Three items on the Pomeranian's list change how the dog is handled day to day.
Tracheal collapse is the most important. The cartilage rings supporting the windpipe soften and flatten, producing a honking cough that worsens with excitement, heat or pressure on the throat. A harness rather than a collar is not a preference in this breed, it is a rule for life.
Patellar luxation is the common orthopaedic problem — a kneecap that slips out of its groove, producing a momentary skipping step. Many cases are mild; some need surgery. Discouraging jumps down from furniture helps.
Hypoglycaemia is a puppy risk. A three-pound body has almost no glycogen reserve, so a missed meal or a stressful day can cause weakness, wobbling or collapse. Frequent small meals through the first months are standard, and a listless small-breed puppy should be seen quickly.
Dental disease is the recurring cost, as in every tiny breed, and daily brushing genuinely reduces the anaesthetics needed across a sixteen-year life.
The Akita's burden is autoimmune and endocrine, with hip dysplasia and bloat.