Common Shih Tzu Health Issues

The Shih Tzu is a small, sturdy dog with a distinctive appearance and a charming personality. Like most dog breeds, they suffer from certain health issues. We’ll explore the most common health issues and also provide guidance on how to spot symptoms and provide recommended treatments.

Below are the Top 10 Shih Tzu health problems, with insights provided on how to identify these issues, treatment options available, and of paramount importance–prevention.

#1: Intervertebral Disc Disease

Shih Tzus are susceptible to spinal problems because of their relatively long backs and short legs, both of which can lead to pain as well as mobility problems. When the discs in a Shih Tzu’s spine rupture, slip, bulge outward, or herniate, it’s referred to as intervertebral disc disease, or IVDD.

Genes affect formation of cartilage and lead to a Shih Tzu having its characteristic short legs, but may also cause the intervertebral discs to degenerate as time goes by. This degeneration makes the breed prone to injury.

When It Develops

Shih Tzus are more likely to develop IVDD in middle age or older. However, that isn’t a hard and fast rule as it can start when the dog is as young as three to five years old.

How To Spot Symptoms

Symptoms of Intervertebral Disc Disease in Shih Tzus include:

• Weakness
• Neck pain
• Wobbly gait
• Back pain
• Paralysis

Treatment

Treatment is available for Shih Tzus with Intervertebral Disc Disease. It might include  pain medication, crate rest,  physical therapy, and/or anti-inflammatory drugs.

Surgery might be required to relieve pressure on the dog’s spinal cord.

Prevention

Here are a few preventative measures that might be taken to prevent or manage IVDD in Shih Tzus.

• Weight Control and Exercise: A healthy weight and appropriate exercise are major factors in managing or preventing Intervertebral Disc Disease.
• Vet Check-ups: Early detection of IVDD is crucial to a good outcome for your dog, in order for treatment to begin before the spine suffers severe damage.
• Controlled Activity: Avoiding high impact activities and providing your Shih Tzu with a safe environment.

#2:  Hypothyroidism

Hypothyroidism is a common endocrine disorder in Shih Tzus along with other dog breeds. In this condition, the dog’s thyroid gland doesn’t produce enough thyroid hormone, which may result in a wide variety of symptoms.

The usual cause of Hypothyroidism is lymphocytic thyroiditis, which is an autoimmune condition where the Shih Tzu’’s immune system attacks its thyroid gland. Less common is Secondary Hypothyroidism, which can be caused by pituitary gland problems. It’s also thought that in Shih Tzus with Hypothyroidism, genetics may play a role.

When It Develops

Hypothyroidism in Shih Tzus typically presents itself when the dog is between 1-3 years old.

How To Spot Symptoms

Here are some symptoms of Hypothyroidism in Shih Tzus:

• Lethargy: A decrease in energy levels and overall physical activity.
• Weight Gain: Affected dogs may gain weight in spite of a normal diet.
• Ear Infections: Repeated ear infections may be related to hypothyroidism.
• Skin and Coat Changes: Thinning coat, dry, flaking skin, and hair loss.
• Behavioral Changes: Dogs with Hypothyroidism may seem depressed or show noticeable changes in their behavior.
• Cold Intolerance: Dogs may shiver more easily, and seek out warm places.

Treatment

Treatment for Hypothyroidism in Shih Tzus includes medications such as daily oral doses of synthetic thyroid hormone, usually Levothyroxine. The dosage may be adjusted based on regular blood tests.

Regular vet checks and blood tests are necessary to ensure correct dosage and monitor your Shih Tzu’s response to treatment. Hypothyroidism treatment is a life-long, ongoing thing. But with proper medication and good care, your Shih Tzu can live a long, normal life.

Prevention

There isn’t much you can do to prevent Hypothyroidism in Shih Tzus. Here are a few things that might potentially help:

• Avoid Toxins and Environmental Triggers: For example, chemicals and environmental toxins can impact thyroid function.
• Regular Check-ups: Regular vet check-ups can be helpful in diagnosing Hypothyroidism early and providing proper management.
• Selective Breeding: Since genetics are widely believed to influence this breed’s susceptibility to Hypothyroidism, be sure to look into a puppy’s family background for health problems and don’t breed your Shih Tzu if it has Hypothyroidism.

#3 Brachycephalic Syndrome

Brachycephalic Syndrome, also referred to as Brachycephalic Obstructive Airway Syndrome (BOAS), affects dogs with short, flat faces, such as the Shih Tzu. It is a result of anatomical abnormalities that cause breathing difficulties. These include:

• Elongated Soft Palate: Excessively long soft palate can obstruct the dog’s airway.
• Everted Laryngeal Saccules: Small sacs inside the dog’s larynx that may turn outward, blocking the airway even more.
• Hypoplastic Trachea: Abnormally narrow windpipe.
• Stenotic Nares: Narrow or collapsed nostrils restrict airflow.

When It Develops

As this condition has a genetic predisposition, it may be present at birth, or during puppyhood. Later on, as the puppy gets older and matures, symptoms may become markedly more noticeable.

How To Spot Symptoms

Symptoms of BOAS in Shih Tzus may include:

• Coughing and Gagging: Frequent gagging, coughing, or retching, particularly after eating and drinking.
• Noisy Breathing: Snorting, wheezing, and snoring are common, even when the dog is at rest.
• Exercise Intolerance:Trouble breathing during physical activity,  which causes fatigue and a reluctance to exercise.
• Cyanosis: Bluish appearance of tongue and gums caused by a lack of oxygen.
• Labored Breathing: Struggling to breathe, such as in the heat or when stressed.
• Heat Intolerance: Difficulty with regulation of body temperature, causing overheating.

Treatment

Treatment for Brachycephalic Syndrome in Shih Tzus might be medical, surgical, or both. Medical treatment usually consists of anti-inflammatories and oxygen therapy.

If surgery is necessary, it typically will be to widen the dog’s nostrils to aid breathing, removing inverted laryngeal saccules that interfere with breathing, and/or trimming the longer than normal soft palate so that it doesn’t obstruct the Shih Tzu’s airway.

Prevention

There are a few things you can do to help your Shih Tzu live a good life even with BOAS:

• Keeping Cool: Getting hot is bad for a dog with Brachycephalic Syndrome because it causes more difficulty with breathing. Try to avoid situations where your dog will get overheated.
• Avoid Stress: Stressful situations can make the symptoms of BOAS worse, so try to maintain a calm environment for your Shih Tzu.
• No Strenuous Activity: Moderate exercise and activity is fine, but you don’t want to let your dog engage in high energy or strenuous activity, as it exacerbates respiratory problems.
• Maintain a Healthy Weight: Excess weight will put an added strain on your dog’s breathing issues, so practice portion control, limit snacks, and monitor its weight.

 #4 Obesity

Obesity is a common issue in Shih Tzus. It might cause a variety of health problems, such as diabetes, respiratory problems, joint issues, and even reduced life expectancy. Preventing obesity is critical for maintaining your Shih Tzu’s health and quality of life.

It may be caused by not getting enough exercise and eating too much food, age, health problems like Hypothyroidism, and genetics.

When It Develops

Shih Tzus can become obese at basically any stage from puppyhood until senior years. If you overfeed them as puppies and don’t provide enough exercise, they may become overweight even at such an early age.

In the years from ages one to seven, obesity is much more common. Portion control and regular exercise are key to avoiding too much weight gain. Senior years are also a high risk time for obesity in your Shih Tzu simply because the metabolism slows down and exercise, as well.

How To Spot Symptoms

Signs of obesity in Shih Tzus might include the following:

• Visible Fat: Excess fat on your Shih Tzu’s abdomen, hips, and neck.
• Difficulty Breathing: Panting or labored breathing during low level activity.
• Difficulty Feeling Ribs: Trouble feeling the dog’s ribs without pressing hard.
• Low Energy: Decreased activity level and reluctance to exercise.
• Lack of a Defined Waist: When you look at the dog from above, it doesn’t have a visible waist.

Treatment

Treatment of obesity in Shih Tzus consists of these measures:

• Portion Control: Don’t overfeed your Shih Tzu if you want it to lose excess weight.
• Quality Diet: Feed your dog a high quality, nutritionally complete but not high calorie diet.
• Exercise: Your Shih Tzu needs sufficient exercise to shed pounds
• Not Too Many Snacks: Some dog owners tend to overlook snacks as a source of calories and weight gain in their pets, but snacks count so include them in the daily calorie limit.

Prevention

Prevention of obesity in Shih Tzus is the same regimen as treatment of existing obesity: limit snacks, use portion control of a high quality but not calorie laden diet, provide regular exercise, and take your dog for regular vet check-ups to catch health issues that may cause obesity such as Hypothyroidism.

#5 Cataracts

Cataracts are a common eye condition in Shih Tzus, and are characterized by clouding of the lens inside the dog’s eye, which may cause impaired vision or even blindness. Cataracts may be caused by genetics, diabetes, infection or inflammation, age, trauma or injury, or nutritional deficiencies.

When It Develops

Cataracts in Shih Tzus are typically a middle aged or senior issue, although they can occur at a younger stage in the dog’s life, depending on the cause.

How To Spot Symptoms

Common signs of cataracts in Shih Tzus include:

• Cloudy Eyes: A white or bluish-gray cloudy appearance in the eye.
• Vision Impairment: Signs of reduced vision, such as bumping into objects, difficulty navigating, or hesitation in unfamiliar surroundings.
• Eye Discomfort: Signs of discomfort like pawing at the eyes, redness, or excessive tearing.
• Behavioral Changes: Increased anxiety or changes in behavior due to reduced vision.

Treatment

The most effective treatment for cataracts in Shih Tzus is surgery. Using a technique called phacoemulsification, ultrasound is used to break up and dissolve the cloudy lens, followed by the implantation of an artificial lens.

Prevention

Cataracts cannot always be prevented. However, there are some things a dog owner can do to try and minimize the risk.

• Diabetes Management: Controlling and monitoring blood sugar levels in diabetic dogs can help reduce the risk of cataracts.
• Eye Protection:Avoiding eye injuries or trauma by ensuring a safe environment for your Shih Tzu is important.
• Regular Veterinary Check-Ups: Regular veterinary visits mean early detection of eye problems.

#6: Cushing’s Disease

Cushing’s Disease, also known as hyperadrenocorticism, is a health condition that may affect Shih Tzus. This health issue occurs when the adrenal glands produce too much cortisol, which is a hormone that helps regulate various body functions. About 80% of dogs who have Cushing’s disease will have pituitary-dependent Cushing’s disease.

This type of Cushing’sis due to a tumor in the dog’s pituitary gland. One of the hormones that originates from the pituitary gland is adrenocorticotropic hormone (ACTH). This hormone is what tells the adrenal glands to produce cortisol.

When a pituitary tumor releases more ACTH than normal, the adrenal glands make more cortisol. The result is pituitary-dependent Cushing’s disease. This is the type of Cushing’s Disease that is almost always seen in small dogs such as Shih Tzus.

When It Develops

Cushing’s Disease ordinarily develops in Shih Tzus around middle age or older, six to seven years old and older.

How To Spot Symptoms

The main symptoms of Cushing’s Disease in Shih Tzus are:

• Increased appetite Increased thirst occurs in 80-90% of dogs
• Increased urination occurs in 80-90% of dogs
• Leaking urine
• Circling, may include seizures in dogs or other neurologic signs
• Panting
• Restlessness, which may include senior dog anxiety at night
• Lethargy and tiredness

Treatment

Much of the time, treatment for Shih Tzus with Cushing’s Disease involves medications to control cortisol levels long term. If a tumor is the cause of the disease, the affected gland may be removed by surgery. This is a complicated surgery and might be best performed by a board certified veterinary surgeon.

You should know that this is a high risk procedure. There’s a significant risk of hemorrhage from surgical removal of the gland, along with risk of other postoperative complications. Many pet owners opt to try medical treatment before resorting to surgery.

Prevention

Preventing Cushing’s disease in Shih Tzus involves regular vet care combined with health management. Here are some key measures you can take:

• Weight Management: Keeping your Shih Tzu at a healthy weight can help maintain good health overall.
• Regular vet visits: Catching Cushing’s Disease in its early stages can help assure a better outcome for your dog.
• Monitor for Symptoms: Be alert to changes in your Shih Tzu, including but not limited to Cushing’s Disease.
• Avoid Stress: Try to avoid stressful situations for your Shih Tzu, because stress impacts its adrenal gland.

#7 Dental Problems

Periodontal disease is the most common oral problem seen, present in over 85% of animals two years of age and older. Plaque buildup may harden, becoming tartar, and leading to inflammation of the dog’s gums.

If left untreated, it can cause permanent damage to your Shih Tzu’s gums that result in tooth loss. In Shih Tzus, as is the case in most small breeds, crowding of the teeth in a small jaw may cause rotation and increased periodontal disease.

This breed is prone to severe dental problems, which means you should monitor for signs and symptoms so that if they develop, treatment can be prompt.

When It Develops

Dental problems in Shih Tzus may begin developing early. According to the American Veterinary Dental Society, 80% of dogs show signs of oral disease by the age of three. So, without dental care, you could see damage to your Shih Tzu’s teeth before they turn 3 years old.

How To Spot Symptoms

Signs of dental problems in Shih Tzus include:

• Difficulty chewing
• Bad breath
• Swollen gums

Treatment

If dental problems do appear in your Shih Tzu, you should take him to the veterinarian right away. If the tooth is abscessed, or infected, the vet will prescribe antibiotics and probably something to alleviate pain.

If a tooth is badly diseased or broken, it will probably need to be extracted. After your dog has dental work, keep it on a mechanically soft, bland diet for several days, until the area is no longer swollen or inflamed.

Prevention

Always provide regular dental hygiene and adequate dental care to avoid dental problems in your Shih Tzu. Check-ups, regularly brushing its teeth, along with a healthy diet are vitally important for the prevention of dental problems in Shih Tzus.

Dental toys designed for dogs to massage gums are useful in preventing problems.

#8: Portosystemic Shunt

Portosystemic Shunt (PSS) is a condition that may affect Shih Tzus. It occurs when there’s an abnormal connection between the portal vein and other veins, which allows blood to bypass the liver. This means that toxins and other byproducts aren’t properly filtered out by the liver, and can lead to a variety of health issues.

In most cases, a liver shunt is due to a birth defect called a congenital portosystemic shunt. In some cases, multiple smaller shunts form because of liver disease like cirrhosis. These are known as acquired portosystemic shunts.

When It Develops

PSS is a congenital condition, present at birth. However, if it’s in the 20% of cases caused by underlying health conditions involving the liver, it may develop at any time later in the dog’s life.

How To Spot Symptoms

Here are some symptoms of Portosystemic Shunt in Shih Tzus:

• Disorientation or abnormal behaviors
• Seizures
• Excessive drinking or urinating
• Vomiting and diarrhea
• Stunted growth
• Poor muscle development

Treatment

Treatment for Portosystemic Shunt may utilize medical as well as surgical approaches in some cases. Shih Tzus with portosystemic shunts are typically stabilized by use of special diets and medications, which are given to try and reduce the toxins that are produced and then absorbed in the dog’s large intestines.

If the Shih Tzu is critically ill it may need intravenous fluids to stabilize blood glucose, and medications like Valium to stop seizures, as well as enemas to remove intestinal toxins before they’re absorbed .

If surgery is indicated, there are several surgical treatments that may be performed. The main goal in surgery is to close the shunt so that the dog’s blood will flow through the liver to be filtered instead of bypassing it. One of the favored surgical interventions for Portosystemic Shunt is placement of an ameroid constrictor, a metal band with an inner ring of casein, which is a protein found in milk.

In the dog’s abdomen, the inner ring of the constrictor absorbs abdominal fluid, gradually swelling and pressing on the shunt, causing it to scar shut. Shunts generally close within 3-4 weeks after this procedure, providing the best chance for a long, healthy life in most dogs.

Ameroid constrictor surgery has a survival rate of more than 95%. Many dogs are clinically normal within 4-8 weeks following surgery.

Prevention

Since 80% of dogs with PSS are born with it, there isn’t much you can do to prevent this congenital condition from affecting your Shih Tzu. Still, there are certain measures you can take to be proactive about keeping your dog in good health. These include:

• Monitoring for Symptoms: Keep an eye out for any symptoms of Portosystemic Shunt and see a vet right away if any are observed.
• Balanced Diet: Feed your Shih Tzu a healthy, well balanced diet to promote liver health and overall health.
• Avoid Toxins: As the liver filters toxins from the body, avoid exposing your dog to toxins that might harm its liver.
• Regular Vet Visits: Schedule regular visits with the vet to have your Shih Tzu checked for health problems.

#9: Corneal Ulcers

Shih Tzus as a breed are susceptible to corneal ulcers because of their large, prominent eyes and flat face. These ulcers may appear suddenly without warning and should receive immediate care from a vet as they can worsen quickly and affect your dog’s vision.

Corneal ulcers are open sores on the cornea, which is the clear front part of the eye, and may be caused by various factors including injury, irritation, or  infection.

When It Develops

Shih Tzus may develop corneal ulcers at any age.

How To Spot Symptoms

Here are some common symptoms of corneal ulcers in Shih Tzus:

• Noticeable cloudy spot on the cornea
• Swelling and/or redness of the eye
• Squinting or keeping the affected eye closed
• Excessive discharge or tearing of the eye

Treatment

1. Medications: Antibiotic or anti-inflammatory eye drops or ointments decrease inflammation and treat infection.
2. Protective Measures: Use an Elizabethan (E) collar to prevent the dog from rubbing its eye.
3. Surgery: In severe cases of corneal ulcer, surgery may be required to repair the cornea.

Prevention

Although it isn’t always possible to prevent a corneal ulcer in your Shih Tzu, there are a few proactive preventative measles that might help avoid this condition:

• Grooming: Keeping the hair around the dog’s eyes trimmed can prevent it from causing irritation to the eye.
• Regular Eye Checks:Have the vet check your Shih Tzu’s eyes regularly for any signs of injury or irritation, and monitor its eye health yourself.
• Protective Eyewear: You might opt for using protective eyewear for your Shih Tzu during activities that could cause injury to its eyes.

 #10: Patellar Luxation

Patellar luxation, a common orthopedic issue in Shih Tzus, affects quality of life along with mobility. This condition occurs when the patella, or kneecap, travels from its normal position, which leads to pain as well as difficulty in movement.

Several factors can contribute to patellar luxation in dogs, such as  congenital abnormalities, genetic predisposition, muscle weakness, and trauma. In some cases, incorrect alignment of bones in the dog’s hind legs may increase the risk of patellar luxation.

Small breed dogs are especially prone to this condition due to their anatomical differences and a genetic predisposition. Shih Tzus are very prone to Patellar Luxation, and genetics play a significant part in their susceptibility to this condition.

When It Develops

Patellar Luxation can develop in Shih Tzus at a young age. The condition is often inherited and might be present from as early as 8 weeks old. Even though the luxation may not be evident at birth, the anatomical deformities that cause it are typically present.

How To Spot Symptoms

Symptoms of Patellar Luxation in Shih Tzus include the following:

• Limping
• Lameness
• Abnormal Gait
• Pain
• A bow legged or knock kneed appearance

Treatment

Treatment for Patellar Luxation in Shih Tzus may involve medical therapy, surgery, or both. Medical treatment usually consists of pain medications, anti-inflammatories, crate rest until the knee is stabilized, joint supplements like Glucosamine, and weight management.

Surgical intervention might involve realigning the kneecap, (patella) adjusting soft tissues surrounding the patella to help keep it in place, and making the patellar groove deeper to prevent it from slipping out.

Prevention

Here are some steps that may prove helpful in preventing Patellar Luxation in Shih Tzus:

• Only buy a puppy from someone who practices selective breeding.
• Don’t let your Shih Tzu become obese as this puts more strain on the joints.
• Avoid high impact activities such as jumping or running, especially on hard surfaces.
• Scheduling regular vet visits for your Shih Tzu helps catch any health issues early.

Does Pet Insurance Cover Common Shih Tzu Health Issues?

In most cases, yes. If  you’re considering purchasing a pet insurance policy for your Shih Tzu, check to see if hereditary and genetic conditions are included. You should understand that hereditary or genetic conditions and pre-existing conditions are not the same.

Most pet insurance will not cover pre-existing conditions. You need to check out  waiting periods, benefit limits, and reimbursement percentages, too.

There are numerous types of pet insurance available. You might opt for a policy with coverage for injuries and accidents only. Or, you might prefer a policy that has coverage for health problems as well as accidents. You can find pet insurance policies that offer the following:

• Routine wellness examinations
• Prescription meds
• Surgery
• Diagnostic tests
• MRIs
• Blood and lab tests
• X-Rays
• Prescription food and/or nutritional supplements
• Alternative treatments
• Behavioral therapy

While pre-existing conditions are not usually covered,some pet insurance providers offer this coverage. It will probably cost more, but will include additional benefits if needed for your Shih Tzu.