Shih Tzu are generallya healthy and long-lived breed.  Still, like all other purebred dogs, health issues have been identified as occurring more frequently in Shih Tzu than in most other dogs.   It is important to keep in mind that the health issues listed below is a guideline to what illness may find its way to this breed, not what the dog is doomed to suffer from.  The more you know about the health concerns in the breed the better you can protect your Shih Tzu. 

Some Shih Tzu develop a form a anemia called autoimmune hemolythic anemia, a condition in which the body attacks its own red blood cells.  Symptoms include: Weak, lethargic, an increased heart and respiration rate.  Some dogs respond well to immune-suppressing drugs, such as prednisone, and live a long full life.

Eye Problems
The Shih Tzu has large, prominent eyes and his shortened nose c auses the optic nervse to have an odd location which makes the eyes far less sensitive.  Also, the structure of the shih tzu face can lead to eye ruptures or eyes that actually leave the sockets.  Other eye problems in teh breeed include progressive retinal atrophy (which causes blindness), cataracts, and various malforamtions of the eye that can cause the eyelashes to scar the cornea.  Shih Tzu sometimes suffer for dry eye which can ususally be controlled by prescription eye drops.  Pay careful attentions to your dog's eyes and take hime to the veterinarian for aa checkup at any sign of discomfort.

Hip dysplasia
where the bones of the hip do not fit properly causing wear and tear and arthritis. Often symptoms will begin to show around mid life, starting with a limp and discomfort.  The good news is that because of their small size Shih Tuz aren't nearly as disabled by dysplasia as are large breeds.

Renal dysplasia
This is a condition where the kidney cells do no mature properly in the dog causing the kidney to gradually stop functioning over time. This can take anywhere from several months to years. One of the signs to look out for is severe thirst and urination.  Some dogs can live a full life span with the disease, while others have their lives cut tragically short.

Low blood sugar is very common in all toy breeds, especially when they are puppies. Blood sugar levels are most likely to drop during the ages of birth to 9 weeks and 12 years to death.  The condition can also be brought about by stress and can affect your dog at any age.  Signs are subtle at first with the puppy becoming more lethargic, not playing, and breathing harder.  Treatment is easy, but you must act fast.  The easiest home remedy is Clear Caro Corn Syrup.  You will see improvement within 15 minutes after giving your puppy a teaspoon or so.  You can follow up with a light meal.  Some people leave Kibble out all the time so that the puppy can eat when he’s hungry. I add this in our list of dog disease, but in the Shih Tzu breed, it is more of a problem in young puppies.

Intervertebral disc disease 
This is a condition where discs in the spine slip causing nerve damage, pain and possible paralysis. Most owners report that signs of the slipped disc occurred following a fall or jump. Treatment ranges from rest in mild cases to surgery in more serious ones.

Hypothyroidism is a malfunction in the thyroid where it stops functioning and producing thyroid hormone responsible for proper metabolism. This malfunction is commonly attributed to immune system problems.   It is usually affects middle-aged dogs and is seen in all breeds.  The condition occurs when not enough thyroid hormone is produced.  Symptoms include hair loss and other recurring skin problems, weight gain, muscle loss, and lethargy.  If left untreated, it can result in heart problems. This  disease is usually diagnosed through blood tests. It can be effectively treated with medication. There is no real prevention and is not considered a threat to your dog’s quality of life.

Otitis Externa or Ear Infections
Ear infections are common in any breed, but especially in those whose ears hang as opposed to being held erect.  It is a bacterial infection that begins in the outer part of the ear.   Many things can cause an ear infection:  Wet ears that have not been dried properly after a bath or swimming, ear wax buildup, untreated ear mites, buildup of foreign matter such as seeds or pollen, and hair growth inside the ear canal are just a few causes.    Dogs that have ear infections let us know by scratching, holding their head to one side, shaking their head, or rubbing their ears.  Some will stagger with poor coordination. 
Ear infections are not life threatening if you get it medicated early.  The veterinarian will prescribe a medicated ear wash and usually antibiotics.  If ear mites are the culprit, a medication to kill the mites will also be prescribed.

Umbilical Hernia
Umbilical Hernias are not unique to the Shih Tzu breed, but they are so common that they deserve a mention here.  Most are not life threatening and can be easily repaired surgically when the puppy is spayed or neutered.  An umbilical hernia is a small opening in the abdominal wall at the location where the umbilical cord was attached at birth.  If the opening is large enough, contents from the abdomen can protrude.

Reverse Sneezing
Most Shih Tzu at some time or another will make this snorting/snuffling/honking sound, do not panic, gently cover his nose with your hand thus making him breathe through his mouth and it will stop.

Pinched Nostrils and Teething go Together
Many Shih Tzu puppies nose’s will become tight during the teething phase. It will often cause them to snort and mouth breath. This will go away usually around 12-16 weeks of age sometimes longer. It is very different than Stenotic Nares which is noticed from birth.

Teething Problems

When the Shih Tzu puppies experience teething trouble the noses swell and pinch off some and they may have a little clear, watery discharge. They will also make some snorting and snuffling sounds and may mouth breath. They will usually outgrow this after the adult teeth come in. As long as they are playful and active and eating and drinking well, they are ok. If they can’t eat or drink well and are lethargic or the discharge changes color, they may have developed infection and need to be checked and treated. Most Shih Tzu pups are fine after adult teeth have come in. It is recommended not letting any surgery be done until after adult teeth are in as most will then resolve.

This is a disgusting habit that some Shih Tzu do have. It has been suggested that it is natural instinct linked back to undomesticated times when dogs in the wild would eat their stool to eliminate the scent so that predators wouldn’t pick it up. There are products, such as ‘Forbid’ you can acquire from your Vet or catalogs that can be put on the food that is suppose to help in stopping this habit. I have also been told that a wedge of pineapple with their food or a teaspoon of spaghetti sauce or spinach over their food will help break this habit. Still, being close to remove the poop immediately is the sure method to prevent this from happening should they have the tendency.

Every puppy should have caccinations for rabies, parvovirus, distemper and adenovirus-2 (which also protects against canine infectious hepetitis).  These diseases  are still widespread and can be deadly.  Puppies receive their first shot when they are between 6-8 weeks old.  Until then they receive immunity from their mother's milk.   Vaccines are given in a series between 6 weeks and 4 months.  Dogs should receive a booster shot 1 year later.

Spaying and Neutering
Neutering and spaying your household pets is a sound investment in their health and companionship. You are also doing your part to help control the pet population. With the exception of professional breeders equipped to handle the burdens of breeding dogs, owners should get their pets spayed or neutered as soon as their veterinarian recommends.

What Is Spaying and Neutering?
This is the surgical procedure in which the reproductive organs are removed from a female dog (spaying), or the testicles are removed from a male dog (neutering). Although often thought of simply as a way to prevent unplanned litters of puppies, it also has numerous other benefits for dog and owner alike.

In addition to preventing unplanned litters, which can be a burden on owners and communities, this basic procedure can:
· Eliminate the risk of ovarian and uterine cancer in females and testicular cancer in males
· Reduce the risk of mammary gland cancer in females
· Make males less likely to roam, which can lead to lost dogs.
· Make males less aggressive and more affectionate.
· Male urine marking is significantly reduced when dogs are neutered

When to Spay and Neuter your Shih Tzu
 It is recommended that the females be spayed before she comes into her fist heat cycle (around 6 months old).  Most unaltered males will begin to mark when they reach sexual maturity.  Testosterone definitely plays a key role in urine marking, so neutering at ANY age can help.  It is recommended that they be neutered after they have completed their vaccines series (around 4 months old).  The right time for your puppy to be altered is a medical decision that you and your veterinarian will make together.

 10 Symptoms That You Should Never, Ever Ignore
By Dr. Becker

When your dog starts acting strangely or seems a little inexplicably “off,” it’s often impossible to know whether to take a wait-and-see approach, or hit the panic button. This is especially true when the symptoms are characteristic of certain benign conditions as well as life threatening disorders.

The following symptoms fall into the category of Do Not Ignore. They may or may not indicate a serious underlying disease, but they should be investigated immediately by your veterinarian or an emergency animal clinic.

1. Loss of appetite, weight loss. Often, loss of appetite is the very first sign of an underlying illness in pets. There can be many reasons your dog isn’t hungry or refuses to eat, but not eating can begin to negatively impact his health within 24 hours. And for puppies 6 months or younger, the issue is even more serious.

Weight loss is the result of a negative caloric balance, and it can be the consequence of anorexia (loss of appetite) or when a dog’s body uses or eliminates essential dietary nutrients faster than they are replenished. Weight loss exceeding 10 percent of your dog’s normal body weight will be a red flag for your vet. There can be several underlying causes, some of which are very serious.

2. Lethargy, extreme fatigue. A lethargic dog will appear drowsy, “lazy,” and/or indifferent. She may be slow to respond to sights, sounds and other stimuli in her environment.

Lethargy or exhaustion is a non-specific symptom that can signal a number of potential underlying disorders, including some that are serious or life-threatening. If your pet is lethargic for longer than 24 hours, it’s time to make an appointment with your veterinarian.

3. Coughing. Coughing in dogs, unless it’s a one-and-done situation, generally indicates an underlying problem. Examples include a possible windpipe obstruction, kennel cough, bronchitis, pneumonia, heartworm disease, heart failure, and tumors of the lung.

All causes of coughing require investigation, and in most cases, treatment.

4. Fever. If your dog’s temperature spikes, it usually means his body is fighting an infection. The normal temperature in dogs is 100.5 to 102.5 degrees F. If your pet feels warm to you and his temp is higher than normal, make an appointment with your veterinarian.

5. Difficulty breathing. A dog in respiratory distress will have labored breathing or shortness of breath that can occur when she breathes in or out. Breathing difficulties can mean that not enough oxygen is reaching her tissues. Additionally, dogs with heart failure may not be able to pump enough blood to their muscles and other tissues.

Respiratory distress often goes hand-in-hand with a buildup of fluid in the lungs or chest cavity that leads to shortness of breath and coughing. If your dog has sudden undiagnosed breathing problems, she should see a veterinarian immediately.

6. Trouble urinating. This includes discomfort while urinating, straining to urinate, and frequent attempts to urinate with little success. If your dog cries out while relieving himself, seems preoccupied with that area of his body or is excessively licking the area, you should make an appointment with your veterinarian right away.

There are several underlying causes of urinary difficulties, some of which can result in death within just a few days.

7. Bloody diarrhea, urine, vomit. Digested blood in your dog’s poop will appear as black tarry stools. Fresh blood in the stool indicates bleeding in the colon or rectum. Either situation is cause for concern and should be investigated as soon as possible.

Blood in a dog’s urine, called hematuria, can be obvious or microscopic. There are a number of serious disorders that can cause bloody urine, including a blockage in the urinary tract, a bacterial infection, and even cancer.

Vomited blood can be either bright red (fresh), or resemble coffee grounds (indicating partially digested blood). There are a variety of reasons your dog might vomit blood, some of which are relatively minor, but others are serious and even life threatening.

8. Pacing, restlessness, unproductive retching. When a dog paces and seems unable or unwilling to settle down, it can signal that he’s in pain, discomfort, or distress. One very serious condition in which these symptoms are common is gastric dilatation volvulus (GDV), also called bloat. Another sign of bloat is when a dog tries to vomit but brings nothing up.

Bloat is a life-threatening condition that most often occurs in large breed dogs and those with deep chests.

9. Fainting, collapsing. When a dog collapses, it means she experiences a sudden loss of strength that causes her to fall and not be able to get back up. If a collapsed dog also loses consciousness, she has fainted.

Either of these situations is an emergency, even if your dog recovers quickly and seems normal again within seconds or minutes of the collapse. All the reasons for fainting or collapsing are serious and require an immediate visit to your veterinarian. They include a potential problem with the nervous system (brain, spinal cord or nerves), the musculoskeletal system (bones, joints, muscles), the circulatory system (heart, blood vessels, blood), or the respiratory system (mouth, nose, throat, lungs).

10. Red eye(s). If the white area of your dog’s eye turns bright red, it’s a sign of inflammation or infection that signals one of several diseases involving the external eyelids, the third eyelid, the conjunctiva, cornea, or sclera of the eye.

Redness can also point to inflammation of structures inside the eye, eye socket disorders, and also glaucoma. Certain disorders of the eye can lead to blindness, so any significant change in the appearance of your dog’s eyes should be investigated.
Some symptoms of illness in dogs are best handled by simply giving them a chance to run their course, for example, a temporary GI upset resulting from indiscriminate snacking.

Other symptoms can be so sudden, severe and frightening that you know immediately you need to get your pet to the vet or an emergency animal hospital.