Pekingese Brachycephalic Respiratory Care: From Key Precautions to Lifelong Age-Specific Health Management

RespiratoryBreed HealthMeongsiljang Veterinary Advisory Board

Pekingese dogs are a brachycephalic breed, meaning they are prone to lifelong respiratory issues due to their facial structure. This guide outlines age-specific care strategies from puppyhood through senior years, along with warning signs that require immediate veterinary attention, all based on veterinary evidence.

What Kind of Breed Is the Pekingese?

Pekingese flat-faced brachycephalic structure front view

Pekingese are a small breed that lives with lifelong respiratory issues due to their flat-faced (brachycephalic) structure. The most common health concern is Brachycephalic Obstructive Airway Syndrome (BOAS), which involves a combination of narrowed nostrils, an elongated soft palate, and a narrowed trachea. If your dog has noisy breathing or struggles especially in hot weather, it may be due to structural issues rather than just temperament. Knowing age-appropriate care strategies in advance can significantly reduce the risk of complications.

5 Health Concerns Pekingese Must Monitor for Life

If you’re a Pekingese owner, it’s important to be aware of these potential health concerns.

Brachycephalic Obstructive Airway Syndrome: Structural abnormalities such as narrowed nostrils and an elongated soft palate can cause excess tissue to obstruct the airway, increasing airflow resistance and making breathing difficult.

Proptosis: Due to their shallow eye sockets, Pekingese are prone to eye protrusion, where the eyeball can slip out of the socket even from minor trauma or impact.

Intervertebral Disc Disease (IVDD): Their long backs and short legs place extra strain on the spine, so it’s important to monitor for back issues.

Skin Fold Infections: Moisture can accumulate in facial wrinkles, leading to skin irritation and infection. Keep the folds clean and dry to prevent problems.

Patellar Luxation: This common joint condition in small breeds can cause intermittent limping in the hind legs, so watch for any signs of discomfort or gait changes.

Why Brachycephalic Airway Syndrome Occurs

Brachycephalic airway syndrome occurs in Pekingese due to their unique anatomical features. Although their skulls are short, the surrounding soft tissues do not reduce proportionally, causing excess tissue to protrude into the airway and increase resistance with each breath. Narrow nostrils (stenotic nares) limit airflow, and additional structural abnormalities such as an elongated soft palate, everted laryngeal saccules, and laryngeal collapse may also develop. If you notice snoring, noisy breathing, exercise intolerance, or changes in gum color, consult your veterinarian. These structural defects can be surgically corrected to reduce airway obstruction, so early evaluation upon noticing symptoms helps minimize long-term complications.

Side view of the respiratory tract structure in brachycephalic Pekingese dogs

Respiratory Crisis Signs Requiring Immediate Emergency Care

Seek immediate veterinary care if you notice any of the following symptoms: • Pale or bluish gums (a sign of oxygen deprivation) • Breathing with the mouth open and front legs splayed • Difficulty breathing lasting more than 10 minutes • Fainting or altered consciousness • Collapse or seizures after exposure to heat

Health Care Points for the Puppy Stage (0–3 Years)

This is when respiratory issues first tend to appear. Be sure to have your vet check for nasal stenosis during your puppy’s first health exam between 6 months and 1 year of age. If the narrowing is severe, a nasal widening procedure at this stage can significantly improve breathing for life. It’s also a good idea to request an airway assessment before anesthesia for spay or neuter surgery. Keep up with all vaccinations on schedule, and check your dog’s facial wrinkles and eyes every month.

Health Care Points for the Adult Stage (4–8 Years)

This is the period when respiratory symptoms tend to worsen or when intervertebral disc disease (IVDD) may first occur. Be sure to have lung and heart auscultation performed during annual check-ups, which should be conducted once or twice a year. Limit outdoor walks to 15 minutes or less when temperatures exceed 25°C. Maintaining an ideal body weight (3–6 kg) is important, as excess weight increases the burden on the respiratory system. To help prevent spinal disc issues, replace jumping on and off sofas or stairs with the use of a small ramp.

Health Care Points for the Senior Stage (9+ Years)

This is a period when respiratory function decline and heart disease can occur simultaneously. We recommend chest X-rays and cardiac ultrasounds every six months. If you notice repeated apnea during sleep or frequent waking, please consult your veterinarian. Maintaining an indoor temperature of 22–25°C and humidity of 50–60% can help reduce respiratory irritation. Switch to a senior dog food that is easier to digest, and divide the daily portion into smaller meals.

Globe Prolapse: Why Pekingese Are Especially at Risk

According to ophthalmology textbooks, globe prolapse (globe luxation) is most commonly reported in brachycephalic breeds such as Shih Tzus, Pugs, and Lhasa Apsos. Pekingese, also a brachycephalic breed with shallow eye sockets (orbits), are at risk of their eyes slipping out of the sockets even from minor impacts or trauma. Please use a harness instead of a collar to avoid pressure on the neck. After vigorous play with other animals, check your dog’s eyes; if the globe appears protruded, cover it with sterile saline or a damp gauze pad to prevent the surface from drying out, and proceed immediately to an emergency veterinary hospital.

Close-up of the protruding eye structure in Pekingese dogs

Key Checklist for Daily Pekingese Care

• When temperatures reach 25°C or higher, air conditioning is essential, and outdoor exposure should be limited to less than 30 minutes. • Use a harness instead of a collar — pressure on the neck can worsen airway collapse. • Clean facial wrinkles daily with a soft cloth and keep them dry. • After bathing, thoroughly dry the skin folds with a hair dryer. • To help prevent intervertebral disc disease, replace jumping on and off sofas and stairs with the use of ramps.

Reviewed by a veterinarian

Dr. Tony — Punnawat Phongkittirak

Veterinarian

A veterinarian who majored in veterinary medicine at Khon Kaen University, Thailand, and completed the IVSA program at North Carolina State University in the United States. Drawing on clinical experience at animal hospitals, he works in the pet healthcare field and is dedicated to building a digital care environment that connects pet parents with veterinarians.

Frequently Asked Questions

My Pekingese snores quite loudly. Is this normal?

Brachycephalic breeds may snore due to their facial structure. However, if you notice repeated pauses in breathing during sleep or labored breathing during the day, a veterinary visit is necessary. A veterinarian can distinguish between mild snoring and Brachycephalic Obstructive Airway Syndrome through auscultation and examination.

Will surgery completely resolve the respiratory issues?

Structural correction surgeries, such as nostril widening and soft palate resection, can significantly improve airway obstruction and breathing, though complete normalization is often difficult. Early evaluation and correction when symptoms first appear are beneficial, as they help reduce complications associated with long-term airway obstruction.

What season requires the most caution when raising a Pekingese?

It’s summer. Brachycephalic breeds struggle to dissipate heat, putting them at higher risk of hyperthermia and heatstroke. On days when temperatures exceed 25°C, keep them indoors in an air-conditioned environment, and limit walks to short outings during the early morning or late evening.

Why are my pet’s eyes constantly red?

Due to their protruding eyes, tear film doesn’t spread evenly across the surface, leaving it prone to dryness and exposure. This can lead to exposure keratitis, corneal injuries, or dry eye (keratoconjunctivitis sicca). We recommend having your pet evaluated by a veterinary ophthalmologist.

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References

[1] Esson D.W., Calvarese S., Clinical Atlas of Canine and Feline Ophthalmic Disease, 2nd Ed, Chapter 156: Proptosis of the Globe, John Wiley & Sons, 2022

[2] The Veterinary Workbook of Small Animal Clinical Cases, Case 41: Brachycephalic Breeds — Cephalic Index and Skull Morphology

[3] Packer R.M.A. et al., Impact of Facial Conformation on Canine Health: Brachycephalic Obstructive Airway Syndrome, PLoS ONE, 2015

[4] Liu N.C. et al., Whole-body barometric plethysmography characterizes upper airway obstruction in 3 brachycephalic breeds of dogs, Journal of Veterinary Internal Medicine, 2016