Top 10 Pug Health Problems to Look Out For

1. Introduction

Caring for a pug involves being aware of their distinctive health issues. Since pugs snore, cough, sneeze, and snort more than other dog breeds due to their pushed-in noses, they have distinct health difficulties that require attention. Although you won't be able to stop your pug's health issues as a pet owner, knowing about these potential health issues may help you better care for your pet. Pay extra attention to any of the following symptoms in your pug. Some illnesses are more common in pugs than in other breeds or in dogs in general, whereas others are distinct to pugs. Pugs need their own veterinarians, just like people do. The pug is a distinct breed, and dog owners must be aware of the risks special to pugs.

Pugs have large, expressive eyes, but one of the pug's most hazardous health hazards is eye injuries. In addition to being susceptible to significant injuries from smashed eyeballs, pugs are also susceptible to degenerative eye disorders as they age. Pug puppies and adults of this breed may experience malformations of the eyeball. Inflammation of the cornea that may go unnoticed is a frequent illness and can quickly form abscesses, which can result in total eye and sight loss in one or both eyes if such an abscess is allowed to develop and worsen. Stay on the lookout for signs of eye problems. Due to the folds of skin on the pug, bacteria and debris might be retained, paving the way for infections.

1.1. Purpose of the Guide

The purpose of this guide is to provide pug dog owners with a resource to educate them on the most common health problems that pugs face. By understanding the risks associated with pug health, owners can take steps to prevent future problems and react quickly when medical intervention is necessary. This enables owners to make informed health decisions and provide the best care possible. As with all animals, regular health check-ups with a vet are important in order to be vigilant for these physical problems. The sooner we know, the better opportunity we have to manage or treat the situation. Certain pug health problems may be genetic, but it is still a conversation that needs to be had within the pug community. My hope is that the more we discuss, the more we will find better ways to solve these health issues within our pug world to give our pugs healthy and happy lives, which are something we all value more than anything. Among the health problems to look out for, there are four health problems that have shown to pop up frequently. These health problems will be discussed within this resource. It is important to note that these health issues are concerning for the breed, and it is at the discretion of the pug breeder to look at the information presented along with other various research or data.

1.2. Why Pug Health is Important

Pug health is a topic folks don’t want to think about, but every popular breed of dog has its health problems, and the Pug is no exception. Pugs are a breed with some very unique anatomical features, and these features come with some insurance policy caveats. In fact, many of the maladies that affect Pugs could be said to have a largely anatomical basis. But our primary concern is helping Pugs to maintain and enjoy their Pugsyness. Drawing attention to specific Pug health problems is not about grooming a breed’s reputation but about concerns for a breed’s individual members. Every breed has its health problems; this is not an anomaly. As Pug caretakers, there is no greater tribute to our dogs than to be aware of the challenges they face and diligent about their lifelong welfare. We are the caretakers of a living, breathing breed that enjoyed the favors of royalty and the adulation of tens of millions of owners over several centuries, and a breed that we want to pass on to a happy future. Ideally, you will find exactly the right Pug from conscientious breeders who will discuss the health history of their breed line and be willing to report on results of any screening they do today, to help you ensure that your new buddy has the very best claim shipshape. As the caretaker of a Pug or Pug family, you know your own Pug(s) the very best, so definitely do ask these questions before getting a new addition to the family. Every share someone cares enough to ask probably saves a dog.

2. Brachycephalic Obstructive Airway Syndrome (BOAS)

Brachycephalic Obstructive Airway Syndrome (BOAS) is a broad term used to describe a combination of respiratory problems experienced by dogs with a short head and 'pushed in face.' The physical changes to the head and face reduce the size of the nasal passages and lead to difficulty breathing. BOAS occurs because pugs have a shorter muzzle than the breed's long-muzzled cousins and relatives. BOAS signs include noisy or labored breathing, snoring, exercise intolerance, and overheating. Dogs can also cough in an attempt to ease their discomfort. Treatment for BOAS in pugs may include anti-inflammatory drugs to decrease snoring. Severe cases may benefit from surgery to open up the nostrils and shorten the soft palate, which is the fleshy part at the back of the throat that hangs down and causes difficulty when it is too long. Sedative drugs and steroids are given to open airway passages for those dogs who are so compromised in breathing and require emergency surgical help. It is important when buying a pug puppy to ensure their parents and grandparents have been health tested clear of BOAS to reduce their risk of getting it as well. When treating a dog with BOAS, it is essential to encourage slow, steady growth and maintain a lean body weight by feeding a balanced diet designed to prevent the condition. This can include restricting exercise during hot, humid days to reduce their exercise duration and intensity. Providing access to clean, fresh water, medication to reduce inflammation in their airway passages, and steroids given in an emergency in the event of difficulty in breathing. Recurrent removal of their allergies will also provide some relief. Owners must never go ahead and put their dogs under water trials and games that involve underwater swimming, which can be very dangerous and fatal, making it hard for them to regulate their temperature. Also, avoid inflatable tubes for pugs, thinking it will make them good swimmer dogs; recent deaths have been reported.

2.1. Causes and Symptoms

The shortened face and nose are one of the defining features of pugs. Unfortunately, this anatomical structure leaves them predisposed to difficult and noisy breathing. Brachycephalic obstructive airway syndrome (BOAS) is the collective term used to describe the five essential airway issues seen in pugs, although they can occur in isolation as well. The most common causes include narrow nostrils that do not allow free airflow into the nose, soft tissue that blocks the passage of air into the windpipe and lungs, and a long soft tissue mass inside the windpipe itself. The deeper in the airways these problems are, the more serious they can be, and the more likely they are to result in severe, non-infectious, permanent changes to the structure of the internal airway. Furthermore, the angle of the cranium to the spinal cord can add to these issues.

The symptoms of BOAS—hemming and hawing are often how a vet will describe it—occur when the dog breathes in and can be as pronounced as snorting, the apparent suffocation of sleep apnea, a generally noisy breathing soundtrack, or coughing as the dog struggles to sniff in the air. Often, any sign of distress seems to be proportional to the level of activity. Anyone who notes symptoms similar to this or has to breathe especially deeply or quickly after light activity, especially during the spring and summer months, should consult a vet for a potential diagnosis. Regular check-ups to catch the condition early and understanding potential changes in care and treatment for the day-to-day management of your pet and any potential litter are key.

2.2. Prevention and Treatment

Because brachycephalic dogs already breathe semi-hard (as opposed to brachycephalic dogs, or BOAS, who breathe hard). Therefore, it is urgent to avoid everything that increases the load and not to increase the load with food. The point is the weight; a fat pug will breathe heavier than a normal pug. However, since metabolism is different for everyone, even lean pugs can suck more oxygen than the normal pug. Therefore, if your pug is not fat but still has a problem, contact a veterinarian directly. Also, strenuous exercise sends the signal to the body that it wants more oxygen, so keep it moderate and keep it in a state that does not get too excited.

It is said to have a persistent nature, but how many percent is it maintained? How can it be checked? Thanks, as BOAS is widespread among pugs now. The veterinarian has tested tidal volume, which is the amount of air that enters the lungs during normal breathing. It should expand during normal breathing for a greater chance. If not, there is a big wall making it more difficult to get oxygen, and exercise is needed. The only pugs that need surgery should be released to do better. Treatment differs depending on the severity of the symptoms. Some pugs only need a little rest, while others require surgery. But what's important for all BOAS pugs is to change your lifestyle. If your pug is diagnosed with BOAS, don't worry right away; lifestyle changes can help restore the pug's breath, energy, or expression. It is better to ask a veterinarian for a treatment plan that suits your pug.

3. Skin Fold Dermatitis

Skin Fold Dermatitis. Because of their smushed faces, skin fold dermatitis is all too common in these dogs. This health problem appears when pug skin folds trap moisture and develop bacteria. Since bacteria thrive in warm, moist environments, pugs' facial wrinkles and folds are breeding grounds for infections and inflammation. The skin of the pug is already more prone to irritation and allergies, and the skin folds of the pugs already have oils. If you don't stay on top of managing this dermatitis, this condition of the skin can worsen and result in significant skin infections.

Causes - The pug shape, which results in skin folds, is the primary reason. Symptoms—what does it look like? Every pug owner who knows what skin fold dermatitis is and changes in skin would notice symptoms, including redness, discomfort, or swelling in the folds. And like many skin problems, there could be rashes or any kind of allergic reaction in the folds. Some may have a little discharge of wax or a foul odor from the fold, which is especially the case when yeast is involved. Usually, normal skin yeast inhabits the skin and ears of dogs, but systemic problems can change the balance of yeast overgrowth. Cysts and cutaneous lipomas elsewhere on the skin can develop under the skin folds in the face, although they may still act like any other skin infection or allergic reaction. If you notice any skin folds, you'll want to tell the veterinarian about them in particular and give them a thorough description. Keep the pug clean and dry - If we keep the folds dry and clean, it's a good strategy to avoid dermatitis of the skin fold. In order to prevent small amounts of bacteria and fungi, it may have to build up in the skin.

3.1. Causes and Symptoms

Pug dogs, like other breeds with skin folds, are more likely to develop a condition called skin fold dermatitis. This is usually in the folds of skin around the face, neck, and inside the legs which are held against the body. Such folds provide a dark and moist environment that supports the growth of bacteria. Clinical signs are more likely to develop if the dog is frequently exposed to moisture, lives in a hot and humid climate, or has skin folds that are not cleaned and lubricated regularly. Tightly compressed skin folds or skin folds that are not well separated can also trap moisture and debris. As a result, this condition is more commonly found in brachycephalic breeds with very short noses or very wrinkled skin.

Predisposing factors causing skin fold dermatitis in pugs include high temperatures and humidity, immature immune systems, irritants, trauma, hormonal disease, viral disease, and allergies. Owners should maintain a clean, dry, and well-lubricated coat to prevent skin infections. This should include cleaning between any skin folds, washing with a mild pet shampoo, and using a conditioning rinse or spray to keep the skin moist. Any allergies diagnosed should be managed with a combination of anti-inflammatories or immunomodulators and allergen-specific immunotherapy. There are signs of wetness, swelling, reddening, or discharge associated with a bad odor coming from the skin folds. This discomfort causes the dog to lick or scratch at the skin. Long-term dermatitis can lead to discoloration, thickening, or what is called hyperpigmentation in this tissue due to inflammation. By addressing nutrition, cleaning, and the causes, we can help improve skin health.

3.2. Prevention and Treatment

Prevention:

Regular cleaning of skin folds is recommended. The use of a good quality, gentle, non-irritating cleanser is ideal. The skin folds need to be dried thoroughly after washing to help reduce skin fold moisture.

Treatment:

If skin fold dermatitis is present, prompt veterinary attention is warranted. Topical medications such as medicated shampoos, wipes, or topicals for inflammation can be prescribed. Topical medications to help control skin fold bacterial and yeast populations can also be useful. In severe or recurring situations, surgical resection of deep skin folds can be considered. When skin fold care and prevention are accomplished regularly, this disease can be effectively controlled and pets can remain comfortable and free of irritation.

4. Hip Dysplasia

Hip dysplasia is an inherited condition affecting the hip joints of pugs in varying age ranges. It results from malformation of the joint, leading to problems such as osteoarthritis and disrupting the hip joint's ability to support the normal movement of the pug. Hip dysplasia significantly impacts these dogs, causing pain and reducing their physical abilities. Where owners are vigilant and seek veterinary intervention, hip dysplasia in pugs can be managed and the painful symptoms treated, which may make a significant difference to the pet's quality of life in the long term.
The causes of hip dysplasia include genetics and environmental factors. Where both parents are carriers of the genes for the condition, the risk of affected offspring is much higher than in the general population. This is why purchasing a puppy from health-screened parents is so important and is a cornerstone of responsible breeding practices. Early-onset hip dysplasia can be identified as soon as the pug is old enough to go on walks, while the signs of late-onset dysplasia usually become apparent in middle age. Symptoms are varied but include pain when exercising, stiffness in the rear legs, audible clicking from the hips, lameness or an unusual way of walking, and a reluctance to play or be active.
Vague symptoms such as limping or signs of discomfort when walking may also be noted, so hip dysplasia can be hard to recognize, yet it frequently becomes a serious problem if untreated. The condition can be managed with medication and pain control, and surgery may be in order for severe cases. While there isn't a cure, management should help the pug remain relatively pain-free throughout its life. Considering that hip dysplasia in pugs can become severe or even result in the necessity for euthanasia, it is important that pug owners understand the risks of the condition and possible options for ongoing care and support.

4.1. Causes and Symptoms

Hip dysplasia in pugs is due to an enlarged acetabular rim, which is a hereditary condition and is often bilateral (i.e., both hips are affected). What this means is that before the dog has stopped growing, the hip is not developing, and this causes mechanical changes in the joint and inflammation. Diagnosis of this condition is an X-ray of the hip joint. Because the disease is a loose hip joint, it is possible that the dog can still be sound but later develop inflammation and arthritis throughout the joint. Therefore, even when a dog’s hip X-rays are perfectly normal, it is advisable to keep pugs lean and not let them get overweight, don’t let them eat anything but a normal feed, and make sure they have enough exercise, but not too much exercise, especially not when they are under 1 year of age. Please consult with your veterinarian to see how you can look after your miniature dog appropriately.

A sign of hip or elbow issues is that the dog will develop stiffness when it starts walking after lying down or sunbathing for some time. This is usually “stiffness that walks itself out.” After a short while, the dog isn't stiff anymore. At home, hip dysplasia-affected dogs are generally stiff after a nap and sometimes yelp when they rise. As the problem increases, these dogs can even have trouble standing and walking for an extra few minutes. Dogs with this affliction may limp at first, but after a little while, the limp goes away.

Pain comes from the lower back or from the thighs. Another reason for dogs to not want to stand or lean on their hind legs anymore is arthritis in the carpus or elbow. Because arthritis is a bone deformation caused by deterioration in the bone, a crooked gait can sometimes be distinguished, as well as an inflamed toe. Your vet can do a few simple tests to determine hip and elbow degeneration. Give him a hip evaluation available at your nurturing facility at dog shows or at your vet. Inoculation, medication, and vitamins can help to some extent, but it is sometimes crucial to put these dogs on adequate pain relief or anti-inflammatory drugs to keep them comfortable. For larger animals in particular, surgery is often the only feasible treatment. If you are worried that your dog has weakness or cramps in its or her back or hind legs, get in touch with your vet.

4.2. Prevention and Treatment

If your dog was diagnosed with hip dysplasia, the importance of its treatment and further prevention cannot be underestimated. The earlier you look for proper treatment, the more likely it is for your pug to remain mobile. Hip dysplasia is usually the result of genetic predisposition, which is why breeders have to use responsible breeding practices that would exclude from breeding the dogs that suffer from hip dysplasia. The first thing you can do is to keep your dog fit and healthy by maintaining its weight at the required level, having a nutritionally balanced diet, and regular exercise that wouldn't put pressure on a dog's joints.

What's more, avoiding activities that require a dog to jump during the first year of life is crucial to prevent joint damage that can lead to hip dysplasia. Regular and low-impact exercises like walking or swimming improve joint health. Dogs shouldn't be overexercised, as this can result in additional problems and further worsen hip dysplasia. The treatment varies depending on the severity of a dog's condition. Dogs with mild conditions will benefit from a few options like good nutrition and dietary supplements, physiotherapy, and chondroprotective agents that offer protection against arthritis. More severe cases require pharmacological treatment that will center on pain relief. In some cases, surgery might be necessary. Your vet will advise you on how to perform regular check-ups, as some treatments might not be required if a dog's condition doesn't deteriorate. To sum up, if you've got your dog diagnosed, it's very important you're aware of the situation. You should also avoid activities that result in further damage. If your dogs are bred, you need to check for it as well. You need to think about a maintenance program that will help your dog retain normal function.

5. Eye Problems

The inherent facial structure of pugs also makes them more prone to a wide range of eye problems. The pug's big eyes are highly susceptible to a number of ocular disorders and diseases, many of which might even cause severe visual impairment if left untreated for a long time. Here are some of the common eye diseases pugs are predisposed to:

1. Corneal ulcers: Scratches, anomalies in eyelid or tear production, etc. could all lead to shallow or deep corneal ulcers. If they occur near the dog’s pupils, ulcers could cause excess tearing and light aversion. The eye might also appear bloodshot. In extremely severe instances, corneal ulcers might render a pug blind. 2. Dry eye: When the glands responsible for tear production fail, dry eye or keratoconjunctivitis sicca sets in. This could lead to itching, discomfort, and infection, culminating in inflammation and often, blindness. 3. Progressive retinal atrophy: A degenerative disease in the pug’s cone cells might eventually render your pet blind. Sadly, there is no cure for this disease. 4. Distichiasis: Distichiae are extra eyelashes that grow on the inner eyelid layer and cause intense sensitivity and discomfort. In extreme cases, removing some eyelashes might be the treatment option. Of course, regular check-ins with the vet could also mean you’re just worrying over nothing - in a good way. Normal and routine eye diseases and conditions such as discoloration due to aging and mild inflammation tend to get misdiagnosed as much more serious problems by pet parents. That said, the importance of frequent vet visits doesn’t mean pets can fend for themselves. Keep an eye out for slight puffiness, bloodshot corneas, or yellow or green secretions. Avoid using your fingers. Instead, dab a clean dry cloth. Also, when cleaning their eyes, it’s always best to use a moisturized cloth with a pH-balanced special formula to avoid irritating their eyes. Scents can also be offensive for them. The key to less frequent issues and a happier pug is top-notch primary care. Taking good care of their eyes helps stave off issues early.

5.1. Corneal Ulcers

Corneal ulcers are a severe health issue that pug owners should be on the lookout for. A corneal ulcer arises when the corneal surface is damaged, thus allowing the underlying layers to be affected. Damage leading to corneal ulcers often results from foreign bodies, like dust and hair, that cause an eye infection. Persons with bulging eyes are at risk, ending up with the cornea scratching the inside of the eyelid. Corneal ulcers are very painful, so you may notice your pug excessively blinking or weeping. Clouding over the eye may also be visible, signifying that the cornea is not as clear as healthy. It is essential to seek immediate veterinary assistance if you suspect your pug has a corneal ulcer, as ulcers can lead to loss of sight or loss of the eye. Treatment may include medications or surgery, depending on the severity of the ulcer. Corneal ulcers result from injury, extreme irritation, inflammation, or infection of the cornea and the uveal tract, causing the corneal epithelial layers to abrade, leading to a reduction of vision. Treatment with eye drops can aid the healing through natural encouragement and avoiding infection and scarring. Regrettably, as a comprehensive medical treatment will not work in all of those ulcers, surgical treatment may also be suggested by a hospital. There are a few breeds of dogs, such as pugs, that may not be self-renewing fast enough, particularly when the stromal layers are infected. Since a variety of potential causes may produce a corneal ulcer, a thorough ophthalmic examination is required to identify the cause in order to handle the root cause. To safeguard against corneal ulcers, it is always advisable for patients to have their eyes examined on a regular basis.

5.2. Entropion and Ectropion

Entropion and ectropion are two significant eyelid conditions that can affect pugs. Both of these conditions affect the anatomical positioning of the eyelids, which can lead to ocular discomfort and potential vision problems. Entropion occurs when a portion of the eyelid is malpositioned and rolls or folds inward in such a way that portions of the skin and hair are rubbing up against the corneal surface. Ectropion, on the other hand, occurs when the lower eyelid margin is turned outward away from the globe, leaving the ocular surface exposed and the tear film underproducing for proper ocular lubrication.

The phrase 'pug dog eye' is often used to describe this constellation of conditions, but this must not be confused with other serious and more chronic conditions. For example, entropion can cause excessive tearing, squinting, and sensitivity to light. Dogs suffering from the condition have to make the extra effort to keep their eye closed, which can result in recurring corneal ulcerations. Once an ulcer has formed on the cornea, topical medications and often surgical correction are both necessary to assure a full recovery. Ectropion, in comparison to entropion, causes excessive tearing, squinting, and redness. It can also lead to recurrent ocular surface infections if left unattended, such as conjunctivitis and keratitis. Vigilant dog owners need to be on the lookout for these deviations and get veterinary care before conditions become overly problematic for their pet. Opting for a prophylactic surgical procedure can prevent entropion and ectropion from becoming major issues for pugs.

6. Dental Issues

Along with respiratory issues, dental problems can also be a concern for pugs, as a result of the breed's brachycephalic skull shape. This term means "short-muzzled," referring to the breed's facial structure being relatively compact from tip to back of the head. Dogs in general, and pugs in particular, are also prone to plaque and tartar buildup. Over time, this can lead to serious infections. The back teeth are particularly prone to tooth infections that can spread to the sinuses. Chronic dental pain can cause your pug to avoid food. Your dog may show a preference for soft over hard food. Any infection in the mouth can theoretically spread throughout the body. Unhealthy gums allow bacteria from the infection to circulate around the body. Your dog's body will attempt to control the excess of these bacteria with white blood cells. This increases your companion's systemic inflammation over time. Being a brachycephalic breed, pugs tend to have crowded or missing teeth. Obvious symptoms of dental disease in pugs include the common symptoms shown by dogs in general with similar oral health issues. Bad breath is a common sign of tooth decay. This is especially noticeable in conjunction with some obvious behavior changes during eating. Affected dogs often have trouble trying to eat or drink. They may leave food as if they are "full." Chewing treats on one side of the mouth is a noticeable habit. Mouth chewing is a common sign pets are trying to readjust their bite. Chewing on one side can be either a temporary or long-term movement designed to avoid a particular tooth region.

6.1. Plaque and Tartar Build-Up

When dogs eat, food particles can get stuck between the teeth and on the surface of the teeth. When a dog eats, the particles get wet, creating the perfect condition for a bacterial infection. The bacteria mix with the saliva and food particles and turn into plaque, which adheres to the teeth. Anything the dog eats adds to the plaque in layers. If not removed, the dog's own saliva hardens the plaque into tartar or calculus.

The plaque comes off the teeth, and the tartar is typically located under the gum line, i.e., partly hidden. The tartar buildup can push the gums away and cause them to swell. The bacteria penetrate deeper, and plaque forms under the swollen gums. The teeth may even become loose. This condition is painful. Along with red, swollen gums and bad breath, a dog with gum disease may refuse to eat, drop food out of its mouth, and paw at its face. Once plaque hardens into tartar, only a veterinary hygienist can remove it. Left untreated, tartar buildup can lead to gum disease, tooth invasion, and even heart, liver, or kidney problems. Daily brushing can control plaque. See your veterinarian or veterinary hygienist regularly to have your dog's mouth cleaned in difficult cases or before serious problems appear. If you do not brush your dog’s teeth, its mouth will smell. Only dry biscuits do a minimal job of removing plaque above the gum line. Many dogs have periodontal disease by age three years.

6.2. Periodontal Disease

Periodontal disease is a severe dental concern for pugs. This disease sees a progression from the inflammation of a dog’s gums to attacking the supportive structures of the teeth. It starts with the onset of plaque and, over time, will harden into tartar if left untreated. As it advances, the gums begin to pull away from the teeth, causing pockets that can trap additional debris and discoloration of the teeth. Further still, the gum tissue will start to become eroded, leaving notably loose teeth. This disease can lead to a wide range of problems, including infections that can damage the liver and kidneys. There is often little that can be done in the way of reversal of periodontal disease. Instead, it must more or less be managed to the best of the veterinarian’s ability. This may involve extraction of one or more teeth in advanced cases. Some degree of professional cleaning is often required for milder stages of the disease. Regular veterinary dental care will need to be a priority in the life of a pug that develops periodontal disease.

Symptoms of periodontal disease include obvious bad breath, difficulty eating harder kibble, excessive drooling, inflamed gums, discolored deposits of tartar visible on the teeth, and signs that the pug is clearly in pain. The severity of the problem will depend on the pug, but any dog is likely to experience some discomfort due to this illness. Fortunately, owners can take some steps to prevent or mitigate the symptoms of periodontal disease. Daily brushings can be a game-changer in the lives of pugs and can mitigate the severity of periodontal disease. A range of excellent dog products, such as specialized dental chews, can also help to scrape away plaque. Genetic and environmental factors also play a role in the development of periodontal disease. The illness might arise if a pug is not getting the proper oral care. The dog will require sufficient daily blood flow to sweep away all acids and toxins in the mouth. A proper diet and exercise are vital for the stimulation of healthy gums. Owners can also enroll in regular veterinary dental care to monitor issues in the early stages and approach them in an effective, affordable manner. Pugs become vulnerable to a range of developmental hazards without intervention. Preventative care can potentially spare a pug from more serious illness and thus enhance its quality of life.

References:

O’Neill, D.G., Sahota, J., Brodbelt, D.C., Church, D.B., Packer, R.M. and Pegram, C., 2022. Health of Pug dogs in the UK: disorder predispositions and protections. Canine Medicine and Genetics, 9(1), p.4. springer.com

Sebbag, L. & Sanchez, R. F., 2023. The pandemic of ocular surface disease in brachycephalic dogs: The brachycephalic ocular syndrome. Veterinary Ophthalmology. wiley.com

Sahr, S., Dietrich, A., & Oechtering, G., 2021. Evaluating malformations of the lacrimal drainage system in brachycephalic dog breeds: a comparative computed tomography analysis. Plos one. plos.org

Mach, R., Wiegel, P.S., Bach, J.P., Beyerbach, M., Kreienbrock, L. and Nolte, I., 2022. Evaluation of a treadmill-based submaximal fitness test in pugs, and collecting breed-specific information on brachycephalic obstructive airway syndrome. Animals, 12(12), p.1585. mdpi.com

Wiegel, P. S., Nolte, I., Mach, R., Freise, F., & Bach, J. P., 2022. Reference ranges for standard-echocardiography in pugs and impact of clinical severity of Brachycephalic Obstructive Airway Syndrome (BOAS) on …. BMC veterinary research. springer.com