What are the main health problems in Shih Tzus?

Shih Tzus are generally a fairly long-lived breed (typically 12 to 16 years), but as a flat-faced (brachycephalic) small breed they have several notable health considerations. The flat face brings some degree of Brachycephalic Obstructive Airway Syndrome (BOAS) and breathing considerations, and heat sensitivity. The prominent, large eyes are a significant area, Shih Tzus are prone to various eye conditions and injuries. Dental disease is very common, the small, crowded mouth of a small brachycephalic breed predisposes them to dental problems, making dental care important. Other issues include ear problems (the drop ears and hair can trap moisture), patellar luxation (slipping kneecaps, common in small breeds), and some breed-specific conditions such as certain kidney issues (like renal dysplasia in some lines) and intervertebral disc or back issues. They can also have allergies and skin problems, particularly in the facial folds. Responsible breeders health-test for eyes, hips, and known conditions. With a rescue you cannot control breeding, but you manage risk through good dental care, eye and facial-fold care, weight control, heat management, and routine veterinary care. Overall the Shih Tzu is a reasonably healthy, long-lived companion, but the flat-faced considerations (breathing, eyes, dental, heat) are the defining health areas, and most benefit from preventive care and attention.

Do Shih Tzus have breathing problems?

Shih Tzus are a brachycephalic (flat-faced) breed, so they can have some degree of breathing difficulty and Brachycephalic Obstructive Airway Syndrome (BOAS), though they are generally more moderately affected than the most extreme flat-faced breeds like Bulldogs and Pugs. Many Shih Tzus breathe reasonably well with just some snorting or snoring, while more severely affected individuals may have more significant breathing difficulty (from narrowed nostrils, an elongated soft palate, or other airway features) that can benefit from veterinary assessment and, in some cases, corrective airway surgery. The practical everyday implication of the flat face is heat sensitivity, Shih Tzus cannot cool themselves by panting as efficiently as long-nosed dogs, so they overheat more easily and need heat management, especially in summer (keep them cool, avoid over-exercise in heat, provide water). For most Shih Tzus, the key is sensible management, do not over-exercise them, especially in heat; be mindful in hot weather; keep them at a healthy weight (obesity worsens breathing); and watch for signs of significant breathing difficulty (very laboured or noisy breathing, marked exercise or heat intolerance, distress), which warrant a vet visit. Vancouver's generally cool climate makes heat management quite manageable, and for most Shih Tzus, the breathing considerations are a matter of sensible flat-faced-breed management rather than major intervention, though owners should be aware and attentive.

Why is dental care so important for a Shih Tzu?

Dental care is especially important for a Shih Tzu because, as a small brachycephalic breed with a shortened jaw and a small mouth, they have crowded, often misaligned teeth, which predisposes them to dental disease, one of the most common health problems in the breed (and in small breeds generally). Crowded teeth trap food and plaque more easily, leading to tartar buildup, gum disease (periodontal disease), tooth decay, and eventually tooth loss and infection if not managed, and dental disease is not just a mouth problem, advanced periodontal disease can affect overall health and is painful for the dog. The good news is that dental disease is largely preventable with good care. Preventive dental care for a Shih Tzu includes: regular tooth brushing (ideally daily or several times a week, using dog toothpaste, which is the single most effective home measure); dental chews and appropriate diet; and regular professional dental cleanings by your veterinarian (which may require anesthesia and become a periodic cost, especially as the dog ages). Watch for signs of dental problems, bad breath, red or bleeding gums, difficulty eating, pawing at the mouth, or visible tartar, and have dental issues addressed by your vet. Because dental disease is so common in the breed and professional dental cleanings can be a recurring cost, budgeting for dental care is a real part of owning a Shih Tzu, and good home dental care (especially brushing) is one of the most valuable health habits you can maintain for the breed, both for comfort and to reduce the frequency and cost of professional dental work.

What other health issues affect Shih Tzus?

Beyond the flat-faced breathing, eye, and dental issues, Shih Tzus can be affected by several other conditions. Ears: the drop ears and hair in the ear canal can trap moisture and lead to ear infections, so regular ear checking, cleaning, and drying (especially in damp Vancouver) is worthwhile. Joints: patellar luxation (slipping kneecaps) is common in small breeds including the Shih Tzu, causing an intermittent skip or hop in the gait, and hip issues can also occur; keeping the dog lean helps, and severe cases may need surgery. Back: the breed can be prone to intervertebral disc disease (back problems) in some cases. Kidneys: some Shih Tzu lines have a predisposition to renal dysplasia (abnormal kidney development) and other kidney issues, so kidney health is worth monitoring. Skin: the facial folds and coat can be prone to skin problems and irritation (fold dermatitis), and the breed can have allergies. Some Shih Tzus also have umbilical hernias or other minor congenital issues. None of these is universal, most Shih Tzus do not develop all or even most of them, and many are manageable, but the breed's range of potential issues means routine veterinary care, weight control, good grooming and facial-fold care, dental care, and prompt attention to any symptoms are all worthwhile, and collectively these considerations support budgeting for veterinary care and considering pet insurance for the breed.

How long do Shih Tzus live and is pet insurance worth it?

Shih Tzus are a fairly long-lived breed, typically living 12 to 16 years, which is a good lifespan, and much of keeping one healthy is within your control through the breed's specific care needs: good dental care (regular brushing and professional cleanings), diligent eye and facial care (keeping the eye area clean and the facial hair trimmed, and prompt attention to eye issues), heat management (given the flat face), ear care, weight control (obesity worsens breathing and joints), regular grooming, and routine veterinary care. On insurance: pet insurance is worth considering for a Shih Tzu, because the breed's flat-faced and small-breed health issues can add up, the potential for expensive eye conditions or surgery (eye problems are common and some are serious), the recurring cost of professional dental cleanings (dental disease is very common), possible airway or breathing treatment, and the range of other potential conditions, and Vancouver veterinary care is not cheap. The eye and dental issues in particular, both common in the breed and potentially costly, make the insurance case relevant. As always, take out insurance while the dog is young and healthy, before any condition is diagnosed and excluded as pre-existing (though note that for an adopted adult or senior Shih Tzu, some conditions may already be present, so understand what a policy will and will not cover). Compare providers and read the fine print. For many owners, insurance, or at minimum a dedicated vet fund, provides good protection against the breed's likely eye, dental, and other health costs, and given the Shih Tzu's long lifespan, planning for the health care of a long-lived small companion is worthwhile.

Shih Tzu Health Issues: A Vancouver Owner's Guide

The short answer

The Shih Tzu's defining health areas come from its flat face and small size: some breathing difficulty and heat sensitivity (generally milder than a Bulldog or Pug), prominent-eye vulnerabilities (corneal ulcers, dry eye, and, rarely, proptosis), and dental disease from the crowded mouth (very common). Other issues: ear problems, patellar luxation, back issues, and some kidney conditions. Lifespan is a good ~12 to 16 years. The levers you control: good dental care, eye and facial-hair care, heat management, ear care, and weight control. Because eye and dental care can be costly, the insurance case is real, insure while young (and understand pre-existing exclusions for an adopted adult).

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A Shih Tzu having its eyes and teeth checked at a Vancouver veterinary clinic — Good dental care, prompt attention to the prominent eyes, and facial-hair management are the Shih Tzu owner's most valuable health habits.

The Shih Tzu is a reasonably healthy, long-lived companion, but its flat face and small size create some defining health areas, breathing and heat, the eyes, and dental disease. Knowing them lets you prevent and catch problems early. Here is the medical picture, condition by condition.

Breathing and heat

Shih Tzus are brachycephalic, so they can have some breathing difficulty and BOAS, though generally more moderately than Bulldogs and Pugs. Many breathe reasonably well with just some snorting, while more severely affected individuals may benefit from veterinary assessment and, sometimes, corrective airway surgery. The practical everyday implication is heat sensitivity, they cool less efficiently, so they overheat more easily and need heat management, especially in summer.

For most Shih Tzus, the key is sensible management: do not over-exercise them (especially in heat), be mindful in hot weather, keep them at a healthy weight (obesity worsens breathing), and watch for significant breathing difficulty (very laboured or noisy breathing, marked heat intolerance, distress), which warrants a vet visit. Vancouver's generally cool climate makes heat management quite manageable, and for most Shih Tzus, the breathing considerations are a matter of sensible flat-faced-breed management rather than major intervention.

Eyes, a major consideration

Eye issues are one of the most important health considerations for Shih Tzus, because their large, prominent, exposed eyes are both a breed characteristic and a vulnerability. They are prone to corneal ulcers and injuries (the exposed eyes are easily scratched, sometimes by their own facial hair), dry eye (requiring lifelong treatment), proptosis (the eye prolapsing from the socket, an emergency, in severe cases), cataracts, PRA, and others.

Because the eyes are so prominent and exposed, prompt attention to any eye problem is essential, watch for squinting, redness, cloudiness, discharge, excessive tearing, a visible change, or pawing, and see the vet quickly, conditions worsen fast and some (a proptosed eye, a deep ulcer) are emergencies. Preventive care helps a lot: keep the facial hair around the eyes trimmed (so it does not irritate them), keep the eye area clean, protect the eyes from hazards, and monitor closely. Given the number and potential seriousness of Shih Tzu eye issues, eye health is a major part of care. The American College of Veterinary Ophthalmologists maintains hereditary eye-condition resources.

Why dental care is so important

Dental care is especially important because, as a small brachycephalic breed with a shortened jaw and small mouth, Shih Tzus have crowded, often misaligned teeth, predisposing them to dental disease, one of the most common health problems in the breed. Crowded teeth trap food and plaque, leading to tartar, gum disease, decay, and eventually tooth loss and infection, and advanced periodontal disease affects overall health and is painful.

The good news: it is largely preventable. Preventive dental care includes regular tooth brushing (ideally daily or several times a week with dog toothpaste, the single most effective home measure), dental chews and appropriate diet, and regular professional dental cleanings (which may require anesthesia and become a periodic cost, especially with age). Watch for bad breath, red or bleeding gums, difficulty eating, or visible tartar, and have issues addressed. Because dental disease is so common and professional cleanings recur, budgeting for dental care is a real part of owning a Shih Tzu, and good home dental care is one of the most valuable health habits for the breed.

Ears, joints, back, and kidneys

Beyond breathing, eyes, and dental, Shih Tzus can be affected by several other conditions. Ears: the drop ears and ear-canal hair can trap moisture and cause infections, so regular checking, cleaning, and drying (especially in damp Vancouver) helps. Joints: patellar luxation (slipping kneecaps) is common in small breeds, keeping the dog lean helps, and severe cases may need surgery. Back: some Shih Tzus develop intervertebral disc disease. Kidneys: some lines have a predisposition to renal dysplasia and other kidney issues, worth monitoring. Skin: the facial folds can develop fold dermatitis, and the breed can have allergies.

None is universal, most Shih Tzus do not develop all or even most, and many are manageable, but the range means routine vet care, weight control, good grooming and facial-fold care, dental care, and prompt attention to symptoms are all worthwhile. Collectively these considerations support budgeting for veterinary care and considering insurance.

Lifespan and is pet insurance worth it?

Shih Tzus are fairly long-lived (12 to 16 years), and much of keeping one healthy is within your control: good dental care, diligent eye and facial care, heat management, ear care, weight control, regular grooming, and routine vet care. On insurance: it is worth considering, because the breed's flat-faced and small-breed issues can add up, expensive eye conditions or surgery, recurring professional dental cleanings, possible airway treatment, and the range of other conditions, and Vancouver vet care is not cheap. The eye and dental issues in particular, both common and potentially costly, make the case relevant.

Take out insurance while the dog is young and healthy, before conditions are diagnosed and excluded (though for an adopted adult or senior, some conditions may already be present, so understand what a policy will and will not cover). Compare providers and read the fine print. For many owners, insurance, or at minimum a dedicated vet fund, provides good protection against the breed's likely eye, dental, and other costs, and given the Shih Tzu's long lifespan, planning for the health care of a long-lived small companion is worthwhile. See our Vancouver adoption and ownership costs guide for the numbers.

Browse adoptable Shih Tzus in Vancouver

Rescue Shih Tzus come vet-checked, and a good rescue will share a dog's known eye, dental, and health history so you can adopt informed. Refreshed regularly across Lower Mainland rescues.

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Frequently Asked Questions

What are the main health problems?

The flat-faced and small-breed issues: some breathing difficulty and heat sensitivity, prominent-eye conditions, and dental disease (very common), plus ear problems, patellar luxation, back issues, and some kidney conditions. Lifespan ~12 to 16 years. Dental, eye, and facial care matter most.

Do they have breathing problems?

Some, being flat-faced, but generally milder than Bulldogs or Pugs, many just snort a bit. The practical concern is heat sensitivity, so avoid over-exercising in heat and keep them cool. Watch for significant laboured breathing. Vancouver's cool climate makes management easy.

What eye problems are they prone to?

Their prominent, exposed eyes are vulnerable to corneal ulcers and injuries, dry eye, cataracts, and rarely proptosis (an emergency). Prompt attention to any eye issue is essential. Keep the facial hair trimmed and the eye area clean, and see the vet fast for any change.

Why is dental care so important?

The small, crowded mouth predisposes them to dental disease, one of the most common problems in the breed. Prevent it with regular tooth brushing, dental chews, and professional cleanings. Watch for bad breath and red gums. Budgeting for dental care is a real part of ownership.

What other issues affect them?

Ear infections (drop ears, especially in damp Vancouver), patellar luxation, occasional back problems, some kidney predispositions (renal dysplasia), and facial-fold skin issues and allergies. None is universal, but routine care and prompt attention to symptoms are worthwhile.

How long do they live, and is insurance worth it?

A good 12 to 16 years. Insurance is worth considering, the eye and dental issues in particular are common and potentially costly. Insure while young, before conditions are excluded (note pre-existing exclusions for adopted adults). A dedicated vet fund is a defensible alternative.