Pomeranians live a long time and most of their problems are small ones. But four things come up again and again: a collapsing windpipe, slipping kneecaps, bad teeth, and a coat condition called alopecia X. Puppies add a fifth — low blood sugar, which is the only true emergency on the list.
Two of these are worth understanding properly, because they behave in opposite ways. One quietly costs a fortune and upsets nobody early on. The other upsets everybody and costs comparatively little.
Nothing here is a diagnosis. It is what to notice and what to ask, so you get to a vet early rather than late.
The Ones To Watch First
Tracheal Collapse — The Honking Cough
The windpipe is held open by rings of cartilage. In small breeds those rings can soften and flatten, so the airway narrows when the dog breathes in. The result is a distinctive dry, honking cough — often described as sounding like a goose.
What makes it recognisable is when it happens: on excitement, on exertion, in heat and humidity, and above all when something pulls on the neck.
Which leads to the single most useful thing in this article. Walk a Pomeranian on a harness, never a collar. A collar puts pressure exactly where the trachea is weakest, on a breed already predisposed to this. The AKC lists pressure on the dog’s neck as something that can make the cough worse, and suggests a harness instead of a collar. It is an easy change that is entirely in your hands.
It is progressive. Early on it is managed with medication and weight control. Late on it may need surgery.
Luxating Patella — The Skip
The kneecap slips out of its groove and pops back. The classic sign is a dog that trots along, skips a step or holds a back leg up for a couple of strides, then carries on as if nothing happened.
This is not rare in small breeds. VCA Hospitals says many toy and small-breed dogs have a genetic predisposition, and describes four grades, where a higher grade means more severe. Ask the breeder which health tests are recommended in your country.
Mild grades are often managed with weight control, sensible exercise and keeping the dog off big jumps. Severe grades are surgical.
Alopecia X — Black Skin Disease
Patterned hair loss, usually starting on the tail and back legs, spreading over the body and leaving darkened skin behind. Crucially, it does not itch — which is how it is told apart from allergies and mange, both of which do.
It is classed as primarily cosmetic because it does not usually make the dog unwell. There is no reliable cure. Treatment is weighed against side effects, and for many Poms protecting the exposed skin and keeping the dog comfortable is the wiser path.
Cosmetic is a loaded word here. It is the reason many owners find it devastating — the coat is the breed — and, as below, the reason insurers often will not pay for it.
Dental Disease
A Pomeranian has the same number of teeth as a Labrador in a fraction of the space. Crowding traps food, plaque builds fast, and tooth loss comes early. For this breed dental care is not optional maintenance, it is a core health issue.
Daily brushing genuinely works, and starting it in puppyhood is far easier than starting it at four.
Puppy Hypoglycaemia — The Real Emergency
Tiny puppies have almost no energy reserve, and blood sugar can crash quickly. Signs are weakness, wobbliness, shaking, going off food, and in bad cases collapse or seizures.
This is an emergency. A small amount of honey or glucose syrup rubbed onto the gums can lift the blood sugar enough to buy time — and then the dog goes to a vet immediately, not later. Frequent small meals in the first few months are what prevent it. The AKC explains the signs and first aid.
A Simple Monthly Check
- Listen for the cough. Any new honking sound, especially on excitement, is a vet conversation rather than a wait.
- Watch them trot. A skipped step or a briefly lifted back leg is the kneecap, not clumsiness.
- Lift the lip. Red gum margins, brown build-up or a smell mean it is already overdue.
- Part the coat at the tail and thighs. Thinning without itching is the pattern to note.
- Check the harness fits. And that the collar is for tags only.
What These Problems Cost, And What Insurance Will Not Cover
There is something specific to this breed worth understanding before you buy a policy: the thing most likely to upset you and the thing most likely to cost you are not the same thing — and only one of them is usually insurable.
Alopecia X takes the coat, which for most people is the entire reason they chose a Pomeranian — and being classed as cosmetic puts it squarely in the category insurers commonly exclude. Do not assume it is covered. Ask, and get the answer in writing.
Tracheal collapse is the reverse. It rarely upsets anyone at first, and it is the one that eventually costs real money.
What the common problems cost
- Tracheal stent — one US insurer guide gives US$3,500 to US$6,500, and US$8,000 to US$9,000 at some specialist centres once anaesthesia and imaging are counted. Costs differ by country, so ask your vet for a local estimate.
- Luxating patella surgery — one US guide gives US$1,500 to US$5,000 per knee, averaging near US$3,200.
- Alopecia X — no reliable cure, so the cost is skin protection and comfort rather than a procedure, and it may fall outside your policy entirely.
And what insuring one costs
One US insurer reports an average monthly premium of about US$50, moving with your location and the dog’s age when you enrol. Premiums differ a lot by country, so get quotes where you live.
What to check before you sign anything
- Ask directly how cosmetic and skin conditions are treated. For this breed that single answer decides whether the most likely problem is covered at all.
- Remember tracheal collapse is progressive. It is usually noted on the record as a cough years before it needs a stent — plenty of time for an insurer to call the surgery pre-existing. Enrol before the cough, not after it.
- Are hereditary conditions included? Collapsed trachea and luxating patella both have a breed component.
- Is dental covered? With this breed dental work is a question of when, not if.
Coverage varies by insurer, plan, and where you live, and none of this replaces reading the policy wording or talking to your vet about your own dog. Prices and availability differ by country — if you’re outside the US, check what’s offered where you are.
Post-Clipping Alopecia: Why You Should Not Shave a Pomeranian
A Pomeranian has a double coat, and shaving it down is the one grooming decision that can fail to reverse. In some dogs the coat simply does not grow back properly afterwards — patchy, woolly undercoat with no guard hairs, or bald areas that persist for months or years. It is usually called post-clipping alopecia, and it overlaps with what breeders call alopecia X.
Nobody can reliably predict which dogs it will happen to, which is the reason not to risk it. A shaved double coat also stops doing its job: the undercoat insulates against heat as well as cold, and the guard hairs are what protect the skin from sun.
If your Pomeranian is matted to the skin, shaving may genuinely be the kindest option — that is a decision for your groomer and your vet together, not a reason to avoid the clippers at all costs. But shaving for summer comfort is not a good trade. Brushing out the undercoat does more for heat than removing the coat does.
Frequently Asked Questions
Why does my Pomeranian make a honking cough?
That sound is characteristic of tracheal collapse, particularly if it comes on with excitement, exercise or pressure on the neck. It is worth a vet visit rather than a wait-and-see, because early management is far cheaper and easier than late.
Is a collar or a harness better for a Pomeranian?
A harness, without much argument. A collar concentrates pressure on the windpipe of a breed already prone to it collapsing. Keep a collar for identification tags and walk on a harness.
A Pomeranian losing fur but not scratching. What is it?
Hair loss without itching is the pattern that points toward alopecia X rather than allergies or parasites, which almost always itch. It needs a vet to confirm, because other causes such as thyroid disease look similar and are treatable.
What is the skipping step in my Pomeranian’s back leg?
Almost certainly a luxating patella — the kneecap slipping out and back. It is common in small breeds. Mild cases are managed conservatively; your vet will grade it and tell you which you are dealing with.
How long do Pomeranians live?
They are a long-lived breed, and dental care and weight control do more to protect those later years than almost anything else. Both are entirely within your control.
? From Fluffy’s Bowl: If you take one thing from this page, make it the harness. It costs less than a bag of treats, it takes one shopping trip, and it protects the exact part of a Pomeranian that is most likely to let them down.
