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Health Testing Guide
Which tests are mandatory, how to spot responsible breeders — and what it costs when things go wrong.
For the Pekingese we have compiled 11 mandatory and 11 recommended health tests, drawn from breed-club regulations, the University of PEI (CIDD), and OMIA — weighted by severity and heritability.
What this grade means
The Pekingese suffers from extreme anatomical strain, which leads to the lowest possible health rating. Brachycephalic syndrome manifests severely through audible breathing and respiratory distress, while the flat facial structure predisposes the breed to painful eye conditions such as entropion. Furthermore, natural births are often impossible, making cesarean sections a sad standard for this breed.
Every breed is susceptible to certain inherited conditions. Just like humans, dogs inherit predispositions from their parents. Responsible breeders screen their breeding dogs for these conditions and make informed mating decisions to reduce the risk passed on to puppies.
No — but it's the strongest tool we have. Diet, exercise, environment, and genetics all contribute to whether a dog develops a condition. When breeders use the right tests to identify risk in potential parents, the likelihood of many conditions appearing in the puppies drops significantly.
There's no one-size-fits-all here. For the Pekingese we track 11 mandatory tests plus 11 additional recommended ones. The specific tests and passing thresholds are detailed further below.
Keep in mind
Reliable screening tests still don't exist for many hereditary conditions, and tests for complex polygenic conditions are not always predictive of severity in the puppies. Even so, they're a powerful tool used by every responsible breeder.
There are two main types of health tests:
Screen the dog's DNA for known disease-causing mutations. Can be performed from puppyhood and give a binary result (clear / carrier / affected).
Clinical and imaging exams like X-ray, ultrasound, or ophthalmoscopy. They show how a predisposition actually manifests — usually only conclusive after 12–18 months.
We group breeding programs into three levels based on testing depth. Ask your breeder directly which level they meet.
A breeder at the Great level performs all mandatory tests plus 11 additional clinically recommended screenings that reduce risk in this breed.
In addition to mandatory tests:
Cleft palate
Allgemeine Fitness und Anatomie
A cleft palate is a congenital birth defect where the roof of the mouth fails to fuse properly during development in the womb. This failure leaves an abnormal opening between the oral cavity and the nasal passages. Because these two systems are directly connected, food, liquids, and air cannot be properly separated during swallowing.
Physisch · Passing: CARRIER
Brachycephalic obstructive airway syndrome (BOAS)(BOAS)
Atmung
Brachycephalic obstructive airway syndrome (BOAS) is a severe respiratory condition affecting short-muzzled dog breeds, where the physical shortening of the skull leaves insufficient space for the upper airways. This structural compression forces tissues like the soft palate and nasal passages into a restricted area, significantly obstructing the flow of oxygen to the lungs. Over time, the increased effort required to breathe puts chronic strain on the dog's respiratory and cardiovascular systems.
Physisch · Passing: CLEAR
Keratoconjunctivitis sicca (KCS) - "dry eye"(KCS)
Augen
Keratoconjunctivitis sicca (KCS), commonly known as dry eye, is a chronic disease of the ocular system where the tear glands fail to produce enough natural tears. Without this protective moisture, the cornea (the clear surface of the eye) and surrounding tissues become dry, inflamed, and highly susceptible to painful damage.
Augen · Passing: CLEAR
Progressive Retinal Atrophy (PRA)(PRA)
Augen
Progressive Retinal Atrophy (PRA) is an inherited eye disease that affects the retina, which is the light-sensitive layer of tissue at the back of the eye. In this condition, the specialized cells responsible for detecting light, known as photoreceptors, gradually degenerate and die. Because these cells cannot recover or be replaced, the disease slowly but inevitably leads to complete blindness.
Passing: CARRIER
Distichiasis
Augen und Sehvermögen
Distichiasis is an eye condition where extra eyelashes grow from the meibomian glands, which are the oil glands along the edge of the eyelid. These abnormal hairs point inward and rub directly against the cornea, the clear outer surface of the eye. This constant friction causes mechanical irritation and can damage the sensitive ocular surface.
Augen · Passing: CLEAR
Exposure keratopathy syndrome (exophthalmos, lagophthalmos, and/or macroblepharon)(EKS)
Augen und Sehvermögen
This condition involves chronic damage to the cornea, which is the clear protective outer layer of the eye. It occurs when the eyelids cannot fully close to moisten the eye, often due to protruding eyeballs, incomplete eyelid closure, or an abnormally large eyelid opening. Without proper moisture, the delicate surface of the eye becomes dry, inflamed, and vulnerable to injury.
Augen · Passing: CLEAR
Cataract(HC)
Augen und Sehvermögen
A cataract is a progressive clouding of the lens inside the dog's eye, which is the clear structure that focuses light onto the retina at the back of the eye. When the lens becomes cloudy or opaque, it blocks light from entering, gradually impairing the dog's vision. If left untreated, this condition can eventually lead to complete blindness in the affected eye.
Augen · Passing: CLEAR
Cryptorchidism
Fortpflanzung
Cryptorchidism is a developmental condition of the male reproductive system where one or both testicles fail to descend normally into the scrotum. Instead, the undescended testicle remains trapped inside the abdomen or in the groin area. This failure to descend is a physical development issue rather than an active illness, but it alters how the reproductive organs develop.
Physisch · Passing: Normal (both testicles descended)
Fold dermatitis/pyoderma
Haut und Fell
Fold dermatitis, also known as intertrigo, is an inflammatory skin condition that occurs within deep skin folds. When skin rubs against skin, it traps moisture, heat, and debris, creating an ideal environment for bacteria and yeast to overgrow. This leads to localized skin infections, particularly in breeds with pronounced facial, lip, or tail folds.
Physisch
Mitral valve dysplasia(MVD)
Herz
Mitral valve dysplasia is a congenital heart defect where the mitral valve, which acts as a one-way gate on the left side of the heart, does not form correctly. This malformation prevents the valve from closing tightly, allowing blood to leak backward instead of pumping efficiently to the body. Over time, this leakage strains the heart muscle, which can lead to heart enlargement and eventual heart failure.
Ultraschall · Passing: NORMAL
Hydrocephalus
Nervensystem
Hydrocephalus is a neurological condition affecting the brain and nervous system, commonly referred to as water on the brain. It occurs when cerebrospinal fluid, the natural protective liquid surrounding the brain, builds up abnormally inside the brain's cavities, known as ventricles. This accumulation creates harmful pressure on the surrounding brain tissue, which can impair normal brain function.
Roentgen · Passing: A
These levels are a comparison framework, not an official certification. They help compare breeding programs at a glance.
A complete checklist with every mandatory and recommended test plus identity and rearing questions — take it with you.
Open the full checklistFor breeders
Machine-readable mating rules, minimum ages, scoring schemes, and what's required for HonestDog verification — as a printable guide.
Example rule — Ectropion / Entropion
Both parents must be CLEAR or better.
We compile mandatory tests from official breed regulations and veterinary databases — and check every uploaded certificate for authenticity.
L1 = mandatory under breed-club regulations. L2 = recommended or clinically indicated. L3 = lower prevalence. Every assignment carries a source and confidence rating.
VDH breeding regulations, CIDD (University of PEI), OMIA (University of Sydney), curated veterinary input.
Uploaded certificates are AI-extracted and reviewed by our team for authenticity, date, and result.
11 tests are currently mandatory under the relevant breed-club regulations. The most common are Brachyury (NBT), Cesarean section, Monorchidism. Every test must be completed before mating, and the result must fall within the threshold defined by the regulation.
See breeders who have already uploaded their mandatory tests for verification.
View verified breeders