Pug Health Problems | Symptoms, Treatments & Tips

Boasting a lot of personality in a compact body, Pugs have made their way from the castles of Chinese emperors and Tibetan monasteries all the way to the average American household, and it is no question as to why. An ever-curious personality, a hint of a mischievous nature, and a doting affection to owners make these dogs one of the highest-ranking of all modern-day toy breeds. Compact, full of life, and offering some of the most human-like expressions with their big eyes and furrowed brows, these dogs have a lot of fans and just as much love to give.

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Pug Health Issues

Background and History of Pugs

The lineage of the Pug can actually be traced back to ancient Chinese times as far back as 2,000 years ago. These dogs, along with Shih Tzus and Pekingese, were considered refined royal pets, and it was rare for them to exist outside of Far Eastern royalty dwellings. However, a few Pugs did make their way into Europe sometime around the 1500s thanks to the Dutch settlers. Throughout the years, the loyal Pug as we know it has been known by a lot of names in a lot of different countries, which goes to show just how far-reaching the popularity of the breed has actually been. Pugs gained recognition by the AKC as a toy breed in 1885.

  • Lifespan: 13 to 15 years
  • Weight: Between 14 and 18 pounds
  • Height: Between 10 and 13 inches
  • Breed Type: Toy canine group
  • Personality and Temperament: Affectionate, easygoing, mischievous

Common Pug Health Problems

As lovable as Pugs can be, these little toy canines can have what seems like an unfair share of health concerns. Those big eyes and smooshed faces, along with the small stature, can bring about some heightened risks for certain problems, and there are other conditions that threaten the breed as well. The AKC recommends all Pugs used for breeding are tested with hip and patellar evaluations, have a proper eye exam, and get a DNA test to look for markers of certain Pug-specific diseases. Here is a look at five of the most common Pug health problems.

1. Eye Issues

One thing people love about Pugs is their big eyes because they show off all their various emotions so pointedly. Unfortunately, it is the size of the eyes compared to the small face that make pugs far more vulnerable to eye problems than a lot of other breeds. Pugs can have issues like dry eyes and distichiasis, which involves lashes growing inward and irritating the eye. However, they can also develop some rather serious eye conditions like corneal ulcers, entropion (third eyelid problems), and proptosis (abnormal eye protrusion). Some of these eye problems can be relative to genetics, and pug breeding pairs should have a proper ophthalmologic evaluation before breeding. However, problems can also arise as the Pug gets older. Another potential issue is KCS, keratoconjunctivitis sicca. 

Symptoms of Pug Eye Problems

  • Changes in the appearance of the eyes
  • Pawing or scratching the eyes
  • Redness of the eyes
  • Obvious visual changes (such as bumping into things or not reacting to stimuli)
  • Discharge from the eyes

Treatment Options

Treatment for the many Pug eye problems is diverse and can look much different depending on the situation. Some conditions can be treated with basic medications. For example, medicated eye drops may be prescribed by the vet to help with dry eyes. However, more severe conditions may involve surgical treatment, such as abnormal eye protrusion or corneal ulcers. Pugs should have their eyes checked when they have their annual wellness exam. A standard eye exam can cost around $175 if you visit a specialist, but the general vet can usually help diagnose problems and refer you to a veterinary ophthalmologic specialist if needed.

Tips for Pug Owners

  • Do what you can to protect your Pug's eyes from direct sunlight
  • Have obvious changes assessed immediately
  • If your Pug has visual impairments, work with the vet to create a safety plan for your pet

2. Pug Myelopathy

Pug myelopathy is believed to be a condition unique to Pugs alone but has similar signs as another canine condition known as degenerative myelopathy even though it is a different disease altogether. The condition sometimes gets referred to as "weak rear" because this is exactly what Pug myelopathy looks like; the rear end of the dog seems to droop because of a progressive sort of paralysis of the back legs. The condition itself seems to stem from spinal abnormalities, such as undue compression on the spinal cord or lesions in vertebral discs. Genetics can play a role in this since Pugs are naturally muscular and heavy for their small frames.


  • Walking in an odd fashion
  • Favoring front strength over rear legs strength
  • Lack of sensitivity in the hindquarters
  • Dragging the back legs instead of using them to walk or run

Treatment Options

Even though Pug myelopathy is not necessarily a painful condition, it can definitely be one that is uncomfortable. The condition is progressive, which means it tends to get worse the longer it is present. Palliative treatment can involve things like physical therapy and rehabilitative exercises, which may help preserve muscle strength. Surgery may be an option with some Pugs, but it depends on the root causes of the problem. For example, a Pug that is experiencing numbness due to spinal cord lesions may not be a good candidate for surgery, but one that has issues with discs may benefit. Mobility devices like wheeled carts are commonly used to help a Pug with myelopathy. Dog wheelchairs are actually more affordable than expected at a base price of $335, and the price can go higher for custom-made devices.

Tips for Pug Owners

  • Proactive treatment could mean the difference between loss of rear-limb use and retained mobility
  • Have your vet check for spinal issues at each wellness exam
  • Immobile Pugs can still live long and happy lives with a mobility device, but they will require extra care

3. Pug Dog Encephalitis (PDE) or Necrotizing Meningoencephalitis (NME)

Pugs are prone to a fatal disease involving inflammation of the brain referred to as Pug Dog Encephalitis (PDE). As noted by the name, this disease is a problem that was once thought to be only unique only to Pugs, and there is no fully understood reason why Pugs actually get this disease. However, later research found that certain other breeds can be at risk, and the scientific name for PDE changed to necrotizing meningoencephalitis (NME). A diagnosis of NME can be devastating as the condition usually affects younger Pugs, and tends to be fatal in the majority of cases. There has been one genetic marker determined that could point to a dog having a higher risk for the illness, so breeders are recommended to screen for the illness.

Symptoms of NME

  • Seizures
  • Running in circles non-stop
  • Blindness or sudden visual changes
  • Lameness
  • Comatose state

Treatment Options

Unfortunately, there is no known cure for NME at this time. Typically, symptoms of NME will come about suddenly and drastically escalate over the period of a few weeks until the dog goes into a coma and may die soon after. It is important, however, to discuss any of the aforementioned symptoms of NME with a veterinarian as soon as you see something is wrong because there may be treatments that can help. There are a few promising forms of therapy that may help prolong the dog's life after a diagnosis of NME, such as regular doses of glucocorticoids for immunosuppression.

Tips for Pug Owners

  • Make sure you get your Pug from a breeder who screens for NME
  • Always stay alert to signs of NME even if your Pug has been screened and seek immediate vet care
  • The treatment options available can come along with side-effects with long-term use like excessive weight gain and lethargy

4. Legg-Calvé-Perthes Disease

Legg-Calvé-Perthes disease is a medical name given to the degeneration of a dog's hip joint, and Pugs are especially prone to the problem. The head of the femur bone of the dog's hind legs spontaneously starts to deteriorate, which leads to inflammation of the hip joint and then later, a total breakdown of the hip joint. The root cause of Legg-Calvé-Perthes disease is not known, but researchers do know that the issue is most prevalent in toy breeds. Most dogs actually show signs of the condition when they reach the ages of five to eight months old.

Symptoms of Legg-Calvé-Perthes Disease

  • Lameness that seems to be progressively getting worse
  • Shrinking thigh muscles on hind legs
  • Not putting weight on the one or both of the hind legs
  • Signs of pain when moving back legs

Treatment Options

Obtaining a proper diagnosis for Legg-Calvé-Perthes disease usually only involves an exam and an x-ray. Changes to the bone and joint structures are visible on x-rays, and a vet can usually tell how long the condition has been progressing by the structure of the bones. In the beginning, pain medication and using ice packs may provide a dog with some relief. However, surgery is a common requirement for rehabilitation. Surgery involves removing the affected parts of the femur bone and potentially hip replacement. Further, extensive rehabilitation is necessary and frequent vet visits will be required. Therefore, full surgical treatment may be effective, but it is also quite expensive.

Tips for Pug Owners

  • Pugs who are diagnosed must be closely monitored as the disease progresses
  • Recovery after surgery can involve vigorous exercise and a lot of help from you as the owner
  • Full recovery after surgery can take at least six months

5. Breathing Problems

Pugs, like most brachycephalic (flat-faced) breeds, can have a lot of risks for having or developing breathing problems. Research has shown that about half of all brachycephalic breeds, such as Pugs and French Bulldogs, do have significant breathing issues, and only about 7 to 15 percent of these dogs can breathe normally. The flatter a Pug's face is, the more likely it will be that they have respiratory issues. Stenotic nares, palate problems, and excess skin folds can heighten risks for breathing issues.

Symptoms of Breathing Difficulties

  • Coughing or wheezing
  • Excessive panting
  • Lethargy
  • Rapid breathing
  • Passing out
  • Drooling or foaming from the mouth
  • Bluish lips or tongue

Treatment Options

For the most part, breathing issues in Pugs are only going to be treated through proper monitoring. In the most severe cases, certain forms of surgery may help. For example, a surgery to open up the nasal passages may be effective for some Pugs. Making sure a Pug is kept in a comfortable environment plays the biggest role in avoiding breathing problems, which is why these dogs are always recommended as indoor pets and not outdoor pets.

Tips for Pug Owners

  • Avoid doing anything to overexert your Pug during playtime or exercise, especially in warm weather
  • Never leave a Pug in a hot vehicle or in a sunny backyard with no shade for a long period
  • Learn how to help calm a Pug down that is feeling overexerted to avoid problems by talking to the vet

Other Potential Health Conditions to be Aware Of

  • Luxating patella (knee issues)
  • Skin problems, skin infections, or skin disorders (like pyoderma)
  • Hip dysplasia and other joint problems

Pug Playing in Yard

Special Notes On Pug Breed Variations and Their Health

There are no recognized Pug variations as far as breed is concerned. Some people do claim to own mini Pugs, but these are not recognized by the AKC and often are the result of breeding very small Pugs to achieve a miniaturized version or crossing the Pug with a smaller dog like a Chihuahua. Unfortunately, both the former and the latter can have significant detrimental effects on the overall health of the dog. For example, a miniature Pug that came about through breeding the tiniest of litters can be more at risk for many health issues, including those mentioned here.

Pugs: An Ancient Breed with a Lovable Temperament and Unique Health Needs

Pugs may have a lot of unique health concerns, but that hasn't stopped them from carelessly stepping their way all the way to a popularity ranking of 28 out of 195 breeds by the American Kennel Club (AKC). A Pug is a loyal companion with all kinds of personality to give, and their human-like reactions to everyday situations can be downright comical. If you do plan to make a Pug a part of your family, check out the health concerns you will have to monitor for and get to know the health needs of the breed. Your new little wrinkle-faced pal is bound to settle right into your heart.


Author Sheena HarrisAuthor: Sheena Harris
About Sheena: 
Sheena Harris has 10 years of experience in canine health wellness. Having worked with both veterinarians and breeders across the country to curate content, she has a wealth of insight to share on pet wellness, proper breeding practices, and keeping canine companions happy. Her history in breeding AKC-registered beagles lends a great deal of firsthand insight to her work. She's also been published at dogs.lovetoknow.com.


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