, and/or physical therapy. For IVDD, early surgical treatment can make the difference between lifelong paralysis and a full recovery.

Obesity is a major risk factor for orthopedic problems, so keeping your pug fit and trim is key. Ask your vet to body condition score your pug and give you a target weight. Measure your pug‘s food, limit treats, and aim for daily low-impact exercise like walking and swimming.

Neurological Issues
Though not as common as respiratory, eye, skin, and orthopedic problems, some pugs do suffer from neurological issues like seizures and encephalitis (brain inflammation). Signs of a neurological problem include head pressing, incoordination, repetitive circling, behavior changes, weakness, and disorientation. These symptoms can also be caused by other serious health issues like liver shunts, so an immediate vet visit is in order if you notice any of them in your pug. Diagnosis usually involves bloodwork and advanced imaging like MRI. Longterm medication, dietary management, and/or surgery may be needed, depending on the underlying cause.

Preventive Care
Ultimately, many health problems in pugs stem from prioritizing looks over function in breeding, resulting in dogs whose bodies struggle to do basic things like breathe and move. The very best thing you can do is find a pug breeder who health tests their dogs and breeds for a more moderate head shape and body structure. Adopting an adult pug from a rescue group is another great option, as many health issues will already be apparent.

For the pug in your care, focus on maintaining a healthy weight, avoiding situations that overtax their breathing, keeping the skin folds clean and dry, protecting the eyes, and using a harness instead of a collar. Find a vet experienced with brachycephalic breeds for regular preventive care. By knowing what problems to be on alert for, you‘ll be able to identify issues early and get your pug the care they need to live their best life by your side.