Shih Tzu Common Health Problems

Shih tzu common health problems.

First, A Word About Shih Tzu Common Health Problems

In this post, you will find a few details about shih tzu common health problems, the illnesses, ailments and diseases that are most likely to affect the shih tzu breed.

These are diseases and problems that your shih tzu could suffer from but don’t worry, just because he could suffer it doesn’t mean that he will and the chances are that your dog is going to live a full and healthy life, especially if you play your part and do what you can to make it so.

I just believe that you should be aware of what could happen so that you are prepared in case anything does happen. If you think your shih tzu could be starting to suffer from any of the following conditions, it is important that you take action early to maximize the chances of a full recovery.

Jump to:
Dental ProblemsKidney Disease
Dental DiseaseCushing’s Disease
Eye Problems (opens in new tab)Addison’s Disease
Ear ProblemsKidney Stones
Breathing ProblemsPortosystemic Liver Shunt
Brachycephalic Airway SyndromeUmbilical Hernia
Back Problemsvon Willebrand’s Disease
Intervertebral Disc DiseaseOther Problems
Joint ProblemsAllergies
Hip DysplasiaInfection And Parasites
Patellar LuxationObesity
Problems Of The OrgansInterdigital Furunculosis
Heart MurmurReverse Sneezing
HypothyroidismMinimizing The Chances Of Shih Tzu Common Health Problems
Juvenile Renal Dysplasia

Dental Problems

A shih tzu puppy having a dental inspection.
ID: 238853558 © cynoclub | Depositphotos

I am starting off with dental problems because it is easy to underestimate the importance of keeping you shih tzu’s teeth clean and healthy and the effect this can have on his general health.


The very small mouth and almost non-existent snout of the shih tzu creates an environment prone to several forms of dental disease. Dogs like the shih tzu are more prone to teeth issues than dogs with longer snouts. Most are born with the characteristic underbite, known as a malocclusion, but there is also a chance of misalignment of the teeth, overcrowding or the reverse, oligodontia, a condition where only some of the teeth appear. Sometimes baby teeth remain intact when the adult teeth come through.

In most cases, these conditions can be treated with extractions, the wearing of braces or a combination of the two. Of course, trained professionals must do this but the owner can help with dental health by cleaning their dog’s teeth regularly. If not, as the dog gets older tartar and plaque builds up, eventually spreading to the gums and the roots of the teeth where infections will take hold. The dog may then lose his teeth and there is also the increased danger of the heart, liver, kidneys or joints being affected which could result in the dog’s lifespan being cut short by up to three years. So, if you want your shih tzu to live a full and happy life, keep his teeth clean!

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Eye Problems

There are many eye problems that can manifest themselves upon an unfortunate shih tzu. I have written a separate post exclusively about shih tzu eye problems:

Click here to read about shih tzu and eye problems.

Ear Problems

A vet examining a shih tzu’s ear.
ID: 2784393 © lovleah | Depositphotos

Shih tzu have a comparatively wide ear opening funneling into a deep, narrow ear canal that is kept warm by their thick and hairy ear flap covering. Throw the constantly growing inner ear hair into the mix and it is as if the shih tzu’s ear were a Petri dish, a perfect environment for breeding bacterial cultures.

Ear infections can occur as a result of an allergy, too much hair in the ear canal, a build-up of earwax, the presence of yeast or an ear mite infestation.  Your shih tzu could also suffer an ear infection as a result of swimming in affected water.


  • Shaking of the head so much that you can hear the ear flaps clap.
  • Rubbing of the ears on carpets, rugs, cushions, soft toys, etcetera.
  • Digging out of the ear wax with the paws, then licking the paws.
  • Scratching of the ear with the paws.
  • Bad odor emanating from the ears.
  • Ears feel hot to touch.
  • Agitated by loud noises.
  • If you have a second dog, he may constantly lick the infected dog’s ears.


  • Routine cleaning of the ears with cotton balls and canine ear drops will go a long way to prevent any infections from starting.
  • Regular plucking of the hairs inside the ears will also help prevent infections.
  • If an infection does occur, have your vet diagnose exactly what the infection is so that a course of treatment can be started as soon as possible.
  • Medication, including antibiotics and medicated ear drops, may be prescribed.                                                                                           

Breathing Problems

Anticipating the cold contact of the stethoscope.
ID: 5246714 © fantazista | Depositphotos


Shih tzu, along with most short-nosed breeds, sometimes have difficulty breathing normally because inside their mouths, noses and throats they pack into a smaller space the same amount of tissue as breeds with longer snouts, resulting in narrower or partially obstructed airways.

Brachycephalic Syndrome is brought about by one or any combination of four contributing factors:

  • Elongated Soft Palate:
    • As from birth, shih tzu generally have soft palates that are too long for their mouths and some have part of it overhanging the back of the mouth obstructing the throat and airway.
  • Stenotic Nares:
    • If a shih tzu has this, it will be from birth. The passageways of the nostrils are too narrow, causing breathing difficulties and oxygen deficiency. Stenotic nares can be fatal if left untreated.
  • Abnormally Small Trachea or Collapsing Trachea:
    • Again, if your shih tzu has an abnormally small trachea, or windpipe, it will be from birth. The weakened cartilage that can lead to a collapsing trachea can be from birth, brought on by struggling to cope with other breathing problems or, more rarely, due to a trauma such as an ill-fitting collar or badly designed harness.
    • Click here for a full report concerning Collapsing Trachea.
  • Laryngeal Collapse:
    • Laryngeal collapse, the deterioration of the voice box, is usually brought on by any of the previous conditions causing the cartilage to become fatigued and weakened because of the extra effort put in to inhale sufficient air and oxygen, although there are rare cases of it being caused by trauma.

Any one of these conditions will cause breathing difficulties, so a dog suffering from more than one will have severe breathing problems that will need the intervention of a veterinarian to decide what action to take. You may not notice that your dog has a problem until he is between the age of one year and six years.

As dogs regulate their body temperature by breathing in cold air, if they are struggling to breathe this becomes difficult. If your shih tzu has any breathing difficulties, be wary, especially on hot and humid days, of any rises in body temperature that may lead to heatstroke.


  • Long term noisy and difficult breathing.
  • Sudden worsening of breathing, struggling to breathe.
  • Cyanosis – lack of sufficient oxygen turns the lips and gums blue.
  • Any or all of coughing, choking, gagging or vomiting.
  • Constant panting.
  • Elevated body temperature.
  • Collapse or even death in severe and untreated cases.

Treatment depends upon the urgency and severity of the condition.

  • Emergency treatment:
    • Emergency oxygen supply.
    • Sedation to prevent panic.
    • Anti-inflammatories.
    • If necessary, an emergency, temporary tracheostomy.
  • Mild to severe cases:
    • Removal of the excess piece of the soft palate that is blocking the airway.
    • Removal of excessive and obstructive tissue in the throat.
    • Widening of the external end of the nostrils to allow a greater volume of air through.
    • If necessary, the partial removal of damaged cartilage through the mouth.
  • Severe cases:
    • A permanent tracheostomy.

Dogs treated for mild to severe cases usually recover well. Dogs given a permanent tracheostomy are in danger for a week after the operation from blockages caused by mucus and blood, which must be cleared out. After that, the opening needs to be vigilantly kept clean and dry.

Back Problems

A little girl plays at being a vet to her pet dog.
ID: 8841156 © Klanneke | Depositphotos


This is a frequent occurrence in dogs with short legs and a long back. It is the most common back problem to affect the shih tzu breed. The leverage between the vertebrae and the legs can sometimes cause one or more of the intervertebral, gel-like, shock-absorbing discs to pop out of place. The slipped disc or discs then rub up against the spinal cord causing problems with the nervous system and excruciating pain. If left untreated it can progress to chronic weakness or even paralysis.


  • Severe pain, extreme sensitivity in the affected area.
  • Inability to walk properly, may drag a rear foot.
  • Cannot jump onto the sofa or climb the stairs.
  • Weak limbs, difficulty rising from lying position.
  • Does not want to move or be moved.
  • Muscle spasms.
  • Back is hunched.
  • Loss of appetite.
  • Sudden paralysis, inability to use the back legs.

The paralysis may become permanent if the condition is not treated.


  • Muscle relaxing drugs.
  • Anti-inflammatories.
  • Plenty of rest.
  • Corrective surgery.
  • Complete removal of the ruptured discs if paralysis has occurred.

Joint Problems

A cute black and white shih tzu lying on its side.
ID: 75104531 © Taranukhin | Depositphotos


Hip dysplasia is usually a hereditary disease where the soft tissue surrounding the hip joint develops in an abnormal way that means the bones are not contained as they should be and can move apart slightly. This, in turn, causes extra friction on the joint which leads to osteoarthritis.

The condition can also be initiated or worsened by a shih tzu’s frequent overconfidence in its own jumping capabilities where it lands too heavily, causing an accumulative injury to the hip joint.

Hip dysplasia, which can vary a lot in its severity, is usually diagnosed in senior dogs but there have been cases with dogs as young as four months.


  • Intermittent to constant pain, varying in its severity.
  • Awkward, often narrow stance.
  • Stiffness or lameness in the back legs.
  • Unnatural walking action, usually with difficulty.
  • Rising from a lying position is an ordeal.
  • A gaunt look due to loss of muscle tone.
  • In the severest of cases, total immobility.


  • Anti-inflammatories for the swelling and the pain.
  • Medication for the arthritis.
  • Heat treatment.
  • Special diet to improve joint health and control weight.
  • Dietary supplements to improve joint health.
  • Physiotherapy or controlled exercise.
  • In severe cases, especially where lameness occurs, surgery will be needed.


This condition is an abnormal movement or dislocation of the knee cap, usually on one or both of the back legs. It is hereditary and can happen at any time in the dog’s life. There is a wide range of severity for patellar luxation, varying from an infrequent limp to complete lameness. The degree of the condition depends upon how much play there is between the patella and the trochlear groove that it is usually located in. If left untreated it can lead to osteoarthritis.


  • The dog walks with a limp, or picks up the affected leg and tries to walk on three legs or hops.
  • The dog shows he is in pain by lifting his leg.
  • Lameness in severe cases.

After the knee cap has popped out once, it is likely to pop out repeatedly in the future. The leg may become deformed if not treated but it is very rare that a successful solution cannot be found.


  • The dog may try to pop his own knee cap back into place by thrusting the affected leg out sideways.
  • Less severe cases can often be treated with just anti-inflammatories and arthritis medication.
  • The worst cases can be treated with steroids, bed rest and a gradual return to active exercise after three weeks, avoiding putting the affected leg under stress.
  • Severe cases will need surgery to realign the patella.

Problems Of The Organs

A shih tzu with a heart.
ID: 151602108 © chaoss | Depositphotos


A heart murmur is a hindrance of the blood flow through the heart, so called because of the “whooshing” sound that can be heard amongst the regular heartbeat when examining with a stethoscope. Tests, including blood tests, an ECG and ultrasound carried out by your vet will determine if the condition needs treatment or not.

Heart murmurs may originate from several causes, including heart valve deficiencies, blockages or infections, defects in the heart wall, deterioration of the heart muscle, tumors or heartworm.

A heart murmur can be detected at any age, more often in senior dogs. If detected in a new puppy it will either be congenital or it could be an “innocent” murmur that will disappear at around four months of age.


  • Difficulty in breathing and rapid breathing that may be accompanied by a congested sound.
  • Chesty cough.
  • Tired and weak, doesn’t want to exercise.
  • Cyanosis, that is a bluing of the lips and gums.
  • Fainting fits.
  • Sudden collapses.
  • Distended stomach or pot belly.


  • If detected early enough, medication can be administered for life to make the dog more comfortable and improve life expectancy.
  • Addressing the causes of the heart murmur.
  • If heartworm is the cause, treatment for heartworm will normally clear the murmur completely.
  • Surgery will be needed in severe cases.


In dogs, hypothyroidism is often caused by an inflammation or shrinkage of the thyroid gland. Shih tzu with hypothyroidism suffer from their thyroid glands under producing enough thyroid hormone, the hormone responsible for the regulation of the body’s metabolism. The condition is not common with small dogs but some shih tzu have been known to suffer from it. It can be diagnosed at any age but it is more common to find it in senior dogs.


  • Loss or thinning of the body hair, the head and legs are usually unaffected.
  • Reduced tolerance of cold temperatures.
  • Painful ear infection.
  • Skin infection resulting in sores.
  • Thickening of the skin and increased pigment in the armpit areas.
  • A less common symptom is a widening of the esophagus causing food to be regurgitated.
  • Also less common is the nervous system to be affected in such a way as to cause weakness and an inability to walk properly.


  • Thyroid hormone replacement medicine for life.
  • Antibiotics to treat ear and skin infections.


Juvenile renal dysplasia is a genetically inherited disease most often diagnosed in younger dogs. Not all puppies from the same litter will suffer the same degree of severity. As the shih tzu puppy grows into an adult, the kidneys remain in an immature state and of inadequate size to cope with adult life demands.

Unfortunately, there is no known cure for this condition.


  • Excessive water consumption, up to five times what is considered normal.
  • Excessive volume of urination, usually pale in color.
  • Reduced body weight and comparatively small stature.
  • Signs of debilitation.


  • A low phosphorus, low protein and low sodium diet supplemented with omega-3 fish oils can help lessen the severity of the symptoms.


Microscopic glomeruli, of which there are millions contained within the kidney structure, become inflamed and fail to filter out toxins from the blood in the urine production process. The condition is further complicated as immune system antibodies become trapped within the glomeruli, causing the immune system to attack them.

The condition can be caused by any disease that bears heavily on immune system activity, diseases such as cancer, heartworm, dental diseases, diseases initiated by tick bites, pancreatitis or prostatitis.


  • Weight loss.
  • Loss of muscle tone.
  • Fluid in the abdominal cavity.
  • Fluid in the lungs causing labored breathing.
  • Swollen legs.


  • Medication to inhibit immune complex formation.
  • Medication to prevent high blood pressure.
  • Aspirin to help prevent clotting in the glomeruli.
  • As with JRD, a low phosphorus, low protein and low sodium diet supplemented with omega-3 fish oils.


This is a condition mostly diagnosed in older dogs where the adrenal glands produce too much cortisone for a shih tzu’s body to cope with. The most common cause of this is a benign tumor of the pituitary gland, the organ that is responsible for all hormone production within the body. This is known as pituitary dependent hyperadrenocorticism or PDH.

A less common cause of the disease is a tumor of the actual adrenal glands, known as adrenal dependent hyperadrenocorticism or ADH. Much more rarely, the condition can be brought on by over prescribed corticosteroid drugs for other ailments.

The excess cortisone produced can inhibit the metabolic process, bring on gastrointestinal problems and cause high blood pressure and skin disorders.


  • Greater appetite leading to obesity.
  • Greater thirst leading to increased urination.
  • Excessive panting.
  • Lethargy.
  • Loss of muscle strength.
  • Difficulty sleeping.
  • Fluid in the abdomen causing a pot-belly.
  • Loss of hair.
  • Darker skin pigmentation that may also have scaly, white patches.
  • Skin bruises easily.


  • In most cases, medication for life. The drugs administered may have serious side effects and so will be prescribed to match the severity of the condition.
  • If the condition is caused by corticosteroid over-administration, a gradual reduction in the dosage will often relieve the symptoms completely. The reduction in dosage has to be gradual to prevent an Addisonian crisis. See Addison’s disease below.
  • If the condition is diagnosed as ADH, surgery will be needed to remove the tumor after it has been reduced in size by drugs.
  • The dog’s health will need to be frequently checked for life.


Addison’s disease is almost the direct opposite of Cushing’s disease. With Addison’s the adrenal glands fail to produce sufficient quantities of the hormones cortisone and aldosterone to fight stress and regulate water and electrolytes respectively. The condition can be there for days or months before diagnosis.

There are primary and secondary classifications for this illness. Primary is the most common and occurs when the autoimmune system attacks the adrenal gland. Primary is further classified between typical and atypical cases. The cause of the typical primary condition has never been proved but it may be genetic. Atypical can be caused by cancer or toxins in the system and also over medication of drugs for other illnesses, particularly Cushing’s disease (see above).

Secondary hypoadrenocorticism is often triggered in the same way as Cushing’s disease, a tumor in the pituitary gland. It can also happen if a long-term steroid treatment for another complaint is suddenly stopped.

Treatment is usually for life and is almost always successful.


  • Loss of appetite leading to weight loss..
  • Excessive thirst from dehydration.
  • Lethargy.
  • Loss of muscle strength.
  • Depressed mood.
  • Heart rate too slow.
  • Shaking.
  • Body is cold to touch.
  • Vomiting
  • Diarrhea
  • If the vomiting or diarrhea becomes severe or the dog collapses, it is a medical emergency. Seek the attention of a vet immediately.


  • Daily medication for life to maintain optimum cortisone and aldosterone levels.
  • Regular monitoring of the dog’s health, especially at the start of treatment, with regular blood and urine tests to ensure the medication is working as intended.
  • When faced with a stressful situation, for example, undergoing surgery or being left in boarding kennels, the dosage of the medication may have to be increased.
A cute shih tzu wearing a stethoscope.
ID: 73815665 © belchonock | Depositphotos


Kidney stones do not cause as much pain for dogs as they do for humans and may be so small that there are no symptoms and only get discovered when a shih tzu is x-rayed for another problem. If there is no blockage to the flow of urine, a vet may leave the condition untreated but with regular monitoring for any changes.

However, the stones can go on to be a contributing factor to chronic kidney disease (CKD) or kidney colic, which may be announced by abdominal pain plus vomiting and may progress to swollen or damaged kidneys. This happens when the stones become larger or fragment, causing blockages in the ureter. If this occurs in both kidneys simultaneously it is a medical emergency as the near total blockage of the urine flow will make the dog critically ill.

The most common stones to form inside dogs are formed of calcium oxalate when there is an imbalance in the blood or urine. These stones do not dissolve, making treatment difficult for both the dog and the vet.

Stones formed of struvite, consisting of phosphate, magnesium and ammonium, are less common and form as a result of a bacterial infection. These types of stone can be dissolved with treatment over a period of months.

Stones occur more in female dogs than male dogs and can form several times despite any efforts taken to prevent them.


  • High temperature, fever
  • Painful abdomen.
  • Painful kidney or kidneys.
  • Urine contains blood.
  • Abnormal amount of urine, either an increase or a decrease.
  • Lethargy.
  • Loss of appetite.
  • Vomiting.
  • Loss of weight.


  • Removal or dispersal of non-dissolving stones.
    • Even the most skilled surgery can leave the kidney damaged. For this reason, techniques have been developed where larger stones are broken up into smaller pieces that will pass with the urine. This is performed internally using endoscopes and special tools.
  • Dissolvable stones can be treated with medication, including antibiotics to subdue the infection, special diets low on protein and phosphates and, crucially, plenty of water.
    • Increasing the dog’s consumption of water has the effect of diluting the minerals present in the urine, which helps to reduce the chances of the formation of stones.


Portosystemic liver shunt is a condition where the portal vein, which should be sending blood to the liver for purification, actually links up with another vein and bypasses the liver. PSS can be termed congenital, where it forms from a birth defect, or it can be acquired, where it is brought on by another disease such as cirrhosis. Unfortunately, only around 33% of dogs with PSS respond well to treatment and go on to live a full life.


  • Stunted growth and under-developed muscles.
  • Disorientation, pacing around in circles.
  • Vacant staring into space.
  • Seizures


  • Special diet and medication designed to reduce the toxins reaching the intestines.
  • Severe cases may need an intravenous drip to restore and maintain blood sugar levels.
  • Enemas to remove toxins from the intestines.
  • Medication to prevent seizures.
  • Some simple cases can be corrected with surgery.


An umbilical hernia is often seen on a shih tzu. It happens when the abdominal ring is not closed off properly at birth and some abdominal fat or part of the intestinal wall protrudes slightly under the belly. The precise cause is unknown but it may be at least partly genetic. Most are painless and some even go back inside the body by the time a puppy reaches four months. Surgery to retract the hernia is usually only a matter of necessity if there is part of the intestine trapped, otherwise most umbilical hernias are not detrimental to the health of the dog.


  • A protrusion of between ¼” (0.6 cm) and 1” (2.5 cm) long from the area of the navel.


  • The hernia may be routinely closed by surgery at the time of spaying or neutering.


Several breeds of dog are affected by this hereditary disease, of which the shih tzu is one. It is caused by a deficiency of the von Willebrand protein in the blood, meaning that there is a difficulty forming platelets when there is a hemorrhage. The condition may go unnoticed until the dog is spayed or neutered.


  • In some dogs there may be no obvious symptoms at all, in others there can be spontaneous bleeding from the nose, vagina, bladder or oral mucous membranes,
  • Excessive bleeding after trauma or surgery.
  • In severe cases, death from uncontrollable bleeding.


  • Certain medications must be avoided as they can initiate bleeding. If your dog has, or you think he or she has von Willebrand’s disease, never give medicine for anything without consulting your vet first.
  • A drug known as DDAVP can increase the amount of von Willebrand protein in the bloodstream.
  • In an emergency situation blood transfusions will be necessary. Sometimes the donor blood will be fortified with DDAVP to assist clotting.  

Other Problems

A vet giving an examination to a shih tzu.
ID: 106919752 © vchalup2 | Depositphotos


Dogs can be allergic to many of the same triggers that we humans can suffer from. They may react to certain foods or certain substances and, less commonly, pollen, dust or fungi.

Allergies usually show up between the ages of one and three years and the effects may get worse as the dog gets older. The reaction often causes an itchy rash in the areas of the feet, ears, abdomen and in the folds of the skin. This reaction is known as “atopic dermatitis” or “atopy”.


  • An itchy skin rash, frequently scratched at.
  • Frequent licking of the paws.
  • Frequent infections in the ears.
  • Bloodshot eyes.
  • Frequent rubbing of the face on mats, carpets, cushions, etcetera.
  • Upset stomach and poor appetite.


  • If a food allergy is diagnosed, removing that item from the dog’s diet.
  • If a substance allergy is diagnosed, such as a shampoo, flea and tick treatment or a certain type of bedding, for example, seeking out an alternative product or material that doesn’t cause a reaction.
  • If there is a certain plant or fungus causing the allergy, keeping the dog away from the source as much as possible.
  • Daily, non-steroidal medication, such as Apoquel, to suppress the symptoms.


As with other dogs, shih tzu are at risk from infections such as parvovirus, rabies and distemper, plus parasites such as fleas, ticks, ear mites and all kinds of worms.


  • Prevention is definitely better than the cure here.
  • Before taking charge of your new puppy or rescue dog, make sure that it has had all of the necessary vaccinations and preventative measures taken. Ask to see proof that this has been done.
  • Consult with your vet to make sure that all future vaccinations and boosters are scheduled to be given at the right times.
  • Your vet can also advise you of any extra vaccinations that may be needed for any local issues. For example, here where I live on the south of the Iberian Peninsular, Leishmania, a disease transmitted by a mosquito, is fatal for dogs and prevention needs an initial course of three vaccinations followed by yearly boosters.
  • When out walking your shih tzu, be alert and don’t let him drink any dirty water or eat any discarded food items. Take your own supply of clean water and food with you on the walk if necessary.


In my experience, shih tzu are not greedy dogs and tend to eat only what they need to sustain themselves. However, there have been cases of obesity with the shih tzu breed. Obesity can instigate or cause deterioration in many other diseases such as joint problems, thyroid problems, diabetes, back pain and various heart problems.


  • It is important to obtain dietary advice from the vet and follow it to gradually reduce the dog’s weight.
  • Regular exercise.


Shih tzu, with their hair growth between their paw pads, are subject to abscesses and infections here which are medically known as interdigital furuncles. Equivalent to pimples on the face in humans, these pus-filled blisters can be very painful, causing limping or temporary lameness.

The most common cause of interdigital furuncles is when a hair shaft is pushed back into the skin, causing inflammation that then becomes infected with bacteria. This type of infection often has new furuncles emerging as the old ones heal.

A less common cause is when the infection is caused when a foreign object, such as a splinter or a burr, is forced into the hair shaft. This type of infection usually results in just one abscess and is usually found on a front paw.


  • Tiny bumps that appear in one location between the paw pads.
  • These bumps swiftly grow into shiny, dark red boils up to ¾” (2 cm) in diameter.
  • If any of the boils burst they will exude a blood-like fluid.
  • They are usually so painful that they cause limping or temporary lameness.
  • Frequent licking of the wounds.


  • The vet will make tests to confirm whether the cause is bacterial or invasive and check for any parasites.
  • If it is a bacterial furuncle, a culture may be made in order to choose an effective antibiotic.
  • Oral antibiotics will usually be prescribed for four to six weeks but some cases may require eight weeks. Failure to complete the course of antibiotics may result in a recurrence of the furuncles.
  • Antibiotics may also be administered by ointments and special dressings.
  • If it is an invasive furuncle, it may be lanced to locate and remove the foreign object.
  • Further medication may be required in the event of a secondary yeast infection being discovered.
  • If the correct medication has been prescribed and administered and the furuncles still reappear, there could be another problem such as hypothyroidism, parasites or a fungal infection.


The exact cause of this phenomenon is unknown but it could be down to one or more of an allergic or other nasal irritation, the dog trying to clear mucus from its nose or the dog becoming overexcited. It happens a lot with short nosed, flat faced breeds. If a dog reverse sneezes he will probably continue to have bouts throughout his life.


  • The dog remains in one spot, stretching the head and neck forwards.
  • Breathing may be deep and rapid.
  • There may be snorting and wretching noises.


  • Reverse sneezing is not usually harmful and no medical treatment needed, although some severe cases may need steroid treatment or antihistamines if due to an allergy,
  • It can be distressing for the dog. If this is the case, talk to him reassuringly as you stroke his back and throat area.
  • It is believed in some camps that pinching the nostrils closed to force breathing through the mouth may help. Personally, I think this only causes more distress and that it is better for the bout to see itself out.

Minimizing The Chances Of Shih Tzu Common Health Problems – What You Can Do.

A shih tzu receiving a vaccination in the back of the neck.
ID: 5246738 © fantazista | Depositphotos

As you may have gathered from the previous sections in this article, there are many problems that could affect your shih tzu. Hopefully they won’t, but we need to be aware of them.

The first way of ensuring that none of these diseases ever take hold is to take your shih tzu to the vet for a check over as soon as you become the parent of your new dog and to make sure he gets all of the vaccinations he needs. Then make regular visits for routine check ups and vaccination updates. This way, if anything does happen your vet will spot it straight away and begin treatment at that crucial, early stage.

It is well worth considering pet insurance so that you are not hit financially by a sudden need for any expensive treatment. It would be bad enough of having to go through the trauma of your shih tzu being ill and needing treatment and the last thing you would want to do is deal with how you are going to finance it all as well. Be careful with your choice of provider and do read the small print.

You can also keep an eye on and maintain your dog’s health by regular home grooming. By this, I don’t mean giving your shih tzu a haircut every six weeks or so, although you can do if you have the know how and the tools. Healthy grooming involves a lot more than a haircut:

  • Daily brushing with a suitable brush will remove dead hairs plus unfurl any tangles and mats and help prevent any more forming. The brushing also helps distribute your dog’s natural oils for a healthy, glossy coat.
  • Every four to six weeks give your shih tzu a bath using dog grade shampoos and conditioners that do not contain the harmful to dogs ingredients that the human grade equivalents do. Avoid bathing any more often as essential oils needed to keep the skin and coat healthy will be washed away completely.
  • Brushing the teeth every second or third day will help maintain dental hygiene and prevent more serious health issues from developing.
  • The nails will need clipping when you can hear them tapping on hard floors, usually every four to six weeks. At the same time, trim back the hair between the paw pads with suitable, curved safety scissors.
  • Every week clean the outer ear canal with cotton balls and ear cleaning fluid to reduce the risk of ear infections.
  • Every two weeks, give your shih tzu a full inspection, looking for anything unusual with the coat, skin, ears, eyes, nose, mouth and paws. Check for any rashes, inflammations, redness, parasites and infections. Remember, if you discover a problem early in its development, the more chance of treatment leading to a full recovery.

You can find out more about grooming in my Grooming section here.

A fit dog is less likely to succumb to health problems, so make sure your shih tzu eats a well-balanced diet of good quality, healthy food and also gets plenty of exercise, including somewhere where he can have a good run around.

Click here for more dietary information in my Feeding Your Shih Tzu section ……..

…….. or here for more information on exercise in my Health And Fitness section.

I hope that you have found the information you required in this rather longer than usual post. If you have any thoughts or questions about shih tzu common health problems, please use the comments box below or use the contact us form. I will endeavour to reply within 24 hours. Be assured that any contact details you give will be held securely on this website and not shared with anybody else.

Bye for now,

Shih Tzu Steve.

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4 thoughts on “Shih Tzu Common Health Problems

  1. who woke up the other morning and stretch like he always does and now he seems to have a problem with his neck

    1. Hello Mary,

      Thank you for your query.

      I am not a qualified veterinarian practitioner, but I can say that this can be anything from a simple muscle strain to intervertebral disc disease and anything in between.

      I can only suggest that you consult your vet as soon as possible to determine exactly what the problem is, so that the correct and prompt treatment can be given.

      You can also “Ask A Vet” live from this website using the appropriate text box in the sidebar (desktop) or underneath this (mobile).

      I hope that this helps and that your dog’s condition is not that serious.

      Shih Tzu Steve.

  2. We recently bought a shih tzu at 11 months old. She had been spayed ,everything but we had to get her on. He a rt guard so in or der in doing that our vet did some lab workups which included liver enzymes workup. In doing that it showed elevated liver enzymes so 2 weeks later we took her back to vet for some type further enzyme. Work up and it had increased since previous visit. Shes at 8lbs and I ask if that old be reason they sold her and according to vet the previous owners vet showed they had done no testing before she was even spayed so my question is they say she can go to a diagnostic lab where they can do scans and test to seeifits microvascular dysplasia or if its the porto systemic shunt disease. She acts fine so is there any way of knowing which she may have just according to her disposition or do you have to have tests for either of these as I’ve mentioned. If shunt I understand that’s futile if the other is it medication. We started. Her on liver enzymes meds for now and she’s just to be monitored. Does either of these cause pain? Thanks for your info. I just saw the article and wanted your option. Thank you so much and any info u can provide is much appreciated.?.thanks..debbie

    1. Hello Debbie,

      Thank you for contacting Shihtzuandyou with your query.

      What an unfortunate and stressful situation. You have my sympathies. The breeder who sold Bruno to us must have known that he was likely to have Addison’s disease, another hereditary illness.

      As I have no personal experience of the two possible illnesses your shih tzu may have, I have been reading up on both of them. I could just repeat here what I have read, but I think it would be better if you read these two articles for yourself as they are written by someone much more qualified than me. They are very informative articles. Just click on these links:

      Hepatic Microvascular Dysplasia

      Portosystemic Shunt in Dogs

      My take on reading these articles is that with the right treatment and a special diet your shih tzu will be able to lead a reasonably normal and largely pain-free life.

      All you can do for now is to wait for the test results and the exact diagnosis of your shih tzu’s illness. Then, between you, you can decide on the best course of treatment.

      I hope it all goes well for you and your shih tzu and that you have many years together. I can tell that she is in good hands.

      I am sorry that I cannot be of any more help to you that this.

      Best wishes and good luck,

      Shih Tzu Steve.

      PS: I am interested to know how the tests go, if you don’t mind letting me know. If you don’t want to do that here, you can use our contact us form. Many thanks.

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