Shih Tzu Health Issues

Yes — Shih Tzus are a brachycephalic (flat-faced, short-snouted) breed alongside Pugs, French Bulldogs, Boston Terriers, and Pekingese. Their compressed skull structure causes Brachycephalic Obstructive Airway Syndrome (BOAS): elongated soft palate, narrow nostrils (stenotic nares), everted laryngeal saccules, hypoplastic trachea. Symptoms range mild (snoring, snorting, exercise intolerance, heat sensitivity) to severe (laboured breathing, gum colour changes during exercise, collapse). Calgary BOAS surgery (soft palate trim + nostril widening): $3,500–$6,500 at general practice, more at specialty clinics (VCA Canada West, Western Veterinary Specialist Centre). Many Shih Tzus do well with management alone (avoid heat, harness not collar, keep weight low, no high-intensity exercise), but moderate-to-severe BOAS benefits significantly from surgery before age 4.

Multiple. Shih Tzus have prominent eyes due to shallow eye sockets — beautiful but vulnerable. Common problems:
(1) Proptosis — eyeball pops out of socket from minor head trauma. True emergency: cover eye with damp cloth, ER vet within 30 minutes. Calgary repair surgery: $1,500–$3,000.
(2) Corneal ulcers from facial hair rubbing the eye — trim hair short around eyes, treat with prescription drops.
(3) Dry eye / KCS — chronic insufficient tear production, lifetime cyclosporine drops (~$30/month).
(4) Cataracts — common in seniors, surgery $3,000–$5,000/eye.
(5) Cherry eye — third eyelid gland prolapse, surgical replacement ~$800/eye.
(6) Distichiasis — extra eyelashes scratching cornea.

Severe and almost universal. Approximately 85% of Shih Tzus have dental disease by age 3 — among the highest rates of any breed. Cause: small jaw with the standard 42 dog teeth means severe overcrowding, retained baby teeth, and food trap pockets. Brachycephalic skull shape compounds the crowding. Shih Tzus often need professional dental cleanings every 6–12 months (vs every 1–2 years for most breeds), with extractions of badly diseased teeth — many seniors end up with no teeth at all and do fine with kibble softened in water. Calgary dental cleaning cost: $500–$1,500 depending on extractions. Lifetime dental care for a Shih Tzu often runs $5,000–$10,000+. Prevention: daily tooth brushing with dog-safe toothpaste from puppyhood, VOHC-approved dental chews, regular vet exams.

Intervertebral Disc Disease (IVDD) is herniation or rupture of the cushioning discs between vertebrae. Shih Tzus are predisposed due to their long-back/short-leg body shape (chondrodystrophic build, similar to Dachshunds and Corgis). Symptoms: reluctance to jump, hunched back, yelping when picked up, sudden hindlimb weakness or paralysis. IVDD is a vet emergency when paralysis or loss of bladder control develops — surgical decompression within 24–48 hours dramatically improves outcomes. Calgary surgical IVDD treatment: $5,000–$10,000+ at specialty neurology (Western Veterinary Specialist Centre, VCA Canada West). Conservative management for mild cases: 4–6 weeks strict crate rest, anti-inflammatories, gradual return to activity. Prevention: don't let Shih Tzus jump on/off furniture (use ramps), keep them lean, support their back when picking up (one hand under chest, one under hindquarters).

Renal (kidney) dysplasia is a congenital condition where kidneys develop abnormally — Shih Tzus are one of the highest-risk breeds. Symptoms typically appear age 2–5: increased thirst and urination, weight loss, vomiting, lethargy, pale gums, ammonia-like breath. Diagnosis: bloodwork (elevated BUN, creatinine, SDMA), urinalysis (low specific gravity), ultrasound (small irregular kidneys). Treatment: prescription kidney diet (Hill's k/d, Royal Canin Renal), subcutaneous fluids if dehydrated, phosphate binders, blood pressure medication. There is no cure — only management. Calgary cost: $200–$500 initial diagnostic workup, $150–$300/month ongoing care. Many Shih Tzus with renal dysplasia live 1–3 years post-diagnosis with good management.

Yes — common in Shih Tzus. Typically appears age 4–10. Symptoms: weight gain despite normal diet, lethargy, dry/flaky skin, hair loss (often symmetrical on flanks), cold intolerance, slow heart rate, recurrent skin and ear infections. Diagnosis: thyroid panel bloodwork (T4, free T4, TSH). Treatment: daily oral levothyroxine ($15–$30/month) is highly effective — most Shih Tzus return to normal energy and weight within 4–6 weeks. Lifelong medication, recheck bloodwork every 6 months. If your senior Shih Tzu is gaining weight and slowing down, ask your vet for a thyroid panel before assuming “old age.”

Frequently. Shih Tzus are one of the higher-risk breeds for atopic dermatitis (environmental allergies) and food allergies. Symptoms: itchy ears with recurrent infections, paw licking and chewing, red belly/groin/armpits, hair loss in patches, hot spots. Triggers: environmental (pollen, dust mites, mold) or food (chicken, beef, dairy, wheat are most common). Diagnosis: elimination diet trial (8–12 weeks on novel-protein hydrolyzed diet, $80–$120/bag), allergy serology testing ($300–$600). Treatment: Apoquel (~$70/month), Cytopoint injections (~$80/month), medicated shampoos, fatty acid supplementation, strict avoidance of food triggers. Calgary specialty veterinary dermatology: Western Veterinary Specialist Centre. Allergies are lifelong and management-focused, not curable.

Three reasons: (1) brachycephalic airway anatomy means any tracheal pressure is dangerous, especially during exercise. (2) Shih Tzus are prone to mild tracheal collapse alongside Pomeranians and Yorkies — collar pressure accelerates the damage. (3) Eye proptosis risk — sudden leash jerk on a collar can cause eye to pop out of socket due to shallow eye sockets and short snout structure. Use a back-clip or vest-style harness for daily walks. Front-clip harnesses are fine for training but watch for chest pressure. Collars are okay for ID tags only, never for leash attachment. See our Pomeranian health guide for the full tracheal collapse breakdown — same condition, same management.

Yes — estimated 15–25% have some degree. Graded 1–4. Calgary luxating patella surgery: $3,000–$5,000 per knee. Many Grade 1–2 cases managed without surgery using weight control, joint supplements, limited high-impact activity (no jumping off furniture — also reduces IVDD risk). See the Pomeranian health guide for full grade-by-grade breakdown — toy breeds share this issue.

Significantly. Brachycephalic breeds are hit hard at both temperature extremes.

Hot weather (above 22°C): Shih Tzus cannot pant efficiently due to compressed airway — heat exhaustion happens fast. Avoid midday walks May–September. Watch for excessive panting, gum colour changes, collapse.

Cold weather (below 5°C): brachycephalic dogs can't warm air efficiently before it hits the lungs. Below -10°C: limit walks to 10–15 minutes, use a winter coat, wipe paws after to remove salt.

Calgary chinook winds (rapid temperature swings) trigger flare-ups in some allergic Shih Tzus. Dry winter air worsens dry eye and skin conditions.

A Shih Tzu emergency kit:
(1) Saline eye flush and clean gauze (corneal ulcers and proptosis events)
(2) Pet first aid kit with vet wrap, antiseptic, tweezers
(3) Phone numbers programmed in: regular vet, Calgary 24-hour emergency clinic (Paramount, VCA Canada West, CARE Centre), Pet Poison Helpline 1-855-764-7661
(4) Current photo of your dog with weight noted (Shih Tzu weight matters for medication dosing)
(5) Carrier or harness within easy reach
(6) Pet insurance card or vet financing info (CareCredit, ScratchPay) — brachycephalic surgery, IVDD surgery, and proptosis repair often run $3,000–$10,000+

Yes — Shih Tzus are one of the breeds where insurance reliably pays for itself. The combination of brachycephalic surgery risk ($3,500–$6,500), IVDD surgery ($5,000–$10,000), eye conditions (proptosis $1,500–$3,000, cataract $3,000–$5,000/eye, dry eye lifetime drops), luxating patella surgery ($3,000–$5,000 per knee), dental cleanings every 6–12 months ($500–$1,500 each), allergy management ($800–$1,500/year), and renal dysplasia management means most Shih Tzus will exceed their lifetime premium contributions in vet costs. Enrol before symptoms appear — pre-existing conditions are excluded across every Canadian provider. Calgary average: $35–$60/month for a young healthy Shih Tzu with $300 deductible / 80% coinsurance / $15,000 limit.