What I Really See in Pug Patients: The Most Common Diagnoses and Their Costs
Anyone with a Pug quickly becomes familiar with the vet clinic. In my experience, there are five main areas that regularly bring Pugs in for treatment:
· Brachycephalic Obstructive Airway Syndrome (BOAS): The most well-known Pug diagnosis. Narrowed nostrils, elongated soft palate, chronic respiratory distress. Corrective surgery costs 1,500–3,000 €, diagnostics 300–800 €. Important: BOAS is excluded by all insurers as it's considered congenital and breed-typical.
· Eye Injuries: The large, protruding eyes are extremely sensitive. I see corneal ulcers in Pugs regularly. Diagnostics 100–300 €, surgery 800–1,500 €. Acquired eye injuries are covered.
· Skin Fold Infections (Dermatitis): The deep folds on the face and body are an ideal breeding ground for bacteria and fungi. Ongoing treatment 200–600 € per year – often throughout the dog's lifetime.
· Wirbelsäulenprobleme (z. B. Hemivertebrae): Hemivertebrae occur much more frequently in Pugs. MRI 400–1,200 €, surgery 3,000–6,000 €. Congenital malformations are excluded – acquired spinal problems may be covered.
· Patellar Luxation: Surgery 1,200–2,000 €. Common in Pugs due to their short legs and compact body. Covered after 18-month waiting period.
Additionally, there are allergies and itching (400–1,000 € annually), heart problems like mitral valve insufficiency (diagnosis + medications 400–900 €/year), and dental problems from crowded teeth (treatment 300–700 €, dental surgery 500–1,200 €).
My tip as a vet tech: If you have a Pug, get used to regular eye checks, daily fold cleaning, and annual dental exams. These three routines prevent most emergencies in the long run.
Focus on the cuddles, we'll focus on the costs.
From the Clinic: Benny, 5 Years – Corneal Ulcer and Patellar Luxation in the Same Year
Benny is a typical Pug patient. His owner brought him to the clinic in spring because Benny was squinting and his eye was tearing. Diagnosis: Corneal ulcer – probably from a grass blade or play. Treatment with eye drops, two follow-ups, and a special protective contact lens cost 380 € total.
Four months later, Benny limped during a walk – he suddenly wasn't using his hind leg. The vet diagnosed Grade III Patellar Luxation. The surgery including X-rays, anesthesia, procedure, and three weeks of aftercare: 1,650 €.
Benny's Costs in One Year:
Benny's owner had health insurance with Dalma at 80% reimbursement. His out-of-pocket for the year: about 500 € instead of 2,540 €.
Focus on the cuddles, we'll focus on the costs.
Surgical Insurance or Full Cover: Which Plan Fits a Pug?
Basically, you have two options: surgical insurance or comprehensive dog health insurance. Both models can make sense depending on health status and risk.
1. Surgical Insurance for Pugs
Surgical insurance covers costs when your dog needs surgery – for example, for Patellar Luxation or serious eye injury. Dalma includes the following benefits, among others:
· Surgical procedures for illness or accident
· Diagnostics and pre-operative exams up to 30 days before surgery
· Hospital stays up to 30 days after surgery
· Medications, bandages, and necessary aftercare
· Alternative treatments like physical therapy up to 30 days after surgery
· Dental operations after waiting period
· Emergency boarding up to 250 € per year
2. Dog Health Insurance (Full Cover) for Pugs
Health insurance covers not just surgery, but also diagnostics, treatments, medications, and preventive care. You can choose between 80 and 100 percent reimbursement and annual limits between 1,500 € and unlimited. Included benefits include:
· Veterinary costs for diagnostics, exams, and treatments
· Prescribed medications
· Unlimited physical therapy
· Alternative healing methods like acupuncture or osteopathy
· Behavioral therapy up to 5 hours per policy year
· Telemedicine via FirstVet
· Preventive Care Budget for vaccinations, dental care, and deworming (from 1,500 € annual limit)
My Assessment as a Vet Tech: For Pugs, full cover is almost always the better choice. In my experience, Pugs incur not just high surgical costs, but also ongoing costs for diagnostics, medications, and regular treatments. Skin care, eye drops, heart medications – it adds up over the years.
Focus on the cuddles, we'll focus on the costs.
How Much Does Pug Insurance Cost at Dalma?
Costs depend on age, health status, and coverage scope. Dalma's dog health insurance for Pugs starts at an average of 90 € per month. Surgical insurance is usually available from 45 € monthly.
As of March 2026. Dalma offers flexible plans and 15 percent discount when insuring multiple dogs.
From age 10 onwards, the reimbursement rate for conditions decreases by 5% annually. For accidents, it remains unchanged.
Focus on the cuddles, we'll focus on the costs.
Waiting Periods for Pugs
The following waiting periods apply before full coverage takes effect:
· 2 days for accidents
· 14 days for operations
· 30 days for medical treatments
· 12 months for breed-specific conditions (z. B. Patellaluxation, gewisse Atemwegsprobleme – mit Ausnahme von BOAS)
· 12 months for dental treatments like FORL, gingivitis, and periodontitis
· 18 months for Patellar Luxation (surgical)
Pre-existing conditions that existed before contract signing are excluded. Early coverage – ideally in puppyhood – is therefore advisable.
Focus on the cuddles, we'll focus on the costs.
What's Not Covered for Pugs – and Why BOAS Is the Major Exception
Dalma offers very comprehensive coverage, but some conditions are excluded due to their genetic or congenital nature. Not covered include:
· Brachycephalic Obstructive Airway Syndrome (BOAS) – narrowed nostrils, elongated soft palate, chronic respiratory distress
· Congenital or inherited malformations
· Epilepsy
· Treatments relating to pregnancy and birth
· Cosmetic procedures without medical indication
· Diseases from lack of vaccination protection
Why BOAS is excluded: Brachycephalic syndrome is not a condition a Pug "develops" over its lifetime – it's a direct result of breeding anatomy and therefore classified as congenital by all insurers. Other respiratory conditions that don't result from brachycephaly and develop after contract signing may be covered.
However, these are covered with waiting periods:
· Patellar Luxation (after 18 months)
· Dental diseases like FORL, gingivitis, or periodontitis (after 12 months)
· Certain breed-specific respiratory problems – not BOAS (after 12 months)
Focus on the cuddles, we'll focus on the costs.
Cost Reimbursement at Dalma
100% digital. Upload invoice via app (photo + confirm diagnosis), deadline 8 days. Reimbursement target 48 hours (contractually up to 5 business days). Up to 4x GOT rate including emergency fees. Free choice of vet worldwide. Telemedicine via FirstVet free and unlimited.
Focus on the cuddles, we'll focus on the costs.
Insuring a Pug: Who Benefits – and Who Doesn't?
Especially worthwhile: If you insure your Pug in puppyhood. Then Patellar Luxation, dental diseases, eye injuries, and acquired skin problems are covered after waiting periods. Many breed-typical conditions only develop over the lifetime and then count as new-onset.
Less helpful: If your Pug is already older and BOAS, knee, eye, or heart diagnoses were known before contract signing. Especially with Pugs, remember that brachycephalic syndrome is not insurable.
From my experience as a vet tech: Most Pug owners with insurance use it regularly. Pugs are not dogs that never need the vet. The question isn't if, but when and how often.
Focus on the cuddles, we'll focus on the costs.
Frequently Asked Questions About Pug Insurance
Is dog health insurance worthwhile for a Pug?
Yes, dog health insurance is especially worthwhile for Pugs. Due to their brachycephalic anatomy and genetic peculiarities, Pugs frequently need veterinary care. Respiratory problems, eye injuries, skin fold infections, and orthopedic conditions occur regularly and can incur high costs.
Which diseases occur most frequently in Pugs?
Pugs are especially susceptible to respiratory difficulties, eye problems like corneal injuries, skin fold infections, allergies, dental problems, and Patellar Luxation. Spinal problems and heart disease also occur more frequently in this breed than in others.
Is Brachycephalic Obstructive Airway Syndrome covered in Pugs?
No, Brachycephalic Obstructive Airway Syndrome is considered congenital and breed-typical and therefore not insurable. This includes narrowed nostrils, elongated soft palate, and chronic respiratory distress. Other respiratory conditions that are not congenital and develop after contract signing may be covered.
Does insurance cover eye injuries?
Yes, acquired eye injuries like corneal ulcers or eye inflammation are covered. Especially in Pugs, the large, protruding eyes are very sensitive, so eye treatments are common and can quickly become expensive.
Are skin fold infections and allergies covered in Pugs?
Yes, non-congenital skin conditions like skin fold infections, allergies, or chronic itching are covered. These conditions often recur in Pugs and require regular treatments and medications.
Is Patellar Luxation covered in Pugs?
Patellar Luxation is insurable if it's not congenital and is diagnosed after coverage begins. At Dalma, surgical treatment has an 18-month waiting period.
Are dental problems covered in Pugs?
Yes, dental problems like tartar, gingivitis, or periodontitis are covered after the waiting period. Pugs often have crowded teeth due to their short muzzle, which promotes dental disease.
Is surgical insurance enough for a Pug?
Often not. Pugs incur not just high surgical costs but also ongoing expenses for diagnostics, medications, and regular treatments. Dog health insurance with full cover is therefore usually the better choice.
Is there a deductible for Pugs at Dalma?
No, Dalma has no deductible. Eligible costs are reimbursed at 80 to 100 percent depending on the plan.
Is the contract cancelled after high vet costs?
No, Dalma waives cancellation after a claim. Your Pug remains insured even after expensive treatments or surgeries.
Why is full cover especially recommended for Pugs?
Full cover includes not just surgery but also diagnostics, medications, physical therapy, and preventive care. Since Pugs often need long-term or recurring treatment, full cover provides the most comprehensive protection.
Focus on the cuddles, we'll focus on the costs.
Focus on the cuddles, we'll focus on the costs.
