Ask A Vet Online – Help, I’ve got a stuffy-nosed Pug!


Natalie Kent asked:

My 8 year old pug has just been diagnosed with Pseudomonas in his nose. He’s been having problems with his nose for about a year,   discharge, blocked up etc. Vet did a nose swab and found this bacteria. He’s been on marbocyl antibiotics for 2 weeks and it’s not       completely gone away, still a bit of discharge and a bit stuffy but vet refuses to give any more tablets, what else would you suggest?


Hi Natalie, thanks for your question. Because of the conformation of their skull and nasal passages, Pugs are prone to a range of different breathing problems, and may suffer from recurrent nasal infections, so I’ll start by discussing the anatomy of the nasal passages and the defects Pugs typically suffer from. Pseudomonas is a particularly nasty bacterium that can be very difficult to treat effectively, so I’ll also talk about appropriate antibiotic therapy and the reasons why the symptoms may not have resolved. Finally, I’ll look at different ways forward for your dog.

What is the “normal” anatomy of a dog’s nose and airway?

When a dog breathes in, the air flows through the nostrils (also known as the “nares”) into the nasal chambers. The left and right sides are separated by a dividing wall (the “nasal septum”) so what affects one side doesn’t always reach the other; and they are separated from the mouth by the bone of the hard palate (the ridged roof of the mouth). These chambers aren’t open – they are almost filled with scrolls or swirls of bone called the conchae (because they look a bit like sea shells), leaving only a narrow space in between for air to flow. This is important because even a small amount of fluid or swelling of the tissues here can make a dog very congested and uncomfortable.

Behind these 2 chambers is a common space where left and right nasal chambers meet called the nasopharynx; the floor of this is made up of a strong muscular band called the soft palate. When breathing, the soft palate prevents food from entering the nasal passages. The air then flows through the larynx (voicebox), down the trachea (windpipe) and into the lungs.

Opening out of the airways in the skull are the sinuses; these are hollow spaces inside the bone that make the head lighter and easier for the dog to carry around. There are 2 sets – on each side of the skull is a frontal sinus (in the forehead) and maxillary sinus (in the upper jaw, just above the tooth roots).

So what’s different about pugs?

Dogs can be divided into 3 different groups of breeds, based on their skull shape:

  • Dolichocephalic – dogs with long noses, e.g. Greyhounds
  • Mesocephalic (also known as mesaticephalic) – dogs with medium noses (most dogs, e.g. Labradors)
  • Brachycephalic – dogs with short noses (e.g. Pugs).

As one of the most extreme brachycephalic breeds, Pugs almost always suffer from some degree of Brachycephalic Airway Obstruction Syndrome. This is a condition caused by selective breeding over many generations for an abnormally short skull, and includes a range of conditions such as:

  • Nostril Stenosis – narrowing of the nostrils.
  • Elongated Soft Palate – over-long soft palate that blocks the airway.
  • Everted Laryngeal Saccules – folds of flesh that stick out into the voicebox, blocking airflow.
  • Hypoplastic Trachea – where the windpipe is a little too narrow.

These are all caused by excessive amounts of soft tissue – in the course of breeding for the modern Pug, we’ve been very successful in shrinking their bones, but not so much the soft tissues around them. As a result, Pugs have loads of extra folds of tissue in their nasal chambers and airways, making breathing a little more difficult.

That’s all very interesting, but why did my dog get the infection in the first place?

There are a number of possible reasons, but let’s start with the most obvious – with lots of extra soft tissue in their noses, all those little crevices, nooks and crannies are perfect for bacteria to find a home and start to grow!

Other possible underlying causes include:

  • Foreign bodies – dogs are particularly prone to getting things stuck up their noses, like grass seeds or even bits of food.
  • Tooth infection – because the roots of some of the upper teeth are right next to the maxillary sinuses, an infection of the tooth can cause sinusitis and nasal infection.
  • Fungal infections – fairly rare in the UK, but they do occur.
  • Polyps – benign growths in the nasal chambers or pharynx.
  • Tumours – malignant growths of the airways.

These conditions aren’t uncommon in dogs, and often result in secondary bacterial infection. Once the infection is resolved, however, the symptoms may persist or recur because the underlying problem has not been addressed.

What is Pseudomonas?

Pseudomonas is a Gram Negative bacterium (meaning it has a double cell membrane as well as a cell wall) that commonly causes skin, ear and sometimes nasal infections. It is a very tough organism, and is prone to rapidly developing resistance to antibiotics. This means that in most cases, a prolonged (usually 2-6 weeks) course is required to ensure that it is completely eliminated. Exactly what antibiotic to use will depend on the results of the culture and sensitivity swab which your vet did – judging by what you’ve said, it would seem that this particular infection was susceptible to marbofloxacin (Marbocyl), a fluoroquinolone antibiotic commonly used against these bacteria.

So why hasn’t the treatment worked?

There are a number of possible reasons.

Firstly, it may simply be that the course wasn’t long enough – however, your vet is right to be cautious about just handing out more antibiotics; overuse of antibiotics in animals or people is one of the main drivers of antibiotic resistance.

A second possibility is that the course was long enough, but the Pseudomonas is now resistant to marbofloxacin; I’ve seen this happen before when treating these infections. You give an antibiotic that the bacterium is proven to be sensitive to, and within a week or two, the test results show that they have gained resistance to it.

Alternatively, there may have been other bacteria on that nasal swab that didn’t show up because there were so many Pseudomonas. In that case, if they weren’t susceptible to marbofloxacin, they’ll still be there causing problems even once the Pseudomonas are all dead.

Finally, and given the duration of the problems you’ve been having I’d say this is the most likely, there may be another underlying problem (such as a nasal polyp, a foreign body, dental disease, or even his nasal conformation and anatomy) that is causing the symptoms.

OK, what should I do next?

I think the most important thing is to find out what’s going on inside your dog’s nose right now. You know that some weeks ago there was a Pseudomonas infection; however, you’ve got no idea if that’s still the case and that treatment has failed (and if so, why); or if the symptoms are ongoing despite the successful treatment because the Pseudomonas were themselves only secondary to something else.

The first step would be for your vet to repeat the nasal swab (if possible, using the same laboratory) and see how the results are different – what bacteria are growing there now, and what antibiotics they are susceptible to.

The next thing to consider would be direct visualisation of the nasal chambers under anaesthetic; this usually involves rhinoscopy (putting a camera or endoscope up the nose) and/or retrograde visualisation (looking at the back of the nose with an endoscope or mirror) to see if there’s anything stuck there, or any masses or polyps growing. This isn’t always easy in pugs and may require referral to a specialist; however, your vet will be able to perform X-rays of the skull and nasal chambers, as often polyps and tumours are often clearly visible on an X-ray of this region.

I think it’s very important for you to discuss your concerns with your vet, and talk about further diagnostics – you really need to sort out what’s going on in that nose to make him comfortable again and to hopefully avert any more serious consequences! All the best, I hope you can get this sorted out quickly.

David Harris BVSc MRCVS


27 thoughts on “Ask A Vet Online – Help, I’ve got a stuffy-nosed Pug!

  1. My Jack russell has a flare up of a skin condition , last year the vet treated him with antihistamines, if i can avoid another visit to the vets as we had i last week and another in 2 weeks for conjunctivitis, Ii am hoping to give cetirizine which i can purchase anywhere … my dog is 17 pounds , what dose should i give him. he has ointment for the eye condition and takes no other medication.

    1. Hi Gail. We’re unable to give specific dosing advice unfortunately, so I’d recommend asking your vet regarding the dosage they’d recommend as your dog is under their care. They’ll be happy to advise you – you can ask when you’re at your other appointment – and they also know your dog’s history so are best-placed to advise on the most appropriate treatment to help your dog feel better.

  2. Hi! I have a black pug who is 10 months old
    Whenever he start eating most of the time he start doing reverse sneezing while eating,what to do?

    1. Hi Saran. I’d recommend popping your Pug in to see your vet, just so they’re able to give him a thorough check over and see if they can identify the cause of this as it could be related to his breed. They’ll then be able to recommend ways in which to manage this or give him treatment if it’s required.

  3. Hi, I have just had my bitch spayed, and my dog is behaving as though she is in season. They have been kept apart but he is off his food and whining. Will this last as long as a normal season? Thanks Gina

    1. Hi Gina, sometimes this behaviour does happen, almost like a phantom season. It doesn’t normally last long, but if you are worried about your dog not eating and seeming distressed, please speak to your own vet.

  4. Bacterial diseases are easy to treat than viral or fungal diseases. Most bacterial diseases are recoverable. Using a suitable antibiotic according to vets guide is best treatment

  5. There a red puffy bump in the fold an on top of that right side if his nose there was like pash on it. So I wiped it with a tissue an push so antibachtie on the red bump. What I’m asking what could this red bump be? An dodo I do ok.

    1. Unfortunately, there’s no way of knowing over the internet! It might be a small abscess or spot in the skin fold, but it could be something more serious; if it doesn’t resolve in a few days, I’d advise you to get it checked out by your veterinarian.

  6. My 18 yr old pug I sadly had to put to sleep because of old age illness the last draw was one nostril completely closed & she was struggling to breathe! Now her 16 yr old son I hand raised one nostril is starting to do the same besides blind he is healthy, is there anything I can do to help him?? Desperate ?

    1. Unfortunately, the pug’s facial anatomy makes them very susceptible to breathing problems. I would seek veterinary attention sooner rather than later, as there may be treatments that can help alleviate the symptoms.

  7. Hi I got a baby pug 6weeks old and seems to be batteling to breath sounds like a stuffy nose he is very small only weights 80grm pls need help

    1. Noisy breathing in pugs is pretty common – however, if he’s struggling, that needs a vet check, to see if there’s anything that can be done to improve matters. 80g at 6 weeks is pretty small, so there might be some underlying problems that need addressing.

  8. Hi,
    I have 2 10 week old kittens, and they both haven’t had a poo for 2 days.
    I find it a bit strange that they both havent had poo’s.
    Should I go to the vets?

    1. I think it would be worth a chat with your vet – constipation is quite common in cats, and if they’re both suffering, a common factor like a change in diet is likely to be the issue. Your vet, who knows them better than I do (!) will be able to advise you on suitable management; if they’re still not pooing after 3 days, then a check up is likely to be needed.

  9. hi there , i have a 8 week old pug and in the morning he sneezes and doesnt do well with the cold and also he is having a runny nose but later in the day he is fine. is there anything i can do to make him feel better.

    1. Respiratory signs are, sadly, not uncommon with very short-nosed dogs like pugs. However, there may be something else going on, such as an allergic reaction, so I’d suggest a check up with your vet to make sure there’s nothing more serious underlying it.
      Assuming there isn’t, the best approach is probably to keep him warm until he’s a bit older and better able to tolerate the sudden shock of going from warm to cold air.

  10. My 12 week old pug seems to have a cold she is not her self her nose is running bubbly as such, I have ur snuggled up warm and she sleeping well is there any information you could give me to try and keep her happy and healthy I am a new pug mammy and a very worried for her. She eyes are also watery as if she is crying

    1. It sounds like it might be a respiratory infection; keep her warm, and make an appointment to get her checked out by your vet. Because of their restricted airways, pugs are prone to various respiratory problems, and its best to stay on top of them.

  11. My pug is having some strange behaviors . He has all of a sudden become aggressive with other animals . He sounds like when he barks or makes a noise he is contested He throws his head up in the air and licks his nose a lot I have to make him quit he also has something going on with his eyes he wants to shut them one especially like it is irritated. All of a sudden in the middle of the night he let out a horrible sound like he was in pain I went over to him his heart was beating so fast I could feel it in the top of his head I took a warm cloth and wiped his face off but he never lay down I woke up he was still sitting up but on the floor beside my bed . Can you tell me what might be going on with him ?

    1. It’s very hard to say for certain, but from your description, it sounds like either a seizure or most likely, a partial airway obstruction (probably from an overlong soft palate blocking the windpipe). I think a vet check is definitely indicated though, as it’s clearly causing severe distress and might be dangerous.

  12. I have a twenty – three year old cat, who has recently been given thyroid tablets.
    The cat is old, I’ve been told he’s got a dicey heart. IF I start this thyroid treatment and my cat isn’t stupid, and it’s very hard to trick him into taking tablets., haven’t suceeded so far.., then as I understand it will affect is kidneys. He is a healthy strong cat, always been so, I realise he is old but was shocked to learn that ‘by law’ I am expected to administer this mediction, is this true, I love the cat dearly but he is old, can you explain this law to me as I had apsolutely no idea and feel trapped by the situation and in need of legal advise myself.

    1. Failure to provide an animal with veterinary treatment is indeed a criminal offence under the Animal Welfare Act 2006. Hyperthyroidism is a very serious condition which, untreated, can result in a quite prolonged and very unpleasant death (I have seen cases and I never want to again).
      I strongly advise that you go back to your vets, discuss your concerns with them, and talk about the options. For example, it might be possible to trial a hyperthyroid diet which is used alone with no other food or treats can be effective in managing the condition. Another potential option would be to look at radioactive iodine treatment (although he might be considered a little bit old for that). It’s important to realise too that hyperthyroidism is the most common cause of heart disease in cats – if you can get his thyroid condition under control, there is a good chance that his heart function will improve.
      You can read more about the disease and it’s management in our Pet Health Library entry on Hyperthyroidism.

  13. My almost 2 years rabbit had a gas problem 2 days ago and I treated like always, he became fine but since then he was unstable sometimes. Only when he shakes his head and body strongly. He is completely fine, even he eats much more hay and there no wrong with him only the unstableness when he shakes his head and there is no tilt in his head at all , his eyes are normal.
    So what wrong with him? Is it ear infection?

    I checked his ear but I didn’t see any mites or infection or redness , it completely clean so anyone have any idea what is wrong with him?

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