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Respiratory Problems

Why Pugs Have Breathing Problems


Long ago, societies would breed dogs in order to achieve a very precise appearance of the dog. The Pug was carefully developed to have a very flat face and wrinkles on the forehead. Since most canines have visible, medium to long snouts, as the bloodlines were bred and the Pug dog essentially became a dog without a snout, this made the dog very unique and precious. Those in China believed that the flat face and wrinkles were to be considered good luck. Ironically, it is these features that make breathing issues for the Pug. The facial structure of this dog forces the breathing passages to be very compact. This, along with other structural elements of the body can lead to issues that include:


  • Difficulty breathing when exercising,

  • Excess noises (snorting, snoring)

  • Inability to properly regulate body temperature, which leads to heavy panting

  • Stenotic Nares (pinched nostrils) which can interfere with normal breathing

  • An elongated palate, which can cause frequent episodes of reverse sneezing which can consist of excessive gasps and wheezes that can be quite alarming (although usually do not cause harm)


Normal Noises and Wheezes


The Pug dog will have breathing issues that are considered "normal". Although they may be quite alarming to new unsuspecting owners, the following are common traits that are to be expected:


  • Snoring – Many Pugs snore when napping and sleeping through the night. This is not usually indicative of a serious health issue. If it does become excessive, stenotic nares and/or an elongated palate may be the cause;

  • Snorting Noises – It is typical for a Pug to grunt and snort. This breed will wheeze and gasp a bit. As we look ahead into the details of Pug breathing problems, this will only need to be addressed if it appears to interfere with normal respiratory functions.


Offering an Environment that is Conducive to Easy Breathing


Temperature and humidity levels play a major role in a Pug's ability to breath. When this breed overheats, it puts strain on the respiratory system and high humidity only adds to this. Here's what you can do to help:


  • Keep room temperature in the house between 68 to 75 Fahrenheit (20 to 24 Celcius) – Use an air conditioner during hot weather and take care not to turn the heat up too much in the winter. If owners do not have access to an AC there are some things that can keep a room cooler to help a Pug breath better;

    • Open windows on opposite sides of the house to create air flow;

    • Place fans to help the air circulate throughout the rooms;

    • Keep blinds and curtains closed to block out sunlight that would otherwise heat up the house;

    • Use dehumidifiers to take excess moisture out of the air.

    • Wet down your Pug with luke-warm/tepid water if you see them breathing harder than usual. Towel dry and let them run around damp with the fans blowing on them.




Pug dogs are prone to excess weight gain which can further complicate breathing problems, yet this breed cannot handle excess exercise. Moderate exercise is an important part of providing good care. Here are some tips to follow:


  • Schedule a 20 to 30 minute walk daily, unless your Pug is suffering from a health issue that prevents this

  • During hot weather, take your Pug out early in the morning or in the early evening hours when the sun is not at its brightest.

  • Allow for at least 1 break during this walk, with a rest in a shaded area being optimal

  • Bring along a travel bowl and a chilled bottle of water so that you can offer your Pug hydration while out and about

  • Be aware of your Pug's ability and endurance levels…if your dog has trouble breathing at the 25 minute mark plan to cut back to 20 minutes.

  • If at any time you Pug begins to wheeze or show signs of respiratory distress, immediately stop activity, bring him or her to a cooler area (a shaded spot), offer a drink and do not begin walking again until your Pug has rested. If the episode seems moderate to severe, bring this to the attention of your veterinarian.

  • Use a harness on your Pug as opposed to a collar (that puts all pressure on the neck). A harness will distribute pressure across the back, shoulders and chest.


More Serious Breathing Problems:


Putting aside the breathing issues that are normal and daily occurrences, the Pug dog is vulnerable to some respiratory medical issues.


Stenotic Nares


This is not uncommon with brachycephalic, short-nosed dogs. This is a physical condition in which the dog's nostils are too narrow to allow for proper breathing. This is also referred to as pinched nostrils. It is a congenital trait which means that it is passed down genetically, however it cannot be bred out of the Pug due to facial structure that gives the Pug his unique appearance. For some, this can be noticed at birth, however many veterinarians recommend waiting on surgery because some Pugs outgrow this. Additionally, for some puppies, the nostrils may close off more during the teething phase but re-open enough for easy breathing once the pup's adult teeth have grown in. Due to the changes that can occur during puppyhood, surgery is usually only recommended for severe cases with Pug puppies.


The most common and noticeable sign that this is a problem is if the dog can breathe just fine through his mouth, but not his nose. When the Pug's mouth is open, breathing will be normal; when closed, he will gasp, grunt and struggle for air. If the nares do interfere with breathing at a moderate to high level and/or if the Pug has not outgrown this, the procedure to widen the nares and allow for better breathing is relatively simple. Small pieces of tissue on the wall of the nostril will be removed. There will be a few stitches and most dogs take approximately 1 week to heal.


Elongated Soft Palate


As with the above issue, this is also common to the Pug breed and is due mainly in fact to the facial structure of the dog. The soft palate is a flap of tissue that closes off the dog's airway when he swallows food or drinks water so that these elements are diverted to the stomach and do not enter the lungs. With this condition, it is too large and blocks off the normal breathing passages.


Signs of this include: Excessive snoring, excessive snorting, heavy panting, a tendency to only breathe through the mouth, resulting in the Pug frequently keeping his mouth open (which can lead to excessive drooling), vomiting or coughing during or after eating or drinking


In moderate to severe cases, this is corrected with a procedure that trims away excess tissue. For Pug dogs that have both elongate palates and stenotic nares, often both procedures can be performed at the same time. Most dogs do very well after the surgery as the airway is no longer obstructed and the dog can breathe normally.



Laryngeal Collapse 


·         Written by: Dr. Nicholas Trout

          Edited by: Dr. Theresa Welch Fossum


Laryngeal collapse develops when there is loss of the rigidity and support provided by the laryngeal cartilage (voicebox), causing the larynx to fold and collapse. When this occurs there is an obstruction that prevents normal movement of air into the trachea.

Laryngeal collapse usually occurs secondary to other long standing upper airway disorders, such as those seen in short-faced dogs like pugs, Boston terriers and English bulldogs. The chronic effect of difficulty "pushing and pulling" air through their deformed upper airways weakens, fatigues, and eventually deforms the cartilage. In rare instances the cartilage may fracture and collapse following trauma to the neck.

Most dogs with advanced upper airway disease are over two years of age, but occasionally this condition may be found in younger dogs. Both males and females are affected. 

Laryngeal collapse can result in severe respiratory distress, potentially leading to death.


What to Watch For

·  Difficulty breathing following direct trauma to the upper neck region

·  Increased effort or difficulty breathing, particularly in a dog with a history of upper respiratory problems



Initially, a diagnosis of upper airway obstruction is based upon a history of respiratory difficulty and a physical examination of your pet.

A thorough laryngeal evaluation is difficult and perhaps dangerous to perform when your pet is awake; general anesthesia is required for a thorough examination. Prior to anesthetizing your pet, blood may be obtained to determine his overall health. Additionally, chest radiographs (X-rays) may be performed to evaluate the heart and lungs. Radiographs of the neck may be helpful in traumatic cases of laryngeal collapse, since the cartilage may be mineralized and visible on an X-ray.

Assessment of the larynx is performed under light anesthesia. The diagnosis is made by direct visualization of the fleshy folds around the vocal cords being everted into the airway (everted laryngeal saccules), and/or a deviation and collapse of the cartilage of the larynx toward the midline.



Your dog may benefit from a weight loss program. Limiting the amount of exercise your pet gets will also be helpful. Keep your dog in a cool or air conditioned environment, particularly during the warm months of the year.

Some dogs get much worse when they become excited, so sedatives might be beneficial. 

Since laryngeal collapse is an anatomic abnormality of the upper airway, medical options are purely palliative. If the laryngeal collapse is associated with other upper airway problems, surgical correction of these conditions is recommended. Once laryngeal collapse occurs the prognosis becomes more guarded. 

Surgical resection of everted laryngeal saccules and abnormal folds of tissue around the epiglottis, the cartilage flap that flips up to protect the airway when swallowing food or water, can be performed when the degree of collapse is mild to moderate. In more severe cases, a permanent opening must be created in the trachea to allow air to by-pass the obstructed upper airway (permanent tracheostomy).


Home Care and Prevention

Since the surgical correction of various defects is performed through the mouth, there is no incision to monitor or sutures to be removed. Feed soft food and water for a week or so after the procedure. Avoid excitement or situations in which your dog will pant.
Following a permanent tracheostomy, the surgical site will need to be kept clean and free of debris. Stitches at a permanent tracheostomy site should be removed within 10 to 14 days after surgery.
The opening will need to be checked daily to ensure that it is not closing over and occluding the new airway. Your pet must NEVER swim since water would instantly be drawn into the lungs.
Laryngeal collapse, when it occurs secondary to chronic upper airway obstruction, should be a preventable disease. If the primary airway disorders are addressed in a timely fashion, that is before the dog is two years of age, it is normally possible to prevent the secondary changes in the laryngeal cartilages.
Sometimes, airway problems get overlooked in the brachycephalic breeds of dog because the owner thinks this is just how a pug or bulldog should sound. Have your pet checked regularly by your veterinarian particularly if airway noise becomes increased with moderate exercise or excitement or if your pet seems unable to exercise a reasonable amount. Excessive snoring and snorting is not normal and should be evaluated.

Once the later stages of laryngeal collapse have developed, correction of the primary problems (stenotic nares and elongated palete) will have very little benefit. 
Although there is a surgical option for the treatment of severe laryngeal collapse, the long-term management of the tracheal opening and the increased risk for aspiration pneumonia should not be forgotten. Your pet will be far happier preventing laryngeal collapse by fixing the underlying causes than dealing with a permanent tracheostomy after the fact.



Collapsing Trachea


The trachea (windpipe) is surrounded by rings of cartilage. This refers to a condition in which the rings break (collapse) inward. This can be quite painful and it causes breathing problems. It is thought that dogs may be predisposed to this, although it can also occur due to injury. In cases of injury this can happen when a Pug is walked on leash and collar. All pressure is put on the neck. Particularly in cases when the puppy or dog unexpectedly lunges forward or out to the side, damage to the airway can occur. For this reason, Pug owners are encouraged to prevent this by always using a harness, which distributes pressure evenly along the back, chest and shoulders of the dog.


Aside from having problems breathing another sign is coughing, often described as a whooping sound. A veterinarian will diagnose this via x-ray that will show the extent of the damage. For minor cases, treatment may include: rest, use of the harness, anti-inflammatory medicines, a reduction in exercise during warm/hot weather. For moderate to severe cases, surgery is often recommended and may be the only option to allow a Pug to be free of discomfort and to restore normal breathing.


Reverse Sneeze Syndrome


While not thought of as a disease process, reverse sneeze is the result of excess postnasal drip in the Pug. Reverse sneeze may be linked to allergies, though this has not been proven yet. There are very few Pugs that do not experience this syndrome at some point, and while the sound may be very frightning for a Pugs owner, revese sneeze syndrome is non-life threatening and can disappear as quickly as it comes.


A Pug experiencing reverse sneeze may initially look and sound as though he is choking, extending the neck and sometimes arching his back.  While in a normal sneeze there is the exhale of air, with a reverse sneeze the Pug is inhaling and accompanying this inhalation is a short, snorting noise that mimics or sounds like a deep cough or loud snore. Reverse sneeze episodes last from a few seconds to a minute or more and may spontaneously reoccur.


There is no treatment necessary for reverse sneeze syndrome. Pugs that have been diagnosed with allergies may benefit from an antihistamine to lessen postnasal drip. Many owners have found that placing their thumb over the nostrils, temporarily reducing the influx of air, reduces the severity and duration of the episode.


Other Conditions


Some other health conditions that can cause a Pug to have difficulties breathing range from allergies to respiratory infections. When in doubt about the noises your Pug makes or any signs of panting or breathing difficulties, owners are encouraged to obtain a diagnosis from an experienced and reputable veterinarian.

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