Pugs may be one of the most beloved dog breeds, but behind those adorable wrinkly faces lies a sobering truth: they’re among the unhealthiest dog breeds in the world. A landmark study by the Royal Veterinary College found that Pugs face risks for certain health conditions that are up to 51 times higher than other breeds.
Quick Answer: The top 10 Pug problems include brachycephalic airway syndrome, eye ulcers, skin fold infections, ear infections, hip dysplasia, patellar luxation, obesity, dental disease, spinal deformities, and Pug Dog Encephalitis. Most stem from their flat-faced anatomy and require proactive management throughout their lives.
If you’re a current Pug owner or considering bringing one into your family, understanding these breed-specific challenges isn’t just helpful—it’s essential. The good news? With proper knowledge and preventive care, you can significantly improve your Pug’s quality of life and potentially add years to their lifespan.
This comprehensive guide draws from the latest veterinary research, including findings from the Royal Veterinary College, to help you navigate the most common health issues affecting Pugs today.
Understanding the Top 10 Pug Problems
The unique physical characteristics that make Pugs so distinctive also make them vulnerable to serious health complications. Let’s explore each condition in detail, along with what you can do to help your companion.
1. Brachycephalic Airway Syndrome (BOAS)
This is the most critical health issue affecting Pugs. Their flat faces result in stenotic nares (narrowed nostrils), elongated soft palates, and narrowed tracheas that severely restrict airflow. Pugs with BOAS struggle to breathe during exercise, sleep, and even rest.
The syndrome leads to chronic oxygen deprivation, making Pugs extremely vulnerable to heat stroke even in mild weather. You might notice loud snoring, gagging, exercise intolerance, or a blue-tinged tongue during activity.
Surgical intervention can open airways and dramatically improve quality of life. Talk to your veterinarian about early assessment, as intervention before age two typically yields the best outcomes.
2. Eye Ulcers and Corneal Damage
Pugs are 13 times more likely to develop eye ulceration than other breeds. Their prominent, bulging eyes are easily scratched by grass, toys, or even their own paws during face rubbing.
Watch for squinting, excessive tearing, redness, or cloudiness in the eye. Untreated corneal ulcers can progress to blindness or require surgical removal of the eye.
Additional eye conditions include dry eye (keratoconjunctivitis sicca), proptosis (eye displacement from the socket), and entropion (inward-rolling eyelids). Regular eye examinations and immediate veterinary attention for any eye irritation are critical.
3. Skin Fold Dermatitis
Those adorable wrinkles create the perfect environment for bacteria and yeast infections. Pugs face an 11 times higher risk of skin fold infections compared to other dogs.
Moisture, warmth, and friction in the folds lead to painful dermatitis, particularly around the face, tail pocket, and body wrinkles. You’ll notice redness, odor, discharge, or your Pug scratching and rubbing affected areas.
Daily cleaning and thorough drying of all skin folds is non-negotiable for Pug ownership. Use veterinarian-recommended wipes or gentle cleansers, and ensure folds are completely dry afterward.
4. Chronic Ear Infections
Pugs experience ear discharge at rates 9.6 times higher than other breeds. Their narrow, folded ear canals trap moisture and debris, creating an ideal breeding ground for bacteria and yeast.
Signs include head shaking, ear scratching, odor, discharge, or redness inside the ear. Chronic infections can lead to hearing loss and require aggressive treatment.
Weekly ear cleaning with appropriate solutions and keeping ears dry after baths or swimming helps prevent recurring infections. Learning how to clean Pug ears properly is essential for preventing these painful conditions. Some Pugs require prescription ear medications to manage chronic conditions.
5. Hip Dysplasia
This genetic condition causes abnormal development of the hip socket, leading to arthritis, pain, and mobility issues. While commonly associated with larger breeds, Pugs suffer from hip dysplasia at concerning rates.
Symptoms include difficulty rising, reluctance to jump or climb stairs, bunny-hopping gait, or decreased activity levels. Early diagnosis through X-rays allows for proactive management.
Weight management is crucial, as excess pounds dramatically increase joint stress. Physical therapy, joint supplements, anti-inflammatory medications, and in severe cases, surgical correction can help affected Pugs maintain mobility.
6. Patellar Luxation (Dislocated Kneecap)
This orthopedic condition causes the kneecap to slip out of its normal position, causing pain and limping. Many Pugs live with low-grade patellar luxation without owners realizing it.
You might see your Pug suddenly hold up a back leg while walking, then resume normal gait after a few steps. Severe cases cause persistent lameness and require surgical correction.
Maintaining ideal body weight reduces stress on the joints. Your veterinarian can grade the severity and recommend whether conservative management or surgery is appropriate.
7. Obesity
Pugs are 3.4 times more likely to become obese than other breeds. Their low exercise tolerance due to breathing difficulties, combined with their food-motivated personalities, creates a perfect storm for weight gain.
Obesity isn’t just a cosmetic issue—it exacerbates breathing problems, joint disease, diabetes risk, and reduces lifespan. An overweight Pug faces significantly higher risks for nearly every other condition on this list.
Strict portion control, measured meals, limited treats, and appropriate exercise within your Pug’s breathing capacity are essential. Your Pug should have a visible waist when viewed from above and you should be able to feel (but not see) their ribs.
8. Dental Disease
Crowded, misaligned teeth are nearly universal in Pugs due to their shortened jaw structure. This leads to accelerated plaque and tartar buildup, periodontal disease, tooth loss, and systemic infections.
Bad breath is often the first sign, followed by difficulty eating, drooling, or visible tartar. Untreated dental disease causes pain and can lead to heart, liver, and kidney problems as bacteria enter the bloodstream. Establishing a routine for keeping your Pug’s breath fresh through daily brushing can prevent serious complications.
Daily tooth brushing with dog-specific toothpaste, dental chews, and regular professional cleanings under anesthesia are necessary. Many Pugs require annual dental procedures to maintain oral health.
9. Hemivertebrae and Spinal Problems
Hemivertebrae are malformed spinal vertebrae that can compress the spinal cord, causing pain, weakness, paralysis, or loss of bladder control. This congenital condition is common in screw-tailed breeds like Pugs.
Mild cases may show no symptoms, while severe cases cause progressive neurological decline. Warning signs include difficulty walking, weakness in hind legs, or inability to urinate normally.
Diagnosis requires X-rays or advanced imaging. Treatment ranges from anti-inflammatory medications and restricted activity to surgical decompression in severe cases.
10. Pug Dog Encephalitis (PDE)
Also called Necrotizing Meningoencephalitis (NME), this is a rare but devastating inflammatory brain disease unique to Pugs. It typically affects young to middle-aged dogs and is almost always fatal.
Symptoms include seizures, circling, blindness, behavioral changes, and progressive neurological decline. There is no cure, and the disease progresses rapidly once symptoms appear.
While rare, awareness is important for Pug owners. Genetic factors play a role, and responsible breeders work to reduce prevalence through selective breeding practices.
Comparing Pug Health Risks: The Numbers Don’t Lie
Understanding the magnitude of these health challenges helps owners prepare appropriately. Here’s how Pugs compare to other breeds based on research from the Royal Veterinary College:
| Health Condition | Risk Compared to Other Breeds | Prevalence Category |
|---|---|---|
| Stenotic Nares (Narrow Nostrils) | 51.3x Higher | Extremely Common |
| Eye Ulceration | 13x Higher | Very Common |
| Skin Fold Infections | 11x Higher | Very Common |
| Ear Discharge | 9.6x Higher | Very Common |
| Allergic Skin Disease | 5.9x Higher | Common |
| Demodectic Mange | 5.6x Higher | Common |
| Retained Baby Teeth | 4.3x Higher | Common |
| Obesity | 3.4x Higher | Common |
How to Protect Your Pug: A Proactive Care Strategy
While the list of potential problems seems daunting, proactive management makes a tremendous difference. Here’s a step-by-step approach to keeping your Pug as healthy as possible:
Step 1: Establish Veterinary Baselines Early
Schedule a comprehensive health assessment within the first few weeks of bringing your Pug home. This should include evaluation of airway function, eye health, joint structure, and skin condition.
Ask your veterinarian about breed-specific screening for hip dysplasia, patellar luxation, and spinal abnormalities. Early detection allows for intervention before problems become severe.
Step 2: Create a Daily Care Routine
Consistency is key for Pug health. Your daily routine should include:
- Wrinkle cleaning: Wipe and dry all facial folds, body wrinkles, and tail pocket
- Eye checks: Look for redness, discharge, or cloudiness
- Tooth brushing: Use dog-safe toothpaste to prevent dental disease
- Weight monitoring: Track body condition weekly to catch weight gain early
- Breathing assessment: Note any changes in respiratory sounds or effort
Step 3: Master Environmental Management
Pugs cannot regulate body temperature effectively due to their compromised airways. Never exercise your Pug in warm weather, and provide constant access to cool, shaded areas and fresh water.
Air conditioning during summer months isn’t a luxury for Pugs—it’s a medical necessity. Monitor humidity levels and limit outdoor time when temperatures exceed 75°F (24°C).
Step 4: Implement Strict Weight Control
Work with your veterinarian to determine ideal weight and caloric needs. Measure all food portions using a kitchen scale, not a cup, as even small overfeeding adds up.
Choose high-quality, portion-appropriate foods and limit treats to less than 10% of daily calories. Regular weigh-ins help you catch and correct weight gain before it becomes problematic. If your Pug won’t eat their meals, it’s important to address the underlying cause rather than resorting to high-calorie treats.
Step 5: Schedule Preventive Veterinary Care
Beyond annual wellness exams, Pugs benefit from bi-annual veterinary visits to monitor chronic conditions. Many Pugs require regular dental cleanings, eye examinations by veterinary ophthalmologists, and orthopedic assessments.
Budget for higher-than-average veterinary costs. Consider pet insurance that covers breed-specific conditions, as Pug healthcare expenses typically exceed those of healthier breeds.
The Bigger Picture: Breeding Ethics and Future Health
The extreme health challenges facing Pugs have sparked important conversations about breeding practices and animal welfare. Some countries are implementing regulations to discourage extreme brachycephalic features.
If you’re considering adding a Pug to your family, seek breeders who prioritize health over appearance. Look for breeding programs that select for longer muzzles, open nostrils, and overall structural soundness. Before committing, make sure you’re truly ready for a Pug and the significant health responsibilities involved.
Health testing of parent dogs, transparency about health issues in bloodlines, and willingness to discuss the breed’s challenges are signs of responsible breeding. Avoid breeders who minimize health concerns or prioritize extreme features.
Living Well with a Pug: Quality Over Quantity
Despite these significant health challenges, Pugs can live happy, fulfilling lives with committed, informed owners. The key lies in understanding what you’re signing up for and providing proactive, preventive care from day one.
Focus on quality of life metrics: Can your Pug breathe comfortably? Are they pain-free and mobile? Do they enjoy daily activities within their limitations? These questions matter more than simply extending lifespan.
Many Pug owners find that the extra care required deepens their bond with their dogs. The breed’s affectionate, playful personality and unwavering loyalty make the additional effort worthwhile for dedicated owners.
Key Takeaways About Top 10 Pug Problems
Understanding the top 10 Pug problems empowers you to provide better care and make informed decisions. Remember these critical points:
- Brachycephalic airway syndrome affects nearly all Pugs and requires careful environmental management and possible surgical intervention
- Daily preventive care for eyes, skin folds, ears, and teeth dramatically reduces disease risk
- Weight management is perhaps the single most important controllable factor in Pug health
- Higher-than-average veterinary costs are inevitable—budget accordingly and consider insurance
- Responsible breeding practices are essential for improving breed health in future generations
The reality of Pug ownership includes significant health challenges, but armed with knowledge and commitment to proactive care, you can help your Pug thrive. Stay vigilant, work closely with your veterinarian, and prioritize your dog’s comfort and quality of life above all else.
Frequently Asked Questions
What is the most common health problem in Pugs?
Brachycephalic Airway Syndrome (BOAS) is the most common and serious health problem in Pugs, affecting the vast majority of the breed. This condition results from their flat facial structure and includes stenotic nares, elongated soft palate, and narrowed airways. It causes breathing difficulties, exercise intolerance, and extreme vulnerability to heat stroke. Many Pugs benefit from surgical correction to open airways and improve quality of life.
How can I tell if my Pug is having breathing problems?
Signs of breathing problems in Pugs include loud snoring during sleep, gagging or choking sounds, excessive panting even at rest, blue or purple-tinged tongue or gums, reluctance to exercise, and collapse after minimal activity. If your Pug struggles to breathe, pants excessively in cool environments, or shows a blue tongue, seek immediate veterinary care. Some breathing difficulty is common in Pugs, but severe symptoms require intervention.
Are all Pugs destined to have serious health problems?
While all Pugs face higher health risks due to their brachycephalic structure, not every individual will develop severe problems. The severity varies based on genetics, environmental management, and preventive care. Pugs from health-focused breeding programs with less extreme features tend to have fewer issues. Maintaining ideal weight, providing proper environmental conditions, and receiving proactive veterinary care significantly improve outcomes for individual dogs.
How much does it cost to care for a Pug’s health problems?
Pug healthcare costs typically exceed those of healthier breeds. Routine care including regular vet visits, dental cleanings, and preventive medications may cost $800-1,500 annually. Surgical interventions for airway correction ($2,000-5,000), eye surgeries ($1,500-3,000), and treatment for chronic conditions add significantly to lifetime costs. Many Pug owners spend $3,000-8,000 or more annually on veterinary care. Pet insurance covering breed-specific conditions is highly recommended.
Can Pugs exercise normally or go on long walks?
Pugs cannot exercise like breeds with normal airways. Their breathing difficulties make them vulnerable to overexertion and overheating, even in mild weather. Short walks during cool morning or evening hours are appropriate, typically 15-20 minutes maximum. Avoid exercise when temperatures exceed 75°F. Indoor play in air-conditioned spaces is safer. Always watch for signs of breathing distress and stop activity immediately if your Pug shows excessive panting or blue gums.
What should I look for when choosing a Pug breeder?
Responsible Pug breeders prioritize health over extreme appearance. Look for breeders who health-test parent dogs for genetic conditions, can provide documentation of airway function assessments, openly discuss breed health challenges, and select for less extreme features like longer muzzles and open nostrils. They should offer health guarantees, remain available for lifetime support, and demonstrate knowledge about BOAS and other breed-specific issues. Avoid breeders who minimize health concerns or advertise extreme flatness as desirable.
How long do Pugs typically live with their health problems?
The average Pug lifespan is 12-15 years, though health problems can reduce this. Pugs with severe, unmanaged BOAS, obesity, or multiple chronic conditions may have shorter lifespans. Those receiving proactive care, maintaining healthy weight, and benefiting from surgical airway correction when needed often live longer, healthier lives. Quality of life matters as much as quantity—a Pug that breathes comfortably and remains pain-free may live fewer years but enjoy better daily experiences than one suffering from untreated conditions.