Shih Tzu Throwing Up? – What To Do

Shih tzu throwing up.

When You See Your Shih Tzu Throwing Up

There are several possible reasons that may cause a shih tzu to vomit. Not all of them will require an immediate visit to the vet, if at all. 

When you notice your shih tzu throwing up, to determine if the intervention of a vet is needed and how urgent this is, you need to observe your shih tzu’s symptoms and, however unpleasant this sounds, look at the appearance and contents of the vomit.

Before I go through all of the most common causes of a shih tzu vomiting and the best action to take, I think it’s first most important for you to know when you need to take your dog to be examined by a vet as soon as possible.

When To Take Your Shih Tzu To The Vet

While the most common causes of a shih tzu throwing up are treatable at home, there are some more serious problems that need more urgent, professional attention. Call your vet straight away, use the out-of-hours emergency number if you have to, if your shih tzu has any of these following symptoms.


If your shih tzu just throws up once or twice, this is known as acute vomiting. If he vomits continuously for three days or more, the condition then becomes known as chronic. Take your dog to the vet if his vomiting becomes chronic.


This often goes hand in glove with chronic vomiting. The abdominal muscles have to contract forcefully every time something is brought up. This, together with dehydration caused by the expulsion of so much liquid, leaves the dog feeling weak and looking very sick. The vet may need to put the patient on a drip to replace lost body fluids and nutrients.


Red flecks are likely to be blood, while darker, blackish flecks are likely to be dried blood. If red or black flecks are present in your shih tzu’s vomit, call the vet right away.


This is another one where the vet needs to be consulted immediately. What the dog brings up comes out with tremendous force. 

The solid food contents of the stomach will come out first, followed by the liquid contents. There will then be some dry retching after the stomach has been emptied.


You should also consider a consultation with your vet if your shih tzu is vomiting while also suffering from one or more other major symptoms such as fever, diarrhea or a distended stomach.

A shih tzu on the vet’s examination table.

8 Most Common Causes Of A Shih Tzu Throwing Up

  • The shih tzu is not fed often enough throughout the day.
  • There is a sudden change to different food.
  • The shih tzu bolts his food too fast and swallows it without chewing.
  • There is an intolerance to a certain food item or ingredient.
  • The dog has an allergic reaction to something.
  • A foreign object has been swallowed causing an obstruction.
  • Gastritis or gastroenteritis.
  • Parasites are present.

Observe The Symptoms To Know What Action To Take

It’s not a pleasant thing to do, I know, but if you examine the contents and the constitution of the vomit, together with the time of day and the situation, an assessment can be made to determine the possible causes and what action to take.

Here are some of the most common symptoms a nauseous shih tzu may experience.


This is the most common substance a shih tzu may bring up. It’s strictly speaking not vomit and it is not caused by something the shih tzu ate.

Rather, it’s an expulsion of bile that happens because the shih tzu hasn’t eaten. Small dogs have short intestinal tracts that absorb food rapidly. This soon results in an empty stomach. With no food in the stomach, the bile swills around causing a reflux. The bile is then thrown up as a yellow to pale green liquid which can vary in its viscosity. It can sometimes be accompanied by a white foam.

This is true in 98% of cases. For the other 2%, the yellow liquid is brought up because of gastritis or gastroenteritis.

TREATMENT: An empty stomach can be prevented by spreading out your shih tzu’s daily food allocation. If you give your shih tzu two meals per day, give him the same amount of food but spread it out over three meals per day, morning, midday and evening.

EXAMPLE: Instead of offering two 1.5 oz (42g) meals during a typical day, offer in place three 1oz (28g) meals. Or, if you are already giving your shih tzu three meals daily, try adding an extra dry snack to the menu.

This should help prevent the stomach becoming completely empty and thus also help prevent the yellow vomit issue.

TIP No.1: If you find it difficult to judge portion sizes, first fill up the bowl as far as you have been doing. Then tip out the food and either judge two-thirds by eye or weigh the food on some scales and remove one third.

Place the two thirds back into the bowl and note how far up the food reaches. If you can, mark the position, or make a mental note if you can’t. Then, in future, just fill up the bowl to the mark.

 TIP No.2: A lot of shih tzu parents will not be at home all day to administer the midday meal. If this applies to you, try leaving you dog with a treat release toy that will make available small amounts of food to reach his stomach regularly throughout the day.

For an appetizing filling that will keep your shih tzu interested, stuff the toy with good quality kibble that you have mixed with a coating of good quality smooth peanut butter and a few drops of Omega-3 fish oil.

This is the type of toy I had in mind:

This type of toy is ideal as it not only dispenses the kibble in small amounts at a time, it will also help keep your shih tzu amused during the time you are away. It also has four difficulty levels should your shih tzu outsmart it!


Technically, this is not vomiting. It is the regurgitation of the food that your shih tzu has just eaten. It usually comes up within fifteen minutes of the meal or snack. As the digestion process hasn’t begun, it comes up looking pretty much the same as when it went down only with that sickly odor.

It happens either because the shih tzu eats too much too quickly or because of an intolerance to a food item.

TREATMENT TO PREVENT EATING TOO FAST: The easiest way to regulate the speed at which your shih tzu eats is to use a food bowl or device especially engineered for such a purpose. 

There are slow-feeder bowls available, but the majority of these manufactured for small dogs tend to be made of plastic. Plastic is not a good material to make a dog bowl from as tiny scratches that can harbor harmful bacteria accumulate on the surface over time. Then, in poor quality designs, there are potentially harmful chemicals in the structure of the plastic that may leech out and affect your dog over time.
There are some stainless steel slow-feeder bowls on the market but I’ve not found one yet designed for a small dog. With the bowls built for larger dogs the gaps are too large to regulate a shih tzu’s feeding habits. It’s far more effective to use a portion pacer.


For further information on this, click on the image or product title for the affiliate link that will take you to the product page on Amazon.

Just place the hygienic stainless steel ball in your shih tzu’s existing feeding bowl. The presence and nature of the moving ball as he nudges it with his snout then makes it impossible for him to bolt his food. If you think your shih tzu also gulps his water too fast, you might like to consider a second ball for his water bowl.

TREATMENT FOR FOOD INTOLERANCE: You will need to discover exactly which particular ingredient or ingredients that your shih tzu has an intolerance to. This can be done by process of elimination.

Remove one item from your shih tzu’s diet. Start with the item that you most suspect is causing the reaction. If the vomiting then stops, you’ve found the offending item. If the vomiting continues, try removing the next most suspected item, and so on until you find it.

To help you, here is a list of the most common causes of food intolerance in shih tzus:

  • Inferior additives found in low quality dog food, including by-products, synthetic preservatives, coloring dyes and flavoring, particularly MSG.
  • Ingredients such as soy, corn and grains.
  • There exists a small chance that a protein such as chicken could be causing the issue.

Feeding your shih tzu only high quality food without any unnatural additives is as likely as anything to stop this type of vomiting. 

The high quality food varieties may appear to cost more than the inferior varieties, but for what they potentially save you in vets’ bills, they usually work out more economical, not to mention much healthier for your shih tzu.


This type of vomiting usually happens if a shih tzu becomes highly active soon after consuming a meal and the food hasn’t had time to settle in the stomach.

In hot weather, too much exercise in the middle of the day can cause the onset of hyperthermia, of which vomiting is a symptom. Shih tzus have difficulty controlling their body temperature during periods of excessive heat.

TREATMENT: After you shih tzu has eaten, let him rest for at least one hour before taking him out for a walk or engaging in active play.

In high temperatures, schedule walks for early in the morning and late in the evening when it usually isn’t so hot.

A shih tzu puppy running on the beach. It’s late in the evening and it’s over one hour since he last ate.
ID: 197285118 © | Depositphotos


Vomitless dry retching can be due to a partial blockage of the airway. This can be a food or bone particle, a foreign object that your shih tzu has swallowed, or a hairball.

Hairballs can accumulate if you don’t brush the loose hairs out of your shih tzu’s coat regularly and your shih tzu licks his coat a lot.

Think twice before giving your shih tzu a natural bone to chew on as fragments can splinter off and become lodged in the throat.

TREATMENT: The object causing the obstruction may find it’s way out, though you might try opening your shih tzu’s jaws to see if you can remove the item yourself. 

In the event that the dry retching continues for more than four hours, it’s wise to go and see the vet. If the problem does turn out to be a hairball, the vet may prescribe laxatives to help it pass through the body.

Should the blockage be so severe that your shih tzu has difficulty breathing, you will not have time to get help from a vet. You will have to perform the Canine Heimlich Maneuver yourself.

If you are unfamiliar with the procedure, I explain it here, step-by-step.


The first step is to check to see if you can remove the object yourself.

  • Open your shih tzu’s jaws.
  • Pull the tongue towards the front of the mouth, away from the throat.
  • If you are able to see the offending object, pull it out or hook it out with your finger.
  • Should this not be possible, then continue with the maneuver.

NOTE: ONLY proceed with the canine Heimlich maneuver if there is no alternative as thrusting too forcefully can seriously injure your shih tzu.

  • Hold your shih tzu in your arms with his back resting against your chest.
  • Place your fist against the middle of his chest about 1-inch (2.5 cm) below his armpit level.
  • Cover your fist with the palm of your other hand and make five thrusts inwards and upwards in rapid succession.
  • If this has not dislodged the obstruction, hold your shih tzu by the top of his back legs, face pointing downwards.
  • ONLY if the object has still not been dislodged, place your shih tzu face down with his chest on the palm of your hand.
  • With the palm of your other hand, apply five sharp slaps in rapid succession between the shoulder blades.


You need to take your shih tzu to the vet immediately on the first instance of any projectile vomiting as there are several serious illnesses or diseases that can cause this to happen.

Examples of some conditions that can cause projectile vomiting are the presence of worms, an obstruction in the system, or parvovirus. If it is parvovirus there are usually other symptoms such as bloody diarrhea and weakness.


Ingestion of toxic substances will cause a shih tzu to throw up.

If you think that none of the previously mentioned causes are the reason why your shih tzu is vomiting, then consider that he may have ingested a poisonous substance.

To determine if poisoning could be the reason, look for other symptoms which may include:

  • Particularly intense vomiting. This is typical if a poisonous plant has been eaten.
  • Bleeding from the eyes, nose and mouth. This happens if rat poison has been ingested.
  • Dry retching.
  • Weakness.
  • Fainting.
  • Panic attacks.
  • Pacing.
  • Diarrhea.

TREATMENT: If you know that your shih tzu has taken in something toxic, call your vet straight away. Call the vet even if you are not 100% sure a poisonous substance is to blame. 

Depending upon the poison, you may or may not be asked to make your shih tzu throw-up, typically with a specified dose of hydrogen peroxide.

Then you will probably be requested to take your shih tzu to the surgery, together with a sample of the offending item if you have it. For example, if he has eaten some ivy, take a piece of the ivy with you. Or, if he has drunk some liquid you have spilled, take the rest of the bottle with you.

Typically, poisons will not pass naturally through your shih tzu’s system, so medical intervention from a vet is essential.

For information on food that could be harmful to a shih tzu and cause him to vomit, see my post:

What Can Shih Tzu Not Eat? – Malevolent Morsels Revealed


Acute vomiting may be a symptom of an acute viral infection. As long as the vomiting doesn’t become chronic and there are no other symptoms that merits visit to the vet, this can be dealt with at home. See “General Treatment For Vomiting” below.


If your shih tzu has just been operated upon, there may be a period of nausea and vomiting for a short while afterwards. 

TREATMENT: Your vet should have spoken to you about this and also have prescribed the correct medication.


Three shih tzu enjoying a car ride having taken their Cerenia tablets.
ID: 38912635 © tomwang | Depositphotos

Some shih tzu suffer nausea and vomiting when traveling by car or other vehicle.

TREATMENT: Avoid taking your shih tzu in the car whenever you can. For the times when you have to travel with your shih tzu, your vet or your pet store can provide you with appropriate medication, usually on prescription.

Here is a popular brand of canine travel sickness tablets, or antiemetics, to use a more technical term. You will need a prescription from your vet to purchase these.

Cerenia antiemetic for dogs.


For further information click here to follow this affiliate link to

Home Treatment For Non-Emergency Cases

If the reason for your shih tzu throwing up is not chronic and not in need of urgent medical attention, you can allow him to recover at home.

After the vomiting has ended, wait for a minimum of twelve hours and at least until the next morning before feeding your shih tzu again. This allows his stomach time to get back to normal. Anything fed to your shih tzu before then is likely to be thrown up again.

During the fast, ensure that plenty of water is available for your shih tzu to drink. The act of throwing up has a dehydrating effect and the lost fluid has to be replaced, essentialy. Plus, as he is not eating, he won’t be taking in any moisture with his food.

Generally, dogs like to chew ice. So, one way you can encourage your shih tzu to take fluids on board is to offer him some small chips of ice from a lightly crushed ice cube. If he likes apples, you can try making ice from a mix of equal parts natural apple juice and water to help his sugar levels recover.

When the time comes to end the fast, don’t force your dog to eat but offer him a small portion of bland food of equal parts one protein and one carbohydrate. For example, shredded chicken breast and white rice, or ground lean beef and sweet potato. Offer small portions frequently.

Over the next three days, gradually change back to your shih tzu’s normal diet. Hopefully, he will then be fully recovered. However, if he starts throwing up again, it’s time to call the vet.

If In Doubt ……

I hope that you are now able to make an informed decision about what is the cause of your shih tzu throwing up, what action you can take and whether to involve the vet or not.

I have tried to cover all of the common and most likely scenarios here but I am sure there are other, rarer conditions that can make your shih tzu vomit. 

If you are in any doubt at all, call the vet. It’s better to be safe now than sorry later.

If you have any queries relating to this article or anything concerning the shih tzu breed, please leave a comment in the box below or use our contact us form.

Bye for now,

Shih Tzu Steve.

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