# Pekingese Health Problems: Inherited Conditions and Preventive Screenings


## Key Takeaways

- Brachycephalic Obstructive Airway Syndrome (BOAS) is a progressive, multifactorial condition in Pekingese, characterized by stenotic nares, elongated soft palate, and everted laryngeal saccules, leading to noisy breathing and exercise intolerance. Diagnosis involves clinical examination and BOAS grading, with management ranging from weight control and harness use to surgical correction (alarplasty, staphylectomy).
- Ocular health is compromised by the Pekingese's brachycephalic anatomy, predisposing them to corneal ulcers, Keratoconjunctivitis Sicca (KCS), and entropion. Diagnostic screening includes Schirmer Tear Tests and fluorescein staining, with treatment varying from topical antibiotics and artificial tears to immunosuppressive medications like cyclosporine.
- Intervertebral Disc Disease (IVDD) is a significant concern due to premature disc degeneration in chondrodystrophic breeds, causing pain and potential paralysis. Diagnosis relies on neurological examination and advanced imaging (MRI/CT), with treatment options including strict crate rest and anti-inflammatories for mild cases, or decompressive surgery for severe deficits.
- Mitral Valve Disease (MVD) is prevalent in small breeds, involving degeneration of the mitral valve leading to regurgitation. Early detection via auscultation and confirmation with echocardiography is crucial, with management focusing on medications like pimobendan and ACE inhibitors to slow progression and manage heart failure.
- Skin Fold Dermatitis is common in Pekingese due to their facial wrinkles, creating moist environments conducive to bacterial and yeast overgrowth. Management involves meticulous cleaning and drying of skin folds, with topical or systemic antimicrobials used for infections, and surgical fold resection considered for chronic, severe cases.
- Preventive screenings are paramount, including annual physical examinations, ophthalmic evaluations (Schirmer Tear Test, fluorescein stain), cardiac auscultation, and orthopedic assessments for patellar luxation, with more frequent checks and advanced diagnostics recommended for senior dogs.

---

The Pekingese is a brachycephalic (flat-faced) toy breed with a long history as a companion [dog](/knowledge/veterinary-medicine/clinical-methods/dog). While they are loyal and affectionate, their distinctive anatomy predisposes them to a specific set of inherited and developmental health challenges. For owners and veterinarians, understanding these conditions is essential for providing proactive care. This article provides a definitive, source-grounded overview of the most significant Pekingese health problems, focusing on inherited conditions and the preventive screenings that can help manage them.

**Owner Triage Summary:** If your Pekingese shows any of the following signs, seek veterinary attention promptly: labored breathing, noisy breathing, or collapse after exercise; redness, cloudiness, or discharge in the eye; difficulty rising or lameness; or sudden hind-leg paralysis. These can be signs of brachycephalic airway syndrome, eye ulcers, or intervertebral disc disease, all of which are common in the breed.

## At a Glance: Common Pekingese Health Concerns

This table summarizes the primary inherited and developmental conditions affecting the breed. It is a clinical reference for owners and a starting point for discussions with your veterinarian.

| Condition Category | Specific Condition | Key Clinical Signs | Diagnostic Screening |
| :--- | :--- | :--- | :--- |
| **Respiratory** | Brachycephalic Obstructive Airway Syndrome (BOAS) | Noisy breathing, exercise intolerance, gagging, collapse | Clinical exam, BOAS grading, airway imaging |
| **Ocular** | Corneal Ulcers, Dry Eye (Keratoconjunctivitis Sicca), Entropion | Squinting, redness, discharge, cloudiness | Schirmer Tear Test, fluorescein stain, ophthalmologic exam |
| **Neurological** | Intervertebral Disc Disease (IVDD) | Pain, weakness, incoordination, paralysis | Neurological exam, advanced imaging (MRI/CT) |
| **Musculoskeletal** | Patellar Luxation, Hip Dysplasia | Lameness, skipping gait, difficulty rising | Orthopedic exam, radiographs (OFA/PennHIP) |
| **Cardiac** | Mitral Valve Disease (MVD) | Heart murmur, cough, exercise intolerance | Auscultation, echocardiography |
| **Dermatological** | Skin Fold Dermatitis | Itching, redness, odor in skin folds | Clinical exam, cytology |

## Understanding the Pekingese Anatomy and Predisposition

The Pekingese's most defining feature is its brachycephalic head shape, characterized by a short muzzle, flattened face, and large, prominent eyes. While this conformation is breed-standard, it is the root cause of many health issues. The same genes that produce the flat face also affect the structure of the upper airways, the nasolacrimal drainage system of the eyes, and the alignment of the spine. This makes the Pekingese a prime example of a breed where conformation directly influences health outcomes.

## Respiratory Health: Brachycephalic Obstructive Airway Syndrome (BOAS)

Brachycephalic Obstructive Airway Syndrome (BOAS) is a progressive, inherited condition that is almost ubiquitous in flat-faced breeds like the Pekingese. It is not a single disease but a combination of anatomical abnormalities that obstruct the upper airway.

### Pathophysiology of BOAS

The primary components of BOAS include:

- **Stenotic Nares:** The nostrils are pinched and narrow, reducing the amount of air that can enter the nose.
- **Elongated Soft Palate:** The soft palate at the back of the mouth is too long and extends into the airway, partially blocking it.
- **Everted Laryngeal Saccules:** The saccules (small pouches) in the larynx get pulled into the airway due to the increased negative pressure from breathing, further obstructing airflow.
- **Hypoplastic Trachea:** The windpipe may be narrower than normal.

These obstructions force the dog to work harder to breathe, creating negative pressure that can lead to secondary changes like laryngeal collapse and everted saccules.

### Clinical Signs and Diagnosis of BOAS

Clinical signs of BOAS in a Pekingese can range from mild to severe. They often include:

- Noisy, snoring, or raspy breathing
- Exercise intolerance and rapid fatigue
- Gagging or retching, especially after eating or drinking
- Cyanosis (blue-tinged gums) in severe cases
- Collapse or fainting after exertion or excitement

Diagnosis is based on a thorough physical examination by a veterinarian. The vet will assess the dog's breathing pattern, grade the severity of the airway obstruction, and may recommend sedation to visually inspect the larynx and soft palate. A BOAS grading system is often used to standardize assessment.

### Management and Prognosis for BOAS

Management of BOAS is multi-faceted.

- **Medical Management:** For mild cases, weight management is crucial, as excess fat exacerbates breathing difficulties. Avoiding excessive exercise, heat, and stress is also important. Owners should use a harness instead of a collar to avoid pressure on the neck and trachea.
- **Surgical Management:** For moderate to severe cases, surgical intervention is often recommended. Procedures include widening the nostrils (alarplasty) and shortening the soft palate (staphylectomy). These surgeries can significantly improve the dog's quality of life and airway function. The prognosis after surgery is generally good, but it does not reverse all anatomical changes.

## Ocular Health: A High-Risk Area for the Pekingese

The Pekingese's large, protruding eyes are vulnerable to a variety of inherited and traumatic conditions. Their shallow eye sockets (orbits) offer less protection, making them prone to injury and disease.

### Common Inherited Eye Conditions

- **Corneal Ulcers:** Due to their prominent eyes, Pekingese are at high risk for corneal ulcers (scratch or erosion of the eye's surface). These are painful and can become infected. Signs include squinting, excessive tearing, and pawing at the eye. A veterinary emergency.
- **Keratoconjunctivitis Sicca (KCS or Dry Eye):** This condition is caused by a deficiency in the production of the aqueous (watery) layer of tears. It leads to chronic dryness, inflammation, and pigmentation of the cornea. It is often an immune-mediated condition and is common in the breed.
- **Entropion:** This is a condition where the eyelid rolls inward, causing the eyelashes and hair to rub against the cornea, leading to irritation, pain, and ulceration.
- **Proptosis:** This is the displacement of the eyeball from its socket, often due to trauma or excessive pressure on the neck. This is a dire emergency requiring immediate veterinary care to save the eye.

### Diagnostic Screening for Eye Disease

Routine ophthalmic examinations are vital for Pekingese. A veterinary ophthalmologist or a general practitioner with an ophthalmoscope can perform:

- **Schirmer Tear Test (STT):** Measures tear production to diagnose KCS.
- **Fluorescein Stain Test:** Detects corneal ulcers by highlighting damaged areas on the cornea.
- **Tonometry:** Measures intraocular pressure to screen for glaucoma.

### Management of Ocular Conditions

Treatment depends on the specific condition. Corneal ulcers require topical antibiotics and pain relief. KCS is managed with artificial tears and immunosuppressive medications like cyclosporine. Entropion is often corrected with surgery. The key is early detection and treatment to prevent permanent vision loss.

## Neurological and Orthopedic Concerns

The Pekingese's short legs and long back, combined with a genetic predisposition, make them susceptible to specific spinal and joint problems.

### Intervertebral Disc Disease (IVDD)

IVDD is a common and serious condition in chondrodystrophic (short-legged) breeds like the Pekingese. The discs between the vertebrae of the spine degenerate prematurely, becoming hardened and less flexible. These discs can then rupture or herniate into the spinal cord, causing pain, nerve damage, and paralysis.

- **Clinical Signs:** Signs can range from mild back pain and reluctance to jump to severe hind-leg weakness, incoordination, and complete paralysis with loss of bladder control.
- **Diagnosis:** A neurological examination is the first step. Definitive diagnosis requires advanced imaging, typically an MRI or CT scan, to visualize the herniated disc.
- **Management:** Treatment can be medical (strict crate rest and anti-inflammatory medications) for mild cases, or surgical (decompressive surgery) for severe cases where the dog is in significant pain or has lost the ability to walk. Prognosis is good if treated promptly, but severe cases with no deep pain sensation have a guarded prognosis.

### Patellar Luxation

Patellar luxation is a condition where the kneecap (patella) slips out of its normal groove in the femur. It is a common inherited orthopedic problem in small breeds.

- **Clinical Signs:** The classic sign is a "skipping" gait where the dog holds up a hind leg for a few steps and then resumes normal walking. It can range from a mild, intermittent issue to a severe, persistent lameness.
- **Diagnosis:** Diagnosis is made through a physical orthopedic examination where the veterinarian manipulates the knee joint. Radiographs (X-rays) are used to assess the severity of the condition.
- **Management:** Mild cases may only require weight management and joint supplements. More severe cases often require surgical correction to realign the kneecap.

### Hip Dysplasia

While more common in larger breeds, hip dysplasia can also affect the Pekingese. It is an inherited condition where the hip joint does not develop properly, leading to laxity and arthritis.

- **Clinical Signs:** Signs include difficulty rising, a "bunny-hopping" gait, reluctance to run or climb stairs, and pain.
- **Diagnosis:** Screening is performed via radiographs. The Orthopedic Foundation for Animals (OFA) and PennHIP are two major organizations that evaluate hip conformation.
- **Management:** Management focuses on weight control, controlled exercise, physical therapy, and pain management. In severe cases, surgery may be an option.

## Cardiovascular Health: Mitral Valve Disease

Mitral Valve Disease (MVD) is the most common acquired heart disease in dogs, and it is particularly prevalent in small breeds like the Pekingese. It is a progressive condition where the mitral valve of the heart degenerates, leading to a leak (regurgitation) of blood back into the left atrium.

- **Clinical Signs:** The earliest sign is often a heart murmur detected by a veterinarian during a routine check-up. As the disease progresses, signs include a cough (especially at night), exercise intolerance, rapid breathing, and, in severe cases, fainting.
- **Diagnosis:** Diagnosis is based on auscultation (listening to the heart) and is confirmed with an echocardiogram (ultrasound of the heart), which assesses the structure and function of the heart valves and chambers.
- **Management:** There is no cure for MVD, but early detection and medical management can significantly slow its progression and improve quality of life. Medications such as ACE inhibitors and diuretics are commonly used. Regular cardiac check-ups are essential.

## Dermatological Health: Skin Fold Dermatitis

The Pekingese's facial wrinkles and skin folds are part of its charm, but they can also be a source of chronic skin problems. Skin fold dermatitis occurs when the skin within these folds rubs together, creating a warm, moist environment that is ideal for bacterial and yeast overgrowth.

- **Clinical Signs:** Signs include redness, itching, a foul odor, and a greasy or crusty discharge within the skin folds.
- **Diagnosis:** Diagnosis is typically based on clinical signs and confirmed with skin cytology (microscopic examination of skin cells).
- **Management:** Management involves keeping the skin folds clean and dry. This may require daily cleaning with a veterinarian-approved wipe or solution. In severe, chronic cases, surgical removal of the affected skin folds (fold resection) may be considered.

## Preventive Screenings: A Proactive Approach for Pekingese Owners

Preventive care is the cornerstone of managing breed-specific health issues. A proactive screening program can help detect conditions early, when they are most manageable. According to the American Animal Hospital Association (AAHA) Canine Life Stage Guidelines, regular wellness examinations are critical for all dogs, but they are especially important for breeds with known predispositions.

### Recommended Screening Schedule for Pekingese

- **Puppy (Under 1 Year):**
    - Physical examination: Focus on BOAS assessment, eye health, and orthopedic evaluation.
    - Vaccinations and parasite prevention as per guidelines.
    - Early socialization and behavior counseling.
- **Adult (1-6 Years):**
    - Annual physical examination.
    - Ophthalmic examination (Schirmer Tear Test, fluorescein stain) to screen for KCS and ulcers.
    - Cardiac auscultation to detect early heart murmurs.
    - Orthopedic evaluation for patellar luxation.
    - Baseline bloodwork to establish normal values.
- **Senior (7+ Years):**
    - Semi-annual physical examination.
    - All adult screenings, plus:
    - Echocardiogram to assess heart health.
    - Radiographs (X-rays) to evaluate for arthritis and IVDD.
    - Full bloodwork and urinalysis to screen for systemic diseases.

## Regional Considerations for Pekingese Care

While the core health issues are the same, there are regional differences in disease prevalence and care guidelines that owners should be aware of.

- **North America (US & Canada):** The focus is on routine screenings as recommended by the AVMA and AAHA. Heartworm and tick-borne disease prevention is a standard part of care, with regional variations in parasite prevalence.
- **Europe:** The Federation of Veterinarians of Europe (FVE) emphasizes responsible breeding practices and health screening. The European standard for BOAS grading is often more formalized, with some countries considering surgical correction of severe BOAS as a welfare necessity.
- **Australia:** The Australian Veterinary Association (AVA) highlights the importance of heat stress management for brachycephalic breeds due to the country's warm climate. Owners are often counseled on the risks of exercising their Pekingese during hot periods.

## Unsafe Home Remedies and Owner Misconceptions

It is crucial to avoid unsafe home remedies that can worsen a Pekingese's condition.

- **Human Medications:** Never give a Pekingese human pain relievers like ibuprofen or acetaminophen. These are toxic to dogs and can cause severe liver and kidney damage.
- **"Wait and See" for Eye Issues:** Any eye problem should be treated as an emergency. Do not wait to see if a red or squinting eye resolves on its own. A corneal ulcer can progress rapidly and lead to blindness.
- **Over-Exercising a Brachycephalic Dog:** Do not force a Pekingese to exercise in hot or humid weather. Their compromised airways make them highly susceptible to heatstroke. Always provide access to cool water and shade.
- **Using a Collar:** A collar can put pressure on the trachea and exacerbate breathing problems. Always use a well-fitted harness for walks.

## Prognosis and Quality of Life

The prognosis for a Pekingese with these inherited conditions varies greatly depending on the specific condition and the timing of intervention. With proactive veterinary care, many Pekingese live long, happy, and comfortable lives.

- **BOAS:** With surgical intervention and weight management, most dogs experience a significant improvement in their quality of life.
- **Eye Conditions:** Early detection and treatment can often save vision and prevent chronic pain.
- **IVDD:** Many dogs with mild to moderate IVDD recover fully with medical or surgical treatment. However, prevention of recurrence is a lifelong goal.
- **MVD:** With early diagnosis and medication, dogs can live with MVD for years without a significant decline in quality of life.

## Limitations and When to Contact a Veterinarian

This article provides a comprehensive overview of common Pekingese health problems, but it cannot predict the specific health of any individual dog. Breed-level information is a guide, not a diagnosis. Many Pekingese may never develop these conditions, while others may face them early in life. Genetics, environment, and lifestyle all play a role.

**You should contact your veterinarian immediately if your Pekingese exhibits any of the following red flags:**

- Sudden or severe difficulty breathing, or a blue-tinged tongue.
- Collapse, fainting, or severe lethargy.
- Any eye injury, redness, cloudiness, or squinting.
- Inability to walk, dragging a limb, or severe pain.
- Repeated vomiting or diarrhea (or diarrhoea) that lasts more than 24 hours.
- Seizures.

Early intervention is the single most important factor in achieving a positive outcome for many of these conditions. Do not hesitate to seek professional veterinary advice.

## The Clinical Reality of Brachycephalic Airway Obstruction

Brachycephalic Obstructive Airway Syndrome is not a static condition. It is a progressive, dynamic disease process that worsens as the dog ages, and the rate of progression is influenced by body condition, environmental temperature, and activity level. In the Pekingese, the combination of a severely shortened muzzle and a relatively large tongue base means that even mild anatomical abnormalities can produce significant clinical signs. The negative pressure generated during each inspiratory effort does not simply stop at the nose and throat. It is transmitted down the airway, and over time, this chronic suction effect pulls the softer tissues of the larynx inward. This is why a young Pekingese with mild stertor (snoring) can develop frank respiratory distress by middle age if the underlying obstruction is not addressed.

### The Role of Body Condition in Airway Severity

One of the most underappreciated factors in BOAS severity is body fat. Adipose tissue deposited in the pharyngeal region and around the chest wall mechanically compresses the airway and restricts diaphragmatic excursion. A Pekingese that is even 10 to 15 percent overweight can experience a dramatic worsening of clinical signs that is entirely reversible with weight loss. This is not speculation; it is a consistent clinical observation that weight reduction frequently produces a more immediate improvement in exercise tolerance than any medication. For the owner, this means that body condition scoring should be a monthly ritual, not an annual afterthought. The ribs should be easily palpable with a thin layer of fat, and there should be a visible waist when viewed from above.

### The BOAS Grading System in Practice

Veterinarians use a standardized BOAS grading system that assigns a functional class based on the dog's response to a standardized exercise test. The test involves a three-minute walk followed by an assessment of respiratory effort, stertor, and recovery time. A grade 0 dog shows no audible respiratory noise and recovers immediately. A grade 1 dog shows mild stertor that resolves within five minutes. A grade 2 dog shows moderate stertor, increased respiratory effort, and takes longer than five minutes to recover. A grade 3 dog shows severe respiratory distress, cyanosis, or collapse and requires immediate intervention. This grading system is not merely academic. It directly informs the surgical decision-making process. A grade 2 or 3 Pekingese is a candidate for early surgical intervention, while a grade 0 or 1 dog may be managed conservatively with weight control and activity modification.

### The Case for Early Surgical Intervention

There is a persistent misconception among some owners that airway surgery is a last resort. In reality, the opposite is true. Early intervention, before the development of laryngeal collapse, is associated with better long-term outcomes. Once the laryngeal cartilages begin to lose their rigidity, the surgical options become more limited and the prognosis becomes more guarded. For a young Pekingese with confirmed stenotic nares and an elongated soft palate, alarplasty and staphylectomy performed at one to two years of age can prevent the secondary changes that lead to respiratory crisis in later life. The recovery from these procedures is generally rapid, with most dogs eating soft food within 24 hours and returning to normal activity within two weeks. The owner should discuss the surgeon's experience with brachycephalic breeds, as the soft palate surgery requires precision to avoid over-resection, which can lead to nasopharyngeal regurgitation.

## Ocular Surface Disease: Beyond the Basics

The Pekingese eye is a study in vulnerability. The shallow orbit provides minimal bony protection, and the prominent globe is exposed to environmental irritants, trauma, and the breed's own facial hair. While corneal ulcers, dry eye, and entropion are the headline conditions, the clinical reality is more nuanced. Many Pekingese suffer from a combination of these problems simultaneously, and each condition can exacerbate the others.

### The Interplay of Dry Eye and Corneal Ulcers

Keratoconjunctivitis Sicca is not simply a dry eye. It is a chronic inflammatory state of the ocular surface. The tear film has three layers: an outer lipid layer, a middle aqueous layer, and an inner mucin layer. In KCS, the aqueous layer is deficient, which leads to a cascade of events. The cornea becomes desiccated, the conjunctiva becomes inflamed, and the normal protective mechanisms of the eye are compromised. A Pekingese with untreated KCS is at significantly higher risk for corneal ulceration because the cornea is no longer adequately lubricated or protected. This is why the Schirmer Tear Test is so critical. It is a simple, inexpensive test that can be performed in minutes, and it provides objective data on tear production. A reading of less than 15 millimeters per minute is suspicious, and less than 10 millimeters per minute is diagnostic for KCS.

### The Diagnostic Workflow for a Painful Eye

When a Pekingese presents with a red, squinting eye, the diagnostic workflow must be systematic. The first step is a thorough history, including any recent trauma, exposure to irritants, or changes in the home environment. The veterinarian will then perform a neuro-ophthalmic examination to assess the pupillary light reflexes and menace response. This is followed by a Schirmer Tear Test, which should be performed before any topical medications are applied, as the drops can artificially elevate tear production. After the tear test, a fluorescein stain is applied to the cornea. The stain adheres to areas where the corneal epithelium is damaged, revealing ulcers that may not be visible to the naked eye. If an ulcer is present, the veterinarian will assess its depth and check for a melting appearance, which indicates collagenase activity and requires aggressive therapy. Tonometry is then performed to rule out glaucoma, which can also cause a red, painful eye and is a true emergency.

### The Importance of the "Hidden" Ulcer

One of the most dangerous ocular conditions in the Pekingese is the indolent or "boxer" ulcer, which is a superficial, non-healing corneal ulcer. These ulcers are characterized by a loose epithelial edge that fails to adhere to the underlying stroma. They are often slow to heal and can persist for weeks or months despite appropriate medical therapy. The Pekingese is predisposed to these ulcers due to the breed's corneal anatomy and the chronic low-grade trauma from entropion or trichiasis (eyelashes rubbing on the cornea). If a corneal ulcer does not show significant improvement within five to seven days of appropriate medical therapy, the veterinarian should consider a debridement procedure, where the loose epithelium is gently removed with a cotton-tipped applicator, followed by a grid keratotomy to encourage epithelial adhesion.

### Long-Term Management of Chronic Dry Eye

The management of KCS is a lifelong commitment. The mainstay of therapy is topical cyclosporine, which stimulates tear production and reduces immune-mediated inflammation of the lacrimal glands. The response to cyclosporine is not immediate. It can take four to six weeks to see a meaningful increase in tear production, and some dogs require the addition of topical tacrolimus, which is often more potent. In addition to immunomodulatory therapy, artificial tear supplements are used to provide symptomatic relief. The owner should be prepared for twice-daily medication administration for the life of the dog. Regular rechecks with the Schirmer Tear Test are essential to monitor the response to therapy and adjust the medication dose. In severe, refractory cases, a surgical procedure called parotid duct transposition, which reroutes the salivary duct to the eye, may be considered, but this is a salvage procedure with significant potential complications.

## Intervertebral Disc Disease: A Deeper Dive into Diagnosis and Prognosis

Intervertebral disc disease in the Pekingese is a consequence of chondrodystrophy, a genetic condition that affects the development of cartilage and bone. In chondrodystrophic breeds, the intervertebral discs undergo premature degeneration, often beginning as early as one year of age. The nucleus pulposus, the gelatinous center of the disc, becomes calcified and loses its shock-absorbing capacity. This makes the disc prone to rupture, either as an acute extrusion (Hansen Type I) or a chronic protrusion (Hansen Type II).

### The Neurological Examination: What the Veterinarian is Assessing

When a Pekingese presents with back pain or hind-limb weakness, the neurological examination is the most important diagnostic tool. The veterinarian will assess the dog's posture and gait, looking for proprioceptive deficits, which are indicated by knuckling of the [paws](/knowledge/veterinary-medicine/clinical-methods/paws) or a lack of conscious awareness of paw position. The spinal reflexes are then evaluated. A normal withdrawal reflex with absent voluntary motor function suggests an upper motor neuron lesion, while a decreased or absent withdrawal reflex suggests a lower motor neuron lesion. The presence or absence of deep pain perception is the single most important prognostic indicator. Deep pain is assessed by applying firm pressure to the toes with a hemostat. A dog that withdraws its limb or vocalizes in response to this stimulus has intact deep pain perception, which carries a favorable prognosis. A dog that does not respond has absent deep pain perception, which carries a guarded to poor prognosis, even with surgical intervention.

### The Role of Advanced Imaging

Plain radiographs can identify calcified discs and narrowed disc spaces, but they cannot definitively diagnose a disc herniation. The gold standard for diagnosis is magnetic resonance imaging (MRI), which provides detailed images of the spinal cord, the intervertebral discs, and the surrounding soft tissues. An MRI can identify the location and extent of the herniation, as well as any associated spinal cord compression or swelling. Computed tomography (CT) with myelography is an alternative, but MRI is generally preferred due to its superior soft tissue contrast. The decision to pursue advanced imaging should be made in consultation with a veterinary neurologist or surgeon, and it is typically recommended for any dog with moderate to severe neurological deficits or a lack of response to medical management.

### The Window for Surgical Intervention

The timing of surgical intervention is critical. For a dog with intact deep pain perception that is non-ambulatory (unable to walk), surgery within 24 to 48 hours of the onset of signs is associated with a recovery rate of over 90 percent. For a dog with absent deep pain perception, the recovery rate drops to approximately 50 percent, and the window for surgery is much narrower, ideally within 12 to 24 hours. This is why it is essential for owners to recognize the early signs of IVDD, which include reluctance to jump, a tucked-up abdomen, crying or yelping when picked up, and a stiff or stilted gait. Any of these signs warrant an immediate veterinary evaluation.

### Post-Operative Rehabilitation and Prevention of Recurrence

Recovery from IVDD surgery is not immediate. It requires a structured rehabilitation program that includes strict rest for the first two to four weeks, followed by a gradual return to activity. Physical therapy, including passive range of motion exercises, massage, and controlled walking, is essential to maintain muscle mass and prevent joint stiffness. Bladder management is also critical, as many dogs experience temporary urinary incontinence or retention. The owner must be prepared to express the bladder manually or use a urinary catheter under veterinary guidance. Prevention of recurrence is a lifelong goal. This involves maintaining a lean body condition, avoiding high-impact activities like jumping on and off furniture, and using a harness instead of a collar to reduce stress on the cervical spine. Some veterinarians recommend the use of a ramp or stairs to allow the dog to access elevated surfaces without jumping.

## Patellar Luxation: Grading and Surgical Decision-Making

Patellar luxation is graded on a scale of I to IV, and this grading system directly informs the treatment plan. A Grade I luxation is one where the patella can be manually luxated but returns to its normal position spontaneously. These dogs are often asymptomatic or show only occasional skipping. A Grade II luxation is one where the patella luxates spontaneously and remains luxated for a period before returning to its normal position. These dogs frequently show a skipping gait and may have intermittent lameness. A Grade III luxation is one where the patella is luxated most of the time but can be manually reduced. These dogs have a persistent lameness and often develop secondary arthritis. A Grade IV luxation is one where the patella is permanently luxated and cannot be manually reduced. These dogs have a severe, debilitating lameness.

### The Surgical Options for Patellar Luxation

Surgical correction of patellar luxation is recommended for Grade III and IV luxations, as well as for Grade II luxations that are causing significant or frequent lameness. The surgical approach depends on the underlying anatomical abnormalities. The most common procedures include a tibial tuberosity transposition, where the bony attachment of the patellar ligament is moved to realign the quadriceps mechanism, and a trochleoplasty, where the groove in the femur is deepened to better accommodate the patella. In cases of severe angular limb deformity, a corrective osteotomy may be necessary. The prognosis after surgery is generally good, with most dogs returning to normal or near-normal function. However, the development of arthritis is inevitable, and long-term management with joint supplements and anti-inflammatory medications may be necessary.

### The Importance of Early Diagnosis in Puppies

Patellar luxation is often present at birth, and the condition can be detected in puppies as young as eight weeks of age. Early diagnosis is important because it allows for early intervention. A puppy with a Grade II luxation that is causing frequent lameness may benefit from surgical correction before the development of secondary bone deformities. The owner should ask the breeder about the patellar status of the puppy's parents and littermates, as the condition is heritable. A puppy from a line with a history of patellar luxation should be monitored closely and examined by a veterinarian at the first sign of any gait abnormality.

## Mitral Valve Disease: The Silent Progression

Mitral valve disease is a degenerative condition that progresses slowly over years. The earliest sign is a heart murmur, which is caused by turbulent blood flow through the leaking valve. The murmur is often detected during a routine wellness examination before the dog shows any clinical signs. This is why annual auscultation is so important. A Pekingese with a newly detected murmur should undergo a baseline echocardiogram to assess the severity of the valve degeneration and the degree of cardiac enlargement.

### The Staging of Mitral Valve Disease

The American College of Veterinary Internal Medicine (ACVIM) has established a staging system for MVD. Stage A is a dog at high risk for developing MVD but with no current evidence of the disease. Stage B1 is a dog with a murmur but no evidence of cardiac enlargement on radiographs or echocardiography. Stage B2 is a dog with a murmur and evidence of cardiac enlargement. Stage C is a dog with current or past clinical signs of heart failure, such as coughing, difficulty breathing, or exercise intolerance. Stage D is a dog with end-stage heart failure that is refractory to standard therapy. The staging system is critical because it determines when to initiate therapy. Dogs in Stage B2 should be started on medication, typically pimobendan, to delay the onset of clinical signs. Dogs in Stage C require a more aggressive treatment protocol that includes diuretics, ACE inhibitors, and pimobendan.

### The Owner's Role in Monitoring

The owner plays a critical role in monitoring a Pekingese with MVD. The resting respiratory rate is the most sensitive indicator of impending heart failure. The owner should be instructed to count the dog's respiratory rate while it is sleeping or resting quietly. A rate of more than 30 breaths per minute, or an increase from the dog's baseline, warrants an immediate veterinary consultation. Other signs of heart failure include a cough that is worse at night or upon waking, increased respiratory effort, restlessness, and a decreased appetite. Early recognition of these signs allows for timely adjustment of medication and can prevent a full-blown congestive heart failure crisis.

## Skin Fold Dermatitis: A Practical Management Guide

The management of skin fold dermatitis is a daily commitment. The goal is to keep the skin folds clean and dry, which requires a consistent routine. The owner should use a soft, damp cloth or a veterinary-approved wipe to gently clean the folds, followed by thorough drying with a clean, dry cloth. The use of a hairdryer on a cool setting can be helpful for ensuring complete dryness, especially in humid climates. The owner should avoid using harsh soaps or human shampoos, which can disrupt the normal skin barrier and exacerbate irritation.

### The Role of Topical and Systemic Therapy

When a skin fold infection is present, treatment is required. Mild infections may respond to topical antimicrobial wipes or creams. More severe infections may require systemic antibiotics or antifungals. The choice of medication depends on the results of skin cytology, which can identify the presence of bacteria, yeast, or both. In recurrent or severe cases, a surgical procedure called fold resection may be recommended. This involves removing the excess skin that creates the fold, which eliminates the moist environment that promotes infection. Fold resection is a relatively straightforward procedure with a good success rate, but it is not without risks, including wound dehiscence and scarring.

## The Preventive Screening Schedule: A Detailed Rationale

The preventive screening schedule for a Pekingese should be tailored to the individual dog's risk factors, but there are some general guidelines that apply to all dogs of the breed.

### The Puppy and Young Adult Period

The first veterinary visit for a Pekingese puppy should include a thorough physical examination, with a focus on the respiratory and ocular systems. The veterinarian should assess the patency of the nostrils, auscultate the heart and lungs, and perform a basic ophthalmic examination. The puppy should also be screened for patellar luxation, as this condition is often present at a young age. The first year of life is also the time to establish a baseline for body weight and body condition score, which will be used to monitor for obesity later in life.

### The Adult Period

For an adult Pekingese, annual wellness examinations are the minimum standard of care. These examinations should include a Schirmer Tear Test and fluorescein stain to screen for dry eye and corneal ulcers, as well as a thorough cardiac auscultation to detect any new murmurs. The veterinarian should also perform an orthopedic examination, including palpation of the stifles to assess for patellar luxation. Baseline bloodwork, including a complete blood count and serum chemistry profile, is recommended to establish normal values and screen for early signs of systemic disease.

### The Senior Period

For a senior Pekingese, semi-annual examinations are recommended. In addition to the screenings performed in the adult period, the senior examination should include an echocardiogram to assess heart structure and function, radiographs of the spine and hips to evaluate for IVDD and arthritis, and a full bloodwork panel with urinalysis to screen for kidney and liver disease. The senior period is also the time to be vigilant for cognitive decline, which can manifest as disorientation, changes in sleep-wake cycles, and decreased interaction with the family.

## Special Population Considerations

### The Brachycephalic Puppy Under Anesthesia

Anesthesia in a brachycephalic breed like the Pekingese carries unique risks. The compromised airway makes intubation more challenging, and the risk of post-anesthetic respiratory complications is higher. The owner should ensure that the veterinary team is experienced with brachycephalic breeds and that they have a plan for managing the airway during and after the procedure. Pre-anesthetic sedation should be used judiciously, and the dog should be monitored closely in the recovery period.

### The Pregnant Pekingese

Pregnancy and whelping in a brachycephalic breed can be challenging. The narrowed birth canal and the large head of the puppies often necessitate a cesarean section. The owner should discuss a whelping plan with the veterinarian well in advance of the due date. The respiratory compromise associated with BOAS can also be exacerbated during pregnancy due to the increased oxygen demand and the pressure of the gravid uterus on the diaphragm.

### The Obese Pekingese

Obesity is a common and serious problem in the Pekingese. It exacerbates every health condition discussed in this article, including BOAS, IVDD, patellar luxation, and MVD. The owner should work with the veterinarian to establish a weight management plan that includes a measured diet and a controlled exercise program. The use of a food scale to measure portions is essential, as visual estimates are often inaccurate.

## Preparing for the Veterinary Visit: What the Owner Should Bring

A well-prepared owner can significantly enhance the efficiency and effectiveness of a veterinary visit. The owner should bring a list of any current medications, including the dose and frequency. They should also bring a list of any observed clinical signs, including when they first noticed them and any factors that seem to make them better or worse. A video of the dog's gait or breathing pattern can be extremely helpful, as these signs may not be apparent during the examination. The owner should also be prepared to answer questions about the dog's diet, exercise routine, and environment.

## The Limitations of Breed-Specific Health Information

It is important to recognize that breed-specific health information is a statistical guide, not a guarantee. Not every Pekingese will develop every condition described in this article. The expression of inherited diseases is influenced by a complex interplay of genetics, environment, and lifestyle. A Pekingese from a responsible breeder who screens their breeding stock for the conditions described in this article may have a lower risk of developing these diseases than a Pekingese from a less careful breeding program. However, even the most responsible breeder cannot guarantee that a puppy will be free of all inherited conditions. This is why preventive screening is so important, regardless of the dog's pedigree.

## The Role of the Owner in Long-Term Health

The owner is the most important member of the veterinary healthcare team. The owner is the one who observes the dog on a daily basis and is best positioned to detect subtle changes in behavior, appetite, and activity level. The owner is also the one who implements the veterinarian's recommendations for diet, exercise, and medication. A proactive, informed owner can make a significant difference in the quality and length of a Pekingese's life. This includes not only following the recommended screening schedule but also being vigilant for the early signs of the conditions described in this article and seeking veterinary attention promptly when they are observed.

## Related Clinical & Scientific Guides

* [Birman Health Problems: Inherited Conditions and Cardiac Screenings](/knowledge/veterinary-medicine/breed-specific-health/birman-health-problems-inherited-conditions-and-cardiac-screenings)
* [Singapura Cat Health Problems: Inherited Conditions and Cardiac Screenings](/knowledge/veterinary-medicine/breed-specific-health/singapura-cat-health-problems-inherited-conditions-and-cardiac-screenings)
* [Siberian Cat Health Problems: Inherited Conditions and Cardiac Screenings](/knowledge/veterinary-medicine/breed-specific-health/siberian-cat-health-problems-inherited-conditions-and-cardiac-screenings)