What are the main health problems in Shih Tzus?

Shih Tzus are generally a fairly robust and reasonably long-lived companion breed, but they have a number of characteristic health conditions owners should know about, several stemming from the breed's flat (brachycephalic) face and its prominent eyes. The most important are: brachycephalic-related issues (because Shih Tzus have a flat face, they can have some breathing considerations and are heat-sensitive, though generally less severely affected than a more extreme brachycephalic breed like the French Bulldog); eye conditions (the Shih Tzu's large, prominent eyes are notably vulnerable to injury and a range of eye problems, making eyes one of the most important considerations for the breed, covered below); dental disease (as a small breed, Shih Tzus are prone to dental problems, so dental care is important); ear infections (their floppy, hairy ears are prone to ear problems); and skin and allergy issues (Shih Tzus can be prone to skin problems and allergies, and skin-fold issues around the face). Other conditions that can occur include patellar luxation (slipping kneecaps, common in small breeds), hip dysplasia, intervertebral disc disease (back problems, which they can be prone to), renal dysplasia (a kidney condition seen in the breed), and various others. That is a fair list, but many individual Shih Tzus live good, healthy lives. For adopters, the practical priorities are: protect and monitor the eyes (the breed's most vulnerable feature) and seek prompt care for any eye problem; take dental care seriously; keep up ear care and manage any skin/allergy issues; manage the dog's heat exposure given the flat face; keep the dog lean; and maintain good routine veterinary care. For an adopted Shih Tzu, ask the rescue what is known about the dog's health, and be aware that dental disease and eye or ear issues are relatively common in the breed.

Are Shih Tzus affected by breathing and heat issues?

Yes, Shih Tzus are affected by brachycephalic (flat-faced) issues, including some breathing considerations and heat sensitivity, though generally to a less severe degree than a more extreme brachycephalic breed like the French Bulldog. Because the Shih Tzu has a shortened muzzle and flat face, the airway is somewhat compromised, which can cause snoring, snorting, and noisy breathing (common and usually not serious), and, more importantly, reduces the breed's ability to cool itself efficiently by panting, making Shih Tzus heat-sensitive and more prone to overheating than a normal-muzzled dog. Some Shih Tzus have more significant brachycephalic airway issues (stenotic nares, an elongated soft palate, etc.) that can affect breathing more substantially, and in more affected dogs corrective surgery is sometimes considered, but many Shih Tzus have relatively mild brachycephalic issues and manage well with sensible care. The practical implications for an owner, particularly in a city with hot, humid summers like Montreal, are around heat and exercise management: protect the dog from heat (keep it cool in hot, humid weather, ideally with air conditioning on very hot days), avoid exercise and exertion in the heat (exercise in the cooler parts of the day, and keep it gentle when it is warm), provide shade and water, never leave the dog in a hot car or space, and watch for signs of overheating (excessive panting, distress, weakness), as a brachycephalic dog can overheat more easily than most. Because the Shih Tzu's brachycephalic issues are generally milder than the most extreme flat-faced breeds, and its exercise needs are modest anyway, managing heat and exercise for a Shih Tzu is quite achievable, but it is a real consideration, especially in summer. In winter, conversely, the Shih Tzu's coat provides some warmth, though as a small dog it still benefits from care in extreme cold. Overall, the breed's brachycephalic nature means some breathing and heat considerations that are manageable with sensible care, above all protecting the dog from heat and keeping exercise gentle and cool-weather-timed.

What dental, ear, skin, and other conditions affect Shih Tzus?

Beyond the brachycephalic and eye issues, Shih Tzus can be affected by several other conditions. Dental: as a small breed, Shih Tzus are prone to dental disease (crowded teeth in a small mouth leading to tartar, gum disease, and tooth loss), so regular dental care, tooth brushing and professional cleanings as needed, is genuinely important for the breed's health and comfort, and is a real recurring consideration. Ears: the Shih Tzu's floppy, hairy ears reduce air circulation and are prone to ear infections, so regular ear care (checking and cleaning, keeping them dry, and managing the hair in and around the ears as part of grooming) is worthwhile, and any signs of ear problems (odour, redness, discharge, head-shaking) should be addressed. Skin: Shih Tzus can be prone to skin problems and allergies (causing itchy skin, ear issues, and skin infections), and can have skin-fold issues around the face (the facial folds need to be kept clean and dry to prevent irritation and infection), so good skin care, aided by regular grooming, matters. Other conditions: Shih Tzus can be prone to patellar luxation (slipping kneecaps, common in small breeds), hip dysplasia, intervertebral disc disease (back problems, so protecting the back by keeping the dog lean and managing jumping helps), renal dysplasia (an inherited kidney condition seen in the breed, which responsible breeders screen for), and various others. Most individual Shih Tzus will not develop most of these, but awareness helps catch issues early. The practical priorities for a Shih Tzu owner, alongside eye and heat care, are: take dental care seriously; keep up ear care and manage any skin/allergy issues (aided by regular grooming, which also lets you check the skin); keep the dog lean and protect its back; and maintain good routine veterinary care. Regular grooming, which the breed needs anyway, doubles as an opportunity to check the eyes, ears, skin, and body.

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

Shih Tzus are a reasonably long-lived breed, typically living around 12 to 16 years, and many stay healthy and happy well into their senior years with good care, small dogs generally live longer than large ones, and the Shih Tzu is among the longer-lived. Much of keeping one healthy is within your control: protect and monitor the eyes (the breed's most vulnerable feature) and seek prompt care for any eye problem; take dental care seriously (regular brushing and professional cleanings); keep up ear care and manage skin/allergy issues; manage the dog's heat exposure given the flat face (keeping it cool and exercise gentle in hot weather); keep the dog lean (protecting the joints and back); maintain the coat with regular grooming (which supports skin and coat health and lets you spot problems); and stay on top of routine veterinary care so conditions are caught early. On pet insurance: it is worth considering for a Shih Tzu, because while the breed is reasonably robust, it has a number of potential conditions that can be costly, eye conditions (some, like corneal ulcers or serious eye problems, can need urgent or specialist treatment or surgery), dental disease (professional cleanings and extractions add up over a long life), ear and skin issues (which can be chronic), back problems, and others, and Montreal veterinary care is not cheap. The breed's long lifespan also means many years over which conditions can arise. As always, take out insurance while the dog is young and healthy, before any condition is diagnosed and excluded as pre-existing. Compare providers, understand coverage (including whether dental, which is common in small breeds, is covered, as many policies exclude or limit it) and any limits, and read the fine print. If you self-insure instead, keep a solid vet fund in mind, with the eyes and dental particularly in mind. Note that for an adopted adult or senior Shih Tzu, some conditions (especially dental or eye issues) may already be present, so understand what a policy will cover, and factor in that a rescue Shih Tzu may need dental or other work.

Shih Tzu Health Issues: A Montreal Owner's Guide

The short answer

Shih Tzus are fairly robust and long-lived (~12 to 16 years), but the flat face and prominent eyes bring characteristic issues. The biggest: eye problems (the large, exposed eyes are prone to corneal ulcers, dry eye, and injury, and a serious emergency, proptosis, in trauma). Also brachycephalic breathing and heat sensitivity (milder than a French Bulldog, but protect from heat in Montreal summers), dental disease, ear infections (floppy, hairy ears), skin/allergy issues, and patellar luxation and back problems. The levers you control: protect and monitor the eyes, take dental care seriously, keep up ear/skin care, manage heat, and keep the dog lean. Regular grooming doubles as a health check. Insurance is worth considering, insure while young.

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A Shih Tzu being examined at a Montreal veterinary clinic — Protecting and monitoring the eyes, dental care, ear and skin care, and heat management are the Shih Tzu owner's most valuable health habits.

The Shih Tzu is a fairly robust, notably long-lived companion, but its flat face and gorgeous prominent eyes come with a characteristic set of considerations, the eyes above all. The good news is that most are very manageable with sensible care, and much of it is in your hands. Here is the medical picture, condition by condition, starting with the breed's most vulnerable feature.

Eyes: the most vulnerable feature

The Shih Tzu's large, round, prominent eyes, set in a flat face, are notably exposed and vulnerable, making eye care a key part of owning the breed. Conditions include corneal ulcers and abrasions (the exposed eyes are prone to scratches and ulcers, painful and needing prompt treatment), dry eye (needs ongoing management), irritation from facial hair (keep it trimmed or tied back), eyelid issues, cataracts, and, in a serious emergency, proptosis (the eyeball prolapsing from the socket in trauma, a medical emergency).

Eye care is a real, ongoing part of caring for a Shih Tzu: keep the hair around the eyes trimmed or tied back so it doesn't irritate them, keep the area clean, watch closely for signs of problems (redness, cloudiness, discharge, squinting, pawing at the eye), and seek prompt veterinary attention for any eye concern, many eye conditions (especially corneal ulcers) are painful and worsen quickly, and prompt treatment gives the best outcome. Given the vulnerability and that some conditions are expensive to treat, the eyes are a significant part of the insurance argument, and attentive eye care is one of the most important things a Shih Tzu owner does. The American College of Veterinary Ophthalmologists maintains eye-health resources.

Breathing and heat sensitivity

As a brachycephalic (flat-faced) breed, Shih Tzus can have some breathing considerations (snoring, snorting, noisy breathing, usually not serious) and, more importantly, are heat-sensitive (the flat face reduces cooling by panting, so they overheat more easily), though generally less severely than a French Bulldog. Some have more significant airway issues that occasionally warrant corrective surgery, but many manage well with sensible care.

The practical implications, especially in Montreal's hot, humid summers, are around heat and exercise: protect the dog from heat (keep it cool, ideally with air conditioning on very hot days), avoid exercise and exertion in the heat (exercise in the cool hours, gently when warm), provide shade and water, never leave the dog in a hot car, and watch for overheating (excessive panting, distress, weakness). Because the breed's brachycephalic issues are generally milder and its exercise needs modest, managing heat is quite achievable, but it's a real consideration in summer. In winter, the coat provides some warmth, though a small dog still needs care in extreme cold.

Dental, ears, skin, and other conditions

Dental: a small-breed issue, so regular tooth brushing and professional cleanings matter. Ears: the floppy, hairy ears are prone to infections (check, clean, keep dry, and manage the ear hair as part of grooming). Skin: prone to allergies and skin problems, plus facial-fold issues (keep the folds clean and dry). Other: patellar luxation, hip dysplasia, intervertebral disc disease (protect the back by keeping the dog lean and managing jumping), and renal dysplasia (an inherited kidney condition responsible breeders screen for).

Most individual Shih Tzus won't develop most of these, but awareness helps catch issues early. Alongside eye and heat care, the practical priorities are: take dental care seriously, keep up ear care and manage skin/allergy issues, keep the dog lean and protect its back, and maintain good routine care. Regular grooming, which the breed needs anyway, doubles as a chance to check the eyes, ears, skin, and body (see our grooming guide).

Lifespan and the insurance case

Shih Tzus are reasonably long-lived, typically ~12 to 16 years. Protect and monitor the eyes, take dental care seriously, keep up ear/skin care, manage heat, keep the dog lean, maintain the coat, and stay on routine vet care. On insurance: worth considering, the breed's potential conditions, eye conditions (corneal ulcers or serious problems can need urgent or specialist treatment), dental (cleanings and extractions over a long life), ear and skin issues (which can be chronic), and back problems, can be costly, and the long lifespan means many years for conditions to arise.

Take out insurance while the dog is young and healthy, before any condition is diagnosed and excluded. Compare providers, and check whether dental (common in small breeds) is covered, since many policies exclude or limit it. If you self-insure, keep a solid vet fund with the eyes and dental particularly in mind. For an adopted adult or senior, some conditions (especially dental or eye issues) may already be present, and a rescue Shih Tzu may need dental or other work. Montreal vet care isn't cheap. See our adoption guide for the cost picture.

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Frequently Asked Questions

What are the main health problems?

Several stem from the flat face and prominent eyes: eye problems above all, plus some breathing and heat sensitivity, dental disease, ear infections, skin/allergy issues, and patellar luxation and back problems. Generally a robust, long-lived breed (12 to 16 years), but the eyes are the key watch-point.

Why are eye problems such a concern?

The large, prominent eyes in a flat face are exposed and vulnerable to corneal ulcers, dry eye, and injury (and, in trauma, the emergency of proptosis). Keep the hair around the eyes trimmed, keep the area clean, and seek prompt care for any eye concern, ulcers especially are painful and worsen quickly. The eyes are a big part of the insurance case.

Are they affected by breathing and heat issues?

Yes, as a brachycephalic breed they can snore and are heat-sensitive (they cool less efficiently), though generally milder than a French Bulldog. In Montreal summers, protect the dog from heat, exercise in the cool hours and gently when warm, and watch for overheating. Manageable with sensible care given their modest exercise needs.

What dental, ear, skin, and other conditions affect them?

Dental disease (a small-breed issue, so brush and get cleanings), ear infections (floppy, hairy ears), skin/allergy and facial-fold issues, plus patellar luxation, hip dysplasia, back problems (IVDD), and renal dysplasia. Regular grooming doubles as a chance to check the eyes, ears, skin, and body.

How long do they live?

Reasonably long-lived, typically 12 to 16 years. Protect and monitor the eyes, take dental care seriously, keep up ear/skin care, manage heat, keep the dog lean, maintain the coat, and stay on routine vet care. Many stay healthy into their senior years.

Is pet insurance worth it?

Worth considering, eye conditions (ulcers or serious problems), dental (over a long life), ear and skin issues, and back problems can be costly, and the long lifespan means many years for conditions to arise. Take insurance out while the dog is young, and check whether dental is covered. Keep the eyes and dental particularly in mind.

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Shih Tzu Health Issues