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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 Pug we have compiled 1 mandatory and 9 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 Mops suffers significantly from its extreme anatomy, which almost always leads to Brachycephalic Obstructive Airway Syndrome (BOAS) and chronic respiratory distress. Furthermore, the breed is heavily affected by the fatal Pug Dog Encephalitis (PDE) as well as painful hemivertebrae in the spine. These serious, often life-shortening issues make the Mops a high-risk breed in terms of health.
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 Pug we track 1 mandatory tests plus 9 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 9 additional clinically recommended screenings that reduce risk in this breed.
In addition to mandatory tests:
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
Ectropion / Entropion
Augen
These are structural eyelid abnormalities affecting a dog's eyes. In cases of entropion, the eyelid rolls inward, causing the eyelashes or fur to rub painfully against the surface of the eyeball. In ectropion, the eyelid sags or rolls outward, leaving the sensitive inner lining of the eye exposed and unprotected.
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
Complex vertebral malformation(CVM)
Bewegungsapparat
Complex vertebral malformation is a congenital condition where the bones of the spine, known as vertebrae, do not develop properly during fetal growth, sometimes resulting in abnormally shaped bones like "butterfly vertebrae." This structural defect affects the skeletal system and can put pressure on the spinal cord, which is the main nerve pathway running down the back.
Roentgen · Passing: A
Atopy(CAD)
Haut und Fell
Atopy is a chronic allergic skin disease where a dog's immune system overreacts to common environmental substances like pollen, mold spores, and dust mites. This inappropriate immune response damages the natural protective barrier of the skin, leading to persistent inflammation and irritation. It primarily affects the skin, which is the body's largest organ system.
Haut
Demodicosis / Demodectic mange
Haut und Fell
Demodicosis is a skin disease caused by an overgrowth of microscopic Demodex mites that naturally live inside a dog's hair follicles. While these mites are normally harmless, an inherited or acquired weakness in the immune system can allow them to multiply uncontrollably. This overgrowth leads to inflammation and damage to the skin barrier.
Haut · Passing: CARRIER
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
Sick sinus syndrome(SSS)
Herz und Kreislauf
Sick sinus syndrome is a disorder of the heart's electrical system, specifically affecting the sinoatrial node, which acts as the heart's natural pacemaker. This malfunction causes the heart to beat too slowly, too quickly, or with long pauses, disrupting normal blood flow to the body. An echocardiogram (an ultrasound of the heart) is typically performed alongside electrical monitoring to rule out other structural heart diseases before proceeding with treatment.
Physisch · Passing: NORMAL
Meningitis(SRMA)
Nervensystem
Meningitis is a severe inflammatory condition affecting the protective membranes, called meninges, and blood vessels surrounding the brain and spinal cord. In dogs, this most commonly occurs as an immune-mediated disorder known as Steroid-Responsive Meningitis-Arteritis (SRMA), or 'Steril-eitrige Meningitis-Arteriitis'. This means the dog's own immune system mistakenly triggers inflammation in these nervous system tissues without any actual infection being present.
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 — Keratoconjunctivitis sicca (KCS) - "dry eye"
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.
1 tests are currently mandatory under the relevant breed-club regulations. The most common are Keratoconjunctivitis sicca (KCS) - "dry eye" (KCS). 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