Your Pug

Caring for Your Faithful Companion

Pugs: What a Unique Breed!

Your dog is special! She’s your best friend, companion, and a source of unconditional love. Chances are that you chose her because you like Pugs and you expected her to have certain traits that would fit your lifestyle:

  • Outgoing, playful personality
  • Needs minimal exercise
  • Vigilant watchdog with a ready bark
  • Even-tempered, affectionate, and happy-go-lucky
  • Good with children and other pets
  • Small, but sturdy

However, no dog is perfect! You may have also noticed these characteristics:

  • Can be independent and strong-willed
  • Prone to quite a few health problems
  • Makes a lot of snorting, snuffling, and wheezing noises, and she may snore
  • Can be difficult to housetrain
  • An indoor dog that doesn’t do well in the heat
  • Prone to boredom and separation anxiety when left alone and will find trouble

Is it all worth it? Of course! She’s full of personality, and you love her for it! Pugs are joyful pals and make great travel companions; after all, who could leave those big brown eyes at home?

We first came to know Pugs in China centuries ago. They were treasured pets kept by royalty; it was common for a Pug to have her own guard, palace, and even chef! Many Pug owners agree that they haven’t lost their ancestry and still behave like royalty. She was first acknowledged by the AKC in 1885 and was quickly welcomed into American homes. Her moderate exercise requirements make her a great apartment pet. The Pug is a generally healthy breed with an average lifespan of 13-15 years.

Your Pug’s Health

We know that because you care so much about your dog, you want to take good care of her. That is why we have summarized the health concerns we will be discussing with you over the life of your Pug. By knowing about health concerns specific to Pugs, we can tailor a preventive health plan to watch for and hopefully prevent some predictable risks.

Many diseases and health conditions are genetic, meaning they are related to your pet’s breed. There is a general consensus among canine genetic researchers and veterinary practitioners that the conditions we’ve described herein have a significant rate of incidence and/or impact in this breed. That does not mean your dog will have these problems; it just means that she is more at risk than other dogs. We will describe the most common issues seen in Pugs to give you an idea of what may come up in her future. Of course, we can’t cover every possibility here, so always check with us if you notice any unusual signs or symptoms.

This guide contains general health information important to all canines as well as the most important genetic predispositions for Pugs. This information helps you and us together plan for your pet’s unique medical needs. At the end of the booklet, we have also included a description of what you can do at home to keep your Pug looking and feeling her best. You will know what to watch for, and we will all feel better knowing that we’re taking the best possible care of your pal.

Brushing your dog’s teeth daily will prevent periodontal disease.

Brushing your dog’s teeth daily will prevent periodontal disease.

General Health Information for your Pug

Dental Disease

Dental disease is the most common chronic problem in pets, affecting 80% of all dogs by age two. And unfortunately, your Pug is more likely than other dogs to have problems with her teeth. It starts with tartar build-up on the teeth and progresses to infection of the gums and roots of the teeth. If we don’t prevent or treat dental disease, your buddy will lose her teeth and be in danger of damaging her kidneys, liver, heart, and joints. In fact, your Pug’s life span may be cut short by one to three years! We’ll clean your dog’s teeth regularly and let you know what you can do at home to keep those pearly whites clean.


Pugs are susceptible to bacterial and viral infections — the same ones that all dogs can get — such as parvo, rabies, and distemper. Many of these infections are preventable through vaccination, which we will recommend based on the diseases we see in our area, her age, and other factors.


Obesity can be a significant health problem in Pugs. It is a serious disease that may cause or worsen joint problems, metabolic and digestive disorders, back pain and heart disease. Though it’s tempting to give your pal food when she looks at you with those soulful eyes, you can “love her to death” with leftover people food and doggie treats. Instead, give her a hug, brush her fur or teeth, play a game with her, or perhaps take her for a walk. She’ll feel better, and so will you!

Roundworm egg as seen under the microscope.

Roundworm egg as seen under the microscope.


All kinds of worms and bugs can invade your Pug’s body, inside and out. Everything from fleas and ticks to ear mites can infest her skin and ears. Hookworms, roundworms, heartworms, and whipworms can get into her system in a number of ways: drinking unclean water, walking on contaminated soil, or being bitten by an infected mosquito. Some of these parasites can be transmitted to you or a family member and are a serious concern for everyone. For your canine friend, these parasites can cause pain, discomfort, and even death, so it’s important that we test for them on a regular basis. We’ll also recommend preventive medication as necessary to keep her healthy.

Spay or Neuter

One of the best things you can do for your Pug is to have her spayed (neutered for males). In females, this means we surgically remove the ovaries and usually the uterus, and in males, it means we surgically remove the testicles. Spaying or neutering decreases the likelihood of certain types of cancers and eliminates the possibility of your pet becoming pregnant or fathering unwanted puppies. Performing this surgery also gives us a chance, while your pet is under anesthesia, to identify and address some of the diseases your dog is likely to develop. For example, if your pet needs hip X-rays or a puppy tooth extracted, this would be a good time. This is convenient for you and easy for your friend. Routine blood testing prior to surgery also helps us to identify and take precautions for common problems that increase anesthetic or surgical risk. Don’t worry; we’ll discuss the specific problems we will be looking for when the time arrives.

Genetic Predispositions for Pugs

Liver Problems

Your Pug is more likely than other dogs to have a liver disorder called portosystemic shunt (PSS). Some of the blood supply that should go to the liver goes around it instead, depriving the liver of the blood flow it needs to grow and function properly. If your friend has PSS, his liver cannot remove toxins from his bloodstream effectively. To check for this problem, we’ll conduct a liver function test in addition to a standard pre-anesthetic panel every time he undergoes anesthesia. If he develops symptoms such as stunted growth or seizures, we’ll test his blood and possibly conduct an ultrasound scan of his liver. Surgery may be needed, but in some cases, we can treat with a special diet and medication.


Pugs are more prone to an uncommon, but serious, condition called chylothorax where the chest cavity fills with a milky substance called chyle. In affected dogs, chyle accumulates in the chest cavity because of a faulty lymphatic duct called the thoracic duct. Chylothorax, while rare, is life threatening and requires immediate medical attention. Often surgery is need to help manage the disease. Watch for difficulty breathing, coughing or lethargy as these may be the first signs of this disease.

Eye Problems

Not many things have as dramatic an impact on your dog’s quality of life as the proper functioning of his eyes. Unfortunately, Pugs can inherit or develop a number of different eye conditions, some of which may cause blindness if not treated right away, and most of which can be extremely painful! We will evaluate his eyes at every examination to look for any signs of concern.

Because your Pug has eyeballs that naturally protrude, he is more vulnerable to eye injuries. Scrapes or punctures to the cornea (the protective covering on the eyeball) are the most common injuries. Not only do they hurt, they can become infected and affect his vision. Don’t let him ride in the car with his head out the window as this is a frequent cause of eye injuries. Call us right away if he has any problems with his eyes. A damaged cornea is painful and should be treated immediately. Medication and sometimes surgery is required.

Entropion. Notice how the lower lid curls in towards the surface of the eye to cause irritation.

Entropion. Notice how the lower lid curls in towards the surface of the eye to cause irritation.

Entropion is a condition where the eyelid rolls inward, causing the eyelashes to rub against the cornea (surface of the eyeball). This is an extremely irritating and painful condition that can ultimately lead to blindness. It can happen in any dog breed; however, your Pug is especially at risk for this heritable disorder. Surgical correction is usually successful if performed early.

Dry eye, also known as keratoconjunctivitis sicca or KCS, is common in Pugs. The tear glands no longer produce enough tears to keep the eye moist, which results in sore, itchy eyes and infections. Ouch! Symptoms include a thick discharge, squinting, pawing at the eye, or a dull, dry appearance of the eye. This is a painful condition; please call us immediately if you notice any of these signs. We’ll conduct a tear test when we examine him. If he has this disease, we’ll prescribe ointment that you’ll need to apply for the rest of your dog’s life.


Diabetes mellitus is a fairly common disease in dogs. Any breed can be affected, but Pugs have an above average incidence. Dogs with diabetes are unable to regulate the metabolism of sugars and require daily insulin injections. It is a serious condition and one that is important to diagnose and treat as early as possible. Symptoms include increased eating, drinking, and urination, along with weight loss. If he shows signs, we will conduct lab tests to determine if he has this condition and discuss treatment options with you. Treatment requires a serious commitment of time and resources. Well regulated diabetic dogs today have the same life expectancy as other canines.


In humans, an allergy to pollen, mold, or dust makes people sneeze and their eyes itch. In dogs, rather than sneeze, allergies make their skin itchy. We call this skin allergy “atopy”, and Pugs often have it. Commonly, the feet, belly, folds of the skin, and ears are most affected. Symptoms typically start between the ages of one and three and can get worse every year. Licking the paws, rubbing the face, and frequent ear infections are the most common signs. The good news is that there are many treatment options available for this condition.

A microscopic image of a Demodex mite.

A microscopic image of a Demodex mite.


Demodex is a microscopic mite that lives in the hair follicles of dogs. All dogs have them. Normally a dog’s immune system keeps the mites in check, but some breeds, like your Pug, develop an overabundance of these mites. In mild cases, pet owners may notice a few dry, irritated, hairless lesions. These often occur on the face or feet and may or may not be itchy. Secondary skin infections may occur. Prompt veterinary care is important to keep the disease from getting out of hand. Many pets seem to outgrow the problem, while others require lifelong management.

Skin Infections

Your Pug is prone to a form of skin infection called lip-fold pyoderma, which occurs because the folds of skin along the lower jaw are usually moist. Bacteria and yeast can readily gain a foothold and cause a reddened, smelly area that is uncomfortable for your dog. We will examine him for this problem, but let us know if you see signs. We’ll recommend treatment with antibiotics as necessary. When symptoms are severe, the excess skin folds can be surgically removed.

Granulomatous Meningoencephalitis (GME)

GME is an acute, progressive inflammatory disease of the central nervous system (CNS) of dogs. It can cause severe and often irreversible damage to the brain. Middle aged, small breed dogs such as Pugs are more susceptible. The cause is unknown. Three syndromes of GME have been recognized, and symptoms may be acute, leading rapidly to death, or they may chronically progress over several months. Sometimes only the eyes are involved. Treatment includes corticosteroids. Response to therapy is variable and the prognosis is generally poor.

Bone and Joint Problems

A number of different musculoskeletal problems have been reported in Pugs. While it may seem overwhelming, each condition can be diagnosed and treated to prevent undue pain and suffering. With diligent observation at home and knowledge about the diseases that may affect your friend’s bones, joints, or muscles you will be able to take great care of him throughout his life.

Both hips and elbows are at risk for dysplasia, an inherited disease that causes the joints to develop improperly and results in arthritis. Stiffness in your Pug’s elbows or hips may become a problem for him, especially as he matures. You may notice that he begins to show lameness in his legs or has difficulty getting up from lying down. We can treat the arthritis—the sooner the better—to minimize discomfort and pain. We’ll take X-rays of your dog’s bones to identify issues as early as possible. Surgery is sometimes a good option in severe and life-limiting cases. Keep in mind that overweight dogs may develop arthritis years earlier than those of normal weight, causing undue pain and suffering!

Young Pugs may be prone to a painful degenerative hip condition called Legg-Calve-Perthes Disease. The exact cause of this condition is still not completely understood, but it is thought to be a problem with blood supply to the hip, which causes the femoral head (the top of the thigh bone) to become brittle and easily fracture. Ouch! Usually occurring between six and nine months of age, it causes pain and lameness in one or both rear legs, and often requires surgery.

Normal Knee

Normal Knee

Illustration of patellar luxation. Notice how the knee cap has moved out of the groove it normally resides in.

Illustration of patellar luxation. Notice how the knee cap has moved out of the groove it normally resides in.

Sometimes your Pug’s kneecap (patella) may slip out of place (called patellar luxation). You might notice that he runs along and suddenly picks up a back leg and skips or hops for a few strides. Then he kicks his leg out sideways to pop the kneecap back in place, and he’s fine again. If the problem is mild and involves only one leg, your friend may not require much treatment beyond arthritis medication. When symptoms are severe, surgery may be needed to realign the kneecap to keep it from popping out of place.

Spinal Deformities

Pugs are more likely than other canines to be born with spinal deformities (a condition called hemivertebrae), which may lead to spinal cord damage, instability, or disability. We’ll take X-rays when he is young to ensure that we identify problems early because symptoms can worsen with age, weight, and sometimes activity. During his life, if he develops symptoms of any back problems, we’ll rule out any other causes, such as a slipped spinal disc or arthritis and may prescribe medication, acupuncture, or rehabilitation.

Tumors, both benign and cancerous, can look like anything. This red swelling on the skin surface is a cancer known as a Mast Cell Tumor. Be sure to have all lumps and bumps checked out.

Tumors, both benign and cancerous, can look like anything. This red swelling on the skin surface is a cancer known as a Mast Cell Tumor. Be sure to have all lumps and bumps checked out.

Mast Cell Tumor

Mast cell tumors are a particularly nasty type of skin cancer found more often in Pugs, and the sooner they are surgically removed the better. Trouble is, they often look just like other kinds of skin lumps and lesions, some of which are harmful, and others not. All suspicious lumps should be tested and any questionable lump should be surgically removed as soon as possible. Many cancers are cured by surgically removing them, so early detection and removal is critical.

Degenerative Myelopathy

Degenerative Myelopathy is a neurologic condition, similar to ALS or Lou Gehrig’s Disease in people, that causes weakness and poor nerve function in the hind legs. It affects Pugs more frequently than other breeds. If your dog has this disease, he will become increasingly weak and disabled in the hind legs and will eventually suffer from paralysis in his hindquarters, along with incontinence. Rehabilitation, exercise, acupuncture, and dietary supplements can be helpful, but there is no cure. A genetic test is available to determine whether your dog is at risk for this heritable disease.

Bladder or Kidney Stones

There are a few different types of stones that can form in the kidney or in the bladder, and Pugs are more likely to develop them than other breeds. We’ll periodically test his urine for telltale signs indicating the presence of kidney and bladder stones; they are painful! If your buddy has blood in his urine, can’t urinate, or is straining to urinate, it is a medical emergency. Call us immediately!

Narrow nostril openings make breathing air in more challenging.

Narrow nostril openings make breathing air in more challenging.

Respiratory Distress Syndrome

This disease, also known as brachycephalic syndrome, affects dogs with a short nose, like your Pug. He has the same amount of tissue in his nose and throat as the longer-nosed dogs, but there’s no place for it to go. As a consequence, the soft palate (the soft part at the back of the roof of the mouth), is too long and hangs down into the airway. The nostrils are often too small, and sometimes the trachea, or windpipe, is narrow and undersized. All of these things lead to a narrow and obstructed airway. Many of these dogs can barely breathe! Watch for exercise intolerance, loud breathing, coughing, bluish gums, or fainting. With his short nose, he is also more likely to develop other problems, such as flatulence from excessive air intake, pneumonia from aspirating food, or heat stroke. In severe cases, surgical correction may be recommended.

Pug_7137341LargeTaking Care of Your Pug at Home

Much of what you can do to keep your dog happy and healthy is common sense, just like it is for people. Watch her diet, make sure she gets plenty of exercise, regularly brush her teeth and coat, and call us or a pet emergency hospital when something seems unusual (see “What to Watch For” below). Be sure to adhere to the schedule of examinations and vaccinations that we recommend for her. This is when we’ll give her the necessary “check-ups” and test for diseases and conditions that are common in Pugs. Another very important step in caring for your pet is signing up for pet health insurance. There will certainly be medical tests and procedures she will need throughout her life and pet health insurance will help you cover those costs.

Routine Care, Diet, and Exercise

Build her routine care into your schedule to help your Pug live longer, stay healthier, and be happier during her lifetime. We cannot overemphasize the importance of a proper diet and exercise routine.

  • Supervise your pet as you would a toddler. Keep doors closed, pick up after yourself, and block off rooms as necessary. This will keep her out of trouble and away from objects she shouldn’t put in her mouth.
  • She has low grooming needs. Brush her coat as needed, at least weekly.
  • Pugs often have serious problems with their teeth, so you’ll need to brush them at least three times a week!
  • Clean her ears weekly, even as a puppy. Don’t worry—we’ll show you how!
  • Her deep wrinkles need to be cleaned and dried often to prevent infections.
  • She is well suited for apartment living; she will need a daily walk and regular inside play.
  • She is sensitive to temperature extremes; avoid any prolonged exposure and be very alert to the signs of heat stress.
  • Keep your dog’s diet consistent and don’t give her people food.
  • Feed a high-quality diet appropriate for her age.
  • Exercise your dog regularly, but don’t overdo it at first.

What to Watch For

Any abnormal symptom could be a sign of serious disease, or it could just be a minor or temporary problem. The important thing is to be able to tell when to seek veterinary help, and how urgently. Many diseases cause dogs to have a characteristic combination of symptoms, which together can be a clear signal that your Pug needs help.

Office calls

Give us a call for an appointment if you notice any of these types of signs:

  • Change in appetite or water consumption
  • Tartar build-up, bad breath, red gums, or broken teeth
  • Itchy skin (scratching, chewing, or licking), hair loss
  • Lethargy, mental dullness, or excessive sleeping
  • Fearfulness, aggression, or other behavioral changes
  • Dry, scaly, sometimes itchy hairless patches on face or paws
  • Lumps or bumps – regardless of size


Seek medical care immediately if you notice any of these types of signs:

  • Scratching or shaking the head, tender ears, or ear discharge
  • Inability or straining to urinate; discolored urine
  • Cloudiness, redness, itching, or any other abnormality involving the eyes
  • Slow or stunted growth; sometimes seizures after eating
  • Increased hunger and thirst, weight loss
  • Dragging the hind toes and hind limb weakness
  • Loud breathing, tires easily at exercise
  • Leg stiffness, reluctance to rise, sit, use stairs, run, jump, or “bunny hopping”

Partners in Health Care

DNA testing is a rapidly advancing field with new tests constantly emerging to help in the diagnosis of inherited diseases before they can become a problem for your friend. For the most up-to-date information on DNA and other screening tests available for your pal, visit www.Genesis4Pets.com.

Your Pug counts on you to take good care of her, and we look forward to working with you to ensure that she lives a long and healthy life. Our goal is to provide the best health care possible: health care that’s based on her breed, lifestyle, and age. Please contact us when you have questions or concerns.


  • Ackerman L. The Genetic Connection: A Guide to Health Problems in Purebred Dogs. Second edition. AAHA Press; 2011.
  • Bell JS, Cavanagh KE, Tilley LP, Smith FW. Veterinary medical guide to dog and cat breeds. Jackson, Wyoming. Teton New Media; 2012.
  • Gough A, Thomas A. Breed Predispositions to Disease in Dogs and Cats. 2nd Edition. Wiley-Blackwell; 2010.
  • Crook A, Dawson S, Cote E, MacDonald S, Berry J. Canine Inherited Disorders Database [Internet]. University of Prince Edward Island. 2011. [cited 2013 May 19]. Available from: http://ic.upei.ca/cidd/breed/pug
  • Breed Specific Health Concerns [Internet]. American Kennel Club Canine Health Foundation, Inc. [cited 2013 May 19]. Available from: http://www.akcchf.org/canine-health/breed-specific-concerns/?breed=pug

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