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).
- 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.
- 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.