13 Most Common Shih Tzu Health Problems - FrenchieWiki (2024)

Shih Tzus are generally pretty healthy

With a lifespan of 10–18 years, Shih Tzus are considered a fairly healthy breed.

This might come as a surprise to some, as flat-faced dogs like the Shih Tzu are known for being notorious for health issues (namely the Frenchie!)

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But they’re prone to some health issues

But they’re still prone to their fair share of health issues (just like any other breed!)

Some of these conditions are due to genetics and present at birth, so the only way to reduce the risk of these is through selective breeding of dogs that are known not to have these issues in their family history.

But other conditions develop over the years are can be prevented through healthy lifestyle modifications— most of these lifestyle changes also have a positive impact on the genetic conditions as well.

Most conditions are manageable

Fortunately, most of these conditions are manageable— by knowing the signs of these health problems, you’ll be able to spot them early on and get your Shih Tzu the treatment they need to live a long & happy life.

Read on to learn…

  • The most common Shih Tzu health problems
  • How to help your Shih Tzu live a longer, healthier life

Breathing Problems

Shih Tzu’s are loved for their adorable appearances, squishy little faces, and fluffy coats…

But their squishy little faces come with one big drawback:

They cause lots of breathing issues.

While this doesn’t mean every Shih Tzu is doomed to have severe breathing problems,

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They’re a brachycephalic breed

Shih Tzus are what are known as a brachycephalic breed, which is a fancy way of saying “flat-faced dog“.

Other brachycephalic breeds include…

  • Pug
  • Boxer
  • Boston Terrier
  • French Bulldog
  • English Bulldog

1. Brachycephalic Airway Syndrome (BAS)

This is a condition that affects most dogs with flat faces— that means you too, Shih Tzus!

It can cause breathing difficulties, snoring, and even collapse of the airway in severe cases.

It’s a collection of issues— not it’s own disease

BAS isn’t a disease of its own, but rather a collection of upper airway abnormalities that when grouped together make up Brachycephalic Airway Syndrome.

Conditions that make up Brachycephalic Airway Syndrome include…

  • Stenotic nares— narrow, pinched nostrils that prevents healthy nasal breathing; easily correctable with surgery
  • Extended nasopharyngeal turbinates— when the turbinates (part of the nose that humidifies and warms air) extend into the area behind the nose & mouth causing airway obstruction; surgery may be necessary in severe cases
  • Elongated soft palate— the soft palate is the roof of the mouth; when it is too long, it can extend back toward the throat and partially block airflow; may require surgery
  • Laryngeal collapse— a condition when the cartilage that supports the larynx (voice box) becomes weak, leading to collapse; can be treated with surgery
  • Everted laryngeal saccules— when something called the laryngeal saccules become inflamed, and turn inside-out leading to airway obstruction; can be treated with surgery
  • Hypoplastic trachea— a congenital condition where the trachea (windpipe) is abnormally narrow; can be treated with surgery

Symptoms of Brachycephalic Airway Syndrome

  • Frequent panting (especially with minimal exertion)
  • Noisy breathing
  • Tiring easily
  • Snoring

Treatment of Brachycephalic Airway Syndrome

  • Corticosteroids
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Oxygen therapy
  • Surgery


  • https://vcahospitals.com/know-your-pet/brachycephalic-airway-syndrome-in-dogs

2. Reverse Sneezing

Reverse sneezing is a common condition in which the dog appears to be inhaling sharply and snorting.

Reverse sneezing can be scary

It’s scary to see your Shih Tzu reverse sneezing, especially if you haven’t seen it happen much before.

But it’s harmless

But rest assured, it is usually harmless and often triggered by irritants or excitement (but it’s a bit freaky to see in the moment)

Symptoms of Reverse Sneezing

  • Standing still & craning neck
  • Head and neck extended
  • Rapid and long inhalations
  • Loud snorting and gagging sounds

Treatment of Reverse Sneezing

There are a few things that you can try to treat reverse sneezing…

You can try…
  • Changing their diet
  • Using a humidifier to keep their nasal passages moist
  • Avoid irritants such as smoke, perfume, pollen, dust, or cleaning chemicals
  • Figuring out if there’s an allergen causing the reverse sneezing (and remove it)
How to quickly stop reverse sneezing
  1. Cover their nostrils with your fingers
  2. Lightly (very) blow in their face
  3. Massage their throat
  4. Try to calm them down

3. Tracheal Collapse

Tracheal Collapse is a condition in which the dog’s windpipe loses strength & rigidity which can lead to partial or complete collapse of the airway.

It’s a progressive disease

It is progressive disease that can cause episodes of respiratory distress, however, it is not life-threatening in its early stages (only in later severe stages).

Avoiding triggers & making lifestyle changes helps a lot

Avoiding triggers such as smoke & dust and making lifestyle modifications like weight loss & using a harness can improve symptoms and slow its progression.

It’s more common in Shih Tzus

It’s highly common in toy & small breeds like the Shih Tzu, Pomeranian, Yorkshire Terrier, Toy Poodle, and Lhasa Apso. It’s thought that there is a genetic factor to Tracheal Collapse

It usually develops in middle to old age

According to VCA Hospitals, tracheal collapse usually occurs in “middle-aged to senior dogs (4–14 years)”, but note that it can still occur in younger dogs.

Symptoms of Trachea Collapse

  • Coughing or gagging, particularly after exercise, excitement, or eating/drinking
  • Wheezing or difficulty breathing
  • Rapid or noisy breathing
  • Blue tongue or gums (in severe cases)

Treatment of Trachea Collapse

  • Lifestyle modifications— weight loss, reducing exercise intensity, using a harness on walks, and avoiding irritants like smoke & dust
  • Medications— sedatives to reduce coughing and anxiety; cough suppressants; bronchodilators; steroids; and antibiotics
  • Surgery— surgery may be necessary for severe cases; this includes tracheal stents or tracheal rings


4. Stenotic Nares

Stenotic nares is a condition in which the dog’s nostrils are too narrow, causing breathing difficulties.

The diagnosis of stenotic nares is pretty straight forward. Your vet is sure to notice their narrow nostrils when they’re puppies and likely suggest they undergo surgery to improve their breathing.

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Symptoms of Stenotic Nares

  • Pinched, narrow nostrils
  • Noisy breathing

Treatment of Stenotic Nares

Stenotic nares is a anatomical issue so the only real “cure” for it would be surgery to reduce the size of the nostrils.

Surgery is highly recommended as dogs with better breathing live longer, happier lives. They’ll sleep better, tolerate more exercise, and just be happier (imagine always having a stuffy nose!)

Joint Problems

5. Hip Dysplasia

Hip Dysplasia is a condition in which the hip joint is not properly formed, causing the “ball and socket” joint of the hip to become loose & unstable.

This leads to wear and tear over time, eventually leading to inflammation, pain, and arthritis.

Hip Dysplasia is most common in medium-to-large breeds such as the German Shepherd, Golden Retriever, and Rottweiler, however, it is also common in smaller breeds such as the French Bulldog and Pug

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Varies in severity

Hip Dysplasia varies in severity and tends to get progressively worse over time

  • No Hip Dysplasia— Normal hip joint function with no signs of joint laxity or abnormal wear and tear.
  • Mild Hip Dysplasia— Minor signs of looseness or laxity in the hip joint, with little or no pain or discomfort.
  • Moderate Hip Dysplasia— Noticeable looseness or instability in the hip joint, with potential pain, lameness, or difficulty moving.
  • Severe Hip Dysplasia— Significant looseness, degeneration, or malformation in the hip joint, with chronic pain, stiffness, and disability.

Causes of Hip Dysplasia

  • Genetics
  • Being overweight
  • High-strain activities (like jumping on/off high surfaces and running on hard surfaces)
Genetic & Environmental Factors

Hip Dysplasia is thought to be caused by a combination of genetic and environmental factors.

While the genetic factor can only be reduced through careful selective breeding, there are still ways that you can reduce the risk of your Shih Tzu developing Hip Dysplasia.

Prevention of Hip Dysplasia

While there is a large genetic factor to Hip Dysplasia, there are still environmental & lifestyle factors at play such as the dog’s weight, bad habits such as jumping on/off high surfaces (like a bed), and their overall health.

You can reduce the risks of Hip Dysplasia by…
  • Responsible breeding— breeders can reduce the risk of a dog developing Hip Dysplasia by not breeding dogs together that are known to have a history of Hip Dysplasia
  • Healthy weight— being overweight places more strain on joints, which can cause and/or accelerate any joint issues
  • Avoid over-exercise— you should avoid exercises that put a lot of strain on the hip joints such as jumping on/off high surfaces (especially landing on hind legs, like holding a toy above them to make them jump for it), running on hard surfaces, and repetitive high-impact exercise
  • Regular veterinary checkups— by taking your Shih Tzu to the vet on a regular basis (at least once a year for a checkup), you’ll be able to detect any health issues like Hip Dysplasia early on, and start treatment to slow the progression of it

Symptoms of Hip Dysplasia

  • Limping
  • Decreased activity
  • Difficult standing up
  • Pain and/or stiffness
  • Decreased range of motion of the hip
  • Reluctance to stand up, run, jump or climb stairs

Treatment of Hip Dysplasia

  • Lifestyle changes— weight loss, exercise restriction, avoiding running on hard surfaces
  • Physical therapy— generally recommended before
  • Medication— anti-inflammatory medications, joint supplements, joint fluid modifiers
  • Surgery— procedures include: double or triple pelvic osteotomy (DPO/TPO); femoral head ostectomy (FHO); total hip replacement (THR)

6. Luxating Patella

Symptoms of Luxating Patella

  • Abnormal gait/walk
  • Lameness of leg
  • Reduce range of motion
  • Swelling of the affected leg
  • Audible clicking of kneecap
  • Pain, especially when walking or running
  • Difficulty standing or reluctant to stand on a leg

Treatment of Luxating Patella

  • Lifestyle changes— In mild cases, simple lifestyle changes might be enough to control symptoms and prevent progression. These include reducing physical activity, avoiding jumping, and maintaining a healthy weight.
  • Physical therapy— Physical therapy can help to strengthen the muscles around the knee, improve range of motion, and reduce pain & inflammation.
  • Medication— Both pain medication & anti-inflammatory drugs may be used to manage symptoms. Supplements such as glucosamine and chondroitin have also been shown to support joint health.
  • Surgery— Advanced stage patellar luxation may require surgery to restore healthy function; the recovery is pretty quick and has a very good success rate


Hormonal Problems

7. Cushing’s Disease

Cushing’s Disease (hyperadrenocorticism) is a condition where the body produces too much cortisol, a hormone produced by the adrenal gland.

This can be caused by various factors, including a benign tumor on the adrenal gland, specifically an adrenal adenoma.

Tends to develop later in life

Cushing’s Disease usually develops in dogs 8 years or older.

It is important to monitor older dogs for signs of Cushing’s disease, and to work closely with a veterinarian to determine the underlying cause of any symptoms.

Cushing’s Disease can be caused by…

  • Tumor— A benign (non-cancerous) tumor on the adrenal gland can cause it to produce too much cortisol. Tumors on the pituitary gland may also cause Cushing’s Disease as well.
  • Medication— Long-term usage of steroid medications such as prednisone can cause Cushing’s Disease by suppressing adrenal gland function. By lowering the dose or stopping the medication, the condition may be able to go away as the adrenal glands resume normal function.

Symptoms of Cushing’s Disease

  • Drinking & urinating more than usual (the most common symptom)
  • Increased appetite
  • Hair loss
  • Thinning skin
  • A pot-bellied appearance

The symptoms of Cushing’s Disease develop slowly over time (usually over the course of a year), so they might not be immediately noticeable to you…

Treatment of Cushing’s Disease

There is no known cure for Cushing’s Disease, but it can be carefully managed with treatment & monitoring.

Treatment of Cushing’s Disease includes…
  • Medication— Anti-cortisol medication such as trilostane or mitotane can lower the production of cortisol.
  • Surgery— Procedures to remove the tumor from the affected adrenal gland can be performed when your dog is healthy & the tumor is small and localized to one adrenal gland. Successful removal can cure Cushing’s Disease.
  • Dietary changes— A diet low in fat and moderate in fiber is usually recommended in conjunction with other treatments to alleviate symptoms of Cushing’s Disease.
Prognosis of Cushing’s Disease

With early diagnosis and proper treatment, many dogs with Cushing’s disease can go on to live normal, healthy lives— there are many ways to manage the disease.

My Shih Tzu had Cushing’s disease for many years & lived for 13 happy years.


Eye Problems

8. Ocular Proptosis

Ocular proptosis, also known as exophthalmos or proptosis, is a condition in which one or both eyes protrude from their normal position within the eye socket (orbit) and appear to bulge out of the eye socket.

It is more common in flat-faced dogs like the Shih Tzu, Pug, and Bulldogs, however, it can occur in any breed.

Symptoms of Ocular Proptosis

  • Bulging or protruding eyes— this is the most common symptom
  • Cloudy cornea (eyeball)
  • Pain around the eyes
  • Swelling, redness, and/or bloodiness in or around the eyes
  • Difficulty closing the eyes completely, which can lead to dryness and irritation of the cornea

Treatment of Ocular Proptosis

The treatment of Ocular Proptosis is always surgery.

It’s not always treatable

In some cases, there has already been too much damage done to the eye to save it— in these cases, the eye would need to be removed.

Surgery consists of repositioning the globe of the eye

However, if you get treatment right away, their eye may be savable— in these cases, surgery will be performed to reposition the globe of the eye.

Get treatment immediately

WARNING: Ocular Proptosis is an emergency. If you notice your Shih Tzu’s eye seems to be protruding, make sure you immediately take them to be seen by an emergency vet

Prompt treatment of Ocular Proptosis is extremely important to ensure the best outcome.

Prognosis of Ocular Proptosis

The prognosis of Ocular Proptosis is not great— according to Today’s Veterinary Practice, around 72% of cases result in blindness.

Prognosis is generally better in flat-faced dogs— this is due to the fact that less force is needed to cause Ocular Proptosis in flat faced dogs compared to ones with normal snouts.


Skin Problems

9. Allergies

While Shih Tzus shed a lot less than other dogs and generally considered to be a hypoallergenic dog that’s good for allergy sufferers…

That doesn’t mean they’re free from allergy issues themselves.

Allergies are quite common in Shih Tzus

In fact, allergies are quite common in Shih Tzus.

Dogs with longer hair — like the Shih Tzu — may be more prone to skin irritation or infections, which can exacerbate allergy symptoms. However, proper grooming and hygiene can help reduce the risk of these issues.

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It is believed that up to 20% of dogs will develop allergies over their lifetime.

Types of Allergies

  • Environmental Allergies: Shih Tzus can also be allergic to various environmental factors such as pollen, dust, mold, and other allergens found indoors or outdoors. (environmental allergies are common)
  • Contact Allergies: Shih Tzus can develop contact allergies from coming into contact with certain materials such as fabrics, cleaning products, or shampoos.
  • Food Allergies: Shih Tzus may develop allergies to certain types of food, such as beef, chicken, dairy, or grains. (this type of allergy is quite rare)

Allergy Symptoms

  • Face rubbing
  • Itchy skin & butt
  • Licking their feet
  • Coughing & wheezing
  • Vomitingand diarrhea
  • Sneezing and/orreverse sneezing
  • Runny discharge from the eyes or nose
  • Stomach problems— Chronic bad gas or diarrhea


Other Issues

10. Dental Issues

While Shih Tzus are adored for their tiny squishy flat faces, this can lead to dental issues.

Flat faced dogs like the Shih Tzu have smaller-than-average jaws, which leads to dental crowding and misalignment.

This increases their risk of periodontal disease, therefore, you should regularly clean & care for your Shih Tzu’s teeth. Taking care of your dog’s dental health is essential, but it’s even more important for a Shih Tzu.

Symptoms of Periodontal Disease

  • Bad breath
  • Tooth root abscesses
  • Loose or missing teeth
  • Tartar buildup on teeth
  • Difficulty eating or chewing
  • Pawing at the face or mouth
  • Red, swollen, or bleeding gums

11. Renal Dysplasia

Shih Tzus are prone to something called “Renal Dysplasia”.

This is an inherited kidney disease present at birth that causes the part of the kidneys that produces urine (nephron) to not fully develop.

It is a progressive disease with no cure, but there are treatments and lifestyle modifications available to manage the illness.

Symptoms of Renal Dysplasia

  • Bad breath
  • Lethargy & weakness
  • Loss of appetite, weight loss, and/or vomiting
  • Excessive thirst and urination (diluted urine is also common)
Symptoms sometimes take years to show up

While Renal Dysplasia is genetic and present at birth, it’s also possible for some Shih Tzus to not show any symptoms of Renal Dysplasia until later in life when the disease has progressed to a more advanced stage.

Treatment of Renal Dysplasia

  • Dietary changes— A diet low in protein and phosphorus can help reduce strain on the kidneys. There are also prescription foods available specifically for dogs with kidney disease that your vet can prescribe.
  • Fluid therapyIV fluids can help maintain ideal hydration and electrolyte balance
  • Medications— There are various medications that may be prescribed to manage symptoms of renal dysplasia, including medication to manage blood pressure, anemia, and gastrointestinal upset.
  • Dialysis or kidney transplant— In severe cases of renal dysplasia, dialysis or kidney transplantation may be considered. These are complex procedures that require specialized veterinary care and may not be available at all veterinary hospitals.

Renal Dysplasia must be regularly monitored

Shih Tzus with Renal Dysplasia will also require regular checkups at the veterinarian.

This is important so that the progression of the disease can be monitored & treatment adjusted as needed.


12. Portosystemic shunt

A portosystemic shunt (PSS) — also called a liver shunt — is a congenital issue in which the blood flow to the live goes around the liver rather than through it.

As the liver is responsible for removing toxins from the blood, this lack of blood flow can lead to these toxins building up in the blood stream. These toxins can lead to many symptoms & health problems such as…

Symptoms of Portosystemic Shunt

  • Lethargy
  • Stunted growth
  • Behavior changes
  • Excessive water drinking
  • Urinary issues and/or bladder stones
  • Weight loss, vomiting, constipation, and diarrhea
  • Excessive urination, difficulty urinating, or blood in urine
  • Abnormal neurological function: seizures, blindness, head pressing, and ataxia

Treatment of Portosystemic Shunt

  • Surgery— Surgical correction of PSS is done by narrowing the shunt; this is usually done over the course of multiple operations rather than completely closing the shunt in one procedure.
  • Medications & IV Fluids— After surgery, your Shih Tzu will need IV fluids and pain medications throughout their recovery. IV fluids can also help to stabilize blood sugar and restore proper hydration.
  • A special dietDiet modification can be used to limit their exposure to toxins. These include a diet low in protein and supplementation with lactulose, a sugar that reduces the toxins produced in the intestines.

Prognosis of Portosystemic Shunt

The prognosis for dogs with PSS depends on the severity of the condition and how early it is detected and treated.

Early treatment is key

In general, the earlier the condition is diagnosed and treated, the better the prognosis.

If left untreated, PSS can lead to serious health problems and even death.

Dogs can live a full life with successful treatment

After successful treatment, many dogs can go on to live normal, healthy lives, although some may require ongoing medical management to manage symptoms and prevent complications.


13. Epilepsy

Epilepsy is a neurological disorder that causes recurrent seizures.

The severity of seizures can range from mild to severe and have many different causes and triggers.

What is a seizure?

A seizure in dogs is a sudden, uncontrolled burst of electrical activity in the brain that can cause a variety of physical and behavioral symptoms.

What causes seizures?

Seizures can be caused by a variety of factors, including epilepsy, brain injuries, infections, toxins, and metabolic imbalances.

During a seizure, a dog may experience a range of symptoms, which can vary in intensity and duration. Some common symptoms of a seizure in dogs include:

Symptoms of Seizures

  • Pacing or circling
  • Loss of consciousness
  • Urinating or defecating
  • Vocalizing or crying out
  • Drooling or frothing at the mouth
  • Stiffening or shaking of the limbs
  • Temporary blindness or disorientation
  • Convulsions or involuntary muscle contractions

Treatment of Epilepsy

  • Medication— Anti-seizure medication is the primary treatment of epilepsy. These include: phenobarbital, potassium bromide, levetiracetam, and more.
  • Dietary modificationDiet is an important part of managing epilepsy. Some dogs may benefit from low-carb diets to stabilize blood sugar, elimination diets to remove allergens, prescription diets for epilepsy, and supplements such as Omega-3 fatty acids, MCTs, vitamin E, and selenium.
  • Healthy lifestyle changes— Reducing stress, regular exercise, and avoiding seizure triggers are important in managing epilepsy.
Epilepsy can’t be cured— but it can be managed

Epilepsy cannot be completely cured, however, it can be well-managed through medication, dietary modification, and healthy lifestyle changes.

Seizures can be frightening to witness, but it is important to stay calm and keep the dog safe during the episode.

Keeping your dog safe during a seizure
  • Avoid touching or restraining the dog during the seizure, as this can increase their anxiety and make the seizure worse.
  • Clear any objects or furniture out of the dog’s way and make sure they are not in danger of falling or injuring themselves.
  • After the seizure has ended, contact a veterinarian to determine the underlying cause and develop an appropriate treatment plan.

Prognosis of Epilepsy

The prognosis for dogs with epilepsy can vary depending on the underlying cause, the severity of the seizures, and how well they respond to treatment.

While epilepsy cannot be cured, many dogs with epilepsy can have their seizures effectively managed with medication and lead normal, healthy lives.

Regularly checkups are important

It is important to monitor dogs with epilepsy closely and work with a veterinarian to adjust their treatment plan as needed to ensure the best possible outcome.


13 Most Common Shih Tzu Health Problems - FrenchieWiki (2024)
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