8 Pug Common Health Issues [+Signs and Prevention]

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pug dressed like a doctor

Pugs have a distinctive and endearing look, but the breeding practices that created their charming appearance also predispose them to develop certain health issues.

When you choose a Pug as your furry companion, knowing about the common health issues can help you prepare for potential problems. That way, you’ll be ready to seek care if you see signs of trouble.

Before you panic, remember the tendency to develop certain diseases is not a guarantee that your Pug will have any of the conditions I’ll describe below. But most dogs will deal with at least one health issue in their lifetime. The conditions below commonly appear in Pugs.

The most common health issues that Pugs deal with include brachycephalic Obstructive Airway Syndrome(BOAS), eye problems, orthopedic issues, periodontal disease, allergies, skinfold dermatitis, ear infections, and Pug Dog Encephalitis (PDE). 

In this article, I’ll describe seven health conditions that commonly affect Pugs and how they present across your dog’s lifecycle. Then, I’ll compare Pug health with other dog breeds and give you a list of signs to watch out for. At the end, I’ll share some preventative measures and general healthcare tips for your furbaby.

Common Health Problems in Pugs

With their compact bodies and flat faces, Pugs are susceptible to a list of health issues. Below, we’ll examine the most common problems in this breed.

Brachycephalic Obstructive Airway Syndrome (BOAS)

The Pug’s characteristic flat face sets the breed up for changes in the airway and throat known as BOAS. With the syndrome, dogs tend to have a narrower windpipe and nostrils along with an elongated soft palate. This anatomical structure can make it difficult for your furbaby to breathe. 

Flat-faced breeds like Pugs, Boxers, French Bulldogs, and English Bulldogs are prone to developing BOAS.

Although Pugs are born with flat-faced anatomy, symptoms of BOAS usually surface in mature dogs.

Brachycephalic breeds have compressed skull bones that give them a shorter snout. The skull structure can result in various anatomical abnormalities, including narrow nostrils, an elongated soft palate, an undeveloped or narrow trachea, and everted laryngeal saccules. All of these structural problems can interfere with airflow and cause breathing problems. 

Signs include:

  • Noisy breathing/snoring
  • Difficulty breathing
  • Coughing
  • Gagging
  • Exercise intolerance
  • Pale gums
  • Collapse

If your Pug’s BOAS is minor and the symptoms are mild, you can usually do it medically. If the structural defects are more pronounced, surgical correction may be needed. Without the appropriate treatment, dogs can experience respiratory distress, worsening symptoms, and eventual collapse. 

To prevent breathing difficulties in Pugs with BOAS, limit time outdoors when it’s hot and humid, help your furbaby reach and maintain a healthy weight, and limit your dog’s exercise/exertion.

Treatment options for BOAS include:

  • trimming the soft palate
  • surgically widening the nostrils
  • removing everted laryngeal saccules

Eye problems

Because Pugs have a flat face and bulging eyes, they’re prone to developing certain eye conditions, including cherry eye, entropion, dry eye, corneal ulcers, and proptosis.

Brachycephalic breeds like Pugs, French Bulldogs, Shih Tzus, English Bulldogs, and Boxers have facial anatomy that makes them prone to developing the above eye conditions.

Cherry eye and entropion are present at birth, and symptoms can appear in puppies The other conditions usually appear in mature dogs. 

With the cherry eye, ligaments that hold the tear gland in place break down, tissue pops out, and it swells. Entropion is a condition where the hair lining the eyelid grows inward and rubs against the eyes. This causes irritation and corneal ulceration.  Dogs with dry eyes don’t produce enough tears to lubricate the eye’s surface. When a cherry eye or a lack of adequate tear production causes dry eyes, the cornea may also ulcerate. Proptosis occurs when the eye bulges and pops out of the shallow socket.

Symptoms of the above eye conditions include:

  • Light sensitivity
  • Blinking or holding the eye shut
  • Squinting
  • Eye redness
  • Yellow or green eye discharge
  • pinkish/red mass in the corner of the eye (cherry eye)
  • Tearing (except dry eye)

Without treatment, these conditions can lead to corneal damage, ulcers, or loss of sight. 

Because most of the conditions above are genetic, your best hope of prevention is to choose puppies from family lines that don’t have a history of these issues. Corneal ulceration may be preventable by treating other predisposing conditions. Additionally, you may be able to reduce the risk of proptosis by discouraging rough play.

The treatments for cherry eye, entropion, and proptosis involve surgery. Dry eye and corneal ulcers usually require medical treatment with antibiotics and/or anti-inflammatory drugs.

Orthopedic issues

Pugs are prone to developing certain orthopedic conditions, including Legg-Calvé-Perthes disease, patellar luxation, and hip dysplasia.

Although hip dysplasia is a common problem in Pugs, it usually affects larger dogs like Dobermans, Great Danes, Retrievers, and German Shepherds. On the other hand, luxating Patellas and Legg-Calvé-Perthes disease occur more frequently in smaller breeds like Pugs, Chihuahuas, Jack Russel Terriers, Poodles, and Pomeranians.

Legg-Calvé-Perthes disease affects young Pugs, usually in their first 4-6 months of life. The anatomy for luxating patellas and hip dysplasia is present at birth, but symptoms of pain or arthritis usually take time to develop and appear in adult dogs.

With Legg-Calvé-Perthes disease, there is an inadequate blood supply to the femoral head, and the bone dies which causes severe pain. When Pugs have luxating patellas, the ligament that connects to the kneecap isn’t centered, and the bone shifts in and out of place. Hip dysplasia is a congenital deformity that features a shallow hip socket and causes a loose joint connection.

Signs of these orthopedic conditions include:

  • Bunny-hop run
  • Difficulty walking or rising
  • Reduced hip joint movement
  • Holding one hind leg off the ground
  • Difficulty/reluctance climbing stairs, getting in the car, or getting on furniture.
  • Sitting with a leg out to the side
  • Cracking/popping sound in the affected knee
  • Progressive lameness in the hind limb
  • Inability to bear weight on one or both legs

Without treatment, each of these conditions will grow progressively worse. Eventually, dogs develop debilitating degenerative arthritis and become increasingly lame.

Because the above orthopedic conditions are genetically linked, the primary preventative measure is choosing a puppy from a trustworthy breeder. Once you have a Pug, feed him a balanced diet that encourages a healthy weight, and give him joint supplements like glucosamine and chondroitin.

If your Pug develops Legg-Calvé-Perthes disease, the treatment of choice is surgical removal of the femoral head. Dogs with luxating patellas and hip dysplasia can usually be medically managed. Treatment includes anti-inflammatory drugs, pain medications, joint fluid modifiers, physical therapy, weight management, and restricted activity.

Periodontal disease

As a brachycephalic breed, Pugs have smaller mouths and crowded teeth, which makes them vulnerable to periodontal disease.

Small dogs and flat-faced breeds include Pugs, Jack Russell Terriers, Chihuahuas, Pomeranians, Shih Tzus, and Toy Poodles.

Periodontal disease can occur at any age but is more common after dogs reach adulthood. According to Cornell’s College of Veterinary Medicine, 80-90% of dogs over 3 years old will suffer from periodontal disease.

The tiny mouth and crowded teeth in your Pug allow food to be trapped and interfere with proper cleaning. As a result, plaque and tartar grow and cause gum inflammation and infection along the gums and tooth line. Bacterial growth eventually damages the roots and tooth enamel, causing decay.

Signs of periodontal disease include:

  • Red, inflamed gums
  • Bad breath/halitosis
  • Gums bleed easily when touched, or teeth are brushed
  • Excessive drooling
  • Receding gums
  • Pawing at the mouth
  • Bloody saliva
  • Discolored teeth that appear yellow or brown

To help prevent periodontal disease in your Pug, brush his teeth daily with dog-safe toothpaste, schedule annual oral exams and periodontal cleanings, and avoid giving your furbaby sugary treats.

Treatment for periodontal disease in your Pug varies depending on the severity of his condition. Dental cleanings may suffice for minor conditions, but more severe cases may call for deep periodontal pocket cleaning, antibiotic gel application, oral antibiotics, or tooth extraction.


Like many other dog breeds, Pugs are susceptible to developing skin allergies from food or environmental triggers.

While skin allergies can affect any dog, they’re more common in certain dog breeds, including Pugs, Jack Russel Terriers, French Bulldogs, Boston Terriers, and Weimaraners.

Allergy symptoms can occur at any age, but they more commonly surface in adults because it usually takes repeated exposure to mount the immune response.

When Pugs contact an environmental or food allergen, their bodies react by releasing histamine, which causes an inflammatory response. In Pugs, the reaction usually manifests as inflamed, itchy skin.

Common signs of allergies include:

  • Red, inflamed skin
  • Extreme itchiness
  • Hives
  • Constant licking or scratching
  • Swelling around the face
  • Itchy, watery eyes
  • Chronic ear infections

Allergic reactions usually increase in severity over time. If your pooch shows signs of sensitivity, talk to your veterinarian about appropriate treatment options. Immediately take your pooch to the emergency clinic any time you observe sudden extreme itching, hives, and swelling around the face. Your pup could be experiencing an anaphylactic reaction.

It’s hard to completely prevent allergies, but you can take action to minimize the reactions. Because symptoms tend to get worse with repeated exposure, try to identify and avoid trigger substances. If your furbaby’s problems are linked to a food substance, you can try a specialized diet.

Veterinarians may prescribe antihistamines or other allergy medications if your Pup suffers from chronic allergies. Skin inflammation and itchiness can be soothed with medicated anti-itch shampoos.

Skinfold dermatitis

Because Pugs have loose-fitting skin that creates wrinkles on the face and body, they are prone to skinfold dermatitis.

Skinfold dermatitis is common in dogs with skin wrinkles, like Pugs, Shar-peis, French Bulldogs, and English Bulldogs.

Skinfold dermatitis can appear at any age, but it is more common in adult Pugs.

The wrinkly skin folds in Pugs tend to rub together and provide a moist, dark environment where bacteria or yeast can grow. This combination of events leads to skin inflammation and infections.

Signs of skinfold dermatitis include:

  • Red, thickened skin
  • Greasy skin
  • Yeasty or foul odor
  • Incessant itching/scratching
  • Licking the affected area
  • Rubbing

If you leave skinfold dermatitis untreated, the inflammation will fester and cause open sores, skin ulcers, and chronic infections.

To prevent skinfold dermatitis in your Pug, clean his skinfolds daily. Use a clean, damp washcloth or pet-safe, medicated wipes. You can also use a salt solution of 1 tablespoon of salt dissolved in 1 pint of water. Dry the area thoroughly after you clean the folds. 

If your Pug develops skinfold dermatitis, treatment may include topical antifungal or antibiotic ointments, anti-inflammatory medications, and medicated shampoos.

Ear infections

Pugs have narrow ear canals that predispose them to ear infections.

Several dog breeds, including Pugs, French Bulldogs, Shih Tzus, Beagles, and Bichon Frises tend to suffer from ear infections.

Ear infections can afflict your Pug at any age. 

Moisture, debris, and bacteria or yeast can collect in your Pug’s narrow ear canal. As the microbes multiply, infection sets in, causing your furbaby pain and discomfort.

Common signs of an ear infection in your Pug include:

  • Reddened ears
  • Excessive ear scratching 
  • Head shaking
  • Tilting the head to the side of the infection
  • A foul odor coming from the ear
  • Dark discharge

Like many infections, untreated ear infections in your Pug can fester and grow worse over time. Eventually, the infection can lead to neurological issues, balance problems, eardrum rupture, pain, and deafness.

To protect your Pug from painful ear infections, check and clean his ears once a week. Keep his ears clean and dry, particularly after baths or going swimming. 

Depending on the severity of the infection, your veterinarian will prescribe topical or oral antimicrobials to treat the condition.

Pug Dog Encephalitis

Pugs are prone to developing a serious neurological condition known as Pug Dog Encephalitis(PDE).

Although PDE is specific to Pugs, other breeds, including Chihuahuas, Yorkshire Terriers, Maltese, and German Shorthair Pointers can suffer from non-infectious encephalitis.

Pugs can develop PDE at any age, but it occurs most commonly in adolescents around 2-3 years old.

Encephalitis is inflammation of the brain that can be caused by an infection, an autoimmune disease, or an unknown trigger. In Pugs, PDE is likely an autoimmune response caused by a combination of gene defects and environmental stimuli.

Signs of PDE include:

  • Loss of balance/coordination
  • Circling
  • Seizures/tremors
  • Lethargy/depression 
  • Behavioral changes
  • Facial paralysis

There is no known treatment to cure PDE, but supportive care can help to minimize the symptoms.

Because PDE is linked to a gene defect, the best way to prevent the disease is by choosing a puppy whose parents tested negative for carrying the defective gene.

Supportive care for PDE includes antiseizure medications, anti-inflammatory medications, and immunosuppressive drugs. These measures can help to minimize your Pug’s symptoms to improve his quality of life.

Pug Health issues across the lifecycle

Your Pug may develop health issues at any point in his lifetime. Some issues, like Legg-Calvé-Perthes disease and entropion, occur in puppies, while other problems, like hip dysplasia and PDE tend to surface in mature Pugs. 

Pug Puppy Health Issues

Various health-related conditions in Pugs stem from anatomical defects present at birth, but they don’t always manifest in puppies. However, signs of distichiasis and entropion usually surface in youngsters. 

Other congenital conditions that become apparent in juvenile Pugs include Legg-Calvé-Perthes disease and patellar luxation. You may notice intermittent lameness or a hopping gait in your puppy if they have one of these conditions.

Adult Pug Health Issues

Many of the health issues that commonly affect Pugs take time to develop. For example, breathing difficulties and other symptoms of BOAS are more common in adults. Some eye conditions like corneal ulcers, dry eye, and proptosis are also more likely in mature Pugs. 

While certain conditions like allergies, skinfold dermatitis, periodontal disease,  and ear infections can occur at any age, they’re more common in adult Pugs. PDE is also most likely to manifest when your pup is around 2-3 years old.

Senior Pug Health Issues

Some health issues are more degenerative and are most likely to surface in the senior years. Arthritis caused by hip dysplasia and sometimes patellar luxation is more common in older dogs. 

Pug Health Issues and Average Lifespan

Pugs can suffer from a variety of health conditions, so their average lifespan is about 11 years, but some can live 12-15 years. 

Health conditions such as BOAS, PDE, and can reduce your Pug’s longevity or quality of life. Fortunately, catching and treating these conditions early helps to minimize their negative effects. 

Pug Health Issues VS Other Dog Breeds

While Pugs tend to live longer than large-breed dogs, their lifespan is often shorter than other small breeds like the Chihuahua.

Pugs share some health issues like hip dysplasia with larger breeds, but they also suffer from typical small breed conditions, including Legg-Calvé-Perthes disease. Overall, Pugs tend to deal with more health conditions than many other breeds.

Health Signs Pug Parents Should Beware Of

The best way to protect your Pug and keep him healthy is to know and understand the top signs of common health issues. That way, you’ll be equipped to recognize conditions and seek treatment early. 

  • Noisy breathing/snoring
  • Difficulty breathing
  • Coughing/gagging
  • Exercise intolerance
  • Light sensitivity/squinting
  • Blinking or holding the eye shut
  • Eye redness
  • Yellow or green eye discharge
  • Bunny-hop run
  • Reduced hip joint movement
  • Holding one hind leg off the ground
  • Difficulty/reluctance climbing stairs, getting in the car, or getting on furniture.
  • Red, inflamed gums
  • Bad breath/halitosis
  • Gums bleed easily when touched, or teeth are brushed
  • Excessive drooling
  • Red, inflamed skin
  • Extreme itchiness
  • Hives
  • Constant licking or scratching
  • Red, thickened skin
  • Greasy skin
  • Yeasty or foul odor
  • Incessant itching/scratching
  • Reddened ears
  • Excessive ear scratching 
  • Head shaking
  • Tilting the head to the side of the infection
  • Loss of balance/coordination
  • Circling
  • Seizures/tremors
  • Lethargy/depression 
  • Behavioral changes

Pug Health Care Tips and Prevention

Pugs may have some significant health issues, but they’re delightful companions. If your heart is set on a Pug, there are some things you can do to help support your furbaby’s health and prevent disease.

  • Schedule routine health checks, including vaccinations and health screenings
  • Work with a reputable breeder who can tell you about the parents’ health histories. 
  • Keep your Pug at a healthy weight. Adults should average about 14-18 pounds.
  • Feed your Boxer a nutritionally balanced diet.
  • Give your dog supplements to support the joints, like glucosamine and chondroitin.
  • Use an orthopedic bed to support your senior Pug if he has hip dysplasia or other joint issues.
  • Groom your Pug about once a week with a grooming mitt. Check and clean your furbaby’s ears at the same time.
  • Brush your Pug’s teeth daily and schedule annual dental cleanings.
  • Check and clean your Pug’s skinfolds daily. 

The Final Woof

Pugs are adorable dogs, but they can develop certain health issues. Understanding the conditions that commonly plague Pugs can help you provide the best possible care for your dog. Your furbaby may not suffer from any of these issues, but they are some of the most common maladies for the breed.

The health issues that affect Pugs can affect the quality and length of the breed’s lifespan. While Pugs tend to live longer than some large-breed dogs, their lifespan is generally shorter than other small breeds. By knowing the top signs of different health issues, you’ll be better prepared to recognize a problem and seek early care. There are also some things you can do at home to care for your furbaby and minimize the risk of disease. 

Photo of author
Dr. Libby Guise earned her DVM from the University of Minnesota in 1994. After working in private practice in Wisconsin for two years, she joined the USDA as a Veterinary Medical Officer. In 2011, Libby came home to focus on raising and teaching her adoptive daughter. She lives in Wisconsin with her daughter, husband, and two furbabies: Charis, a lab-mix rescue pup, and Chesed, a Springer Spaniel.

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