The Spunky Shih Tzu

This distinctive looking dog can easily win your love. You chose to snuggle up with a Shih Tzu because you can expect certain traits:

• Excellent companion
• Needs minimal exercise
• Sweet, playful, and friendly
• Alert, curious, and busy
• Good around other pets and dogs
• Intelligent, friendly, and easily won over

It will take training, socialization, and attention to avoid problems related to these traits:

• An indoor dog that doesn’t do well in the heat
• May have a tendency to bark excessively
• Can be aggressive, fearful, or snappy if not socialized properly
• Can be difficult to housetrain
• Fragile and easily injured due to small size
• Needs frequent attention from her family

Her large personality and adorable underbite make it easy to understand why the Shih Tzu is one of the most popular breeds in the United States.

The “Little Lion Dog” originated in 17th century China and is believed to be a cross between the Tibetan Spaniel and the Lhasa Apso. She is a relatively new breed in America; in the 1960s, only 100 Shih Tzus were registered in the country! Their popularity rose quickly though, and they were recognized by the AKC in 1969. They are sensitive to heat and require only moderate exercise. Shih Tzus are primarily companion dogs, and they take this job very seriously—they love to be with their families whenever possible. The Shih Tzu is a generally healthy breed with an average lifespan of 13-15 years.

Your Shih Tzu's Health

We know that because you care so much about your dog, you want to take good care of her. That is why we have summarized the health concerns we will be discussing with you over the life of your Shih Tzu. By knowing about health concerns specific to Shih Tzu, we at our hospitals can tailor a preventive health plan to watch for and hopefully prevent some predictable risks.

Many diseases and health conditions are genetic, meaning they are related to your pet’s breed. There is a general consensus among canine genetic researchers and veterinary practitioners that the conditions we’ve described herein have a significant rate of incidence and/or impact in this breed. That does not mean your dog will have these problems; it just means that she is more at risk than other dogs. We will describe the most common issues seen in Shih Tzus to give you an idea of what may come up in her future. Of course, we can’t cover every possibility here, so always check with us if you notice any unusual signs or symptoms.

This guide contains general health information important to all canines as well as the most important genetic predispositions for Shih Tzus. This information helps you and us together plan for your pet’s unique medical needs. At the end of the article, we have also included a description of what you can do at home to keep your Shih Tzu looking and feeling her best. You will know what to watch for, and we will all feel better knowing that we’re taking the best possible care of your pal.

General Health Information for your Shih Tzu

Dental Disease

Dental disease is the most common chronic problem in pets, affecting 80% of all dogs by age two. Unfortunately, your Shih Tzu is more likely than other dogs to have problems with her teeth. Dental disease starts with tartar build-up on the teeth and progresses to infection of the gums and roots of the teeth. If we don’t prevent or treat dental disease, your buddy may lose her teeth and be in danger of damage to her kidneys, liver, heart, and joints. In fact, your Shih Tzu's life span may even be cut short by one to three years! We’ll clean your dog’s teeth regularly and let you know what you can do at home to keep those pearly whites clean.

Infections

Shih Tzus are susceptible to bacterial and viral infections — the same ones that all dogs can get — such as parvo, rabies, and distemper. Many of these infections are preventable through vaccination, which we will recommend based on her age, the diseases we see in our area, and other factors.

Obesity

Obesity can be a significant health problem in Shih Tzus. It is a serious disease that may cause or worsen joint problems, metabolic and digestive disorders, back pain, and heart disease. Though it’s tempting to give your pal food when she looks at you with those soulful eyes, you can “love her to death” with leftover people food and doggie treats. Instead, give her a hug, brush her fur or teeth, play a game with her, or perhaps take her for a walk. She’ll feel better, and so will you!

Parasites

All kinds of worms and bugs can invade your Shih Tzu's body, inside and out. Everything from fleas and ticks to ear mites can infest her skin and ears. Hookworms, roundworms, heartworms, and whipworms can get into her system in a number of ways: drinking unclean water, walking on contaminated soil, or being bitten by an infected mosquito. Some of these parasites can be transmitted to you or a family member and are a serious concern for everyone. For your canine friend, these parasites can cause pain, discomfort, and even death, so it’s important that we test for them on a regular basis. We’ll also recommend preventive medication as necessary to keep her healthy.

Spay or Neuter

One of the best things you can do for your Shih Tzu is to have her spayed (neutered for males). In females, this means we surgically remove the ovaries and usually the uterus, and in males, it means we surgically remove the testicles. Spaying or neutering decreases the likelihood of certain types of cancers and eliminates the possibility of your pet becoming pregnant or fathering unwanted puppies. Performing this surgery also gives us a chance, while your pet is under anesthesia, to identify and address some of the diseases your dog is likely to develop. For example, if your pet needs hip X-rays or a puppy tooth extracted, this would be a good time–it’s more convenient for you and easier on your friend too. Routine blood testing prior to surgery also helps us to identify and take precautions against common problems that increase anesthetic or surgical risk. Don’t worry; we’ll discuss the specific problems we will be looking for when the time arrives.

Genetic Predispositions for Shih Tzus

Liver Problems

Your Shih Tzu is more likely than other dogs to have a liver disorder called portosystemic shunt (PSS). Some of the blood supply that should go to the liver goes around it instead, depriving the liver of the blood flow it needs to grow and function properly. If your friend has PSS, his liver cannot remove toxins from his bloodstream effectively. To check for this problem, we’ll conduct a liver function test in addition to a standard pre-anesthetic panel every time he undergoes anesthesia. If he develops symptoms such as stunted growth or seizures, we’ll test his blood and possibly conduct an ultrasound scan of his liver. Surgery may be needed, but in some cases, we can treat with a special diet and medication.

Bone and Joint Problems

A number of different musculoskeletal problems have been reported in Shih Tzus. While it may seem overwhelming, each condition can be diagnosed and treated to prevent undue pain and suffering. With diligent observation at home and knowledge about the diseases that may affect your friend's bones, joints, or muscles, you will be able to take great care of him throughout his life.

• Intervertebral disc disease (IVDD) is a common condition in Shih Tzus. The disease is caused when the jelly-like cushion between one or more vertebrae slips or ruptures, causing the disc to press on the spinal cord. If your dog is suddenly unable or unwilling to jump or go up stairs, is reluctant to move around, has a hunched back, cries out, or refuses to eat or go potty, he is likely in severe pain. He may even experience sudden paralysis—he may drag his back feet or be unable to get up or use his back legs. If you see these symptoms, don’t wait! Call us at (210) 496-1315 or call an emergency clinic immediately! In many cases involving paralysis, we’ll recommend surgical removal of the ruptured discs (within 24 hours of the onset of symptoms for the best results). For less severe cases, rest and medication may resolve the problem. And as with so many other diseases, weight control helps reduce the risk of IVDD. You should also provide ramps or steps for your pet from puppyhood on to prevent your dog from stressing his back by jumping on and off of the furniture.
• Sometimes your Shih Tzu's kneecap (patella) may slip out of place. This is called patellar luxation. You might notice that your pet, while running, suddenly picks up a back leg or skips and hops for a few strides. He might then kick his leg out sideways to pop the kneecap back in place. These are common signs of patellar luxation. If the problem is mild and involves only one leg, your friend may not require much treatment beyond arthritis medication. When symptoms are severe, surgery may be needed to realign the kneecap to keep it from luxating further.
• You’ve probably heard of hip dysplasia, an inherited disease that causes the hip joints to form improperly and leads to arthritis. Hip dysplasia is common in Shih Tzus. You may notice that he has lameness in his hind legs or has difficulty getting up from lying down. We’ll take X-rays of your dog’s joints to identify the disease as early as possible, and we can treat the arthritis—the sooner the better—to avoid discomfort and pain. Surgery is sometimes considered in severe and life-limiting cases of hip dysplasia. And keep in mind that overweight dogs may develop arthritis years earlier than those of normal weight, causing undue pain and suffering.

Eye Problems

Not many things have as dramatic an impact on your dog's quality of life as the proper functioning of his eyes. Unfortunately, Shih Tzus can inherit or develop a number of different eye conditions, some of which may cause blindness if not treated right away, and most of which can be extremely painful! We will evaluate his eyes at every examination to look for any signs for concern.

• Because your Shih Tzu has eyeballs that naturally protrude, he is more vulnerable to eye injuries. Scrapes or punctures to the cornea (the protective covering on the eyeball) are the most common injuries. Don’t let your pet ride in the car with his head out the window as this is also a frequent cause of eye injuries. Not only do eye injuries hurt, they can become infected and affect his vision. Call us right away if your pet has any problems with his eyes. A damaged cornea is painful and should be treated immediately. Medication and sometimes surgery may be required.
• Glaucoma, an eye condition that affects Shih Tzus and people too, is an extremely painful disease that rapidly leads to blindness if left untreated. Symptoms include squinting, watery eyes, bluing of the cornea (the clear front part of the eye), and redness in the whites of the eyes. Pain is rarely noticed by pet owners though it is frequently there and can be severe. People who have certain types of glaucoma often report it feels like being stabbed in the eye with an ice pick! Yikes! In advanced cases, the eye may look enlarged or swollen like it’s bulging. We’ll perform an annual glaucoma screening to diagnose and start treatment as early as possible. Glaucoma is a medical emergency. If you see symptoms, don’t wait to call us, go to an emergency clinic!
• Dry eye, also known as keratoconjunctivitis sicca or KCS, is common in Shih Tzus. KCS reduces the amount of fluid produced by the tear glands such that they are no longer able to keep the eyes moist. This results in sore, itchy eyes and infections. Symptoms of KCS include a dull, dry appearance or thick discharge from the eyes, squinting, and pawing at the eyes. KCS is a painful condition; please call us immediately if you notice any of these signs, and we’ll conduct a tear test on your pet. If he has this disease, we’ll prescribe ointment that you’ll need to apply for the rest of your dog’s life.
• Cataracts are a common cause of blindness in older Shih Tzus. We’ll watch for the lenses of his eyes to become more opaque—meaning they look cloudy instead of clear—when we examine him. Many dogs adjust well to losing their vision and get along just fine. Surgery to remove cataracts and restore sight may also be an option.

Kidney Disease

Glomerulonephropathy is an inherited disease that slowly damages your Shih Tzu's kidneys, causing them to fail, often at an early age. Because damaged kidneys leak protein, we may be able to diagnose this disease by annually testing your pet’s urine for excessive protein. Early detection leads to a happier pet and an easier, more affordable treatment plan. We may also recommend a special diet as part of his therapy.

Bladder or Kidney Stones

There are a few different types of stones that can form in the kidney or in the bladder, and Shih Tzus are more likely to develop them than other breeds. We’ll periodically test his urine for telltale signs indicating the presence of kidney and bladder stones, which in addition are very painful! If your buddy has blood in his urine, can’t urinate, or is straining to urinate, it is a medical emergency. Call us immediately!

Hyperadrenocorticism (Cushing's)

Cushing's Disease is a malfunction of the adrenal glands that causes them to produce too much steroid hormone. This is a common problem in dogs, and your Shih Tzu is more likely than other dogs to be affected. The condition usually develops slowly, and the early signs are easily missed. Symptoms include drinking and urinating more than normal, increased appetite, and reduced activity level followed later by a potbelly, thin skin, and hair loss. Treatment usually includes oral medications and requires close coordination with us to ensure correct dosing.

Cancer

Cancer is a leading cause of death in older dogs. Your Shih Tzu will likely live longer than many other breeds and therefore is more prone to get cancer in his golden years. Many cancers are curable by surgical removal, and some types are treatable with chemotherapy. Early detection is critical! We’ll perform periodic diagnostic tests and look for lumps and bumps when we examine your pet.

Allergies

In humans, allergies to pollen, mold, or dust make people sneeze. In dogs, rather than sneezing, allergies make their skin itchy. We call this skin allergy “atopy”, and Shih Tzus often have it. The feet, belly, folds of the skin, and ears are most commonly affected. Symptoms typically start between the ages of one and three and can get worse every year. Licking the paws, rubbing the face, and frequent ear infections are the most common signs of allergies. The good news is that there are many treatment options available for these conditions.

• Allergies, swimming, overgrowth of hair in the ear canals, and accumulation of earwax can all predispose your dog to ear infections, which are painful and annoying. Shih Tzus are very often afflicted by allergies, which can cause itching and inflammation in the ears and elsewhere. The earlier we diagnose and treat these ailments, the less discomfort and pain your pet will suffer. Be sure to call us if you notice him scratching or shaking his head, a foul odor from the ears, or if his ears seem painful to the touch. By monitoring for ear infections and treating them early, we also reduce the likelihood of eardrum damage that can lead to deafness. Most ear infections tend to recur until we work together to control the underlying cause.

Bleeding Disorders

There are several types of inherited bleeding disorders that occur in dogs. They range in severity from very mild to very severe. Many times a pet seems normal until a serious injury occurs or surgery is performed, and then severe bleeding can result. Von Willebrand’s disease is a blood clotting disorder frequently found in Shih Tzus. We’ll conduct diagnostic testing for blood clotting times or a specific DNA blood test for Von Willebrand’s disease and other similar disorders to check for this problem before we perform surgery.

Heart Disease

Shih Tzus are prone to multiple types of heart disease, which can occur both early and later in life. We’ll listen for heart murmurs and abnormal heart rhythms when we examine your pet. When indicated, we’ll perform an annual heart health check, which may include X-rays, an ECG, or an echocardiogram, depending on your dog’s risk factors. Early detection of heart disease often allows us to treat with medication that can prolong your pet’s life for many years. Veterinary dental care and weight control also go a long way in preventing heart disease.

Respiratory Distress Syndrome

Respiratory distress syndrome, also known as brachycephalic syndrome, affects dogs with a short nose, like your Shih Tzu. Short-nosed dogs have the same amount of tissue in their noses and throats as longer-nosed dogs, but with less area to contain it. As a consequence, the soft palate at the back of the roof of the mouth is too long and may hang down into the airway. These dogs’ nostrils are often too small, and sometimes the trachea, or windpipe, is narrow and undersized as well. All of these differences can lead to a narrow and obstructed airway such that many of these dogs can barely breathe! Watch for exercise intolerance, loud breathing, coughing, bluish gums, or fainting. With his short nose, your pet is also more likely to develop other problems, such as flatulence from excessive air intake, pneumonia from aspirating food, and heat stroke. In severe cases, surgical correction may be recommended to alleviate airway obstruction.

Dental Abnormalities

Teeth abnormalities are often genetically induced and are relatively common in dogs, especially in purebred dogs like your Shih Tzu. An overbite or underbite is called a malocclusion or a bad bite. Oligodontia is a condition in which only a few teeth are present. Misaligned teeth can also occur and cause lots of problems, but can usually be corrected with braces or extractions. (Yes, dogs can get braces!) We want to keep your buddy’s teeth healthy, so we will be watching his developing teeth closely.

Taking Care of Your Shih Tzu at Home

Much of what you can do to keep your dog happy and healthy is common sense, just like it is for people. Watch her diet, make sure she gets plenty of exercise, regularly brush her teeth and coat, and call us or a pet emergency hospital when something seems unusual (see “What to Watch For” below). Be sure to adhere to the schedule of examinations and vaccinations that we recommend for her. This is when we’ll give her the necessary “check-ups” and test for diseases and conditions that are common in Shih Tzus. Another very important step in caring for your pet is signing up for pet health insurance. There will certainly be medical tests and procedures she will need throughout her life and pet health insurance will help you cover those costs.

Routine Care, Diet, and Exercise

Build her routine care into your schedule to help your Shih Tzu live longer, stay healthier, and be happier during her lifetime. We cannot overemphasize the importance of a proper diet and exercise routine.

• Supervise your pet as you would a toddler. Keep doors closed, pick up after yourself, and block off rooms as necessary. This will keep her out of trouble and away from objects she shouldn’t put in her mouth.
• Regular brushing and grooming is needed to keep her coat beautiful.
• Shih Tzus often have serious problems with their teeth, so you’ll need to brush them at least three times a week!
• Clean her ears weekly, even as a puppy. Don’t worry—we’ll show you how!
• She is well suited for apartment living; she will need a daily walk and regular inside play.
• She can be sensitive to warm temperatures; avoid any prolonged exposure and be very alert to the signs of heat stress.
• She is highly intelligent and can be taught to perform a variety of tricks to help keep her mentally stimulated.
• Keep your dog’s diet consistent and don’t give her people food.
• Feed a high-quality diet appropriate for her age.
• Exercise your dog regularly, but don’t overdo it at first.

What to Watch For

Any abnormal symptom could be a sign of serious disease or it could just be a minor or temporary problem. The important thing is to be able to tell when to seek veterinary help and how urgently. Many diseases cause dogs to have a characteristic combination of symptoms, which together can be a clear signal that your Shih Tzu needs help.

Office Calls

Give us a call for an appointment if you notice any of these types of signs:

• Change in appetite or water consumption
• Tartar build-up, bad breath, red gums, or broken teeth
• Itchy skin (scratching, chewing, or licking); hair loss
• Lethargy, mental dullness, or excessive sleeping
• Fearfulness, aggression, or other behavioral changes
• Lumps or bumps – regardless of size
• Slow or stunted growth; sometimes seizes after eating
• Drinks and urinates more, eats more; potbelly, poor coat

Emergencies

Seek medical care immediately if you notice any of these types of signs:

• Scratching or shaking the head, tender ears, or ear discharge
• Inability or straining to urinate; discolored urine
• Cloudiness, redness, itching, or any other abnormality involving the eyes
• Coughing, exercise intolerance, rapid breathing at rest
• Loud breathing, tires easily at exercise
• Leg stiffness; reluctance to rise, sit, use stairs, run, or jump; “bunny hopping”