Shih Tzu Health Problems: An Honest Guide

The Shih Tzu is an affectionate, long-lived little companion — but like all pedigree breeds, and particularly as a flat-faced one, it carries some health risks worth understanding before you commit. Being honest about these is not about putting you off; it is about helping you buy from a responsible breeder, spot problems early, and give your dog the best chance of a comfortable life. Here is a factual guide to the main Shih Tzu health problems and what you can do about them.

The flat face: breathing problems (BOAS)

The Shih Tzu is brachycephalic — flat-faced — and in some dogs the shortened skull and muzzle contribute to brachycephalic obstructive airway syndrome (BOAS). This can cause noisy breathing, snoring, snorting, reduced exercise tolerance and, in more severely affected dogs, real difficulty breathing that may need surgery. Flat-faced dogs are also less able to cool themselves by panting, which makes them more vulnerable to heatstroke — a genuine emergency. Practical steps: never over-exercise your dog or leave them in heat, keep them lean, watch for laboured breathing, and choose a breeder who selects for more open nostrils and a slightly longer muzzle. Welfare campaigns by organisations such as the RSPCA encourage buyers to prioritise the ability to breathe easily over an extreme flat face.

Eye problems

Because Shih Tzus have large, prominent eyes set in a flat face, the eyes are exposed and prone to injury and disease. Common problems include:

• Corneal ulcers and injuries, sometimes caused by hair rubbing on the eye or by trauma the dog barely notices.
• Dry eye (keratoconjunctivitis sicca), where the eye does not produce enough tears, leading to discomfort and thick discharge.
• 'Cherry eye', a prolapse of the tear gland of the third eyelid that appears as a red lump in the corner of the eye.
• Pigmentary changes and other inherited eye conditions that responsible breeders screen for.

Daily eye checks, keeping facial hair trimmed or tied back, and seeing a vet promptly for any squinting, redness, cloudiness, discharge or rubbing are essential. Eye problems in this breed can deteriorate quickly, so never adopt a wait-and-see approach.

Ear infections

Shih Tzus have hairy ear canals that can trap moisture and wax, predisposing them to ear infections. Signs include head-shaking, scratching at the ear, odour, redness or discharge. Regular checks and keeping the ears clean and dry help prevent problems; see your vet at the first sign of trouble rather than letting an infection take hold.

Skin and coat problems

The breed's dense coat and facial skin folds can lead to skin irritation and fold dermatitis if not kept clean and dry, and the breed can also be affected by allergic skin disease. Keeping the coat well groomed, the folds clean and dry, and acting early on any redness, itching or odour all help. Our grooming and care guide sets out the routine that prevents most of these issues.

Dental disease

Like many small breeds, Shih Tzus are prone to dental disease, partly because of crowding in a small mouth. Dental disease is painful and can affect overall health, so regular tooth brushing with dog toothpaste, appropriate dental chews and routine vet dental checks are important. Browse dental care for toothbrushes and aids.

Joints and other conditions

Smaller breeds, including the Shih Tzu, can be affected by patellar luxation (slipping kneecaps) and intervertebral disc disease (IVDD), a back problem seen in long-bodied and some small breeds. Hip problems can also occur. Keeping your dog lean, avoiding repetitive jumping onto and off high furniture, and using ramps or steps where helpful all reduce strain. Any limping, reluctance to move, yelping or signs of back pain should be checked by a vet.

Weight: the risk that magnifies all others

Carrying excess weight makes every one of these problems worse — it strains the joints and back, worsens breathing in a flat-faced dog, and raises the risk of other diseases. Because a Shih Tzu's shape is hidden under a thick coat, judge condition by feel and ask your vet to body-condition score them. The pet calorie calculator helps you feed the right amount, and a slow feeder can help a fast eater.

Reducing the risks

• Buy from a responsible breeder who health-tests, registers with The Kennel Club and breeds away from extreme flat faces (see our cost and buying guide).
• Care for the eyes and folds daily, and act fast on any problem.
• Keep your dog lean and protect them from heat and overexertion.
• Stay on top of dental care, ears, grooming and routine vet checks.
• Insure early and use our pet life expectancy tool and vet finder to plan care.

Many Shih Tzus live long, happy, comfortable lives — but they do so most reliably when owners buy responsibly, prevent what can be prevented, and treat problems early. For more, see our guide on lifespan and health.

*This is general guidance, not a substitute for advice from your vet, who can examine and advise on your individual dog.*

Sources

• The Kennel Club — Shih Tzu breed health and health schemes (thekennelclub.org.uk).
• PDSA — flat-faced dog health and common conditions (pdsa.org.uk).
• RSPCA — flat-faced (brachycephalic) dog welfare (rspca.org.uk).
• RVC VetCompass — UK dog health research (rvc.ac.uk/vetcompass).
• Blue Cross — dog health and eye care (bluecross.org.uk).