Study highlights high early mortality but potential for treatment to increase short-term survival for Pugs with protein-losing enteropathy

25 February 2026

Pugs with protein-losing enteropathy have high early mortality, but potential for treatment to improve short-term survival, according to new research published in the Journal of Small Animal Practice.

While previous research has found that Pugs with protein-losing enteropathy (PLE) have higher proportional mortality compared to all other breeds in referral care, it was unknown whether this is also the case for Pugs managed only in primary care practice.

A new study by researchers from the Royal Veterinary College gives a comprehensive insight into the clinical management and outcomes of 51 Pugs reportedly diagnosed with PLE in UK primary care, using data from the VetCompass programme.

The findings show that 43% of Pugs died presumed due to PLE, with over half of these deaths occurring within three months of diagnosis. The majority of Pugs that died were euthanased (64%), and the remainder had an unassisted death. The underlying cause for the PLE diagnosis in most Pugs in the study was not identified.

Clinical signs at diagnosis commonly included diarrhoea, vomiting, inappetence, lethargy, weight loss and increased drinking. Other reported clinical signs at the time of death were pale mucous membranes, seizures and anaemia – findings which haven’t been reported in the literature previously.

Treatment prescribed for PLE were variable and included dietary therapy, prednisolone, clopidogrel, chlorambucil, cyclosporin and/or cobalamin supplementation. Pugs treated with prednisolone or clopidogrel were significantly more likely to be alive after three months, suggesting that these treatments may improve short-term outcomes. However, the treatment effects did not persist at one or two years after diagnosis, and further research is needed on longer-term therapies.

Pugs diagnosed with PLE in primary care practices had similar outcomes to those reported from referral practices, suggesting a generally poor prognosis regardless of treatment setting. However, this could also be explained by more severe cases being referred versus treated in primary care practices. Therefore, future studies should also include the impact of severity of disease on the outcome.

Dr Aarti Kathrani, lead author of the study, said: “The results of our study will help to increase awareness and highlight the outcome and various causes of death in Pugs with protein-losing enteropathy. We hope the results will also help drive much-needed further research into the mechanism, pathophysiology and consequence of this disease, which is needed to help discover effective therapeutic targets that could help improve the prognosis of this guarded condition.”

Read the full study in the Journal of Small Animal Practice: https://onlinelibrary.wiley.com/doi/10.1111/jsap.70094