Shih Tzu

Health Problems

Shih Tzus are normally very loving and enjoy spending lots of cuddle time with their pet parents. These little pups generally enjoy good health and a long life of between 10 and 16 years. However, Shih Tzu health problems do exist—including eye disease, ear problems and back pain.

To be clear, Shih Tzus from responsible breeders tend to be robust, but pet parents should still be knowledgeable about common Shih Tzu health problems. This way, they can be on the lookout for early symptoms and ensure that any medical issues are addressed as quickly as possible. A great way to keep on top of your dog’s health is to schedule yearly health checkups with your vet. Petco offers a variety of veterinary services, including full-service hospitals and vaccination clinics.

Pigmentary keratitis

Some of the most common Shih Tzu health issues involve their eyes, and pigmentary keratitis is prominent in other brachycephalic breeds like pugs and bulldogs. This condition is an inflammation of the cornea that can be caused by chronic irritation related to tears, decreased tear production or quality, an incorrect blink reflex or simply due to your dog’s naturally large eyes. Eventually, eye pigmentation begins to cover the central cornea and the pupil until light has trouble entering your dog’s eye. If left untreated, it can result in ulcers and even lead to blindness.

How to Spot it

Signs of this Shih Tzu health concern include red eyes, eye discharge, sensitivity to light and excessive tearing. Your dog’s eyes may also appear cloudy or white because of scarring or brown due to the advanced spread of pigmentation.

Recommended Solutions

Depending on the type of keratitis, your vet may treat the condition with eye drops, oral antibiotics or even steroid medications. Due to the ocular problems caused by the natural shape of this breed’s eyes, your veterinarian may also recommend surgery to improve eyelid function. Surgery can help prevent pigmentary keratitis from recurring and help prevent other Shih Tzu health issues stemming from the shape of their eyelids.


If you notice brown or dark-colored stains beneath your Shih Tzu’s eyes, their eyes may be producing excess tears—a Shih Tzu health problem known as epiphora. This is common in breeds with smaller and flatter faces, like the Shih Tzu. The causes of epiphora can range from allergies to overproduction of tear glands or blocked tear ducts due to inflammation or a congenital issue. The shape of their faces often means that extra tears can’t drain back into their tear ducts—as they do in non-brachycephalic canines—resulting in tearing on the face, stains and possibly skin irritation.

How to Spot it

Because this Shih Tzu health concern is often associated with excessive tearing, look for a lot of moisture under your dog’s eyes. In lighter-colored dogs, you’ll likely be able to see brown or red spots where the excess tears have been pooling. The stains may also have a strange odor or irritate the skin around pooling areas.

Recommended Solutions

The first recommendation your veterinarian will likely make is to find the reason behind excessive tearing. This can include allergies, irritants, a blocked tear duct, stress or poor diet, conformational issue, an eye infection or simply excess hair that needs to be trimmed around the eye area. Causes like allergies and irritants may require an eye flush and medication, while blocked tear ducts could require minor surgery to remove the obstruction.

Ocular proptosis

This is a particularly nasty Shih Tzu health problem where the eyeball begins to move forward and become dislodged from the socket beyond the eyelid. In extreme cases, the eye can come entirely out of the socket. Ocular proptosis is more prevalent in Shih Tzus due to the shape of their faces but is typically caused by a concussive injury, increase in pressure in the brain or if their facial skin is stretched backward by force.

How to Spot it

If you notice that your dog’s eye looks inflamed, seems to be bulging from the socket or their conjunctiva becomes irritated or swollen, these can be signs of ocular proptosis. Since Shih Tzus’ eyes naturally bulge a little, this common health issue can be diagnosed if your pup’s eyelid doesn’t fully cover their eye.

Recommended Solutions

If caught early, your veterinarian or veterinary ophthalmologist can perform surgery to address this problem and reposition your dog’s eyeball in its proper place. This Shih Tzu health concern is very serious and must be addressed immediately to save the eye and prevent total vision loss.


If you notice that your dog’s eye looks cloudy or opaque, they may be suffering from cataracts. Cataracts are typically hereditary—though they can also be caused by injuries or diabetes—and primarily affect Shih Tzus who are 8 years or older. If untreated, cataracts can grow across the lens of the eye, increasing your dog’s visual impairment and leading to further Shih Tzu health problems.

How to Spot it

Cataracts usually appear as a milky or cloudy film over your Shih Tzu’s eyes. Ocular cloudiness could be a sign of a few different eye issues, so be sure to consult your veterinarian if you notice this symptom.

Recommended Solutions

Fortunately, cataracts can be removed with specialized surgery to restore your dog’s vision. The surgery for this Shih Tzu health condition often involves a process called phacoemulsification that uses a small, ultrasonic probe to break up the cloudy lens. The flawed lens is removed and replaced with an intraocular lens—an artificial lens implant—that allows your dog to see clearly.

Ear infection

A Shih Tzu’s floppy ears and long, warm ear canals are an inviting home for bacteria and ear mites. Because of their long hair, Shih Tzus can frequently experience a buildup of hair and earwax in their canals. Allergies are also a common Shih Tzu health issue and can likewise cause irritation and itching in their ears. Ear infections—also known as otitis externa—are understandably common with this breed.

How to Spot it

Telltale signs of ear infection include scratching at the ears due to crusting or scabs caused by allergies or infections. You may also notice your dog shaking their head, redness of the inner ear, a dark discharge, a bad odor or general pain in their ear area.

Recommended Solutions

Your vet can swab your pet’s ear and use a microscope to determine the nature of the ear infection. They can then prescribe medication to clear up the infection. Petco’s pharmacy includes ear and eye relief medications. One of the best ways to avoid this common Shih Tzu health concern is to check and clean your dog’s ears regularly with dog specific ear products. At Petco, we offer many ear-cleaning solutions, including wipes and cleansers that should be used regularly to help prevent future ear problems.

Patellar luxation

A common hereditary Shih Tzu walking problem, patellar luxation occurs when the front of a dog’s kneecap becomes dislocated. This condition can vary in degree of severity, with some dogs showcasing a limp every so often, while others become completely immobile. Patellar luxation—even in its milder forms—leads to arthritis or other orthopedic conditions later in your dog’s life, so it should always be treated.

How to Spot it

Symptoms include an irregular gait, difficulty walking or jumping and pain or lameness. It can affect a single back leg or both back legs. If you see your dog skipping on their back leg every so often, it can be a telling sign of this Shih Tzu health problem.

Recommended Solutions

A range of different treatments exists for this condition—including arthritis medication, joint supplements and weight management solutions. Corrective surgery may be required for more severe cases, depending on the level of pain and immobility your dog is experiencing.

Hip dysplasia

While hip dysplasia is often linked to large breed dogs, it can affect any dog—including your Shih Tzu. Walking problems are caused by a displacement in the hip joint that can cause degenerative joint disease or arthritis. It typically varies in severity but often grows worse and more painful as a dog ages.

How to Spot it

Over time, you may notice your dog limping or walking with an abnormal gait. They may have trouble jumping on and off beds or in and out of cars where they once moved freely. In severe cases of this Shih Tzu health issue, your dog may have trouble standing up from a lying position—or may not be able to stand at all due to the pain.

Recommended Solutions

In some extreme cases, hip dysplasia can be addressed with surgery to restore mobility. Typically, medications and calming aids can also help moderate the pain enough to assist your pup in resuming regular physical activity.

When it comes to joint problems like these, prevention can be crucial. When playing with dog toys or exercising your Shih Tzu, try to avoid letting them jump off of high places or landing on hard surfaces. You can also consult your veterinarian to see if joint supplements may help reduce inflammation as your pet ages. This could help prevent Shih Tzu walking problems when they get older.

Brachycephalic syndrome

With their short, flat faces, Shih Tzus sometimes have trouble breathing and can be susceptible to certain respiratory issues like respiratory distress syndrome—also known as brachycephalic airway syndrome. Again, this is caused by congenital defects of the nose, palate and trachea, which can easily become obstructed.

Small dogs like Shih Tzus also have small and delicate tracheas—more commonly known as windpipes. If the cartilage of the windpipe weakens, it can flatten out, making breathing more difficult for your pup.

How to Spot it

It should be fairly simple for pet parents to spot the symptoms stemming from these Shih Tzu health problems. Breathing may become shallow or difficult, and you may notice your pet wheezing more than usual. You may also see that your pup exhibits excessive panting, trouble eating, snoring, coughing and—in extreme cases—collapsing or fainting. These symptoms are often signs to bring your canine to your veterinarian to discuss possible causes.

Recommended Solutions

Nonsurgical solutions to Shih Tzu respiratory problems can include discontinuing a restrictive collar, adjusting your dog’s sleeping position and avoiding overexcitement. Your veterinarian may also recommend limiting your Shih Tzu’s exercise during hot or humid and cold weather, as overly thin or thick air can be more difficult for your pup to breathe. Some dogs naturally adjust to a collapsed trachea—but if you notice your dog struggling to breathe, take them to your vet. They may recommend performing surgery to reopen your dog’s airway.