What You Need to Know About Pug Health Before Adopting

Pugs have always been a well-liked dog breed because of their adorable, warm, and sweet personalities. Small yet sturdy, they are known to make exceptional family dogs. Unfortunately, as a brachycephalic (or, flat-faced) breed, most Pugs are prone to many moderate to serious health issues. Thankfully, most are treatable and have a fairly good prognosis with medical management or surgery.

And if you follow events in the dog world, you probably have heard of Vito, the handsome Pug who won Best of Show at the 2024 National Dog Show. While Pug parents around the globe cheered and celebrated, the reality of a Pug winning a well-publicized national dog show was concerning to veterinarians and animal welfare advocates. As we've seen before, breeds who win dog shows quickly gain popularity, leaving them vulnerable to overbreeding by irresponsible backyard breeders and puppy mills.

So, before you sign off on the adoption papers, here’s some important information that you should know to give your new Pug their best life.

About the Pug dog breed

Pugs are small, compact, sturdy, and very social dogs, weighing between 10 and 25 pounds. They originated as an ancient Chinese breed kept by the ruling class. Today, their sweet nature has made them a very popular family dog. Pugs have a full hair coat, known for heavy shedding, that comes in a variety of color combinations: fawn, silver fawn, black, apricot, brindle, and merle. They are a brachycephalic breed which means that they have adorable, pushed-in faces, lots of wrinkles, and bulgy eyes. Unfortunately, this favored pushed-in facial structure, which has been selectively bred over the past few decades, has led to several serious health issues. 

Common Pug health problems

Below are the most common pug health concerns to keep in mind.

Brachycephalic obstructive airway syndrome (BOAS)

The most notable feature of Pugs is their adorable, human-like flat faces. Pug puppies are absolutely irresistible. But looking at the structure of the Pug’s face, you’ll notice that in many cases, the nose is pushed in and the nostrils are very narrow, if not completely closed (aka stenotic nares). Other features that are not visible, though very common for brachycephalics, are an elongated soft palate and a hypoplastic (or, smaller than normal diameter) trachea.

Ivan Babydov / Pexels/

All of these contribute to a Pug’s inability to breathe normally, which is called Brachycephalic obstructive airway syndrome (BOAS). Many other brachycephalic breeds — including the French Bulldog, English Bulldog, Boston Terrier, Boxer, Pekingese, Lhasa Apso, and Shih Tzu — are also affected by BOAS. The more pushed in the face, the more likely it is a dog will suffer from respiratory symptoms. 

• Symptoms of BOAS include loud, scratchy, snorty breathing, which some consider a cute and normal part of the breed. But in reality, that loud, strained breathing indicates that the dogs are unable to get an adequate amount of air into their lungs. These breathing issues can lead to difficulty exercising, obesity, and overheating — which are even worse in hot climates.

• Talk with your vet about options. Fortunately, stenotic nares and elongated soft palate can be corrected with surgery, though this comes with some risk and can be costly. Not all Pugs require surgery, but many do. Ask your veterinarian if your Pug needs this surgery, and if so, to refer you to a specialty hospital. 

Can BOAS in Pugs be prevented?

Preventing BOAS (or brachycephalic obstructive airway syndrome) in Pugs requires a change in their breeding practices. Selective breeding of Pugs with less pushed-in faces, longer noses, and wider nares will result in fewer respiratory issues. Additionally, changing kennel club breed standards to require less pushed-in facial features and longer snouts would be important in driving home this change.

Eye ulcers and infections

Another adorable Pug feature is their big bulgy, dark eyes. But just like their cute, pushed-in noses, their eyes can be a source of medical issues, though often with less invasive treatment options. 

In some cases, when Pugs close their eyes, the eyelids don’t completely cover the eye. Over time, this may lead to drying and sores (or ulcers) in the cornea. This, in turn, can lead to permanent clouding, dark pigmentation of the cornea, and loss of vision. All of this is very painful for the Pug. 

• Symptoms of corneal ulceration include squinting, tearing, clouding on the surface of the cornea, and redness in the conjunctiva (the dark pink tissue under the eyelids).

• Take your Pug to a vet if you see them experiencing any changes in their eyes. Treatments are fairly standard: topical eye drops, ointments, and oral anti-inflammatory medication. In more severe cases, your veterinarian may recommend surgery to correct the eyelid structure.

Overheating

All dogs are prone to hyperthermia (or overheating) due to their insulating coats and inability to sweat like people do. Pugs are no exception. With their moderate to severe breathing issues, that risk may increase, especially when temperatures rise above 70 degrees. To keep Pugs safe when it’s warm or hot outside, they should be kept indoors with the air conditioning on. Take them out for short bathroom breaks in shady areas. Exercise should be limited to avoid overheating and respiratory distress.

• Watch for symptoms of hyperthermia, which include excessive panting, loud and squeaky breathing, weakness, and passing out. If your Pug exhibits any of these symptoms of overheating, bring them inside to cool off.

• A trip to the ER may be required. If the symptoms become extreme, use cold, wet towels and ice packs to start getting them cooled off right away — and take them to a veterinary hospital immediately. Body temperatures greater than 106 degrees Fahrenheit can cause organ failure requiring hospitalization for IV fluids and monitoring.

Skin conditions

Keeping your dog clean should always be part of your routine care for them. But this is especially important for Pugs, given their adorable but sometimes problematic skin folds. As cute as they are, the deep folds in between their wrinkles, especially the large skin flap just above the nose, tend to become moist, warm, and collect debris, which can lead to bacterial and yeast infections in the skin — a condition called skin fold dermatitis.

Pugs are also prone to environmental allergies which are manifested as itchy, inflamed, infected skin (allergic dermatitis), ear infections, and inflammation between the foot pads. These inflammatory skin conditions are treated with medications, bathing, supplements, and allergy shots (hyposensitization).

• Symptoms of skin infection may consist of a musty smell, inflamed skin, oily fur, flaky or thickened skin, and hair loss.

• Keep your Pug healthy. Daily cleaning, ointments, antibiotics, and sometimes surgery to remove the deep wrinkles (aka a Pug facelift) can help keep their skin clean and healthy. 

Orthopedic conditions

There are several orthopedic conditions — related to their muscle and bones — that Pugs are prone to, and Pug parents should be aware of. Symptoms can appear early, while Pugs are still puppies, or later in life with normal activity and aging. These hereditary conditions include patella luxation (a dislocated kneecap), hip dysplasia (an improperly developed hip joint), Legg-Perthes disease (a hip disorder), and hemivertebrae (an abnormally developed spine). 

Diagnosis of all of these orthopedic issues involves a full physical exam, radiographs, and sometimes an MRI. Your local veterinarian may be able to perform surgery, or they will refer you to a surgeon or specialty hospital for surgery. 

Below are more details on how to identify these orthopedic conditions.

• Patella luxation 

This orthopedic problem can be seen in humans and dog breeds, including Pugs. It is generally not painful, but over time can lead to more serious issues. Patella luxation occurs when the groove holding the kneecap in place is too shallow. This typically leads to knee instability, because the kneecap can luxate, or slip off to the side of the knee. When the patella luxates, a dog will typically hold their leg up, and then put it back down when/if the patella slides back in on its own. Depending on the severity of this, your veterinarian may recommend surgery to deepen the groove to hold the patella in place. Overall, the prognosis tends to be very good. 

• Hip dysplasia

Although hip dysplasia is typically a condition in larger dog breeds, it can also occur in Pugs. The hip is a ball-and-socket type of joint where the head of the femur (ball) fits into the acetabulum (socket), which is part of the pelvis. When the socket is too shallow to hold the ball in place, and/or the ball won’t fit properly due to being misshapen, the hip becomes unstable and painful. Depending on the severity, dogs may have a bunny hop, lameness, weakness, stiffness, and obvious pain when getting up and down off the floor. Over time, dogs can develop chronic arthritis and lameness. Anti-inflammatory medications are helpful, and there are a number of different surgical options available depending on the severity and progression of the dysplasia. 

• Legg-Perthes disease 

This is another condition affecting the hips. Unlike hip dysplasia, it is a more acute, painful hereditary condition often seen in younger dogs. Legg-Perthes disease is caused by poor blood supply to the head of the femur. As the bone deteriorates, the hip becomes very painful. As with hip dysplasia, symptoms of Legg-Perthes include abnormal gait and lameness. A veterinarian may suggest surgical removal of the femoral head (called a femoral head osteotomy), resulting in a very good long-term prognosis.  

• Hemivertebrae 

This condition is caused by a malformed vertebrae, and is associated with the Pug’s curly tail. (Hemivertebrae also affects French Bulldogs and other breeds with corkscrew tails.) Depending on the location and severity of the case, the vertebrae may put pressure on the spinal cord causing neurological issues in the back legs as well as incontinence. This usually arises early in life, once puppies are finished growing. Some dogs, but not all, will respond well to surgery. 

6. Encephalitis

Pug dog encephalitis (PDE) is a progressive neurological disease seen primarily in female, fawn-colored Pugs who are less than seven years old. Although very rare, it is usually fatal. Genetic testing can be done to determine how likely an individual Pug will be to develop Pug encephalitis and if they are likely to pass it on to offspring if they are bred.

• Symptoms of encephalitis include seizures, lethargy, weakness, a wobbly gait, and blindness.

7. Obesity

With so many health issues, Pugs aren’t able to exercise to the extent other dogs can. So they tend to put weight on easily. It takes a lot of discipline for pet parents to feed their Pugs appropriate amounts of food to keep them slim. But it is worth the struggle, because the excess weight can exacerbate your Pug’s respiratory and orthopedic issues.

Vertikala / Stocksy/

How to care for a Pug

Looking after your Pug is a labor of love for these sweet-natured dogs. And the more time and energy you invest in their care, the healthier they will be.

What to feed a Pug 

Pug needs are similar to other dogs. Feed them high-quality commercial kibble or freshly made food twice a day. Check with your veterinarian for dietary recommendations based on your Pugs’ overall health. If they have food allergies, gastrointestinal, kidney, or other organ failure, they may benefit from a special formulation.

Training a Pug

Pugs are very sweet and cooperative dogs. They enjoy learning basic dog manners and the social aspects of going to dog training classes. Most are not suited for intense agility and other sports, but as long as they don’t have severe respiratory compromise, they might enjoy tricks classes or agility for fun classes. 

Care for a Pug

General care of Pugs is similar to any other breed of dog. They require fresh nutritious food, clean water available at all times, especially in the warm weather, regular grooming, mild exercise, and a lot of love. They are very social dogs requiring lots of attention and interaction with their family. They love other dogs so many pet parents tend to pair Pugs with other Pugs or other breeds and breed mixes.  

While they cannot be exercised as rigorously as other dogs, they do appreciate being out in fresh air and tend to love socializing at parks, beaches, and other outdoor, dog-friendly places. For most Pugs, this is all the exercise they need to stay fit and healthy. Just make sure your Pug has regular veterinary checkups and is fully vaccinated and protected against contagious diseases before socializing them.

Pug grooming 

Pugs tend to shed much more than the average dog, so regular bathing, brushing, and grooming. Most importantly, daily cleaning to keep their face folds clean is very important to prevent infections and other skin issues. 

How often your Pug should visit the vet 

Get your Pug regular checkups once to twice a year, depending on their age and overall health. Wellness blood screens, vaccines, and heartworm, flea, and tick preventatives should all be used to keep your Pug healthy. Be aware of the hereditary health problems they are prone to (listed above), so you can recognize symptoms and get them to your veterinarian right away should an issue arise. 

Why are Pugs so popular despite their long list of health issues? 

Although they are definitely a high-maintenance breed in terms of health, Pugs are known for being sweet and good-natured. Additionally, they require less exercise and are compact enough to cohabitate with their humans in smaller living environments. Pet parents tend to intensely adore their Pugs, resulting in Pug clubs, Pug meetups, Pug posters, Pug calendars, and lots of Pug logo-wear. 

If you’re ready to add a Pug to your family, be sure to check Adopt a Pet for rescued Pugs available for adoption. Please keep in mind that, while the above list is long, not all Pugs suffer from all or any of these issues. With the right care, most can live long, healthy lives.

Commonly asked questions

How long do Pugs live? 

You can expect your Pug to live 12 to 15 years. However, their lifespan will be dependent on how well you care for them and their overall health. 

What are the most common health issues for a Pug?

The most common health issues for a pug include: breathing issues such as brachycephalic obstructive airway syndrome (BOAS), eye issues and diseases, overheating, dermatitis, and orthopedic conditions (see “Orthopedic conditions,” above). 

How much do Pugs cost?

Purebred Pugs can cost hundreds to thousands of dollars, depending on the breeder. However, adopting a Pug from a rescue or shelter is much cheaper, coming with an adoption fee of $100 to $800, and typically includes vaccines, spaying/neutering, and microchipping. 

References

“New Research Shows Pugs Have High Health Risks and Can No Longer Be Considered a “Typical Dog” from a Health Perspective.” Rvc.ac.uk, 18 May 2022, www.rvc.ac.uk/vetcompass/news/new-research-shows-pugs-have-high-health-risks-and-can-no-longer-be-considered-a-typical-dog-from-a-health-perspective.

O’Neill, Dan G., et al. “Health of Pug Dogs in the UK: Disorder Predispositions and Protections.” Canine Medicine and Genetics, vol. 9, no. 1, 18 May 2022, cgejournal.biomedcentral.com/articles/10.1186/s40575-022-00117-6, https://doi.org/10.1186/s40575-022-00117-6.

“Pug - Hemivertebrae.” Ufaw.org.uk, 2024, www.ufaw.org.uk/dogs/Pug-hemivertebrae#affecteds. Accessed 7 Jan. 2025‌.

“Susceptibility to Pug Dog Encephalitis (PDE) | Veterinary Genetics Laboratory.” vgl.ucdavis.edu, vgl.ucdavis.edu/test/pde-susceptibility.