Shih Tzu Health

By Janice A. Jones Last Updated February, 2025

Shih Tzus are loving, long-lived companions, but like all dogs, they can experience health issues throughout their lives. Some conditions are common to many breeds, while others occur more frequently in Shih Tzus due to their size, structure, or genetics.

This page serves as a central health resource for Shih Tzu owners. It brings together clear, experience-based explanations of common symptoms, conditions, and preventive care topics, with links to in-depth articles for those who want to learn more.

Not every Shih Tzu will experience these problems, and seeing a condition listed here does not mean your dog is destined to develop it. The goal of this page is to educate, raise early awareness, and help you recognize when something may need attention.

Use this page as a reference guide. Browse by topic, follow links that match your concern, and always seek professional veterinary care when symptoms are severe, sudden, or worrying.

Shih Tzu Health ResourcesShih Tzu Health Resources

Important: The information on this page is provided for educational purposes only and is not a substitute for professional veterinary diagnosis or treatment. Always consult your veterinarian regarding your dog’s health.

Table of Contents of Shih Tzu Health Related Articles

Digestive & Metabolic Conditions

Skin, Coat & Allergies

Eyes, Ears & Respiratory Issues

Structural & Genetic Conditions

Parasites, Environmental & First Aid Concerns

Preventive Care & Everyday Health Essentials

These resources focus on everyday care, prevention, and practical skills that help support your Shih Tzu’s long-term health and well-being.

Safety & First Aid

Preventive Health & Wellness

Natural & Topical Care

Parasite & Environmental Protection

Everyday Owner Questions

When to Call the Vet

Many common health issues in Shih Tzu dogs can be managed through routine care and home monitoring. However, there are times when veterinary care is urgent and should not be delayed.

Contact your veterinarian promptly or seek emergency care if your Shih Tzu experiences any of the following:

  • Difficulty breathing, excessive panting, or blue or pale gums
  • Collapse, seizures, or loss of consciousness
  • Persistent vomiting or diarrhea lasting more than 24 hours
  • Sudden weakness, lethargy, or inability to stand
  • Signs of severe pain, such as crying, trembling, or guarding a part of the body
  • Eye injuries, bulging eyes, or sudden vision changes
  • Suspected poisoning or ingestion of a toxic substance
  • High fever, heat stress, or symptoms of heat stroke
  • Trauma from a fall, bite, or accident

If you are ever unsure whether a situation is urgent, it is always safest to contact your veterinarian for guidance. Early treatment can make a significant difference in outcomes.

Shih Tzu Health Articles

The following sections provide a brief overview of common health issues that may affect Shih Tzu dogs, with links to more detailed articles where available.

Addison's Disease in Dogs

Vague symptoms of intermittent diarrhea and vomiting, lethargy or depression, increased thirst and loss of appetite may suggest Addison's Disease. 

Rare in Shih Tzu dogs, this condition does exist, and since the symptoms are hard to pin down, it is worth knowing about.

Learn more about Addison's Disease

Allergies

Is your Tzu baby suffering from allergies?  Whether it is Flea bites, food allergies, contact or airborne allergies, there is hope and relief in sight.  Read about the way Shih Tzu Allergies are treated in the 21st Century.

Learn about Allergies and What You Can Do for Your Dog

Anal Glands/Anal Sac Problems

Is your dog scratching, scooting, or biting at his rear end?  It might be time to express his anal glands. Although not the most pleasant of tasks, this page will teach you how to do this yourself at home.

Learn about Anal Glands and How to Prevent Problems

Bee Stings in Dogs

Read this article before your dog gets stung by a bee or wasp and gather up the first aid supplies needed to remove the stinger and treat the wound.  You'll be glad you did.

Learn all about Bee Stings Just in Case Your Dog Gets Stung

Brachycephalic Syndrome

Like many other short nosed dogs, the Shih Tzu has a short head which makes them prone to a disorder known as brachycephalic airway obstruction syndrome (BAOS). Find out how this Shih Tzu health problem might affect your fur-baby.

Learn about Brachycephalic Syndrome and How it Affects Your Tzu

Coccidiosis in Dogs

Coccidiosis is the medical term used to describe a puppy that has ingested a one-celled organism called Coccidia.  Not all puppies are plagued with these intestinal parasites, but if they are, you should know how to manage the problem. 

Learn about Coccidia and How to Manage this Parasite

Coprophagia (Eating Feces)

A most disgusting but common problem.  Whether this is more a behavioral or health problem is still open for discussion.  Learn what you can do to prevent your Shih Tzu from engaging in this practice.

Learn What You can Do to Prevent Your Shih Tzu from Eating Poop

Cushing's Disease

Cushing's Disease in Shih Tzu dogs is a rather complex condition that was named after the doctor (Dr. Harvey Cushing) who first diagnosed the syndrome in 1932.  It is more common for the smaller breed dogs and can occur in Shih Tzu dogs, although not the most common genetic problem.

Learn about Cushing's Disease

Dander in Shih Tzu Dogs

Even though Shih Tzu dogs are known as hypoallergenic, they still have dander which can be a problem for people who are highly allergic.  There are ways to deal with any dander problems, especially for those who live in city apartments.

Learn more about Dander in Shih Tzu dogs.

Dandruff in Dogs

Got that telltale signs of doggie dandruff?  Find out why your dog has this issue and what you can do about it.  This article also covers walking dandruff if you are concerned about skin mites, this is a must read.

Learn about Dandruff in Dogs

Dental Health

Good dental health is vital to your dog’s overall health.  Poor dental hygiene cannot only affect your dog’s teeth and mouth, but it can also extend to your dog’s vital organs.

Learn Ways to Manage Your Dog's Dental Health

Dry Skin

Is your Shih Tzu suffering from dry skin?  Is a simple case of dry flaky skin or is there an underlying problem that is causing the problem.   There are many causes of dry skin, but there are also plenty of useful things you can do to cure their dry, itchy skin.

Read about Dry Skin and What you Can Do to Prevent It.

Eye Problems

Shih Tzu have beautiful eyes that seem to look clear through to your soul, but those amazing eyes can have all sorts of problems.  Learn about the many different types of problems and what you can do to protect your dog.

Learn about Eye Problems in Shih Tzu

Ear Infections

Any dog can get an ear infection, but the Shih Tzu breed is prone to them due to the way their ears hang.  Breeds with floppy low hanging ears have more infections than their erect ear cousins.

Read about Ear Infections and How to Treat Them.

Ear Mites

Those pesky little mites - whether they are on your dog's skin or in his ears, any type of parasite can wreak havoc on your Tzu's well-being.  Ear mites are tiny and live in the ear canal.  They cause itching and can lead to additional problems such as secondary ear infections.

All About Ear Mites

Fleas:  How to Get Rid of Them

If you have problems with fleas, this is the article to read.  There are different ways to go about it, but your dog will appreciate getting rid of those unwanted friends.  

Giardia

Another intestinal parasite that is common in dogs, Giardia is a protozoan that wrecks havoc with a dog's digestive tract causing diarrhea and vomiting.  It is also a Public Health Issue. 

Learn about Giardia and How to Manage an Outbreak

Heat Stroke

Shih Tzu Heat Stroke is a dangerous condition and may be more common than you think, especially if you live in a warm climate. 

Shih Tzu, like all dogs with short flat noses (brachycephalic), may have difficulty breathing and may overheat, especially in hot weather. Protect your dog from hot situations with these practical tips.

Read about Tips for Avoiding and Dealing with Heat Stroke

Hair Loss in Shih Tzu Dogs

Hair loss, also known as alopecia, is uncommon but does occur in the Shih Tzu breed.  There are many reasons thinning and hair loss can occur.  Learn about the causes, symptoms, treatments, and prevention of hair loss and follow Lucy's hair loss story.

Shih Tzu Hair Loss

Hypoglycemia in Small Puppies

Hypoglycemia or low blood sugar can be a serious medical emergency especially in tiny Shih Tzu puppies.  This article discusses the causes, treatment and prevention options for new puppy owners.  If you are thinking about a tiny Tzu, this is a must read.

Hypoglycemia in Young Puppies

Inguinal Hernia

Inguinal hernias are common in many dog breeds but they have also been reported in the Shih Tzu breed.  Whether the bulge on your puppy's lower abdomen is a true inguinal hernia or just a delayed closure, know the facts and then decide what you should do.

Inguinal Hernia

Intestinal Worms

Discussing those nasty little worms that exit in the intestines and hearts of dogs does not make for polite dinner conversation. However, if left unchecked, these little creatures can make your dog and even you very ill and could be potentially deadly.

All About those Nasty Intestinal Worms

Mobility Issues

Shih Tzu dogs reach a point in their life where health declines.  Mobility is often the first sign that your dog is reaching his senior years.  Learn how to help them live a quality life dispite some deficits.

Mobility Issues in Ten-year-old Shih Tzu Dogs

Obesity

Who wants to think about the "F" word.  No, No, here I'm referring to "FAT."  This is a problem in this breed, especially for spayed or neutered dogs that have become to comfortable warming laps and taking afternoon siesta.

A Primer on Obesity in Dogs

Paw Pad Problems

Shih Tzu dogs tend to pick up debris and other potential toxins on their paw pads and surrounding hair every time they go outdoors.  Some also  suffer from allergies that cause them to bite and lick their paws constantly.  This article will provide some information and hopefully solutions to those ever present paw pad problems.

Learn how to Manage Paw Pad Problems

Renal Dysplasia

Formerly called Juvenile  Renal Dysplasia, this devastating and deadly disease can hit at anytime from puppyhood onward.  Symptoms include increased thirst and urination to lethargy, vomiting and debilitation as renal failure sets in.

Renal Dysplasia

Reverse Sneezing

While not exactly major health concerns, little dogs often have problems with reverse sneezing.  Learn what causes reverse sneezing and how you can stop your dog's reflex easily.

Reverse Sneezing

Seizures in Small Dogs

It's very scary to watch, but this disorder is more common than you think.  Learn more about seizures and what you can do to help.

Seizures in Small Dogs

Stenotic Nares

You may have heard them called pinched nostrils, but the condition is very common in Shih Tzu and other Brachycephalic breeds.  When little noses are narrow, airflow is restricted and breathing becomes difficult.

Stenotic Nares

Tear Stains

If you have a white dog, chances are you will encounter staining at one point or another.  Read up on what causes such an unsightly mess and what you can do to reduce or eliminate these tear stains.

Read about Tear Stains

Umbilical Hernia

This is a problem in many breeds including the Shih Tzu.  It's usually very noticeable as a small swelling on the puppy's abdomen where the umbilical cord was attached. Find out if you should worry.

Read about the Umbilical Hernia

Vomiting (Puppy)

Poor puppy looks miserable but is it a medical emergency?  Find out what causes vomiting and what you should do about it.

Learn what causes Puppy Vomiting and How to Manage it.

Worming Puppies

You might think that worming puppies is simple.  Give the pups some worming medicine and all's right with the world.  Well, sorry to inform you, it is not as easy as it sounds. This article is intended to help other breeders as well as puppy parents deal with those pesky parasites and keep your fur friend happy and healthy.

Everything you need to know about Worming Puppies

Shih Tzu Health: Keeping Them in Top Shape

Foods Toxic to Dogs

This is a must-read article for all new dog owners.  There are some foods that dogs should not be given.  Learn what some of these toxic substances are before it is too late.

Foods Toxic to Dogs

First Aid Supply Kit

Hopefully you'll never have a canine emergency where you must dip into a first aid kit.  But, let's face it, this is the real world and even though the Shih Tzu dog looks like royalty, they just can't just sit still and look pretty.

How to Build a First Aid Kit for Dogs

Human Medicines You Can Give to Your Dog

Did you know that you can give your dog some of the same medications you take yourself.  This list of over the counter medications might surprise you.

A List of Human Medicines to Give Dogs

Vaccinations (Puppy & Adult Shots)

There is so much controversy concerning the vaccinations we give our dogs – are they necessary?  What will happen if I vaccinate?  What will happen if I do not vaccinate?  What vaccines should I consider and which ones do not need to be given?  If you want the lowdown on the vaccination controversy, click on our article.

Vaccinate Your Dog

How to Give a Dog a Pill

Do you have a Shih Tzu that is nearly impossible to give a pill?  We have one.  Learn how we managed to get medication down Cooper's throat. Article and Video.

How to Give a Pill

What Puppies Need

If your dog could talk, What do you think he'd ask for?

We can only guess at what puppies need because our little canine friends cannot talk and tell us directly. 

We can only surmise that what we need, they need too.  Here is a list of ten things that we think your puppy would ask for if he/she could talk.

Read What Puppies Need

8 Practical Ways to Keep Your Shih Tzu Healthy

Every breed of dog is prone to some health issues, and Shih Tzu canines are prone to eye, ear, and back problems.

Allergies is another major problem in this breed.  Proper pet care will minimize the risk of these illnesses.

Read 8 Practical Ways to Keep Your Shih Tzu Healthy

Puppy Vitamins and Supplements

My dogs' health and the health of my puppies is a top priority to me.  That is why I started using this immune system builder for my own dogs and I am seeing some amazing results in my dogs’ health, coat, and energy level. 

Read more about Puppy and Adult Vitamins

Using Coconut Oil For Dogs

You have probably heard about cooking and baking with coconut oil, but that is only one of the many different numbers of uses of the product. Here is a product that has become increasingly popular for uses on the exterior of the body, not limited to just ingestion of it.

There are a countless number of benefits that come from coconut oil. From hair and skin to weight loss and anti-aging, everyone can find a way to benefit from coconut oil.

Learn Ways to Use Coconut Oil for your Shih Tzu

Please check back frequently as we continue to add articles on Shih Tzu Health. If you don't see something that interests you, feel free to contact me. I am always learning, reading, and exploring new topics to add to this Shih Tzu Health Resource Library.

References and Further Reading

Dog Breed Health

Canine Health Information Center

Pin for Future Reference

Shih Tzu puppy posing with a stethoscope and syringeShih Tzu Health

"Hi, I'm Janice Jones, a former veterinary technician and Shih Tzu expert with over 40 years of experience with the breed. Through Miracle Shih Tzu, I combine my medical background and extensive breed knowledge to provide reliable, practical advice for Shih Tzu owners. My mission is to help you give your Shih Tzu the happiest, healthiest life possible through evidence-based information and real-world solutions. Whether you're new to the breed or a seasoned owner, you'll find trusted guidance here for all aspects of Shih Tzu care.

I hold an undergraduate degree in Psychology with a minor in biology, Early Childhood Education, and Nursing, and a Master's in Mental Health Counseling.