Shih Tzu Guide

Shih Tzu Health Problems

Shih Tzus are sturdy little dogs and many live long, comfortable lives, but the breed has a handful of health problems that owners should know about before they bring one home. Most of them trace back to the same features that make the breed so recognizable: the short face, the large round eyes and the small, crowded mouth.

None of this is a reason to panic, and no breeder can honestly promise a dog will never have a problem. It is a reason to know what to look for, what a vet will check, and what to ask the person you buy from. For the other side of the picture, see the guide to how long Shih Tzus live.

What are the most common Shih Tzu health problems?

Veterinary sources, including VCA hospitals and the UK VetCompass studies of pet dogs, repeatedly come back to the same list for the breed:

Breathing trouble linked to the short face, called brachycephalic obstructive airway syndrome (BOAS).
Eye problems, including dry eye, corneal ulcers and extra eyelashes.
Dental crowding and gum disease.
Ear infections.
Skin allergies and itchy skin.
Kneecaps that slip out of place (patellar luxation).
Hip dysplasia and spinal disc disease.
Kidney disease that starts in puppyhood (renal dysplasia).
Overheating in warm weather.

Not every Shih Tzu will have any of these, and plenty have none. The sections below take them in turn.

Do Shih Tzus have breathing problems?

Some do. The Shih Tzu is a brachycephalic breed, which means the skull is short and the soft tissues inside the nose and throat are crowded into a small space. In BOAS the nostrils may be narrow, the soft palate may be too long, and the windpipe may be small. Dogs with it snore loudly, breathe noisily, tire quickly and struggle in heat.

Reverse sneezing is a different and much more common thing. The dog draws air in with short, snorting gasps, often after excitement or drinking, and the episode passes in under a minute. It looks alarming but is usually harmless. Mention it to your vet, and if your dog ever has blue-tinged gums, collapses or struggles to breathe at rest, that is an emergency.

A vet judges breathing by watching the nostrils, listening to the chest and seeing how the dog copes with a little exercise. Ask to see a puppy's nostrils, which should be open.

What eye problems do Shih Tzus get?

Those big, slightly prominent eyes are lovely and also exposed. The eye conditions vets list most for the breed are:

Dry eye: the eye does not make enough tears, leaving it sore, red and sticky. It needs ongoing treatment.
Corneal ulcers: scratches or sores on the surface of the eye, which cause squinting and watering and need prompt care.
Distichiasis: extra eyelashes that grow from the lid edge and rub on the eye.
Proptosis: the eyeball pops forward out of the socket after an injury or pressure on the neck. This is an emergency, and it is the reason a harness is kinder than a collar for a Shih Tzu.

Tear staining, the brown streaks below the eyes, is mostly cosmetic. Wipe the area daily with a soft damp cloth or a vet-approved wipe, and trim the hair near the eye so it cannot poke in. A dog that squints, paws at an eye or has thick yellow or green discharge needs a vet that day, not next week.

How many teeth does a Shih Tzu have, and why do they go bad?

Like other dogs, an adult Shih Tzu has 42 teeth, and a puppy has 28 baby teeth that fall out as the adult set comes in, mostly between about four and seven months. The trouble is that those 42 teeth have to fit into a short jaw. Teeth sit crowded and twisted, food and bacteria collect between them, and tartar builds up fast.

Baby teeth sometimes stay in place when the adult tooth comes through beside it. Your vet will want to remove a retained tooth, because it traps food and pushes the new one out of line. Dental disease in small dogs can lead to painful gums, loose teeth and infection that can affect other organs over time.

Daily tooth brushing with a dog toothpaste is the single best habit. Add regular dental checks and professional cleaning when your vet recommends it. Costs for a cleaning under anesthesia vary widely by area, so ask for an estimate.

Why do Shih Tzus get ear infections and skin problems?

Shih Tzus have drop ears covered in long hair, and hair also grows inside the ear canal. Air does not circulate well, moisture stays in, and yeast and bacteria thrive. Signs are head shaking, scratching, a bad smell or dark discharge. Many dogs are prone to repeat infections because of an underlying allergy.

Skin allergies are among the more common reasons Shih Tzus visit the vet. Signs include licking the paws, rubbing the face on carpet, red skin in the armpits and belly, and hot spots. Causes include pollen, dust mites, fleas and, less often, food. Your vet may suggest a flea program, medicated baths, an elimination diet or allergy medication.

Good grooming helps. A clean, brushed and trimmed coat is easier to check, and the grooming guide covers ear care and bathing. Shih Tzus are also not a guaranteed answer for allergic people, as the hypoallergenic guide explains.

What joint and back problems affect Shih Tzus?

Three conditions come up most often.

Patellar luxation: the kneecap slips sideways out of its groove. A dog may skip a step, hold a back leg up for a few strides, then run on. Mild cases are managed; severe grades often need surgery.
Hip dysplasia: a loose, poorly formed hip joint that can lead to arthritis. Stiffness after rest or reluctance to jump are the signs.
Intervertebral disc disease: the cushions between the spine bones bulge or burst. Mild cases cause back pain and a hunched stance, and severe cases can cause weakness or paralysis. A long back and short legs raise the risk.

Keep your dog lean, use ramps or steps for furniture and cars, and avoid regular jumping from height. A vet can check the knees and hips by hand, and X-rays show the rest.

What kidney and other inherited problems should I know about?

Renal dysplasia is a condition in which the kidneys do not develop properly before birth. It is described in the breed and can cause kidney failure in a young dog. Signs include drinking and urinating a lot, poor growth and weight loss in a puppy or young adult. A vet can check kidney values with a blood and urine test.

Bladder stones are another issue vets see in small breeds, with signs such as straining, blood in the urine or frequent small urinations. Some dogs also develop low thyroid levels as they age. These conditions are less common than the ones above, but they are why an annual vet check matters for a Shih Tzu, even when the dog looks fine.

How can I tell if my Shih Tzu is too hot?

The short face makes it hard for a Shih Tzu to cool by panting, so heat is a real risk and not a minor annoyance. Signs of trouble are heavy, noisy panting, drooling, bright red or pale gums, wobbling and vomiting. Move the dog into shade or air conditioning, wet the body with cool, not ice-cold, water, and get to a vet.

The easy fix is prevention. Walk early or late on warm days, never leave a dog in a parked car, and keep the house cool. Dogs that live in a hot climate need extra care in summer. A lean dog tolerates heat better, which is one more reason to follow the feeding guide and keep the weight sensible.

What can I ask a breeder, and what does a vet check?

No breeder can guarantee a dog will never be ill, and a promise of "guaranteed healthy" is one nobody can honestly make. Here is what you can reasonably ask:

Has the puppy seen a vet, and can you see the written record of its vaccinations and worming?
Do the puppy's eyes look clear and bright, with no discharge, and do the nostrils look open?
What health protection is in the contract, and for how long?
Will the breeder still answer questions after the puppy goes home?

At Royal Silk Shih Tzus, every puppy is seen by my vet before going home, the vaccination and worming record goes with it, and the contract carries a one-year health guarantee in writing. The what comes with your puppy page sets this out, and the guide to choosing a Shih Tzu breeder covers the rest.

After you bring a puppy home, book a vet visit within the first few days. The vet will check the eyes, ears, teeth, heart, lungs, knees and belly, and plan the remaining vaccinations. You can meet the puppies available now on their profile pages.

Quick Answers

Are Shih Tzus unhealthy dogs?

Not as a rule. Many are healthy for many years, but the breed is prone to certain problems because of its face, eyes and build. Knowing them early makes them easier to catch and manage.

Why is my Shih Tzu's eye watery or crusty?

Mild tear staining and morning crust are common. Heavy discharge, squinting or redness can mean an ulcer, an infection or dry eye, so have a vet look at it promptly.

Do Shih Tzus snore?

Many do, because of the short nose and soft palate. Loud snoring with tiring easily or struggling in warm weather is worth raising with your vet.

What is reverse sneezing in a Shih Tzu?

It is a sudden run of snorting inhales, often triggered by excitement, drinking or a collar pulling on the neck. It usually passes within a minute and is not painful.

Should my Shih Tzu wear a collar or a harness?

A harness is usually kinder, because pulling on a collar presses on the neck and can aggravate breathing and, rarely, push the eyes forward. Keep a collar for the ID tag.