Pug Health Care Guide: Key Points on Brachycephalic Respiratory Issues and Obesity

RespiratoryBreed HealthMeongsiljang Veterinary Advisory Board

Pugs are prone to respiratory issues and obesity due to their brachycephalic (short-nosed) anatomy. We’ve put together a clear overview of conditions to watch for, weight management tips, and how to handle emergencies.

What Health Problems Are Pugs Vulnerable To?

Pugs are a small breed particularly vulnerable to respiratory, obesity, and eye conditions due to their flat facial structure (brachycephalic). To keep them healthy and by your side for a long time, respiratory care and weight management are the most important factors. Understanding and managing their naturally narrow airway structure and tendency to gain weight easily can help prevent many issues. Pugs are one of the representative breeds reported to have Brachycephalic Airway Obstruction Syndrome (BAOS) and are repeatedly mentioned in veterinary literature as a breed at high risk for brachycephalic-related respiratory diseases.

Top 5 Conditions to Watch for in Pugs

Brachycephalic Airway Syndrome: This is a common condition in Pugs, where breathing becomes difficult due to narrow nostrils and an elongated soft palate.

Obesity: Pugs have a strong appetite and low activity levels, making it easy for them to gain weight. Obesity can worsen the narrowed upper airway obstruction typical of brachycephalic breeds.

Corneal Ulcers: Due to their large, protruding eyes, Pugs are prone to corneal damage from external irritation. They are known to be a breed that frequently develops corneal ulcers.

Skin Fold Infections: Moisture and bacteria can accumulate in the facial folds, leading to skin inflammation.

Patellar Luxation: This is a joint condition where the kneecap slips out of place, and it can occur in Pugs as well. If you notice limping or a hopping gait, it’s best to have your vet check them.

Why Is Brachycephalic Airway Syndrome Dangerous?

The most significant health risk for Pugs is Brachycephalic Airway Syndrome. A combination of narrowed nostrils, an elongated and thickened soft palate, and a narrowed trachea can make breathing uncomfortable even during normal activities. If your Pug snores heavily, pants excessively after exercise, or continues to gasp for air for extended periods on hot days, you should suspect this syndrome. In severe cases, your veterinarian may recommend surgical options such as soft palate resection or nostril widening. Many Pugs experience a noticeable improvement in breathing comfort following surgery.

A side view of a pug breathing with its mouth slightly open.

Go to the Emergency Vet Immediately If You See These Symptoms

If your Pug’s gums or tongue turn purple or blue, if they’re too breathless to stand, or if they seem disoriented, head to an emergency vet clinic right away. During the hot summer months, the risk of heatstroke is very high, so avoid walks at midday and stick to short outings in the early morning or evening.

Pug Obesity Management — How to Use Body Condition Score (BCS)

Pugs are prone to worsening respiratory issues when they become overweight, as their already narrow airways face increased pressure. Using a Body Condition Score (BCS) makes it easy to determine whether your pet is at a healthy weight. On a 9-point scale, a score of 4 to 5 is ideal. Your pug is at a normal weight if you can feel their ribs with a slight layer of fat when you run your hand along their sides, and if you can see a visible waistline when viewing them from above. A score of 6 to 7 indicates overweight, while 8 or higher is considered obese. If you cannot feel the ribs at all, consult your veterinarian to create a weight-loss plan.

A top-down view of a pug standing on a scale at the animal hospital.

Key Points for Pug Dietary Management

The key to weight management in Pugs is controlling portion sizes. Follow the recommended feeding amount on the food packaging, and limit treats to small amounts within the daily total calorie allowance to help manage weight.

High-protein, high-fiber food: Helps increase satiety while managing weight.

Treat substitution: Using kibble as training rewards can reduce extra calorie intake.

Splitting meals: Feeding 2–3 times a day can help reduce feelings of hunger.

If weight loss is needed, a veterinarian can recommend an appropriate feeding amount and food based on the target weight.

Eye Health and Skin Wrinkle Care

Pugs’ large, expressive eyes are one of their most charming features, but they also make the eyes more vulnerable to external irritants. If you notice excessive tearing, frequent eye rubbing, or redness, it could indicate corneal ulcers or dry eye, so prompt veterinary examination is recommended. Proper care of facial wrinkles is equally important. Gently clean the folds with soft gauze two to three times a week and ensure they are completely dried afterward. Moisture left in the wrinkles can lead to bacterial or yeast infections. Redness or an unpleasant odor in the wrinkle areas may be early signs of dermatitis.

A close-up view of the Pug's wrinkled face and large eyes.

What Pug Owners Must Remember

Pugs are extremely sensitive to heat. As a brachycephalic breed, their narrowed airways make it difficult to dissipate heat efficiently, putting them at high risk of overheating. Keep your home cool and always bring a cooling vest and water when going out during the summer. Additionally, brachycephalic dogs generally tend to have higher carbon dioxide levels and lower oxygen levels compared to dogs with other skull shapes. Before any surgery or dental scaling, be sure to inform your veterinarian that your dog is brachycephalic so they can take special precautions regarding respiratory and anesthesia management.

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

Is it always abnormal when a pug snores?

Mild snoring is common in brachycephalic breeds due to their facial structure. However, if the snoring worsens over time, if your pet appears to stop breathing during sleep, or if they have labored breathing even during the day, please consult your veterinarian.

What is the ideal weight for a Pug?

Because Pugs vary in skeletal size, it’s difficult to set a single ideal weight for all of them. The most accurate approach is to aim for a Body Condition Score (BCS) of 4–5 on the 9-point scale, maintaining a condition where the ribs can be felt with a slight touch and a waistline is visible when viewed from above. The most precise way to determine your Pug’s target weight is to set it together with your veterinarian.

What’s the best way to exercise a pug?

To avoid straining their breathing, it’s best to take them on short, light walks twice a day, each lasting about 15–20 minutes. On hot or humid days, please replace outdoor walks with indoor play instead.

How often should you clean the wrinkles on a Pug’s face?

Aim for two to three times a week as a baseline, but during humid seasons like summer, it's best to clean them daily. Dampen a soft gauze pad with lukewarm water and gently wipe the area, then make sure to dry it completely.

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References

[1] Packer RMA et al., Impact of Facial Conformation on Canine Health: Brachycephalic Obstructive Airway Syndrome, PLoS ONE, 2015

[2] Ladlow J et al., Brachycephalic obstructive airway syndrome, Veterinary Record, 2018

[3] German AJ, The Growing Problem of Obesity in Dogs and Cats, The Journal of Nutrition, 2006

[4] Burkholder WJ, Use of body condition scores in clinical assessment of the provision of optimal nutrition, J Am Vet Med Assoc, 2000

[5] O'Neill DG et al., Disorders of Pugs under primary veterinary care in England, Canine Genetics and Epidemiology, 2016