Diet, Allergies & Recurrent Ear Infections in Pugs: What Winston Taught Us

Originally published 2024 — Updated August 2026
I originally wrote this article after the heartbreaking loss of Winston, Pickwick's Cosmic Constellation in the Stars, at only five years of age.

Winston was a pug we bred but did not own. He was deeply loved, and his owner worked closely with her veterinarians throughout his illness, treating each problem as it arose and following the medical advice she was given. Nothing in this article is intended to second-guess the difficult decisions made while trying to help him.

Instead, Winston's experience sent me down a path of learning much more about recurrent ear disease, allergies, nutrition, pancreatitis, diabetes, and the effects of long-term medications. Veterinary knowledge and treatment options continue to evolve, and I understand some of these issues differently today than I did when I first wrote this article.

So, in Winston's honor, I am updating it.

When an Ear Infection Keeps Coming Back
Ear infections are common in dogs, and an occasional infection does not necessarily indicate a larger problem.

Recurring ear infections, however, can sometimes be a clue that something else is going on.

Allergic skin disease is one possible underlying cause. Allergies may be environmental, food-related, or a combination of factors. Once the ear becomes inflamed, yeast and bacteria can take advantage of that unhealthy environment and create a secondary infection.

Those infections need to be treated. But when they repeatedly return, today's lesson for me is simply to become curious:

Why does this keep happening?
That doesn't mean an owner or veterinarian has done anything wrong. It means that recurrent disease sometimes warrants looking beyond the current infection to see whether an underlying problem can be identified.

Can Food Be Involved?
Sometimes.
Food allergy or food-responsive skin disease can cause itching and may be associated with recurring skin and ear problems in some dogs.

But this is one area where I want to correct something I wrote in the original version of this article.

I previously gave fairly categorical advice about avoiding ingredients such as corn, wheat and soy. I no longer think that is an accurate or particularly useful way to think about canine food allergies.

Dogs can react to many different dietary proteins and ingredients, including some that we might otherwise consider perfectly good ingredients. Chicken, beef, dairy, egg, wheat, soy and others have all been implicated in individual dogs.

That doesn't make those ingredients inherently “bad.”

A chicken-allergic dog has a problem with chicken. That does not mean chicken is a bad ingredient for every dog.

Likewise, we can't diagnose a food allergy simply by reading the ingredient panel on a bag of dog food.

How Is a Food Allergy Diagnosed?Another correction to my original article: blood and skin allergy tests are not considered reliable ways to diagnose food allergy in dogs.

The accepted approach is a properly controlled elimination diet trial, usually using an appropriate veterinary therapeutic hydrolyzed or novel-protein diet, followed by a dietary challenge.

And this is one of those situations in which following your veterinarian's instructions really matters. Treats, chews, flavored medications and supplements containing other proteins can interfere with a carefully conducted trial.

If symptoms improve during the elimination period and return when the previous food or suspected ingredient is reintroduced, that gives the veterinarian much more useful information.

If one of our Pickwick pugs begins experiencing recurrent ear or skin problems today, a conversation about whether a controlled diet trial might be appropriate is one of the things I encourage the owner to have with the veterinarian.

It is a question worth asking—not a diagnosis we can make ourselves

Winston's Medical Journey
Over time, Winston experienced recurring ear problems and required repeated veterinary treatment. Eventually his treatment included extended use of systemic corticosteroids.

Later, he developed diabetes and pancreatitis.

An emergency veterinarian who treated Winston believed his prolonged steroid exposure had played an important role in the development of his diabetes.

With what we know about glucocorticoids and insulin resistance, that is medically plausible. Long-term systemic corticosteroids can cause significant insulin resistance and can contribute to or precipitate diabetes in a susceptible dog. But I want to be careful here, too. We cannot go back and reconstruct every factor that contributed to Winston's illness.

Diabetes and pancreatitis can themselves have a complicated relationship, and many factors can contribute to pancreatic disease. Nor does Winston's experience mean that corticosteroids are “bad” medications. Steroids can be enormously valuable and sometimes lifesaving. There are medical situations in which they are exactly the right treatment.

What Winston's experience changed for me was not a fear of medication. It changed the questions I ask when a dog requires repeated or long-term treatment.

Treat the Dog in Front of You
Today, if one of our pugs develops chronic allergic disease, I encourage the owner to work with the veterinarian to manage the dog's immediate discomfort and investigate the underlying problem when possible.

Sometimes systemic steroids may be appropriate. Sometimes a veterinarian may recommend other approaches.

For allergic itch, for example, veterinarians now have options such as Cytopoint (lokivetmab), an injectable monoclonal antibody that works differently from systemic corticosteroids. We have personally had good experiences with Cytopoint in pugs for whom our veterinarians felt it was appropriate.

But there is no one treatment that is right for every pug.

The best plan depends upon the individual dog, the cause of the symptoms, whether a secondary infection is present, the severity and duration of the disease, and the dog's overall health.

What Do We Feed at Pickwick?
People ask this frequently, so I am happy to share what works well for us—with the important caveat that our experience is not proof that there is one perfect food for every pug.

At Pickwick, we currently feed primarily pawTree kibble, most often Chicken & Oatmeal or Chicken & Sweet Potato, with a small amount of pawTree freeze-dried raw as a topper. We add water, a little fish oil, sometimes chicken broth, and a small amount of NuVet powder.

Our pugs have done very well on this feeding routine, and we have been pleased with their condition, coats and overall health.

For transparency, I am also a pawTree Pet Pro, which means I may financially benefit when someone purchases pawTree products through my business. I recommend it because of our experience with our own dogs, but I think readers deserve to know about that relationship when considering my recommendation.

I do not claim that pawTree prevents allergies, pancreatitis, diabetes or other diseases, and I don't believe that every dog needs to eat exactly what ours eat.

The individual dog matters.

A Word About Dog-Food Ingredient Lists
I also look at dog-food labels somewhat differently now.

In the original article, I placed a great deal of emphasis on avoiding particular ingredients and on having “real meat” appear first on the ingredient list.

Ingredient lists can certainly provide useful information, particularly when we're trying to identify something an individual dog cannot tolerate. But they aren't a complete measure of the nutritional quality of a food.

Fresh meat contains a great deal of water, for example, so its position on an ingredient list can make comparisons between foods misleading. Likewise, ingredients such as corn, wheat or a properly processed meat meal are not automatically evidence that a food is poor quality.

I still believe owners should know what they are feeding. I still read labels. I still have preferences based upon my experience feeding generations of pugs.

But I've learned to be more cautious about dividing individual ingredients into simple categories of “good” and “bad.”

What About the Food Winston Ate?
While we can't know for certain that it was the food Winston was eating (Royal Canin, with the pug on front of bag) contributed to the sequence of events that eventually let to the illness, we do know that something in his diet could conceivably have contributed to his recurring ear disease if he had a food-responsive allergy. Many pugs do. Many pugs are sensitive to corn, wheat, soy. But, environmental allergies, or other causes of inflammation, or several factors acting together are also possibilities. We cannot diagnose that retrospectively. But, we can over time make informed decisions based upon many cases. This is a good sequence to follow: ear infection? ...... appropriate vet recommend meds, ear drops etc. to treat immediately ....... allergy test(s) BY VET not the online cheaper versions  ..... adjust accordingly (allergic to eggs? find appropriate food and read labels carefully -- allergic to dust? -- allergic to wheat? etc.) Deal with the cause, don't just put bandaids on.

What Winston Taught Me
Winston's owner loved him and did what loving dog owners do: she sought veterinary help when he was sick and followed the recommendations she was given.

Nothing I have learned since changes that.

And nothing in this article means that Winston's eventual illness could necessarily have been prevented. We simply don't know.

What his experience did do was make me a better-informed breeder.

Because of Winston, when I hear that one of our pugs has developed repeated ear infections, I now encourage the owner to have a broader conversation with the veterinarian.

Not because anyone has done something wrong.

Because Winston taught me that recurring symptoms can sometimes contain useful information.
So today, in addition to asking how we can make the pug comfortable and treat the current infection, I encourage owners to ask:

Do we know why this keeps happening?
Could there be an underlying allergy? 
Would a controlled food trial be useful? Find a food with limited ingredients (i.e. PawTree) so you can see if there is a sensitivity to chicken, or beef etc.
Could environmental allergies be involved?
Are yeast or bacteria secondary to something else?
Important: Have your vet conduct an allergy test (not the cheap ones you can buy online).
If long-term medication is becoming necessary, what are its benefits and risks?
Are there alternatives worth discussing?
Would consultation with a veterinary dermatologist help?
Those are questions—not accusations and not diagnoses.
They are simply additional tools we have available to us.

Winston's Legacy
Every dog we breed teaches us something.
Some teach us about structure. Some teach us about temperament. Some teach us about training, longevity or genetics.

And occasionally, one teaches us something we wish we had never needed to learn.
Winston was one of those dogs.

His story isn't about blame. It isn't about a bad owner, a bad veterinarian, a bad medication or a bad bag of dog food.

It is about learning.

Winston was deeply loved throughout his life. And because of what I learned from his experience, I now know more questions to ask and more information to share with the families who take home the pugs we breed.

That seems to me a fitting legacy for a very special little pug.

Thank you, Winston.