Fri. Mar 29th, 2024

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Pugs are one of the most distinctive-looking dog breeds. They’re adored for their bug eyes, curly tail, squished face and folds of skin. Their personalities are also charming. Pugs tend to be active, endearing, affectionate and eager to please.

However, many of the pug’s defining characteristics also bring about distinct health issues. Infact, because pugs tend to have so many health problems, they can no longer be considered a “typical dog from a health perspective,” according to a 2022 study in Canine Medicine and Genetics. If you still decide to adopt or purchase a pug, educating yourself about these health concerns and how to prevent them is essential to providing it with the best care.

Common Health Issues for Pugs

Because pugs are at high risk of developing health issues, you’ll want to be aware of all the most common ones. Sadly, some don’t have a cure and can’t be avoided due to their genetic nature—but others can be prevented with caution and proper care.

An adult pug should be taken to the vet at least once a year, but for senior dogs over 8 years old, you may want to take them every six months. Keep in mind that you may also need to go more often if your pug has any of these health conditions.

1. Brachycephalic Obstructive Airway Syndrome (BOAS)

Pugs are a brachycephalic (short-muzzled) breed, which means they are prone to Brachycephalic obstructive airway syndrome (BOAS). This respiratory disorder is lifelong, progressive and in severe cases, can shorten the dog’s lifespan. A pug has BOAS when it has one or more airway abnormalities. Usually, these include stenotic (narrowed) nostrils, an elongated soft palate, an enlarged tongue and a reduced size of the windpipe.

“The elongated soft palate covers their airway. So when you open their mouth, it’s like a frog,” explains Dr. Lindsay Butzer, D.V.M., a veterinarian at Clint Moore Animal Hospital in Boca Raton, Florida. “You have to really pull their tongue down to get it out of the airway. So when they’re hot, they can’t really get air in.”

BOAS can’t be prevented due to the pug’s anatomy—they’re nearly 54% more likely to develop this syndrome than non-pugs, according to a 2022 study of U.K. pugs published in Canine Medicine and Genetics. However, other brachycephalic breeds such as French Bulldogs, Boxer Dogs, Boston Terriers and Shih Tzus are likely to have BOAS too.

Get a sense of your pug’s risk of BOAS early on by checking its nostrils. A visual scale published in PLoS One shows variations of a pug’s stenotic nostrils to help you understand your pug’s likelihood of BOAS. Your pug may also be more susceptible to BOAS if it’s female or overweight.

After your pug turns 1, you can have it checked by a vet for BOAS. Some symptoms include difficulty exercising, sensitivity to heat, noisy and labored breathing, gastrointestinal disorders like vomiting, coughing and sleep apnea.

BOAS can place additional strain on the heart and increase a pug’s risk of high blood pressure so it’s important to speak to a vet and review solutions. Mild cases can be managed with limited exercise, weight loss if your pug is overweight and avoiding hot temperatures and stress.

“Be really careful with them in the summer months—[don’t] exercise them too much outside. They need to [be] in cool environments, in the A/C,” advises Butzer.

Oxygen therapy and nonsteroidal anti-inflammatory drugs (NSAIDs) may also be suggested for short-term relief. For extreme cases where the dog is struggling to breathe, surgery can improve airflow in the nostrils and shorten an elongated soft palate.

2. Cancer (Oral Melanoma and Mast Cell Tumors)

Cancer is the leading cause of death for pugs. Mast cell tumors (MCTs) are a type of skin cancer that are common in middle- to senior-aged dogs (small dogs are seniors at 11 to 12 years old.) A 2006 study published in Veterinary and Comparative Oncology found that 56% of pugs had MCTs. Golden retrievers, Labrador retrievers, Boston terriers and boxers are also frequently affected.

MCTs are thought to be caused by environmental and hereditary factors. The most defining symptom of a mast cell tumor is a red or swollen lump that appears to get bigger and smaller at different intervals. “The mast cells are allergy cells that live dormant and they [tend to] flare up and calm down,” says Butzer, explaining that that is why you may notice the lump one day but then it’s nowhere to be found the next day.

Unfortunately, the lump is really the only noticeable symptom. Sometimes though, ulcers can form in your pug’s stomach or intestines. At that point, you may observe vomiting, loss of appetite, lethargy or black stool.

Treatment involves surgical removal of the cancerous mass. Dogs will usually recover quickly, with a two-week recovery time, says Butzer. For serious tumors, chemotherapy or radiation therapy will likely be recommended after the surgery.

Oral melanoma is one of the most commonly diagnosed oral tumors for dogs. Although it usually affects dogs around 11 years of age, it’s a common health issue in younger pugs (small dogs are considered young if they’re under 11 years old.)

In a 2022 critical review of oral melanoma published in Veterinary Sciences, it was found that dogs with heavily pigmented oral mucosa, or the “skin” lining the mouth, have an increased risk of developing oral melanoma. Pugs fall into this category because “they have black gums, [and due to this], the pigment has more melanocytes, [cells that produce melanin]. [So there’s] a higher chance of these melanocytes tipping off and turning into cancer cells,” explains Butzer.

You’ll know if your pug has oral melanoma because it will have a bleeding mass in the mouth or a lump on the cheek. Your pup may also exhibit a loss of appetite, increased drooling, facial swelling and bad breath.

Treatment requires surgically removing the mass or lump. After, chemotherapy or radiation therapy will be necessary to further banish the cancer.

3. Patellar Luxation

Patellar luxation is a scientific term for a slipped kneecap, and pugs are one of the breeds most likely to be affected. This commonly shows up as a congenital issue but it can happen later in life due to trauma.

Patellar luxation occurs when a kneecap slips out of the grove, causing your pug to have instability in its leg. The main symptom you’ll witness in your pup is a skipping or hopping movement as they walk.

“They can live with [patellar luxation] but they’re going to limp. It [becomes] painful too, because they [will] develop arthritis in their knees,” says Butzer, recommending surgery to pop the kneecap back in place.

However, she says if surgery isn’t feasible at the moment, it’s important to keep your pug’s “weight down as much as possible and start it on glucosamine supplements.” The supplements help by stimulating cartilage growth in the kneecaps and soothing the pain—but be sure to check with a vet before doing so.

4. Hip Dysplasia and Legg-Calvé-Perthes Disease

There are two main issues that can affect pugs’ hips. The first is hip dysplasia, a genetic disease that affected 71% of pugs, according to the Orthopedic Foundation for Animals. As a pug grows into an adult, its hip joint is supposed to grow appropriately as well. However, with hip dysplasia, the ball and socket joint that make up the hip joint don’t grow at the same time, causing looseness.

Due to this, “they will have a limping gait or it’ll be painful for them to get up and down,” Butzer explains. Signs of hip dysplasia can be observed when pugs are about a few months old, but they’re more likely to show up when they’re 1 or 2 years old.

Hip dysplasia will lead to degenerative joint disease or osteoarthritis so it’s necessary to get it diagnosed early so a vet can help your pug lead a better quality of life. Most dogs with mild cases can live with the condition by taking non-steroidal anti-inflammatory drugs (NSAIDs).

They may also take “veterinary-approved glucosamine, chondroitin sulfate and omega-3 fatty acid nutritional supplements,” according to VCA Animal Hospitals. Physical therapy may also be recommended. Surgery may be required for more severe cases or if NSAIDs aren’t effective.

The second issue affecting a pug’s hips is Legg-Calvé-Perthes Disease. This condition pops up in other small dog breeds as well and is thought to be caused by blood flow issues to the femur bone’s head in a dog’s hind leg. This leads to the disintegration of the hip joint and then osteoarthritis.

It’s a painful condition so you’ll notice your pug dragging its legs, lameness or wincing and other signs of pain when moving its hip joint. If you suspect your pug has this condition, a vet will take X-rays to diagnose it.

Usually, this disease will require surgery, followed by lots of exercise and physical therapy. However, there are some cases where the condition can be managed with painkillers and cold therapy, which involves using ice packs or commercial gels to reduce inflammation and pain.

5. Corneal Ulcers, Entropion and Dry Eye

Pugs’ eyes are often lovingly referred to as “bug eyes” due to their wide nature. While they can be adorable, their size makes pugs and other brachycephalic breeds more vulnerable to eye infections.

Additionally, pugs typically have eyelids that are too long for their eyes and bottom eyelids that roll inward, so their eyelashes can scratch the cornea. The inward rolling of the eyelid is called entropion and is a hereditary disorder (but surgery can correct it.) All of these factors make it impossible for Pugs to blink properly.

When a pug’s eye gets scratched, agitated or infected—either by itself or by a twig, eyelash, dirt, shampoo or something else—it can lead to a corneal ulcer, a wound on the cornea. This can also occur as a result of Keratoconjunctivitis Sicca (KCS) or chronic dry eye, which pugs are genetically predisposed to.

When a dog has a corneal ulcer, its eyes will appear red, swollen or cloudy. You may also spot white, yellow or green discharge oozing out of them. Corneal ulcers are often very painful for dogs, so you may witness them squinting, rubbing their eyes, blinking repeatedly or keeping their eyes closed.

Treatment for corneal ulcers varies based on severity. For simple cases, broad-spectrum topical antibiotics and topical pain medications may be prescribed. In extreme cases where the eye is jeopardized, a conjunctival flap or graft may be vital. This surgery involves creating a stalk of the conjunctiva (thin membrane that covers the white of the eye) and attaching it to the corneal ulcer. Recovery usually takes six to eight weeks.

If the ulcer is deep, it can cause the eye to burst. In these cases, the eye may have to be surgically removed.

When a pug has dry eye it will appear red and irritated, and they may squint, blink repeatedly or hold their eyes shut. There may also be a thick yellow discharge present. Corneal scarring may develop which appears as a dark film covering the eyes or a dull appearance.

Treatment for dry eye requires lifelong medical care and includes daily anti-infective eye drops to stimulate tear production. Tear replacement lubricating drops may also be necessary and require application every two to six hours.

Preventative measures include not letting your pug hang its head out the car window, as debris can fly into its eye. Similarly, if going on a walk, consider dog goggles to shield their eyes. To prevent intense dry eye symptoms, you can start your pug on over-the-counter artificial tears and eye lubricants since pugs are known to get dry eye—just be sure to discuss it with a vet first.

“I recommend [lubricating] a pug[‘s eyes] twice a day, morning and night, to help it have clear eyes as it ages,” suggests Butzer. Lubricating eye drops can be found at most pet stores. Do not use eye drops meant for humans.

6. Skin Fold Dermatitis and Infections

Although humans may love to kiss the wrinkles on a pug’s face, they can actually become a convenient place for infections. This is seen in other wrinkly dogs too such as Shar-peis and in short-nosed dogs like bulldogs.

“They have folds on their face that can become brown with tear stains and accumulate yeast and bacteria,” explains Butzer, adding that the folds on the body can become hotbeds for bacteria too.

Infections begin with skin dermatitis, which means that the skin becomes inflamed. This occurs when moisture and buildup get trapped in the skin folds, which leads to the growth of bacteria. During this stage, you’ll notice your pug scratching, rubbing or licking the area. You may also smell the infection as it produces a yeasty odor.

If the dermatitis advances, it can evolve into a pyoderma infection. With this, you’ll notice more severe symptoms such as oozing pus, swelling, redness or slimy skin. Your pug may also exhibit low energy, loss of appetite or tremors.

Pugs are also at high-risk for staph infections, which can be transmitted from animal to animal and even to humans in rare cases. Symptoms can include fever, loss of appetite, scratching, pus-filled lesions and “infections of the eyes, skin, ears or respiratory system,” according to petMD.

Treatment will include antibiotics, antifungals and anti-itch medication if your pug can’t stop picking at the infection. Topicals such as medicated shampoo, medicated spray or Epsom salt foot soaks may also be suggested, especially if your pug has recurrent infections.

Butzer says that most infections can be prevented by using medicated wipes to clean your pug’s folds daily. Alternatively, you can use a damp washcloth or unscented baby wipes to wipe away any debris or dirt. Be sure to dry them well after cleaning, though. Regular baths (every one to three months) are another way to ensure your pug’s folds stay clean.

Does Pet Insurance Cover Common Health Issues for Pugs?

Many of the best pet insurance companies frequently cover the common health issues for pugs. A typical pet insurance policy may pay for costs related to:

  • Accidents and injuries.
  • Chronic illnesses, such as dry eye.
  • Common illnesses, such as skin allergies.
  • Serious illnesses like cancer.
  • Hereditary conditions like hip dysplasia.
  • Testing and diagnostics such as X-rays or MRIs.
  • Medical procedures like hospitalizations or surgeries.
  • Holistic and alternative procedures.
  • Wellness procedures like neutering and routine wellness exams.
  • Behavioral therapy to help with mischievousness.
  • Prescription medications.
  • Prescription food and supplements.
  • Microchip implantation.

However, preexisting conditions, experimental treatment, grooming, dental cleanings, food and dietary supplements and non-veterinary expenses such as a dog license typically aren’t covered.

While you’re investigating which pet insurance policy is best for your pug, double-check what the various companies and plans cover.

Are Pugs the Right Breed for Me?

With proper socialization, pugs are known for getting along well with babies, other dogs and even cats. They’re able to fit in with pretty much any lifestyle due to their friendly, spunky, loyal and energetic temperament.

“A pug is normally very happy and they have a lot of bouncy energy,” Butzer says. “I recommend them as a first family dog.”

As for exercise, pugs don’t need a ton. Up to one hour per day is sufficient, says the U.K.’s The Kennel Club. Of course, if your pug has breathing difficulties such as BOAS, you’ll want to have it exercise a little less and mainly indoors to help reduce the risk of heat stroke.

Pugs can be a bit stubborn and easily distracted when it comes to training. “They’re a companion breed, so they’re not a breed that was bred to work. It makes them kind of stubborn,” explains Butzer. With lots of treats and consistency, though, training is possible.

Because pugs are susceptible to a slew of health issues, it’s critical to be prepared not only with knowledge but with a great pet insurance policy. Pugs are high-maintenance when it comes to their health so you’ll have to be attentive to their needs and quirks. This will include daily cleansing of their face and wrinkles as well as daily teeth brushing. Pugs are quite prone to periodontal disease.

Moreover, you’ll want to keep them out of the heat and other humid conditions as much as possible. If you live in a tropical climate, be sure that they’re getting lots of time in the A/C or shade instead of direct sunlight.

Find The Best Pet Insurance Companies Of 2023

Pug Health Frequently Asked Questions (FAQs)

What’s the right diet to feed my pug?

Pugs are at a heightened risk of obesity so the best food for the breed would be something that helps manage their weight effectively. Additionally, you’ll want to opt for small dog-specific food so that the kibble isn’t difficult for them to swallow.

“I always suggest a low-fat, low-calorie gastric diet for pugs,” shares Butzer. “They gain weight really fast and you need to keep them as lean as possible with their broad body type.”

The University of Cambridge  created a visual of obesity in pugs to help you scale what’s normal.

Yes, pugs have short, coarse coats and shed year-round. Some pugs, mostly non-black pugs, have double coats (two layers of fur) so they shed even more. The shedding tends to increase during spring and summer months as pugs get rid of their winter coat. Be sure to use a deshedding brush and shed-control shampoo for your pug to help lessen the pesky hairs.

Brachycephalic breeds tend to have a shorter lifespan, typically living to around 8.6 years. However, according to The American Kennel Club, pugs have an average lifespan of 13 to 15 years.

What is the No. 1 killer of pugs?

The leading cause of death for pugs is cancer. It typically occurs when they’re older and because cancer can spread to other organs, early detection is vital.

Are pugs an unhealthy breed?

Yes, pugs are one of the unhealthiest dog breeds due to the way they’ve been bred over the years. They were specifically bred to have bulging eyes, a wrinkled face, a smooshed nose and other defining characteristics—but those cute features are the very reason they have so many health problems. The British Veterinary Association even put out a press release in 2016 urging people to reconsider adopting or purchasing brachycephalic breeds such as pugs.

Are pugs risky to fly with?

While Butzer doesn’t flat-out discourage flying with a pug, she does emphasize that “they are a risky patient to fly with on an airline.” Pugs don’t do well in hot conditions or stressful situations.

“Because they have a smooshed face and difficulty breathing, if they become stressed out on a plane this can cause an anxiety attack that affects [their] breathing and they can die from that,” Butzer warns.

“Also, if the airline requires them to be put in a bag under the seat with low oxygen this will also impair breathing and can be detrimental to the pug,” she adds.

In fact, many airlines such as Delta, United and Swiss have no-fly policies or restrictions against flying with brachycephalic breeds. If you do decide to fly with your pug, speak with a vet about what you can do to make the journey safer for them.

How much does pet insurance cost for pugs?

Embrace Pet Insurance says its customers typically pay between $37 to $55 per month for their pug’s policy. However, pet insurance costs can differ based on your location, insurance company, the type of coverage, the amount of coverage and the pet’s age.


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