Shih Tzu health problems

Allergies and skin conditions

Shih Tzu owners need to be aware that the breed is sensitive to allergens and tends to develop allergies that present with itchiness, skin irritations and dermatitis. It is recommended to keep an eye on your dog’s skin health at all times.

Some allergies can be well managed with regular preventatives, a specific diet and/or medicated shampoos or foams. As there are a variety of things that could cause a dog to have skin problems, it’s hard to prevent them all before they occur as each dog will react differently to everything in their environment.

Shih Tzu running in a field

Ear problems

Like many dogs with floppy ears, the Shih Tzu is very susceptible to ear infections. These can be triggered by allergies, underlying diseases, or by simply too much moisture in the ear canal. Some ear infections are preventable, whereas with others an underlying cause might not be easily identified.

Cleaning your dog’s ears regularly can help prevent some of the things that lead to an infection, but also allow you to check the interior of the ear for any signs of a problem.

Breathing problems

Brachycephalic Obstructive Airway Syndrome (BOAS)

Like other short-headed (brachycephalic) breeds, Shih Tzus often have respiratory problems because of how their head, face and airways are shaped. Their upper airways are too narrow, which makes it hard for them to breathe.

Dog breeds with Brachycephalic Obstructive Airway Syndrome (BOAS) can have problems regulating their body temperature, so it is advisable to avoid walking them in high temperatures. Instead try to walk your Shih Tzu in either the early morning or late evening when the air is cooler.

Also, BOAS can lead to secondary problems resulting from the increased demands on their heart and lungs, so over-exercising should be avoided wherever possible.

Moderate to severe cases have an immense impact on the animal’s wellbeing as it leaves them with a shortage in their oxygen supply. There are surgeries available to make the airways wider, however dogs whose airways are too narrow to live comfortably should not be bred from.

Collapsing trachea

Another airway problem that can occur in the Shih Tzu is a collapsing trachea (windpipe). The cartilage that gives the trachea its shape can weaken and it will make the structure flatten. The dog’s breathing will become difficult and can become a health risk. For severe cases, there is a corrective surgery available.

Eye problems


A Shih Tzu’s large and sensitive eyes can cause the breed to have issues with their sight, and their genetics can also make these conditions more common than they might be in other breeds. A condition seen more frequently in Shih Tzus is cataracts, a hereditary disorder that causes the eye to cloud over, which can significantly affect your dog’s vision.

This condition can also develop as a dog ages or as a result of another health condition, but the symptoms remain the same. Common signs include:

  • Cloudiness of the eye(s)
  • Excessive discharge from the eye
  • Sensitivity to bright lights
  • Pain from the underlying cause
  • Loss of vision

You should always contact your vet if your pet shows any of these symptoms, so they are able to receive the right treatment.

Progressive Retinal Atrophy

Progressive Retinal Atrophy is a degenerative disease that affects the cells in the retina, which eventually leads to blindness. It is a genetic condition that has no external triggers, effective preventative measures or treatment, so helping your dog adapt to a life without vision is the best thing to do once they have been diagnosed.

Dry Eye and Entropion

Other eye disorders to look out for in a Shih Tzu are “Dry Eye” (Keratoconjunctivitis sicca, KCS) and entropion, which is when the eyelids turn in towards the eye. Both conditions bring damage to the cornea and can lead to ulcerations on the eye.

Eye Injuries

Another thing to respect is the sheer position and size of the Shih Tzu’s eyes and how they sit in the eye sockets. For one thing, their bulging eyes are more prone to injury and sometimes proper eyelid closure isn’t possible due to the anatomy of the Shi Tzus eyes.

This again leaves their eyes more vulnerable, so bear this in mind while out on walks as you’ll be able to help prevent some injuries to the eye by making sure they stick to the path.


Another unfortunately common condition in the Shih Tzu is something called proptosis. This is the dislodging of the eyeball out its socket and the eyelids closing behind it. When this happens, this is an absolute emergency and needs to be seen by a vet immediately.

Joint problems

Hip Dysplasia

Hip Dysplasia is a common and painful genetic health problem seen in Shih Tzus. This condition occurs when a dog’s hip joints develop abnormally, which can have different indications depending on the severity.

The only way to prevent this condition is to make sure dogs with hip dysplasia are not bred from, with various tests able to determine a dog’s hip health before an owner makes the decision to breed.

Luxating Patella

A luxating patella occurs when the kneecap slips out of its normal position in the groove of the thigh bone. It’s considered to be an inherited condition in small and toy dogs and so it’s prevented with responsible breeding. It can also be caused as a result of an injury, so if your dog does develop a luxating patella, it’s often not preventable.

Hormonal problems


One of the hormonal diseases that are often found in Shih Tzus is called hypothyroidism. It affects the thyroid gland of the dog and results in a lack of thyroxine, a hormone that controls the metabolism of the dog. Signs of this disease are hair loss, dull and thin coat, blackened areas of skin, lethargy, less keen to exercise and weight gain.

This disease shouldn’t be left untreated as it affects the dog’s quality of life. Dogs diagnosed with this condition will need to take oral medication for the rest of their lives.

Cushing’s Disease

Cushing’s Disease is a condition caused by a tumour on either one of two important glands found on the base of the brain, which results in the production of too much of the stress hormone cortisol. Sometimes it can be difficult to diagnose the condition as its symptoms can be mild, but once diagnosed, the vet will work on a treatment depending on the severity of the condition.

Liver problems

Portosystemic Shunt

The Shih Tzu is more likely than other breeds to have a liver disorder called portosystemic shunt (PSS). This condition might also be referred to as a liver shunt and means that the blood that usually enters the liver (to filter out any toxins) bypasses the liver via an abnormal connection or vein. This can cause serious problems like stunted growth, because of a lack of the necessary energy needed for proper development.

Surgery is often needed to close the shunt, but your dog will need to be stabilised before they receive this treatment. Sometimes, medication and diet can help ease the symptoms.

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