pug dog walking in forest thinking 'i'm the cutest'

Loving, friendly and mild-mannered, Pugs are one of the most beloved breeds in the world.

Their popularity has skyrocketed over the last couple of decades, and it’s not hard to see why. With their curly tails, snorting noses and comical personalities, Pugs combine the cutest traits of piglets and puppies into one adorable little animal. 

Yet along with the increased global interest in Pugs comes increased awareness of their many health problems, with some veterinarians and animal welfare organizations warning against breeding them at all. 

So how extreme are Pug health problems — and what does that mean for Pug-lovers?

Why Were Pugs Bred Originally?

The Pug is a very old breed, originating in China hundreds of years ago. Pugs were bred for one purpose: to be loving companions. They aren’t hunters, trackers, retrievers, or herders. They exist purely to love and be loved — and they excel at it!

However, the Pug’s distinctive features weren’t nearly as dramatic then as they are today. If you compare the original Pug breed vs now, you’ll notice that today’s Pugs have far shorter snouts, stockier bodies, and smaller heads relative to their proportions.

Over time, humans have bred these exaggerated characteristics into the breed, simply because we find them adorable. Unfortunately, however, the closer Pugs got to the squishy-faced ideal humans want, the farther they deviated from their wild canine ancestors — and from the physical characteristics that would keep them in good health.

The State of Modern Pugs

The health problems that plague today’s Pugs became abundantly clear earlier this year, when an alarming study was published at the Royal Veterinary College in the UK.

After combing through the statistics and data about a wide variety of dog breeds, the study found that Pugs stood out from the pack — and not in a good way. Their results showed that Pugs are drastically more unhealthy than other dog breeds, even compared to other small dogs or “flat-faced” dogs, and are at risk of developing a wide variety of serious health conditions.

Common Pug Health Problems

Breathing & Airway Obstruction

Perhaps the most well-known Pug health problem is that their snuffly snoot comes at a high price, through a condition known as Brachycephalic Obstructive Airway Syndrome (BOAS).

Realistically, a Pug’s classic open-mouthed “grin” is not an indication of cheerfulness or a jolly nature; it’s actually because they’re struggling to breathe. A Pug’s nasal passage is so narrow, breathing through their nose would be like a human breathing through a straw. Therefore, Pugs are forced to open-mouthed pant basically all the time.pug dog panting due to narrow nasal pathway

Heat and overexertion make this problem drastically worse. As Dr. Sian Tranter of Vet Help Direct writes:

“Dog breeds with short noses are called brachycephalics. Their conformation often causes BOAS (Brachycephalic Obstructive Airway Syndrome). This means that it is difficult for them to breathe. Shortening the skull results in excess tissue in the airway. A long soft palate, large tonsils and a swollen larynx all obstruct the airway. This is exacerbated by narrow, closed or slit-like nostrils. The result is limited airflow to the lungs. If you have ever tried to breathe with a heavy cold and sore throat, you can sympathize with how affected dogs feel all the time. 

Some breeders/sellers will insist that the obstructive breathing, snorting and snoring noise are normal. Depending on the severity of the obstruction dogs may breathe noisily at rest or exercise, pant constantly or only when playing or walking. Often these dogs cannot cool themselves down in hot weather and are prone to heat stroke. As many struggle to breathe and swallow simultaneously, they have difficulty eating and may regurgitate food or saliva frequently.”

Brain Inflammation (Encephalitis)

Without a doubt, the most terrifying diagnosis for any Pug parent is the dreaded encephalitis

Pug Dog Encephalitis (PDE) is a neurological brain disorder that is almost always fatal. A Pug’s brain is already slightly too big for their small skull, and PDE occurs when their brain becomes inflamed and swells even further. The pressure of their brain against their skull causes seizures, stumbling, blindness and ultimately death.

PDE is thought to be genetically inherited, but the symptoms typically do not begin until the Pug is 2-3 years old, making it difficult to know if your new pup is a carrier. 

Skin Conditions

Any dog can develop itchy, flaky skin, but many Pugs carry a genetic predisposition for atopy. This is a condition where these dogs are more susceptible to skin issues, such as eczema and allergic rhinitis. Pugs are also at higher risk of alopecia (hair loss) as well as skin cancer.

Plus, all Pugs have to deal with the consequences of all those adorable wrinkles. The folds between a Pug’s wrinkles are wet and warm — the perfect breeding ground for bacteria. It’s common for yeast infections, fungus and even mold to grow in those folds. Pugs’ wrinkles must be cleaned out daily and sometimes even multiple times a day.

Spine & Skeletal Issues

One of the Pug’s cutest features is undoubtedly its piglet-like curly tail. Although many dog breeds feature some kind of curl or curve in their tail — the Shiba Inu or Basenji, for example — the Pug’s tail is curled especially tight, often wrapping completely around itself like a little cinnamon bun.

pug dog in harness looking backSadly, their curly rear becomes less cute when you understand how it impacts a Pug’s entire body. As Dr. Tranter explains:

“Pugs are prone to spinal disease caused by hemivertebrae. The gene that codes for the coils in the tail also causes abnormally shaped vertebrae in other areas of the spine, these are often called hemivertebrae. These vertebrae can put pressure on the spinal cord within, causing chronic back pain and sometimes paralysis and incontinence. Severely affected dogs require spinal surgery to remove the pressure on the spinal cord. Many pugs are affected, x-ray or scanning is required to diagnose this cause of chronic pain.”

If that wasn’t enough, Pugs are also at high risk of Legg-Calve-Perthes disease, a hip deformity which causes the Pug’s rear leg bones to actually shrink. Any small breed dog can develop Legg-Calve-Perthes disease, but Pugs are over 65 times more likely to develop it than all other dogs!

The symptoms of this condition do not appear until the Pug is a few months old. It typically begins as unexplained lameness, a limp that comes and goes. Another common Pug health problem is a luxated patella (their kneecap moving out of place), which also appears as a limp.

Fortunately, both conditions can be corrected — but not without expensive surgery.

Obesity & Diabetes

Obesity is one of the most common canine health problems in the world, estimated to impact over half of all dogs in the US. Pugs, unfortunately, are even more at risk of developing obesity — and all the health problems that go with it.overweight pug dog in a red plaid bandana

Because Pugs often struggle to exercise sufficiently without overheating or becoming unable to breathe, they are more likely to live a sedentary lifestyle. Extra weight quickly turns a barrel-shaped Pug into a blimp and puts enormous strain on their joints. Pugs are also more likely than other breeds to develop diabetes mellitus

Eye Issues

Those big “bug-eyes” that Pugs are known for put them at risk for a variety of eye conditions. According to  Dr. Tranter

“The prominent eyes of the pug mean that tear flow may be insufficient to lubricate the eye. This can result in dry eyes which are prone to painful ulceration by trauma or infection. Constant irritation of the cornea (surface of the eye) often results in pigment laid down in the eye obscuring vision (pigmentary keratopathy). Shallow eye sockets mean that eyes may be more likely to prolapse (pop out) with trauma or play. Both these conditions can lead to loss of an eye. Eyelid abnormalities (entropion and ectropion) can occur and constantly irritate the cornea.”

Pugs are also at higher risk of other common eye conditions, including cherry eye, cataracts, corneal ulcers and conjunctivitis.

What Do We Do About Pug Health Problems

The researchers and veterinarians behind the recent study into Pug health problems strongly advise prospective pet owners not to support the breeding of purebred Pugs.

“Although hugely popular as pets, we now know that several severe health issues are linked to the extreme body shape of Pugs that many humans find so cute,” Dr. Dan O’Neill, lead author of the Royal Veterinary College study, wrote in a statement. “It is time now that we focus on the health of the dog rather than the whims of the owner when we are choosing what type of dog to own.”

pug dog on a bed looking sad

If you truly have your heart set on one of those squishy faces, the researchers suggest adopting from a Pug rescue or looking for a Pug-mix instead. Many pet adoption websites like Petfinder let you filter by breed, so you can easily find rescue Pugs or Pug-mixes in your area.

If you do become the proud owner of a personable Pug, remember that you do have the power to influence your Pug’s health for the better and increase their odds of a long, happy life!

To safeguard your Pug’s health, it’s important to:

  • Watch closely for signs of overheating or difficulty breathing, especially in summer
  • Fight obesity and build strong muscles with a lean, protein-rich diet and regular exercise
  • Groom your Pug properly to keep their skin healthy and free of bacteria
  • Add immune-boosting Omega-3s to your Pug’s diet. Fish, such as salmon, are one of the best natural sources of Omega-3s
  • Visit your vet if you are ever concerned about your Pug’s health, and invest in pet insurance to be ready for anything


Pugs are mild-mannered and friendly dogs who want nothing more than to love us and be our little buddies. Unfortunately, breeding for exaggerated features has resulted in many health problems for these affectionate pups.

The good news is, awareness of Pug health problems is rising, and there are some breeders committed to scaling back the Pug’s dramatic features. But until breed standards officially shift, it’s better to avoid purebred Pugs — and adopt your new best furiend instead!