Ah for pugs' sake, let's get this sorted!

I love pugs.

I always have. They are cute, adorable, friendly and fun.

They make a great family pet, what a beautiful little personality they have. The good reputable pug breeders love their dogs and want only the best for them.

But there's a problem with pugs, one that I want to help bring to the attention of the general public and one that I want to get fixed.

What is this problem? Well it's as simple as this:

Pugs cannot breathe normally!

Many are so bad that they need surgery to be able to breathe with ease, with some even requiring a permanent hole in their throat so that they can breathe. And it's not the odd one that's born like this - it's nearly every single one of them.

My experience as a vet - 20 years of it - is that every single pug I have seen needed surgery (more of which further on) so that it could breathe with ease. Every single one. Not all of them had the surgery (some owners didn't believe me, some couldn't afford it) but as a vet who knows what I am talking about on this matter I am telling you now - all of them needed it.

That's just wrong. It has to be wrong that nearly all of a breed have such a problem that they need surgery to live comfortably. To breathe.

The reason for this is that the anatomy of their skull is such that their upper airways are 'squashed' into too small a space.

Have a look at these images of skulls of different breeds.

The skull of the Collie is a good example of what normal and healthy is - a nice long muzzle allowing the dog's airways to form correctly and therefore to be able breath properly, i.e. get air into and out of its lungs with ease.

Compare this to the Pug and French Bulldog.

You'll see that their muzzles are practically gone. (The technical term for the short muzzled/flat faced breeds is 'brachycephalic'.)

The result is that all the soft tissue structures that are meant to be in the muzzle are compressed into too small a space and squashed to a point of blocking the air coming in. Their nostrils are too narrow; their soft palate is too long and thick; the little bones in what there is of their muzzle are too large for the space that's there; their windpipe is narrowed. Often times their tongue is too big as well.

Because of this these lovely little dogs just cannot get enough air into their lungs without having to make extra efforts to pull this air through narrowed, partially obstructed and convoluted airways. It's like breathing through straws.

The technical term for this condition is Brachycephalic Obstructive Airway Syndrome (BOAS).

(A little science: Brachycephalic obstructive airway syndrome (BOAS) is a well-known combination of several upper airway abnormalities. These abnormalities may be defined as primary (stenotic nares, elongated and thick soft palate, excessive nasopharyngeal turbinates, and hypoplastic trachea) or secondary (mainly laryngeal collapse). Redundant and hypertrophied pharyngeal folds, macroglossia, laryngeal edema, enlarged tonsils, and bronchial collapse may also be present.)

So when these little dogs with BOAS breathe they sound like the dog in the video below. Click play and have a listen.

This is a completely abnormal way for a dog to sound when it breathes. It is a sign that they are struggling to get air into their lungs. It's no different than if you placed a hand over their mouth and nostrils and partially suffocated them.

Most pugs are like this.

Here's the problem: Because most pugs sound like this therefore some will say that this is 'normal' for this breed. Those most likely to say this is 'normal' are unfortunately those who own and breed these breeds. They love their dogs so can't admit there is a serious problem.

That is wrong, it is a perverse logic. It would be like saying because 90% people in a town are obese then it's normal to be obese, or because 90% of my 7 year old child's friends are obese then my morbidly obese child is fine.

Head in sand stuff.

The truth is that many pugs sound like this because so many of them are abnormally formed. They have a hereditary pathological medical condition (BOAS) that causes them to be born with obstructed airways and it is the forced passage of air through these abnormal and obstructed airways that causes the sounds they make. If their airways were normal - that is to say 'normal for a dog' - then they would not sound like this.

Dogs with normally constructed and healthy airways do not sound like this. Normal dogs - or indeed any animal - do not struggle for breath just walking around or sitting doing nothing.

Now this didn't happen by accident - it happened by design. Of course no one set out to design a breed that could not breathe, but what we - humans - did do was make a decision that we like the pugs with flatter faces and over the generations they were bred to look like that.

Have a look at this dog below - this was what pugs looked like in the early 19th century. Much longer muzzles and presumably, therefore, more able to breathe with ease.

The Modern Pug: An Anatomical Abomination?

However, as said, somewhere along the line humans decided that we would prefer them to have flatter faces (and also kinked, curly tails, more of which later). We liked the look of that. It became a kind of fashion.

People looking to buy them wanted the flatter face ones and would pay more for them. Only those with that flat face (and curly tails) would win shows. The combined result of this what that breeders - the vast majority of who were and are good, decent people who love their dogs dearly - bred the flattest face males with the flattest face females and produced litters of flatter faced little pups. They fulfilled public demand, they fulfilled the requirements of the kennel clubs and breed societies and their judges at the shows as only the flat faced ones with the curly tail would win the 'best in show'.

And on it went, the little dogs getting flatter faces as each generation went by until we ended up in today's situation, below.

Yes they were cute and yes they were wonderful little personalities and great little dogs. But the flatter the face the worse the breathing - so by starting out to 'design' a dog that looked a particular way we ended up, inadvertently, designing a dog that cannot breathe in a way dogs should be able to breathe. What a mess we made! As a vet this to me is an abomination.

Now this isn't the only breed that we made a mess of. There are others with inbuilt genetic problems that we as humans 'made' that cause health and welfare issues, but there aren't many breeds where such a high proportion are destined to suffer from birth in the way these extreme brachycephalic breeds are. Bulldogs are just as bad.

The poor pug, struggling for breath, my heart breaks

When I see a new little pug present to me, perhaps for its puppy vaccinations, and who I can see has this problem - which is just about all pugs I have ever seen - I have two separate reactions.

The dog lover in me - well my heart breaks. This poor little pup is destined for a life of struggle and I know that the lovely owners will be shocked and upset when I tell them what the problem is. They will have had no idea. They came in all happy for their puppy's shots, they are going to go out in a degree of shock. Or denial.

The vet in me - well, eventhough I want to change it so that in future these little pugs will be born able to breathe, I still have to do what's right for this little one in front of me so I advise that they go into the University Veterinary Hospital in UCD to be assessed for corrective surgery.

I have yet to have one pug referred back to me from the University Veterinary Hospital saying that it did not need surgery to help it breathe

Here's some plain facts:

  • I have advised referral to UCD for every pug (bar one*) I have seen since I took over Blacklion Pet Hospital Greystones in 2003.

  • Every pug whose owner has taken up may advice and gone in to UCD has been advised by the specialists to have the surgery done.

  • Every pug that has had the surgery has a vastly improved quality of life.

* The one I didn't send in to UCD for surgery, whose breathing was normal. I was over the moon and the owners were thrilled. But I found out a few months later he actually wasn't a pure-bred pug at all. He was a Pug-Jack Russell Cross (A 'Jug'). Here what he looked liked below. As well as healthy looking with a long muzzle and a normal tail, he's a very handsome little fella I think. But look again - does he look familiar? Have a look at him and then go back up and look at the 1800's pug!

Is this a Jug or is it just the same as an 1800's pug?

Is it right to do the surgery when it's needed? Yes, it is.

Have a look here at this little fella before and after surgery, and see that this dog's quality of life is revolutionised.

Yes, this dogs should have been operated on, it would be cruel not to help it. But this dog should never have been born like that. Whilst it is right that the surgery is done when needed, it is absolutely wrong that just about every pug needs it.

That situation is just plain wrong. An abomination.

Tech corner: The surgeries explained....

There are a few different surgical procedures that can be performed depending on the severity of the dogs. The videos below show some of the surgeries - widening of the nostrils and trimming of the soft palate.

This last one below is from a clinic in Spain and is about 9 minutes long. You'll see the dog before the surgery (struggling to breathe), the surgical procedures he had to go through, and then the vastly improved situation after the surgery.

If these don't work then a last ditch surgery is to essentially cut a permanent hole into the windpipe of the poor dog (a permanent tracheostomy). This guy below will have to breathe through this for life and whilst it did save his life it can cause all sorts of other medical problems. As well as not being able to bark. Ever again.

As I have already said: What a mess we have made!

Is this acceptable that nearly all of a breed needs surgery to help it breathe? Absolutely not.

Who in their right mind can argue against an idea that all dogs should be able to breathe easily?

Whilst no-one could argue against the last point unfortunately there are a lot of people worldwide, including some breeders and some in the breed societies and kennel clubs, who don't accept these dogs have a problem.

That - the denial - is actually is the nub of the problem we face.

These dogs have a problem - I've proved it above. Vets worldwide agree, as do welfare orgnisations and just about everyone else. But it's a problem made, facilitated and ignored by people - vets included, to be honest, who didn't speak up when they should have had - 40, 50, 60 years ago that we have all now inherited.

It's not the fault of the current pug owners and breeders that these dogs ended up like this. So there's no blame nor shame in accepting that there is a problem, it actually shows responsibility and love for this breed to accept the problem and then work on fixing it, making up now for the unintended failings of a less enlightened age.

What now? Is there any hope?

Yes there's a problem but it's an eminently fixable problem. We have a responsibility and chance to fix this but we also have an initial moral and ethical obligation to recognise the problem and to own it. Once we own the problem then it can be fixed.

Veterinary Ireland has a policy goal:

"Within a decade all pugs born in Ireland will be able to breathe with ease and without need for corrective surgery"

It's an ambitious goal and one that poses a real challenge. But we are a small country and the advantage of a small country is that we can initiate change much faster and be more nimble. Us Irish also have a way of just getting to the point and putting a solution in place before many others would even have sat down for their coffee! We don't need years of enquiries and working groups and reports, we are well able to use common sense to find a workable solution to achieve a worthwhile and achievable end result in a reasonable time-frame.

We can lead the world on this. We can stand out proud and show the world that the Irish Pug is the best pug, the happiest pug and the healthiest pug in the world. Our pugs can be the envy of the world, they'll be sought worldover to introduce new blood into other countries' genetic pool. And it will be the irish pug owners and breeders who will take the plaudits and reap the rewards.

Importantly doing this does not mean we have to change the breed beyond recognition. They will, can and indeed must stay as the pugs we love. They will keep their sturdy little bodies and their great little personalities. They will just have a slightly longer - more normal (for a dog) - muzzle.

As an example have a look at this little fella on the left below and compare him to the flatter faced one on the right. This guy on the left is the sort of pug we could end up with if we decided that's what we want. I just can't see a reason not to do it. Apart from knowing he is healthier and happier I think he also looks a hell of a lot more handsome!

What can you do?

First thing is don't buy a pug unless they have longer faces and can breathe normally. Look at the parents and if they look like the one on the left above then go for it. If they look like the one on the right then walk away. If the public doesn't buy the dogs with breathing difficulties and will only buy those that are correctly formed then the breeders will change to meet the new demand.

We also hope the Irish Kennel Club and the Irish Pug Dog Club will engage with the vets on this and indeed hope that they take the lead.

I note that the first line on the Irish Pug Dogs Club's page on ethics:

"I shall breed in accordance with the breed standard. I shall not knowingly breed or sell a dog with health problems."

In addition I note on the home page of the Irish Kennel Club website it says:

"Dedicated to protecting and promoting the health and welfare of all dogs.”

Putting these two laudable pledges together it's clear that there is already a commitment by the good breeders to own, address and find a solution for these lovely little dogs. It's now time to act on that commitment.

Let's work to amend the breed standard a little so that only those with longer muzzles (and non-kinked tails - as kinked tails are linked to a serious problem called hemivertebrae which causes severe deformity of the spine) are scored highly in shows.

(As an aside, see below the spine of a dog with hemivertebrae - we can get rid of this problem at the same time.)

The shorter, flatter faces and kinked tails should be heavily penalised in shows. Indeed should these traits not be be reason for disqualification?

There should be a vet check done in advance of any shows and any dog that cannot breathe normally or who has a kinked tail/hemivertebrae should not be permitted to be shown (nor indeed bred from). Of course any pug that had has surgery to help its breathing should not be shown (and also should not be bred from).

If we do this we can achieve our aim that by 2026 all pugs born in Ireland from then on will have a slightly different shaped muzzle and can therefore breathe easier. This in turn will ensure the breeders can be sure that they can abide by their excellent commitments above and that can be confident that every dog they breed with and every pup they sell will not be suffering from the current health problems that can afflict this breed.

The Good, The Bad, The Law

I do though share and agree with the concerns raised by the many good, responsible and ethical breeders, and the Kennel Clubs on these islands, who want to address these issues but who are being undermined by other so-called 'breeders' (I prefer to call them 'churners') who care for nothing other than churning out what they consider as 'products' that they can sell to the unsuspecting public for as much profit as possible.

These 'bad breeders' have to be stopped and this is where government comes in. It's all very well having laudable codes of practice and strong statements from national veterinary and welfare orgnisations, but without enforcement it really makes little difference on the ground.

Commercial breeders have to be more stringently regulated in general - this will protect the good ones from the bad ones as well as of course protecting animal health and welfare - but specifically in this case there is the possibility of using our excellent Animal Health and Welfare Act to prevent these 'bad-breeders' from continuing to reproduce with dogs with these genetic deformities.

Section 11 of the Animal Health and Welfare Act 2013 states:

11.—(1) A person who has a protected animal in his or her possession or under his or her control shall, having regard to the animal’s nature, type, species, breed, development, adaptation, domestication, physiological and behavioural needs and environment, and in accordance with established experience and scientific knowledge, take all necessary steps to ensure that—

(a) the animal is kept and treated in a manner that—

(i) safeguards the health and welfare of the animal, and (ii) does not threaten the health or welfare of the animal or another animal

Could it not be argued that to breed with a dog that cannot breathe normally, or who has hemivertebrae, is in contravention of this section (as breeding a dog that cannot breathe normally, due to it genetics, directly threatens the health of another animal (ie the progeny))?

If that was the case - would an Animal Health and Welfare Officer not have it within his/her authority (having come to the conclusion that an individual dog, due to its genetics, was so severely physically compromised to a point that it is suffering, that to breed with it would threaten its progeny's health and welfare to such an extent that doing so would be in contravention of Section 11) to serve a dog’s owner with an Animal Health and Welfare Notice (by the authority granted by Section 42 of the Act) ordering that the dog must not be bred from?

Let's hope that the problem could be sorted without need to take recourse to the law. But if the problem is not being sorted - if the good breeders' good work is being undermined by a cohort of other 'bad-breeders' who care not a whit about the health and welfare of their animals, then why not consider using the law? That would surely put us top of the world league in terms of willingness of government to tackle an issue such as this in an imaginative and decisive manner.

I gave a presentation on the pug issue at the 2015 Animal Welfare Forum in Farmleigh House, convened by the them Minister for Agriculture Simon Coveney. The Minister said he agreed with our opinion on this matter so let's hope that government support will be forthcoming, be in in terms of legislation or otherwise, if it is needed.

So come on, let's get together and get the pug sorted out!

We - good vets, good breeders, good owners - all want the same thing: Happy, lovely healthy little dogs, recognisable as the little pug we all adore. I love pugs, vets love pugs, they are the most lovely of little dogs you can get. We love them so much that we want to help make the future pugs a little happier and healthier and so that they don't need our medical help as much.

We hope the breeders can see that we are on their side. We want to work with them, we want to help them.

We know that their love and concern for their dogs is only matched by our desire to never have to do these airway surgeries on their little dogs. We only do them because we want to make the little one in front of us more comfortable but the truth is that we want these surgical procedures rendered redundant, into the dustbin of history. We want it so that they will never need to be done.

We love pugs. So come on, let's get the pug sorted out.

Dr Alan Rossiter MVB is the Senior Veterinary Surgeon in Blacklion Pet Hospital Greystones and is a Past-President of Veterinary Ireland.

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