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Pug - Health Concerns

More In Depth Information 

Lets Dive into more Detailed Information on Common Pug Health Issues:

Canine Hypoglycemia- 

Please remember that puppies and even adult dogs 5 pounds and under are predisposed to hypoglycemia and must eat at regular intervals.  We recommend feeding at least times a day until they 6+ pounds.  A stressed-out puppy can be given light Karo syrup or honey rubbed on gums every few hours to keep levels up and help stimulate them to eat and drink on their own. Most pups after the first dose will start eating and drinking within a half hour or so in my experience.  We recommend Tomlyn Nutritional Gel so it not only provide glucose but us vitamins and minerals as well for a puppy under stress not eating well.


Hypoglycemia is common in Toy dog breeds, such as Yorkshire Terrier, Toy Poodle, Pomeranian and other toy dog breeds, and usually seen in puppies 5 to 16 weeks of age. Stress, low body temperature, poor nutrition, sudden change in feed, water and schedule patterns, and infections may precipitate the onset of hypoglycemia. Some puppies bred exclusively for tiny size ("teacup Yorkies, "teacup Chihuahua"), are even more predisposed to transient juvenile hypoglycemia since insufficient muscle mass may make it difficult for the body to store the glucose and keep its blood sugar properly regulated. It has been proven experimentally that eight hours fasting in a Yorkshire Terrier puppy can result in marked variation of blood glucose, showing both hypo- and hyperglycemia. Frequent feeding of a high-energy, protein-rich diet to both mother and puppies may prevent toy-breed puppies from developing hypoglycemia and may help them to overcome periods with a decreased intake of energy. 


Glucose is a type of sugar the body derives from food. The body uses glucose (blood sugar) as its primary energy source. Insulin, a hormone secreted by the pancreas, helps glucose move to the cells of the body so it can be used as nourishment and energy. Hypoglycemia occurs when the concentration of blood sugar levels in the body drop below normal. 

Although this condition can affect any animal, those most at risk are young puppies (juvenile hypoglycemia), working/hunting dogs, pregnant or nursing animals, and diabetic dogs on insulin. Toy breed dogs less than three months of age are the most commonly affected. Hypoglycemia is common in puppies because they have not fully developed the ability to regulate their blood sugar. Stress from Cold, Not Eating due to Stress, Not Being Fed Often Enough, Exercise or Extreme Excitement, Malnutrition from less then quality food, or intestinal parasites may trigger hypoglycemia. Puppies or adult dogs with liver shunts may also develop hypoglycemia. Diabetic dogs who receive too much insulin can become hypoglycemic. In adult dogs, hypoglycemia may occur from hormone imbalances, as a result of severe Addison's Disease, liver disease, pancreatic tumors, sepsis, or as a complication of pregnancy. Symptoms of hypoglycemia will vary depending on how low and how fast the dog's blood sugar level drops. Symptoms include but are not limited to: drowsiness, shivering, collapsing, Lethargy, Weakness, Head tilting, Restlessness, Trembling, Disorientation, Slow breathing, Convulsions or seizures. In severe cases, hypoglycemic dogs may lose consciousness and fall into a coma. A dog can die from hypoglycemia if not treated. 


Prevention - Dogs that have had hypoglycemic episodes, or that may be subject to hypoglycemia should be fed frequent, small meals of quality diet, be kept warm, and exercised appropriately. 


Treatment - Your veterinarian can do a blood test to check your dog's blood sugar levels. If your dog is exhibiting mild signs of hypoglycemia, begin treatment by offering your dog some of it's regular food or treats. Corn Syrup (such as white Karo Syrup), sugar water, or honey, can be added to the food to increase your dog's blood sugar levels. For small dogs start with 1 teaspoon and larger dogs 1 table spoon. 


If your dog is severely hypoglycemic, unconscious or having seizures, you must get some sugar into it immediately. Corn syrup works well because it is a very pure sugar in liquid form. Carefully rub small amounts of syrup on the gums and inside the cheeks. You can use a syringe without a needle to give corn syrup to your dog and reduce the risk of being bitten, but do not use a lot of liquid, to avoid your dog choking. The blood sugar raising effects of corn syrup will last only for a short time, and the hypoglycemia may return. Keep a close eye on your dog and give more syrup or syrup and food as needed until you can get your dog to a veterinarian. If your dog is showing any symptoms of hypoglycemia, treat it accordingly. Better to be safe than sorry. If your dog is not hypoglycemic, you may have raised its blood sugar level for a few hours and if it is, you may have saved his life. Because puppies of 5 to 15 weeks of age are the most commonly affected, most dogs will outgrow this condition as they mature. For other causes of hypoglycemia, treating the underlying disorder is obviously the best way to avoid hypoglycemic episodes. If hypoglycemia is a concern with your dog, have easy and quick access to liquid sugar available. Some suggestions for carrying a sugar supply are: packets of honey, a small syringe (without needle) prefilled with corn syrup, small plastic bottles (with a leak proof lid), or even a tube of cake decorating gel. 


Hypoglycemia Can Be Caused by Xylitol - Puppies and dogs can develop severe hypoglycemia after consuming sugar free gum sweetened with the sugar- alcohol xylitol. In humans, xylitol has little to no effect on plasma insulin or glucose levels, but in dogs xylitol is a strong promoter of insulin release and can cause severe hypoglycemia with collapse and seizures. With the increase appearance of xylitol sweetened products in the US xylitol toxication may become more common.  Often after puppies hit the 5-6 pound mark they are less at risk as long as they are fed a couple meals throughout the day until they become adults and can regulate there systems. 

Xylitol can also be called: birch sugar, sucre de bouleau, the European code E967, Meso-Xylitol, Xlitol, Xylite, and Xylo-pentane-1,2,3,4,5.

Pug Dog Encephalitis (PDE) -

Pug Dog Encephalitis is an inflammatory disease of the brain affecting Pug dogs of either sex. The disease is considered unique to the Pug breed. Similar symptoms have been reported in Maltese, Pekingese and Yorkshire Terrier breeds but is not the same. 


PDE is an invariably fatal disease in the Pug which generally affect Pugs between 6 weeks to 9 years old but median age is 18 months old. Fawn female pugs younger then 7 years old of age are more likely to develop PDE then older, male, non fawn colored pugs. Most pugs affected are on average euthanized 21 days after due to uncontrollable seizures and coma. Clinically, the disease is described as a necrotizing meningoencephalitis. This means that the brain and the layer of tissues surrounding the brain are abnormally inflamed. The term "necrotizing" describes the clinical way in which portions of the brain are literally dying. Although these portions may be very small, they are numerous and cause severe and progressive neurologic symptoms. 


Specific symptoms of PDE include: seizures, pressing of the head against a wall or furniture, a staggering walk, apparent blindness, lethargy, depression, and neck pain. When first presenting symptoms, most pugs simply quit jumping on or off furniture as they once did casually and they appear to have a "stiff neck". Other symptoms include depression, abnormal gait, staring off into space, and intermittent screaming. 


Pug dog encephalitis is difficult to diagnose since its symptoms often relate to other CNS diseases. Seizures may be caused by many other underlying conditions such as hypoglycemia, canine distemper, rabies, toad poisoning, chemicals and toxic plants ingestion. Sometimes it is possible to make the correct diagnosis using the magnetic resonance imaging of the brain (MRI), or analyzing the white blood cells in the spinal fluid. But most often the disease is diagnosed after the dog dies. 


Although PDE is always terminal, treatment may control seizures and reduce the inflammatory process in the brain for a short period of time. A veterinarian may prescribe medication which will make the Pug feel more comfortable, but there is currently no known cure for PDE nor are there medications to alleviate all the symptoms. 


What causes PDE? 


What causes this disease is still being researched!  The current tests are not yet very accurate and unable to tell which dogs will truly be affected.  The current test only about 11% of pugs that are S/S (carrying the genes they think may be related) will actually develop PDE which is about 1/8 dogs that are double carries of the gene being researched currently. They only have a 12.75% greater chance then dogs with 1 or NO Markers which means not having the currently markers they look for does not mean your dog with not get PDE!!!   


The disease has no cure and much research is still needed but if we can pinpoint the correct markers in genes with further research, we can help reduce the odds of litters being born with high risk. 


The discovery in research so far indicates that PDE is a form of autoimmune disease. It is possible that PDE susceptible dogs being exposed to environmental triggers can cause an autoimmune response. They are still looking into those factors. 


It is being strongly urged that breeders do not remove all pugs with 2 copies of markers from breeding but to selectively breed dogs with no markers, only one, or one with 2 copies of marker to a dog with no markers. This way you produce pups with no markers or only one marker which makes them at low risk to develop PDE. 


How can I prevent PDE in my Pugs? 


Since we do not have definitive answer on the causes of PDE, we cannot definitively prevent it. However, research is currently working on this!  

Elongated Soft Palate -

A problem that is frequently seen in pugs is called, elongated soft palate. The soft palate is a flap of mucousal tissue which closes off the animal's airway (nasopharynx) during swallowing to prevent foods and liquids from going into their lungs. 
esophagus opening is above the air way opening in canines.  In dogs with an elongated soft palate, the palate overlaps the epiglottis to a considerable degree, partially obstructing the animal's airway during breathing.  An elongated pallet may show itself through snorting, snoring, gurgling and gagging which to some degree is normal for pugs.  It is when it is constant or presents a health issue that is when it becomes a problem.  The obstruction of the airway may be observed as being problematic during exercise if the trachea collapses and causes a "honk".  During exercise stretched ligaments in the larynx leads to labored breathing and laryngeal collapse. Laryngeal collapse is a late stage in airway obstruction. Pressure changes caused by the elongated soft palate bring about the stretching of the ligaments that support the laryngeal cartilages. These cartilages gradually collapse inward and block the airway.  

TREATMENT: An elongated soft palate is treated by surgically shortening the palate so that the edge opposes or slightly overlaps the epiglottis. You must find a surgeon that is skilled in this surgery and familiar with pugs as is it not an easy surgery to do and pugs are known to not do well under anesthesia.  Pugs should only go under anesthesia when absolutely necessary. This surgery should only be done if the pallet is significantly elongated. 

Anal Glands -

Anal glands are little sacs on the side of the anus (they feel like little beans) and they typically fill up with a smelly brown fluid. They may become inflamed or impacted. Sometimes constipation is the culprit. This is typical among Pugs and Japanese Chins. Some dogs go in regularly to have their anal glands done but most self-express on their own. A typical sign of Anal Gland Impaction is your dog scooting along the ground or turning around looking at his anal area. Some owners may even feel that their spayed female is still having a heat cycle because she may emit a brown fluid. This is coming from her anal glands, not her vulva. Certain Breeds are prone to need their anal glands to be expressed. You can do this yourself, however, not very many dog owners willing to do this. Your vet or groomer can show you how if you want to learn. It is important that the glands are emptied or one or both can become infected and abscess. If the anal glands become infected, they can generally be treated with antibiotics, however, if they abscess, surgical drainage is often the only way to eradicate the problem. If the infection is very inflamed or chronically infected, they may need to be removed. 


A good balanced diet and daily exercise can eliminate anal gland problems. A good walk around the block will not only help the glands from getting impacted, but also will keep your Pugs nails down! A very small leak from the anal glands of your dog can cause a horrible, foul odor. You may not even see it but it may be only a smudge into your dog's coat or legs. Some Pug owners who cannot determine the origin of a bad odor on their dog have come to discover that is anal gland 'juice' leaking. Infected sacs will usually cause a lot of pain for your dog. Do not allow it to get to this stage. If your dog expresses bloody mucous material from the sac, then chances are, his anal glands are infected, and this is best handled by your Vet. 

Eye Conditions -

Dislocation of the Eyeball 

Dislocation of one or both eyeballs can be a common problem in dogs with large bulging eyes such as Boston Terriers, Pugs, Pekingese, Maltese and some spaniels. It is generally caused by dog bites or other trauma. Struggling with these dogs while attempting to hold or restrain them for any reason can cause the eye to bulge out so far that they eyelids snap shut behind the eyeball. This prevents the eyeball from returning to the socket. If this happens, it is an emergency! If not treated right away it may lead to loss of vision. 
Shortly after the eye dislocates, swelling behind the eye makes it extremely difficult to return the eyeball to its normal position. Proceed at once to the nearest veterinary hospital. Carry the dog, if possible. Cover the eye with a wet washcloth. Prevent the dog from pawing at the eye. 


Corneal Abrasions 

The cornea is the clear part of the eye. Corneal injuries are extremely painful and your pug will likely squint his eye and it will often be watery as well. Sometimes the third eyelid often comes out to protect the injured eye. Breeds with bulging eyes, such as the Pekingese, Maltese, Boston Terrier, Pugs and some spaniels are particularly susceptible to corneal injuries. 
Corneal abrasions occur when either the dog accidentally scratches the cornea when itching or when a foreign body such as dirt or lint gets in the eye and damages this surface layer of the eye.  This can even occur from grass blades that just graze the eye surface for make sure your grass is short for your pug!  Swelling at the site of the injury can cause the area to appear hazy or blue like when viewed. 
Corneal abrasions in the upper part of the cornea may be caused by misdirected eyelashes.

 Corneal abrasions from scratches that are not caused by an eyelid or eyelash problem usually heal the quicker you notice them with some simple antibiotic ointment or drops.  If noticed before the haze shows they can heal in just a day or two.  If you see haze, it often heals within a week. 

Corneal Ulcer

Corneal Ulcers (Looks like a divot in the cornea from side view) are usually the result of an injury, such as a deeper scratch or cut. When the surface of the eye is broken, it hurts and tears.  Your pug will squint and the eye will appear watery.  The injury itself can be so small that you will not even be able to see it, unless light is cast upon it from the side, or a special dye is used. Bacteria can cause the ulcer to become infected, so it is important to start eye meds quickly. Ulcers can take up to a month to heal pending how big and deep they went.  During the healing process you may see little red looking veins appear in the eye from the outside of the eye.  They are a sign of healing and work inward till the eye is all healed.


Eye Out Of Socket

Because the Brachycephalic dog's eyeballs slightly bulge out and because their eyes are not protected by a protruding nose, this leaves their eyes at risk. Their eyeballs can get easily scratched, but sometimes, a trauma can cause their eyeball to pop out. Things like accidentally dropping your pug on its head, jumping off furniture and thudding face down, being snapped at by anther dog, a child squeezing them around the neck, and generally anything that is physical trauma or emotional trauma that caused a sudden blood pressure increase. 



This condition is where hairs/eyelashes grow inward and will scratch the eye tissues of the eyeball. It can cause tearing and squinting. If the Pug is in pain, surgery may be required to correct it. 



The eyelid is inverted in this case. It affects the lower lid and affects the eye. It will cause irritation to the cornea because the lashes rub against it. Seek Veterinarian care.


Eye Conditions -

External otitis is and infection of the outer ear and the ear canal. The ear canals are delicate structures and can easily become infected if not properly cared for. 80% of infections occur in breeds with long floppy ears. The reason this is the case is that when the ears get wet for whatever reason (during a bath or from being licked by another dog) not enough air gets to circulate in the ear canals to help dry them out and keep them dry. Breeds with erect ears have fewer ear infections because there is better air circulation. Where there is moisture, bacteria is sure to begin growing and this causes the infection to begin. 
Other causes of outer ear infections include narrowing of the ear canal which can cause wax build up and moisture collection in the ear, allergic skin diseases, foreign bodies in the ears such as foxtails, or burrs, or ear mites. Also well meant, but improper ear cleaning can actually cause moisture to go further into the ear canal. 

Signs of an external ear infection include: head shaking, scratching and rubbing at the affected ear. The dog often tilts or carries his head down on the painful side and cries or whines when the ear is touched. If you were to look into the ear you would see redness and swelling of the skin folds. There is usually a waxy or white discharge accompanied by a foul odor. Hearing can also be affected. 


Bacterial Infections. Infections caused by a bacteria are usually caused by staphylococci. The discharge is usually moist and light brown. Other bacteria that can cause ear infections include pseudomonas or proteus. They usually cause the drainage to be yellow or green. There can also be more than one bacteria growing during an infection. When this occurs treatment with antibiotics can be more difficult. 

Fungal and Yeast Infections. Yeast infections can occur as a result of treating a bacterial infection with antibiotics. They are also common in dogs suffering from Hypersensitive skin disorders. Usually a brown discharge is noted along with a rancid odor. These infections tend to persist until the underlying disease is controlled. 


Because infections of the outer ear can quickly move to the middle and inner ear, it is extremely important to take your dog to your veterinarian as soon as you suspect that they have an ear infection. Only they can do a thorough inspection of the ear canal to determine the extent of the infection, the type of infection, and determine if any damage has already occurred to the inner and middle ear. Once a diagnosis has been made, proper treatment (such as antibiotics) can then be prescribed. Always make sure that the precise dosage of medication is given and do not stop giving the medication to the dog even if he/she seems to feel better. 

Luxating patella (or trick knee, subluxation of patella, or floating patella) 

This is a condition in which the patella, or kneecap, dislocates or moves out of its normal location. 

Patellar luxation is a common condition in dogs. particularly small and miniature breeds. The condition usually becomes evident between the ages of 4 to 6 months. 

Umbilical Hernia -

An umbilical hernia is much like an outie belly button.  It is a condition in which a little bit of abdominal contents most often fat protrude through the abdominal wall at the area of the umbilicus. Small hernias are generally not a problem. It is recommended to electively repair a larger hernia which can let out a little bit of the intestines fall into it, during spay or neuter. 

The exact cause of an umbilical hernia is unknown although some think it to be inherited some think it caused by mom chewing to hard or pulling on the cord during the birthing process.  This is common in brachycephalic and toy breed dogs.  The umbilical opening is normal until birth as it contains blood vessels that pass through from the mother to the fetus. This opening closes shortly after birth or within a few months in most situations.  If it fails to close it is called an umbilical hernia.


There is true hernias and then there are ones that just need time to close on their own. However, if there is always a bulge the hole cannot often heal fully as the bulge is partially in the way.  To help it heal messaging the area a few times a day and laying your puppy on their back while doing so can help it slowly heal and close up naturally.

Umbilical hernias are more common in dogs than cats. They occur on the midline of the abdominal wall through the umbilical ring and can be a variety of sizes from very small to very big. The hernia appears as a soft abdominal mass at the area of the umbilicus. Depending on the size of the opening, abdominal structures such as falciform fat or omentum can float into the opening. This generally does not cause a problem. However, if the opening is large enough, an intestinal loop can become trapped which can become a life-threatening problem. For this reason, it is recommended that larger hernias be closed after. This is most often done concurrently with the spay or castration surgery. 

Some breeds are predisposed to umbilical hernias usually toy breeds and brachycephalic breeds. Brachycephalic (snubbed nose) breeds often have a hard time chewing off the umbilical cords causing the hernia in the puppy. 

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