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Serious Health Issues
Seen with the Shih Tzu Breed


There is not one breed of dog that is immune to all illness and disease. Each breed will be more susceptible to certain disease; this is carried through the bloodline of the breed for centuries.

It is important to keep in mind that Shih Tzu serious health issues is a guideline to what illness may find its way to this breed, not what the dog is doomed to suffer from.

The purpose of listing what the Shih Tzu may be more prone to develop is a method of showing owners what to keep an eye on. Early detection is a very important step to recovery.

Brachycephalic Airway Syndrome

What is this? This is the term given to breeds such as the Shih Tzu that have breathing issues related to their body structure. It is a general term that includes at least one of the 4 issues of stenotic nares, elongated soft palate, collapsed larynx (voice box) and trachea issues (abnormally small or collapsed trachea). The 3 most common issues seen with the Shih Tzu breed are collapsed trachea, elongated palate and stenotic nares. With 50% of Shih Tzu that do have airway syndrome, both elongated palate and stenotic nares are present. 

What happens? Each on its own can cause breathing problems and if a dog has 2 or all 3, breathing can be severely impeded. Wtih stentic nares, the openings of the nostrils are 'pinched' and too narrow. With elongated palate, there is abnormal growth of the soft tissue in the back of the throat. With collapsed trachea, the rings of cartilage in the neck are weakened and/or collapse inward. 

What is the average age when this can occur with a Shih Tzu? Dogs are born with this, but symptoms may not occur until later, anywhere from age 1 to age 6.

What are the symptoms? Coughing, noisy breathing, trouble breathing, these may be worse during or right after exercise. In severe cases, due to lack of oxygen, the dog's lips or gums may turn blue and/or the dog may become unconscious. 

How is this treated? Changes in life style such as using a collar and not a leash, limiting/timing exercise, and the use of certain medications may work to lessen symptoms. Though, surgery is often recommended, particularly if a Shih Tzu has more than one of these health issues. 

IVD Disease

What is this? IVD stands for Intervertebral Disk Disease. This type of illness is seen more in certain types of breeds; usually those with shorter legs and a longer back such as the Shih Tzu, Beagle and Basset Hound.

What happens? A disk slips in the back and presses on the spinal cord.

What is the average age when this can occur with a Shih Tzu? This can happen as young as 2 years old.

What are the symptoms? Muscle spasms, pain, and weakness in the limbs.

What can this progress to? Sadly, this can lead to complete paralysis.

How is this treated? Medicine is used that will include muscle relaxants and anti-swelling drugs. Rest is recommended. Surgery may be performed if rest and medicine is not effective.
happy Shih Tzu
Rugby, 4 years old
Photo courtesy of the Funkhouser family

Patellar Luxation

What is this? The Patellar is a fancy name for a dog's kneecap. This is more apt to happen in toy dog breeds that weigh less than 25 pounds. While any dog can develop this, size does play a factor.

What happens? This is a condition in which the dog's kneecap slips out of place.

What is the average age when this can occur to a Shih Tzu? This can actually be present at birth and if not, can happen at any time.

What are the symptoms? Limping, attempting to walk on just 3 legs for reason of avoiding pressure on the hurt knee and/or raising the leg to try and tell you that they are feeling pain.
What can this progress to? Without treatment, the affected leg may become deformed. This condition rarely goes away without treatment.
How is the treated? Bed rest and anti-inflammatory medications can resolve minor to moderate cases. In some cases steroid medication is given. There should be improvement after 3 weeks. Exercise is then slowly built up, with the goal being that a Shih Tzu that has had this condition is never walked past the point of stress on the knees. For reoccurring cases or severe instances, most likely need surgery. Prognosis is very good after the dog recovers from the operation.

Hip Dysplasia

What is this? This a degenerative joint disease seen in certain breeds, including the Shih Tzu. It is an abnormality involving the hip joint (ball and socket joint) which causes it to slip out of place.

What happens? Most dogs with hip dysplasia are born with normal hips but due to genetic and possibly other factors, the soft tissues that surround the joint start to develop abnormally as the puppy grows. The abnormal growth affects how the bones are held together; instead of staying in place, they move apart. 

What is the average age when this can occur with a Shih Tzu? In some cases, a puppy as young as 4 or 5 months can be diagnosed with this. However since it is a degenerative disease, clear signs often do not show until a Pug is in his later adult years.

What are the symptoms? A bunny hop or walking funny, trouble rising, trouble with mobility, a narrow stance, intermittent stiffness and eventual loss of muscle tone.

How is this treated? Treatment can include weight management, controlled exercise and applying warmth. There are several supplements that can help, along with certain medications for both swelling and pain. In some cases, surgery is needed. 

Stenotic Nares

What is this? This is the medical term for a serious condition of the Shih Tzu's nose.

What happens? The dog's nostrils are very narrow which in turn puts a great deal of stress on the respiratory system and the body as a whole of the Shih Tzu.

What is the average age when this can occur to a Shih Tzu? If a Shih Tzu has this serious medical issue, they are born with it and it is noticed fairly quickly.

What are the symptoms? The Shih Tzu will show clear and obvious difficulty breathing.

What can this progress to? If not treated, a Shih Tzu may actually die from this; as the dog's body simply can not continue to struggle for enough air.

How is this treated? This health issue can flare up when a puppy is teething; for this reason surgery is often put on hold until that phase is over. 
two Shih Tzu in car
Dolly & Murphy -  Photo courtesy of owners: Louis & Babs Kosko
If the condition is severe or if it has not resolved after that point, surgery will widen the nasal openings and restore proper breathing. Prognosis is very good after the procedure is done to correct this.

Harderian Gland Prolapse

What is this? This refers to the eye lid of the Shih Tzu dog.

What happens? All eyelids have glands which produce tears. With this condition, the gland becomes swollen.

What is the average age when this can happen to a Shih Tzu? Normally, if a Shih Tzu is to have this unfortunate serious medical condition, it will develop before the age of 2.

What are the symptoms? As the gland moves around due to a loose connection, it can lead to swelling, excessive discharge, bloody ulcerations and conjunctivitis.

What can this progress to? Untreated, the dog may become temporarily blinded in the affected eye until treatment is given.

How is this treated? Although this is a serious medical condition among the Shih Tzu breed, fortunately the fix is rather simple. Under general anesthesia the dog's gland is gently moved back into place and secured.


What is this? This is referring to an irregular thyroid gland of a dog.

What happens? The thyroid does not function properly, thus interfering with the metabolism of the Shih Tzu.

When does this usually happen to a Shih Tzu? This can happen at any age; however it is more common with older dogs.
What are the symptoms? They are very obvious and should tell you quickly that something is wrong: hair loss, weakness and weight gain.

What can this progress to? In the worst possible scenario, left untreated: coma.

How is this treated? Thankfully, this serious Shih Tzu health issue can be treated and controlled with medication.
Note: This is an overview of some of the health issues that a Tzu may be prone to. For very detailed, easy-to-read, step-by-step information to lead you through every Shih Tzu health issue possible, learn about the new-edition AllShihTzu Book. Now in both print and eBook.

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