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Shih Tzu 101: 6 Common Health Issues Owners Should Know About

Diana Bocco - Writer for DailyTails
By Diana Bocco
Davor Štefanović - Editor for DailyTails
Edited by Davor Štefanović

Updated July 17, 2023.

A Shih Tzu dog lying on the table, being examined by a vet for common health issues

Shih Tzus are the perfect combination of the ultimate cuddle companion and a lovable laptop. Whether you’re already sharing your home with this cute breed or are looking for one to join the family, it’s important to be aware of the most common health problems Shih Tzus might develop during their lifetime.

The more you know in advance, the better prepared you’ll be to identify potential signs of illness early on. And don’t forget—daily exercise, a well-balanced diet, and regular grooming will go a long way in keeping your dog healthy.

6 Common Shih Tzu Health Issues

  • Eye Problems
  • Skin Problems
  • Allergies
  • Ear Infection
  • Joint Problems
  • Breathing Problems

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1. Eye Problems

A vet applying eye drops to a Shih Tzu's eyes


Because they have large, protruding eyes and flat faces, Shih Tzus are prone to developing a number of eye problems throughout their lives. Some eye issues this breed is at risk of developing include:

  • Cataracts: A hereditary condition that is more likely to develop as your dog ages, cataracts appear as “milky clouds” that cover the eyes and affect vision, produce discharge, and cause sensitivity to bright lights. Left untreated, this will eventually lead to blindness, though surgery is an effective treatment in up to 90% of canine patients.
  • Progressive Retinal Atrophy: Also an inherited disorder, it progresses slowly over time, leading first to difficulty seeing at night and eventually blindness. There’s no treatment for it.
  • Dry Eye: A common but manageable condition that causes painful, red, and irritated eyes. It causes dogs to paw at their eyes, squint, or keep their eyes closed. Without treatment, it can lead to eye ulcers, conjunctivitis, and potentially the loss of the eye.

2. Skin Problems

Shih Tzus often suffer from skin allergies that affect their paws, ears, muzzle, and the area around the eyes. The breed is also prone to developing “hot spots,” an area of raw, inflamed skin that’s also very itchy—this causes dogs to lick obsessively, increasing the risk of infection and worsening the problem.

Hot spots can be a sign of a weakened immune system but can also be triggered by bacteria or poor grooming. You can clip the hair around the area and clean it with warm water, but if that doesn’t help, an e-collar and some anti-inflammatory cream from the vet might be needed.

Shih Tzus often experience dry, flaky skin. Common signs of dry skin problems include dandruff, lots of scratching, and some hair loss or thinning. Dry skin can be caused by many things, including a dry environment (especially in winter when the heating is on), allergies, harsh chemicals in shampoos that strip the skin of oils, overbathing or cold weather.

Sometimes switching to a high-quality shampoo and supplementing with vitamin E or omega-3 fatty acids is enough to fix the problem. If not, you might need to see a vet—sometimes underlying medical conditions like metabolic diseases can lead to dry skin.

3. Allergies

Shih Tzus are very sensitive to allergens and can suffer from a number of issues, including not only skin allergies, but also allergies to perfumes, cigarette smoke, mold, and other airborne pollutants. The symptoms and severity will vary depending on the type of allergy. For example, skin allergies often show up as a red, itchy rash on the belly, groin, ears, or paws.

In the case of flea allergy dermatitis, the rash usually appears at the base of the tail and causes severe itching. Medicated shampoos from your vet can sometimes help with skin allergies.

It’s also not rare for Shih Tzus to experience food allergies. These can be caused by a reaction to a specific ingredient in food—anything from pork and chicken to soy, corn, and even food additives. In addition to the typical itchy feeling, food allergies can also lead to yeast or skin infections and serious ear problems. Your vet will help you figure out what ingredient your dog is allergic to through an elimination diet.


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4. Ear Infection

A Shih Tzu being examined by a vet for an ear infection


Ear infections are common in breeds with floppy ears, and Shih Tzus are no exception. Infections can be caused by ear mites, yeast, or bacteria growing in the ear canal – but no matter the cause, they usually result in itchy, smelly ears that produce a dark discharge. They also cause pain and discomfort and usually lead to dogs shaking their head or vigorously scratching their ears to gain some relief.

The first step in treating ear infections is to clean the ears using a special medicated cleanser. Severe cases might require anti-inflammatory or steroid medications and antibiotics.

5. Joint Problems

Shih Tzus are prone to a number of joint problems common in small-size and short-nosed bleeds. This includes elbow dysplasia, a genetic disease caused when the elbow joint is not formed properly. Over time, this causes pressure on the joint and leads to damage and osteoarthritis. It can affect just one elbow or both.

Signs that your dog might have elbow dysplasia include:

  • Lameness or limping (one or both front legs)
  • Paws pointing outwards
  • Swollen elbow
  • Stiffness after lying down
  • Reluctance to exercise or play

Treatment for elbow dysplasia depends on the severity of the symptoms. Severe cases might require surgery or stem cell therapy. Otherwise, your vet might prescribe anti-inflammatories like NSAIDs for pain relief or suggest physiotherapy. Keeping your dog at a healthy weight will reduce the impact on joints.

6. Breathing Problems

A vet checking a Shih Tzu's breathing for issues


Shih Tzus are a brachycephalic breed, which means they have smaller, narrower nostrils and sometimes an undersized trachea (windpipe) as well. This makes them prone to several respiratory problems, including an obstructed airway, where the dog can barely breathe. These kinds of breeds often experience coughing and loud breathing and have a higher risk of fainting if overexerted.

Collapsing trachea is a progressive respiratory condition common in Shih Tzus. Common signs include bouts of respiratory distress and a persistent, dry cough that often worsens at night or when your dog is overexcited. Treatment includes medications (steroids, cough suppressants, or bronchodilators) and preventative care (weight loss, avoiding airway irritants like perfumes or smoke). Severe cases might require surgery.

You can help ease breathing problems in your Shih Tzu by:

  • Minimizing outdoor exercise on very hot days
  • Loosening up your dog’s collar or switching to a harness
  • Running a humidifier in the room where your dog likes to sleep

Securing Your Shih Tzu's Health and Happiness

Being proactive about your pet's health is essential to keeping them happy and in tip-top shape. For peace of mind when your dog feels under the weather and to protect your finances, consider getting pet insurance. You’ll breathe easier knowing your beloved Shih Tzu is always protected.

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