Inguinal Hernia

by Janice Jones     |Last Updated 05-05-2021

The Inguinal Hernia is not common in the Shih Tzu breed but it does happen from time to time.  Unlike an umbilical hernia where there is a small opening in the umbilicus, the inguinal hernia occurs in the area of the inguinal canal located in the groin. 

In this area, the inguinal canal can stretch open allowing fat and even intestines to pass through.  Usually fat is about all that passes causing a small swelling or bulge in the groin area.  If the segment of small intestine become trapped, that is a different story entirely which will be covered below.

Inguinal Hernia

Inguinal hernias can be bilateral, occurring on either side of the abdomen or unilateral, involving only one side.  Inguinal hernias are more frequent in female puppies than in males, but they can happen in both genders.

In female pups, you can see and feel a swelling in the groin area.  In male dogs, the scrotum may look unusually large.   Since there is a real likelihood of genetic transmission, any dog that has had an inguinal hernia should not be bred although the actual mode of transmission has not been identified at this point.

Veterinarians can usually spot the problem during a routine exam and then confirm their diagnosis with abdominal X-rays or ultrasound. 

True Versus Delayed Closure

Many puppies may have a so-called hernia, but end up having a delayed closure of the inguinal area.  This is also true of umbilical hernias. 

If there is a swelling in the groin area, a veterinarian will call it a hernia and breeders typically follow suit. 

Many tiny “hernias” close by the time the pup reaches 12 weeks of age.  The majority of other delayed closures end up closing by 6 months of age.

It is nearly impossible to tell the difference between a true hernia and a delayed closure when the puppy is 8 weeks old and ready to go to their forever home.  The only way that you will know the difference is to watch, wait and see. 

There seems to be a consensus among Shih Tzu owners that delayed closures are relatively common, but true hernias are not.

Reducible Inguinal Hernias

If your dog has a hernia, you may be asked to check it daily.  If you can push a hernia (swelling) back through the body wall, then the hernia is considered to be reducible.  If the swelling cannot be pushed back into the abdomen, it is deemed to be incarcerated.  This is a major problem because an incarcerated hernia will lose blood supply and become strangulated. 

This is a medical emergency and can be fatal.  When this happens, that loop of intestines is cut off from the rest of the intestinal tract.  This would cause an obstruction or blockage.  Not only is blood not getting to where it is supposed to go, but the intestines are blocked.  Without constant blood flow, this segment is deprived of oxygen and nutrients and will die.

If a section of the intestine has died off, you have a medical emergency.

If an inguinal hernia is found when the puppy is very young, the veterinarian will likely hold off surgery until the puppy is old enough to be spayed or neutered.  The hernia repair is done at the same time as they are spayed or neutered so that the puppy will undergo anesthesia only once.

To be sure that the puppy is fine until the surgery, it is a good idea for the owner to check a hernia daily.  If you can push it back into the abdomen, then you know that the puppy is fine.  If there is ever any doubt, it is a good idea to have your veterinarian check your puppy


Other than a small swelling in the groin, a reducible hernia does not cause symptoms in the dog and it is nothing to worry about.  You will know this if you are checking it daily and trying to reduce a hernia (push the swelling or bulge back into the abdominal cavity.)

However, if you cannot push it back in, you have a problem.  A non-reducible hernia may have become strangulated, and food cannot pass through. 

A Quick Lesson in Digestion

A quick lesson in digestion:  Muscles in the wall of the intestines are responsible for moving food and water through the tract. 

The muscles contract (peristalsis) pushing the food along. 

When an obstruction is encountered, the food contents will begin to move in the opposite direction causing vomiting.

After the dog has vomited, he may refuse to eat but most likely continue to drink water.  Water is more likely to pass through the system or may be absorbed into the system. 

The next stage of the problem occurs when blood supply is blocked.  The area of and around a hernia becomes swollen and painful.  The dog feels cramps, then develop a fever, refuse to eat complete, and becomes very lethargic.

The affected area becomes infected with bacterial toxins and metabolic waste which eventually affects the organs of the body.  Liver and/or kidney failure occur and without treatment, the dog will die within 24 to 48 hours.

Symptoms of a Strangulate Hernia:

  • Vomiting
  • Anorexia (Loss of appetite)
  • Depression and Lethargy
  • Pain/Cramping

Luckily, this rarely ever occurs in Shih Tzu dogs.


Surgery is the only treatment for an inguinal hernia. Unless a hernia has progressed to the critical stage, the operation is considered to be minor surgery.  

The veterinarian will make a small abdominal incision and replace anything that has fallen through the opening. The incision is sutured closed. 

According to Embrace Pet Insurance, the typical cost of surgery is between $150 -$400.  Expect to pay much less if done at the same time as a spay or neuter.

Does Your Puppy Have an Inguinal Hernia?

Some Shih Tzu breeders may offer to have the puppy’s hernia repaired before he/she goes home. I have also heard of breeders agreeing to pay part of the operation with the new owners footing the remainder of the bill.  I have also heard of breeders quoting owners $1500 for the surgery. 

This all might sound noble, but our policy is a little different.

Advice From My Veterinarian

I have consulted with my vet and he would not recommend doing surgery on a Shih Tzu at such a young age.  Surgery is risky at any point in the life of a brachycephalic breed but especially problematic in very young puppies. 

If the puppy has a severe hernia, then surgery would be indicated for repair and to save the life of the pup.   Otherwise, my veterinarian will not operate on a dog much less than six months of age.  Of course, I understand that all vets are different.

My Breeding Practices and Policies

All of my puppies are examined by my veterinarian before they are released to go to their forever homes.  If the vet finds anything abnormal including an inguinal hernia, I will let you know.

(In my years of breeding I have only had one puppy with an inguinal hernia. 
It turned out to be a delayed closure). 

You can then decide whether you want to proceed with the puppy sale.  If you choose not to buy the puppy because of a hernia, I will refund your deposit. 

About Janice

Janice is the voice behind Miracle Shih Tzu. Having lived with dogs and cats most of her life, she served as a veterinary technician for ten years in Maryland and twelve years as a Shih Tzu dog breeder in Ohio.

Her education includes undergraduate degrees in Psychology with a minor in biology, Early Childhood Education, and Nursing, and a master's in Mental Health Counseling.

She is a lifelong learner, a dog lover, and passionate about the welfare of animals. Her favorite breed for over 50 years has been the Shih Tzu.

When not writing, reading, or researching dog-related topics, she likes to spend time with her eight Shih Tzu dogs, her husband, and her family, as well as knitting and crocheting. She is also the voice behind Small Dog Place and smart knit crocheting.