Have you been tempted by the irresistible cuteness of a Shih Tzu puppy?
Do you already own a Shih Tzu?
Do you ever look at your Shih Tzu and think: “This is the cutest thing I have ever seen in my entire life and I wish for the most fulfilling life for this beautiful creature?”
If you answered yes to any of these questions then this post is an important read for you. (If you answered no to any of these questions then please see a doctor immediately ;p).
Like all dogs, the Shih Tzu is susceptible to certain diseases and health problems. As their owners, we have a huge responsibility to care and provide for them and this post will provide you with an overview of the health problems that are most common for our beloved breed.
After reading this post I’m sure you’ll feel more confident in recognising the symptoms early and be able to take proactive steps to take preventative care.
The health problems that we will cover in this post include:
- Brachycephalic Airway Syndrome (BAOS)
- Intervertebral Disk Disease (IVDD)
- Patellar Luxation (slipped knee cap)
- Hip Dysplasia (slipped hip joint)
- Hypothyroidism/Hyperthyroidism (irregular thyroid gland)
- Renal Dysplasia (abnormal kidney function)
- Bladder Infections & Bladder Stones
- Periodontal Disease (teeth problems)
- Ear Infections
- Skin Conditions
- Eye Problems
Brachycephalic Airway Obstruction Syndrome (BAOS)
Brachycephalic Airway Obstruction is not just common for the Shih Tzu but can cause problems for all dog breeds with brachycephaly (when the shape of the skull is shorter than typical for its species). Due to the shortening of the jaw and nose, this causes the soft tissue of the nose and mouth area to be squeezed into a much smaller space which in turn can lead to breathing problems.
BAOS is an umbrella term that refers to at least one of four specific conditions:
- Stenotic Nares (abnormally narrowed nostrils).
- Elongated Soft Palate.
- Collapsed Larynx (voice box).
- Tracheal Hypoplasia (abnormally narrowed windpipe).
Due to the increased resistance in the respiratory system, the most obvious symptom is that your Shih Tzu will have noticeable breathing problems. Below is a list of symptoms associated with BAOS:
- Excessive Panting.
- Respiratory Noise.
- Problems Eating.
- Respiratory Distress.
- Rapid Breathing.
- Excessive Saliva.
- Struggling For Breath.
- Blue Gums & Lips.
These symptoms will be particularly noticeable during or after exercise and especially on hot days. In extreme cases, the dog’s gums or lips can turn blue and can also lead to collapse, unconsciousness and sadly even death.
Unfortunately, BAOS is a lifelong condition and can start from as early as 6 months. However, even though dogs are born with this condition it may not present itself until later in life. It’s not uncommon for a Shih Tzu with this conditions not show any symptoms for the first six years of its life.
In less severe cases the vet will examine the dog while they are awake but for more extreme cases and a conclusive diagnosis, there would have to be a thorough examination under anaesthetic. This would include x-rays, blood work and a possible endoscopy that would involve a fibre optic tube being inserted into the airways, making a more accurate assessment and diagnosis possible.
If your Shih Tzu begins to show any of the symptoms listed in the paragraphs above then it’s vitally important to book a visit to your vet as soon as possible.
Depending on the severity of your dogs breathing problems there may be several things that you can do to alleviate their discomfort without the need for medication or surgery. However, even if more drastic measures are needed it is still a good idea to implement some of the following:
- Reducing the dog’s activity (especially on hot days).
- Provide suitable bedding and pillows to alleviate discomfort.
- Use a harness instead of a collar.
- Weight loss if appropriate.
- Limited exposure to cold air.
- Love and affection.
For more severe cases your Shih Tzu may require medication or unfortunately surgery. In the case of an elongated soft palate or a stenotic snare then surgery is usually the best option. This could involve shortening the palate, removal of the tonsils or widening of the nostrils. Where a collapsed trachea has occurred then surgery to reinforce the trachea with prosthetics is usually necessary.
However, on a positive note surgery is not always necessary and the following medications may be prescribed:
- Cough Suppressants.
- NSAIDs (nonsteroidal anti-inflammatory drugs).
As I mentioned above if your dog begins to show any of the symptoms associated with BAOS then please book an appointment with your vet as if there is a problem that needs to be treated it’s always better to begin the treatment as early as possible.
IVDD (Intervertebral Disk Disease)
Intervertebral disk disease is a spinal problem seen is dog breeds that have disproportionately shorter legs such as the Shih Tzu, Dachshund, Beagle, Basset Hound and Lucas Terriers. It is the most common spinal disease with dogs.
IVDD occurs when degenerative changes affect an intervertebral disk (a bone in the spinal cord), causing it to slip. If this happens then the disk can put pressure on the dog’s spinal cord possibly causing:
- Muscle Spasms.
- Limb Weakness.
- Limb Pain.
- Urinary Incontinence.
If your Shih Tzu is developing IVDD there are certain signs of spinal pain that you will begin to notice:
- Abnormal Posture.
- Difficulty moving, jumping, running etc.
- Difficulty climbing stairs.
In more severe cases IVDD can lead to extreme difficulty walking, paralysed bladder, reduced sensation to feel pain, to complete paralysis.
Depending on the severity of the dog’s conditions this disease may be managed with medication but in extreme cases, surgery will be required.
Diagnostic imaging will be used to confirm the disease. Typically a spinal radiograph will highlight degenerative changes to the disk but more advanced imaging will be required to provide a definitive diagnosis for surgery.
In less extreme cases IVDD can be managed with anti-inflammatory and muscle relaxant medication. Unfortunately for more severe cases, surgery may be required.
Patellar luxation is a disease that affects the back legs of many dog breeds but smaller dogs are particularly susceptible. Luxation refers to the kneecap sliding out of place and can start at any age – even as early as 8 to 10 weeks.
If your Shih Tzu is afflicted with Patellar Luxation they may not experience any pain or discomfort and be perfectly fine getting around. However, there are some telltale symptoms that will alert you if your dog is having any problems with its kneecaps:
- Skipping on the back legs.
- Might not show signs of pain.
- Carrying the leg for a few steps.
- Difficulty jumping.
- Bunny hop with both legs.
Although these symptoms might not cause your dog any pain they can lead to secondary and more serious problems including arthritis, swelling and stiffness in the joints and muscle wastage.
If your dog starts to show any of the above symptoms then you should visit your Vet for an examination.
A diagnosis is usually possible with a physical examination by your Vet. Once a positive diagnosis is reached an x-ray will take place in order to determine the necessary treatment and if surgery is an option.
The severity of patellar luxation is determined by four different grades. The most extreme cases being Grade 4 and the least serious being Grade 1. For example:
- Grade 1 – When the kneecap is displaced but can be returned naturally.
- Grade 2 – When the kneecap needs to be manually pushed back into place.
- Grade 3 – When the kneecap will only stay in place for a short while.
- Grade 4 – When the kneecap will not stay in place for any period of time.
For less severe cases medication is usually the option and your dog will most likely be prescribed NSAIDs (nonsteroidal anti-inflammatory drugs). For the worst cases then corrective surgery can be an option including:
- Deepening the groove of the knee cap.
- Tightening the joint capsule.
- Changing the angle of the shin bone.
Hip dysplasia is a genetic degenerative joint disease and can affect all breeds. However, this disease is not as common in smaller dogs like the Shi Tzu affecting only 3%.
The condition can affect either or both joints and is caused by abnormal development of the hip joint. Abnormal growth of the soft tissues in this area can seriously affect the joint structure and cause a laxity of the muscles, connective tissue, and ligaments that help support the dog’s hip joint.
Hip Dysplasia can affect dogs of any age but due to this condition being a degenerative disease, the Shih Tzu does not normally show symptoms until it’s adult years. In some cases, symptoms do not begin until after 10 years of age.
- Walk or run with an altered gait.
- Restricted movement (especially full stretches).
- Stiffness and pain in the rear legs.
- Difficulty climbing stairs.
- Narrow stance.
- General reduced activity.
- Periodic stiffness (just after waking for example).
- Muscle wastage.
A diagnosis is made after your Shih Tzu has had a physical examination and x-rays to determine the extent of the disease. During these tests, your dog may be given medication to relax their muscles or possibly given an anaesthetic.
The results will then be reviewed by a team of radiologists and the appropriate course of treatment will be decided.
If the disease is not too advanced the first steps will involve non-surgical treatments to best relieve the pain and discomfort. These may include:
- Orthopaedic bed.
- Weight management.
- Controlled exercise.
- Keeping warm.
- NSAIDs (non-steroidal anti-inflammatory drugs).
- Supplements (Omega 3, Microlactin, Glucosamine/Chondroitin).
Unfortunately, in more severe cases surgery will be required.
Hypothyroidism / Hyperthyroidism
This condition is associated with the production of certain chemicals in the thyroid gland that is responsible for regulating your dog’s metabolism.
Hypothyroidism is caused by the underproduction of the Liothyronine (T3) and Levothyroxine (T4) hormone. Without the adequate production of these hormones, your dog’s metabolism can be compromised and lead to a certain health condition.
Hyperthyroidism is the opposite of hypothyroidism and occurs when there is an overproduction of the thyroxine hormone causing an accelerated metabolism.
Although these conditions can occur in all dog they are far less common in small breeds such as the Shih Tzu.
- Aggressive tendencies.
- Weight gain
- Hair loss
- Skin sores
- Impaired hearing
- Weight loss.
- Shortness of breath.
- Accelerated heart rate.
- Increased appetite.
- Excessive urinating.
- Polydipsia (increased thirst).
- Enlarged thyroid gland.
Your Vet will diagnose both hypothyroidism and hyperthyroidism in similar ways. A blood test will be performed and the relevant hormones will be measured. The Vet will be specifically looking for the T3 and T4 levels.
A blood assay test may also be performed which specifically looks for the presence of thyroglobulin antibodies.
Thankfully, this condition is not life-threatening and can usually be treated with medication such as synthetic hormones. Treatment will be for the entirety of the dog’s life and will involve oral pills being given on a daily basis as well as regular tests to monitor the T4 levels.
In some cases of hyperthyroidism, the diseased thyroid may need to be surgically removed.
Renal dysplasia is a genetic disease where the kidneys develop abnormally from birth. Sadly, the health problem is irreversible and has a tendency to affect the Shih Tzu more than other breeds of dog.
The kidney is the organ of the body that is responsible for the filtering and removal of waste from the blood. With renal dysplasia, the nephrons (urine-forming units of the kidney) remain immature and comprise the ability of the body to cleanse its system.
In less severe cases your Shih Tzu can live a normal life if treated properly but for worse cases, it can lead to a premature death.
In most cases, the symptoms will start to show at a young age between 6 months and 2 years. However, sometimes the disease can be slow to develop and difficult to recognise, not showing symptoms for several years.
Symptoms can include:
- Excessive thirst.
- High volume of pale urine.
- Low energy.
- Excessive drinking.
If renal dysplasia is suspected then your vet will perform a physical exam which should be able to reveal small or underdeveloped kidneys. Blood tests will also be taken to measure blood urea nitrogen and creatinine levels.
Other tests can include:
- Urinalysis (to determine how well the kidneys filter waste from the blood).
- Biopsy of the kidney.
Unfortunately, there is no cure for this health problem. However, the disease can be managed by implementing a specific diet to lessen the strain on the kidneys supported by nutrient supplementation.
Bladder Infections & Bladder Stones
The Shih Tzu is particularly susceptible to bladder infections and bladder stones so recognising the symptoms of this health problem are extremely important. Although this disease can be easily treated in most cases, if left untreated they can be very serious and even fatal. Therefore if you recognise any of the symptoms in your Shih Tzu you should seek immediate treatment.
A bladder infection (also known as a urinary tract infection or UTI) is contracted through bacteria that finds its way into the dog’s urinary tract. Bladder stones can form as a result of a UTI causing a painful blockage and if left untreated can be fatal.
In most cases, bladder infections can be treated if recognised early. Below are some of the symptoms you should be aware of:
- Blood in urine.
- Discomfort when urinating.
- Urine has a strong or unusual odour.
- Heighten thirst.
- Tender Lower Abdomen.
- Cloudy urine.
- Licking genitals.
- Problems passing water.
- Anti-social behaviour.
- Lower energy.
If you notice any of the symptoms listed above then you should visit your vet immediately. They will first perform a physical examination that will include palpation of the abdomen to reveal any pain or kidney issues. Further tests may include:
- Biochemical profile (to check for underlying disease).
- Blood Count.
- Urinalysis (to check for proteins, pus and blood in the urine).
- Cultured urine (to grow bacteria responsible for the UTI).
In most cases after a UTI has been diagnosed your Shih Tzu will be prescribed antibiotics to combat the infection. As well as medication your Vet may recommend some home remedies including apple cider vinegar, Vitamin C supplements and a general change in diet.
Like all brachycephalic (short, flat nose) dogs, the Shih Tzu is highly susceptible to overheating. This health problem is more common than most people realise and should be taken very seriously by Shih Tzu owners as extreme overheating can be fatal.
If your Shih Tzu has been exercising in the heat or even if the weather is particularly warm you should pay careful attention to your dog’s behaviour. Heatstroke is a life-threatening emergency and if you notice any of the symptoms below you should take immediate steps to cool your dog down.
- Increased temperature.
- Excessive drooling.
- Accelerated heartbeat.
- Muscles tremors.
- Red Tongue.
- Pale Gums.
If your dog is showing signs of heatstroke you should immediately move them to a cool place. The best method of reducing your dog’s temperature is to place them in a cool bath. If this is not possible a garden hose or any kind of cool water should be found as soon as possible. Please note that the water should be cool and not cold and you should never use ice.
You should then take your dog’s temperature rectally ever 5 minutes. Once your Shih Tzu has a temperature of 103(ºF) / 39.4(ºC) or below you can remove them from the bath and take them to the Vet as soon as possible. If the temperature is 105(ºF) / 40.6(ºc) or above you should call your Vet immediately.
For reference, a dog’s normal temperature is usually 101 – 102(ºF) / 38.3 – 38.8(ºC).
If your dog has suffered overheating and their temperature returns to normal you should still take them to the Vet immediately. Depending on your dog’s temperature and general condition when they arrive at the Vets, they may be rehydrated with fluids and a cold water enema may be administered.
Good dental hygiene is not only important for the condition of the teeth but also for your dog’s general health. Dental health problems can not only affect the teeth and the areas of the mouth but can also cause more serious problems to your dog’s vital organs. For example, it’s possible that bacteria from oral infections can find there way into the bloodstream affecting organs such as the lungs, heart and kidneys.
Dental problems are fairly common in dogs and can occur at any age. However, 80% of dogs exhibit some form of dental disease by the age of 3 so it’s important to take care of your Shih Tzu’s oral hygiene from an early age.
The two main diseases that you need to be aware of are periodontitis and gingivitis. Periodontitis is a serious gum infection that damages the soft tissue of the gum and comprises the bone that supports the teeth. Gingivitis is a mild form of gum disease that causes inflammation of the gums.
When cleaning or examining your dog’s teeth, pay attention to the following symptoms that are indicative of dental problems:
- Bad breath.
- Excessive drooling.
- Inflamed gums.
- Bumps and sores on the gums.
- Tumours in the gums.
- Cysts under the tongue.
- Loose teeth.
- Yellow teeth.
- Pain or discomfort while eating.
Even if your Shih Tzu shows no signs of any dental health problems there are things you should do to maintain good oral hygiene. These include regular brushing and cleaning, the use of special dental toys and chew bones. You should also arrange for your dog to have a yearly dental examination by a Vet.
If your dog does develop a more serious oral hygiene problem a trip to the Vet would be necessary. Possible treatments would include the prescription of antibiotics, a professional clean (scaling and polishing), x-rays and surgery.
Epilepsy is a disease of the brain and unfortunately is fairly common in dogs. The disease causes electrical abnormalities in the brain leading to seizures. In the majority of cases, this health problem is inherited but it can also be caused by toxins and brain tumours.
Epilepsy can present itself at any age in dogs but is usually observed before the age of 5.
The disease can range from mild to severe and while the most serious cases can sadly result in euthanasia the less extreme cases can be easily managed.
The primary symptom of epilepsy is a seizure. These can be a general seizure affecting the whole body or more localised in areas of the face. Seizures can vary in terms of intensity, length and frequency and you be able to instantly recognise some or all of the symptoms below:
- Leg paddling.
- Altered consciousness
- Behavioural changes.
- Loss of bladder control.
While the majority of seizures only last a short time, if your Shih Tzu exhibits any of these symptoms you should take them to the Vet immediately.
Epilepsy can be quite difficult to conclusively diagnose and your Vet will first try to rule out other possible cause like toxins and possibly a brain tumour. If the seizures continue to occur over a prolonged length of time then your Vet will almost certainly give a diagnosis of epilepsy.
Firstly, your Vet will perform a physical examination of your Shih Tzu and then move on to further tests including:
- Complete Blood Count.
- Blood Chemistry.
- Toxicology Studies.
- Tests for infectious diseases.
- Cerebral spinal fluid analysis.
- Advanced imaging (MRI/CT scan).
While epilepsy is not curable, in most cases it is treatable will anti-seizure medication. If the disease is severe enough, your dog will be put on a lifelong treatment schedule involving medication and regular monitoring of the condition.
However, it should be noted that your dog may not require any treatment at all. If the seizures are fairly infrequent the effects of the occasional seizure may be less detrimental to your dog’s health than the side effects of being medicated.
Ear infections are fairly common in dogs but in the majority of cases are not a serious health problem and can usually be treated at home. However, if your Shih Tzu does suffer from an ear infection it can be a miserable experience for them and should be treated immediately.
The anatomy of the ear provides an ideal environment for infections to develop and are caused by either bacteria, yeast, fungus or other parasites.
It should be noted that ear problems in the Shih Tzu can be closely associated with allergies and a recurring ear problem may indicate your dog is also suffering from an allergy issue.
If your dog is suffering from an ear infection the signs will be fairly obvious. However, depending on the type of infection the symptoms may be a bit different.
Symptoms of a bacterial infection:
- Redness in the ear.
- Unpleasant smell.
- Discharge from the ear.
- Signs of pain or discomfort in the ear area.
Symptoms of a yeast infection:
- Redness in the ear.
- Discharge from the ear.
- A chalky smell coming from the ear.
- Both ears infected.
- Infection of the entire body.
Although ear infections can be unpleasant for your Shi Tzu they are not the worst health problem your dog can suffer and can usually be diagnosed and treated at home with certain specially designed products. However, if the infection is reoccurring or severe a visit to the Vet would be necessary. If your dog has an issue with ear mites they can be hard to see and your Vet would need to use an otoscope to confirm this diagnosis.
As mentioned above in most cases there are products available to treat an ear infection and a trip to the Vet may not be necessary. Usually, simple hygienic measures are enough and should include cleaning the ears to remove any excess waste, specially designed wipes or ear drops and the removal of excessive ear hair. If you don’t notice an improvement within a couple of days then a visit to the Vet would be necessary.
After visiting your Vet your Shih Tzu may be given the following treatments depending on the severity of the infection:
- Steroids or an antihistamine to reduce swelling.
- Identification of allergies and subsequent treatment.
In the unlikely event of a very severe ear infection then surgery may be required to widen the ear canal.
Skin problems are fairly common with the Shih Tzu and once a problem begins it can accelerate rapidly so with many health conditions prevention is the best cure.
Typical skin problems include:
- Sebaceous adenitis.
- Yeast infection.
- Bacterial infection.
- Flea allergies.
- Environmental allergies.
Skin infections can come from a variety of sources including mites, mange, yeast and bacteria. While environmental causes may include humidity, adverse coat products, air temperature, airborne allergens and food allergies.
It is important to pay attention to the quality of the products that your Shih Tzu comes into contact with. Inferior coat products such as shampoo and conditioner are one of the main causes of skin issues in dogs.
Typical symptoms for skin problems:
- Dry Skin.
- Poor hair condition.
- Hair Loss.
- Licking or chewing.
- Bad odours.
These are some of the obvious symptoms associated with skin condition but there may be other less obvious signs including:
- A runny nose.
- Watery eyes.
As there can be several possible causes for skin problems in dogs an initial diagnosis can be difficult and you will most probably need expert help from your Vet to identify the cause and possible allergy triggers.
Overcoming a skin condition will often involve a variety of treatments. Your Vet will often prescribe medication including anti-inflammatories, antibiotics, antihistamines and steroids. In more severe cases blood tests and intradermal skin tests may be necessary.
However, most treatments will take place at home and may include:
- Restorative bathing session.
- The use of quality shampoo and conditioners.
- Leave-in coat sprays.
- Humidifiers in the home.
- Change of diet.
- Omega 3 supplements.
- More regular dusting and vacuuming.
A hernia consists of a protrusion of tissue through an abnormal opening in the surrounding tissue. A hernia can usually be pushed back in and is known as reducible, otherwise, it is known as an incarcerated hernia.
There are several types of hernias but the most common to effect the Shih Tzu is the Umbilical and the Inguinal.
An umbilical hernia occurs when contents from the abdomen protrude through a small opening in the abdominal wall. It will appear as a small lump on the dog’s stomach where the umbilical cord was attached.
Although there is a genetic element to this conditions most cases are caused when the umbilical cord is cut too close to the abdominal wall at birth. Fortunately, most cases will disappear in the first few months of the puppy’s life.
Inguinal hernias are due to the protrusion of tissue through the inguinal ring (the groin area) and causing a lump on both or either sides.
The most obvious symptom of a hernia is the resulting bulge in the dog’s naval area. The bulge can change in size and appearance while your dog performs certain activities but if the hernia is small they usually cause no pain or discomfort.
For larger hernias further symptoms may include:
- Pain or discomfort.
- An increase of temperature at the swollen area.
- Lack of appetite.
- Lethargy and depression.
A hernia can be easily diagnosed by sight alone. Your Vet will initially attempt to push the lump back into the abdomen so they can determine the extent of the opening. Other tests may include an x-ray or ultrasound.
Umbilical hernias rarely require surgery is they are fairly small and your Shih Tzu should be able to live a long, happy life with no health problems at all. It’s not uncommon for small hernias to completely close by themselves as the dog develops.
A larger hernia may require corrective surgery and involves a reduction of the hernia and the removal of the surrounding tissue.
Eye problems in the Shih Tzu are fairly common due to the shape of the head and face. As the Shih Tzu is a brachycephalic breed they have a flattened face and large, protruding eyes causing continued exposure and less protection from the environment.
Although some eye conditions have a genetic basis most are caused by irritation and trauma due to the shape and positioning of the eyes. Infections are common due to the lack of eye protection from foreign objects.
Unfortunately, the list of health problems associated with the eye for the Shih Tzu is fairly long. These include:
- Corneal Ulcers.
- Progressive retinal atrophy.
- Keratopathy Syndrome.
- Proptosed Globes.
- Keratoconjunctivitis Sicca.
- Harderian Gland Prolapse.
As there are many different eye conditions a specific symptom may indicate a specific problem so if you notice any of signs listed below you should visit your Vet immediately for a professional diagnosis.
Symptoms of an eye problem include:
- Redness around the eye.
- Swelling of the eye.
- Obvious visual problems.
- Increased tears.
- Pain or discomfort.
- Discolouration of the pupil.
- Night blindness.
- Loss of peripheral vision.
- Protrusions from the side of the eye.
There are many treatments for various eye problems your Shih Tzu may suffer from and of course, they will depend on the specific condition. In less severe cases simply applying eye drops or removing eyelashes may be a possible treatment but for more extreme cases surgery may be needed.
Most of the eye conditions your dog may suffer from are caused by irritation to the eye so careful attention should be paid to remove any hair and other foreign objects.
Fortunately, the health problems associated with the eye are rarely fatal and even is the worst case scenario happens and your dogs suffers from complete blindness, they can still live a long fulfilling life.
Ok, I know this post is a bit of a grim read but as with all living beings things can go wrong and it’s always better to be educated and aware of the signs so we can recognise the problems early and seek the appropriate treatment.
But I’m sure if you treat your Shih Tzu well and show them the love they deserve they’ll make it to a ripe old age and pass away peacefully in their sleep dreaming of chasing squirrels 🙂
Just for the giggles 🙂 Take Care, Elliott.