| Age of Pug in months | |
| Where did you acquire your Pug? | Show breeder Other breeder Pet shop Rescue |
| Sex | Male Female |
| Colour | Fawn Black |
| Has this Pug been spayed or neutered? | |
| Allergies | |
| Cervical disc disease | A degeneration or malformation of the cushioning discs between the spinal column bones in the neck. |
| Collapsed trachea | |
| Corneal ulcer, superficial | |
| Cystitis and cystic calculi | Infection of the bladder which often leads to formation of abnormal mineral deposits (bladder stones). |
| Demodectic mange | |
| Diabetes | |
| Distichiasis and Ectopic Cilia | A second row of eyelashes and lashes that grow on the inside of the eye lid |
| Dry eye | A condition where one or both eyes do not produce a normal amount or type of tears. |
| Dystocia | Complications of the birth process (difficult birth). |
| Elongated soft palate | |
| Encephalitis | An inflammatory condition of the brain causing signs of central nervous system dysfunction and epilepsy (seizures). |
| Entropion | Eyelid that is turned in. |
| Epilepsy | A disease characterized by convulsions (seizures) and/or disturbances of consciousness. |
| Exposure keratopathy syndrome | A condition where the Pug does not close its eyes completely when sleeping, causing the drying of the cornea and formation of pigment. |
| Hanging tongue | |
| Hemivertebrae | A wedge shaped vertebrae instead of the usual square one; can cause paralysis |
| Hepatic portosystemic shunt | A malformation of blood vessels in the liver or an abnormal communication between the arteries and veins in the liver. |
| Hip dysplasia | |
| Hypothyroidism | A disease where the body produces an abnormally low amount of thyroid hormones. |
| Legg-Perthes disease | Necrosis (death) of the femoral head. |
| Mastocytoma | A mast cell tumour. |
| Monorchid/chryptorchid | One or both testicles remain undescended. |
| Patella luxation | Slipping knee caps |
| Pannus | Migration of blood vessels and the pigment of the eye, usually from the outer edge to the middle until they cover the cornea |
| Pigmentary keratitis | An inflammatory condition of the cornea characterized by abnormal pigmentation. |
| Severely undershot jaw | A condition where the lower jaw is too long for the upper jaw. |
| Stenotic nares | Pinched or very tight nostrils. |
| Syncope | A brief period of fainting or collapse. |
| Ulcerative keratitis | An inflammation of the cornea characterized by the formation of ulcers. |
| Umbilical hernia | A break in the abdominal muscle wall at the point where the umbilical cord enters the body. |
| Vaginal hyperplasia | An overgrowth of tissues of the vagina. |
| Wry mouth | A condition where the teeth do not meet properly; a crooked mouth. |
| Have the Pug's hips been x-rayed? - | |
| If yes, have the x-rays been submitted to a registry for evaluation? (e.g. OFA) | |
| Have the Pug's knees been checked by a vet? | |
| If yes, have the knees been certified? (e.g. by OFA) | |
| Have the Pug's eyes been examined by an ophthalmologist? | |
| If yes, has the exam form been submitted to an eye registry (e.g. CERF)? | |
| Has this Pug had a reaction to routine vaccination? |