Shih Tzu Health Information

A healthy, happy Shih Tzu puppy can provide years of love, devotion and enjoyment for you for many years.  Before you consider bringing a new puppy into your home, you should familiarize yourself with the Shih Tzu breed.  There are so many things to consider before picking out the perfect fit for you and your family.  We have put together a little information to help when you take one of our Cocktail Shih Tzu puppies home.

Shih Tzu come in many sizes and typically have a long lifespan of 10 to 16 years.  A well bred smaller size Shih Tzu from a reputable breeder will have no shorter lifespan than a standard size Shih Tzu. They are simply miniature versions of the standard size and will have the same life span, health issues and breed tendencies that a standard size Shih Tzu will have.  Life span is a good question that is asked by many. There are many factors that determine the life span of a Shih Tzu or any dog. Breed, size, genetics, stimulation, and environmental factors all play a part in how long your Shih Tzu will live.

If you are reading this, then you are already considering the Shih Tzu breed, “Shih Tzu”… This is such a wonderful little breed…  They are non-shedding, extremely lovable, quiet little dogs.

As important as genetics are, environmental factors, such as diet, stress, chemicals etc. are as important throughout the life of your Shih Tzu.  The way a Shih Tzu puppy is raised from day one is also an important factor in a puppy’s life.  We do our best to give our Shih Tzu puppies the best possible start even before they are born.

Our Shih Tzu’s are fed the best food that I can provide for them, expense is not an issue.  We feed our adults Shih Tzu Fromm Grain Free Surf and Turf and our Shih Tzu puppies Fromm puppy food.  Our Shih Tzu mommies are fed 4% fat Cottage cheese throughout their pregnancy to provide the proper fat and calcium not only that the mother needs but also for the developing puppy…. If our Shih Tzu puppies end up small as they grow it is because of genetics also known as Imperial Shih Tzu, not because of poor development or diet.

Our Shih Tzu are given the minimum vaccinations and worming that they need to keep them healthy.  We worm our shih Tzu puppies at 3, 5, 7 weeks only as needed, not every week starting at 2 weeks as some shih tzu breeders do.  Our shih Tzu puppies are kept in our home in a very clean environment. Our babies are introduced to potty pads at a very early age and also bathing and grooming.  They are let out of their puppy pens to explore at a very early age. Whether it is to find the potty pad, drag around a toy or just climb over the vacuum sweeper hose.  Our shih Tzu puppies are played with, talked to and kissed every day.  This is all good stimulation which helps our puppy’s development.

We believe that socialization is a very big part of a Shih Tzu puppy’s development.   We use “Early Neurological Stimulation in Dogs” for all of our puppies starting at day three through day sixteen when their neurological systems are developing.  This series of exercises also called Bio Sensor stimulation jumpstarts their neurological system.  It improves heart rate, promotes stronger heart beats and adrenal glands, provides more tolerance to stress and greater resistance to disease.

Stress is very important and also affects a dog’s life.  Studies have shown that stress can considerably lower your dog’s life span…  Stress in dogs can also be passed on to offspring…  Dogs that are kenneled in crowded pens with excessive barking most of their breeding lives are under a lot of stress.  Our Shih Tzu’s get clean fresh blankets every day.  They have their own couch and TV that is left on for them throughout the day. They are let out to go potty together in a nice large fenced grassy yard.  There is minimal barking in our home and our Shih Tzu get white knuckle bones and plenty of toys to keep them stimulated and happy.

Don’t be afraid to ask questions, read and learn.  We will always be happy to answer any questions you may have regarding our Shih Tzu puppies and our Shih Tzu breeder program. Below we have provided information on Shih Tzu breed tendencies and Shih Tzu health issues to help answer questions you might have in raising a Shih Tzu puppy.  These breed tendencies are not only specific to the Shih Tzu breed, but are in fact common to many other toy breeds and brachyphelic flat faced breeds. Most of these issues will resolve themselves into adulthood which may be different from other breeds.


Shih Tzu are bred to have flat faces.  The flatter the face, the more likely your new shih Tzu puppy will suffer from tight nostrils when they are teething.  Just like a human baby, swelling takes place as a shih Tzu puppy teethes.  Swelling of the bronchial tubes, gums, ear canals, and nostrils are all common. Because they have a lot of teeth for tiny little mouths their noses will often swell and tighten during teething.  Shih Tzu teethe very slowly, sometimes they are still teething at six months old.  The nostrils may appear pinched but will gradually widen and open back up again as the shih Tzu puppy grows.  During this time your Shih Tzu puppy may snore, snort, sniffle or make strange noises.  This may be accompanied by tearful eyes and a clear runny nose with the occasional bubble.  Many Shih Tzu puppies may never experience any of these teething symptoms, other puppies may have only one symptom, and some puppies more.

A tight nose in a teething Shih tzu puppy is very different than Stenotic Nares or a sick puppy. A teething Shih Tzu will not be running a fever, will play and act normally and will have a normal appetite. Any discharge from the nose will be clear.  A shih Tzu puppy who is teething typically rests peacefully and often loves to find things to chew when awake. If your shih Tzu cannot eat or drink well and are lethargic or the discharge changes color, they may have developed infection and need to be checked and treated.

Shih Tzu puppies will usually outgrow this after the adult teeth come in. As long as they are playful, active, eating and drinking well, there is no cause for concern.  Most Shih tzu puppies are fine after teething and it is recommended to wait before considering surgery until after their adult teeth are in.


Tight nostrils are very common in the Shih Tzu breed.  Tight nostrils due to teething and Stenotic Nares or pinched nostrils are not the same thing. Tight Nostils will generally come on when the Shih Tzu puppy is teething and sometimes not go away until the adult teeth have fully come in, sometimes up to a year old.  Tight nostrils may come and go as the shih tzu puppies gums are swelling from the teething process.  Some shih tzu puppies have a difficult time breething out of their noses during this time, but as long as they are active and eating and drinking normally it is of little concern.

Stenotic Nares on the other hand are different and are present at birth.  Occasionally stenotic nares are not noticed immediately.  From the time the baby is born he can have difficulty breathing through his nose and can struggle with nursing due to the inability to breath and eat at the same time. Stenotic nares are caused by the malformation of the nose cartilage which can happen with brachycephalic breeds.  This malformation of cartilage can block the shih tzu’s upper respiratory tract and is characterized by a defect in the flow of air through the dog’s upper respiratory tract.  This malformation of cartilage can often cause the nostrils to collapse as the puppy takes in air during inspiration.  The collapsed nostrils lead to obstruction of the dog’s airways.  Shih Tzu puppies suffering from severe cases of stenetoic nares may have nostrils that are so tight and the nasal openings so narrow that the nose is nearly closed.  Severe stenotic nares can cause other health concerns over time.  If the Shih Tzu puppies Stenotic Nares are so severe that they cannot breath through their nose, and is causing lethargic behavior or other health concerns, surgery may be needed to enlarge the nasal openings in order to improve the Shih Tzus’ respiration.  The surgical procedure involves the removal of the extra cartilage on the nose.


Hypoglycemia, or low blood sugar (sometimes called “sugar shock”) is a condition where the blood sugar level drops to an extremely low level due to lack of food, or by using up all stored energy without it being replenished. (Such as when your shih Tzu puppy plays for an extended period of time without eating.)  The most common trigger is stress (such as going to a new home).

Shih Tzu Imperial teacups and Tiny Toys can be prone to hypoglycemia because they have such tiny digestive systems. They can only store a small amount of food (energy) in their stomach at one time.  Their liver and pancreas which are necessary for digestion and sugar balance are also small and usually underdeveloped as well. Most shih tzu puppies tend to grow out of hypoglycemia as they get older. As they grow, so do their major organs. This makes them more able to utilize and to process the food that they eat so it can sustain them
for longer periods of time.

REMEMBER: to prevent hypoglycemia, shih tzu puppies need to eat several small meals a day.  It is much easier to prevent by always having a readily available food supply, than to have to treat it once it happens. It is very scary to see a puppy that you love so dearly in “sugar shock.”

Symptoms of hypoglycemia. Hypoglycemia can occur without warning in a healthy shih tzu puppy and can be a very scary thing! So it is best to know what to look for! Your shih tzu puppy may exhibit one or more of these signs: The first sign that is usually seen is vomiting on an empty stomach. (clear liquid) If your teacup has not eaten in a while, and vomits without acting sick, give them food, Nutri-Cal or Karo syrup immediately!  Some other signs are acting listless, weak, tired, sometimes walking with an unsteady gait and drunk, shakiness, falling over, stiffening up, laying on their side paddling with their feet and being unable to get up, and in very severe advanced cases, laying on their side and being totally unresponsive or comatose.

If your shih tzu puppy becomes hypoglycemic, it is very important that you react IMMEDIATELY!! If the puppy is not given some quick form of nutrition containing sugar (i.e. Nutri-Cal, honey, sugar, glucose, Karo syrup or sugar containing product) to raise the blood sugar immediately, coma and/or possibly death could result.

If any of these symptoms occur, give the puppy a small dose of either Nutri-Cal, honey, sugar, glucose, Karo syrup, pancake syrup or any sugar containing product that is handy. Time is of the essence, so reach for whatever is the closest at the moment. If the puppy is unable to swallow do not force liquids down it’s throat as it can get into the lungs and cause asphyxiation. If the puppy is too weak to swallow and take the honey or Nutri-Cal on it’s own, put it on your finger and rub it on the roof of it’s mouth. If necessary, pry his mouth open. It may be necessary to give several doses. (I like to keep a product called Pet Nutri-Drops on hand. It allows nutrition to bypass digestion and be absorbed directly into the bloodstream. Very handy if a puppy is too unresponsive to swallow on his own.)


Hernia’s in shih tzu puppies as well as other toy breeds are very common and are not a medical condition or cause for immediate concern.Hernias usually show up at around 2-5 weeks of age and some of them will close on their own by around 6 mos of age (delayed closure).

A hernia is a protrusion or bulge of a part of the body tissue, fat, or an organ through an abnormal opening of the surrounding tissues.A hernia which can be pushed back into the abdomen is called reducible. Hernias which are not reducible are called incarcerated. If the blood supply to an incarcerated hernia is pinched off the hernia becomes strangulated. A strangulated hernia is an emergency situation and must be brought to the immediate attention of your veterinarian.

There are numerous types of hernias, each type named after its affected area. Some of the most common types of hernias in Shih Tzu puppies are and umbilical hernia and an inquinal hernia.

An umbilical hernia is the most common type of hernia found in shih tzu puppies. In the case of umbilical hernias, a portion of fat or internal organs protrudes through an incompletely closed umbilical ring. Umbilical hernias may be present at birth, or may be acquired. The most common means of acquiring an umbilical hernia is  as a result of the umbilical cord being severed too close to the abdominal wall.   It can also be caused by the shih tzu’s uneven bite. Sometimes the moms tend to have a harder time “cutting the cord” and will tug, pull or even chew the cord too short.In most cases umbilical hernias are small and reduce as the puppy grows. Generally, by the time the shih tzu  pup is six months old the hernia will shrink and disappear on its own.Very rarely is an umbilical hernia a health concern.  They are quite common in the Shih Tzu breed and are easily fixed if so desired. Your Vet may do it free of charge or for a small fee as long as they are already spaying or neutering your shih Tzu.

An inguinal hernia is the result of abdominal organs, fat or tissue protruding through the inguinal ring. Inguinal hernias are presented as skin-covered bulges in the groin. They can be bilateral, involving both sides, or unilateral, involving only one side. You can not tell if a puppy has a true hernia until they are at least 5-6 mos old. They are almost always just delayed closures.
Inguinal hernias are more common in females than males, but do occur in both sexes. As with umbilical hernias most inguinal hernias will shrink and disappear as the puppy grows, although you must keep an eye on the size of the hernia(s). Large inguinal hernias if ignored could potentially cause a health concern for the shih tzu if the muscles closes up around the hernia and strangles it. Inguinal hernias can also occur in unspayed, middle-aged female dogs. This may occur as the result of stretching of abdominal tissue due to pregnancy. True permanent inguinal hernias are rare in the Shih Tzu.

Open Fontanel

An open Fontanel is the puppies soft spot on the top of the head.  While the fontanel can fail to close in any dog, toy breeds are most often affected. Dog breeds predisposed to open fontanels include the Chihuahua, Yorkshire terrier, shih tzu, Imperial shih Tzu, Maltese and Pomeranian. It’s particularly prevalent in so-called teacup dogs, the extremely tiny versions of the littlest breeds.

Typically soft spots close by the time the shih tzu puppy reaches 2-3 months of age and some close right away.  Sometimes a puppy will still have a soft spot on their head as an older puppy.  This is much more common in small/tiny Shih Tzu than in standard size Shih Tzu puppies but can occur with any size puppy.  It is much more common in the small Imperial size puppies who are slower to mature than standard size Shih Tzu puppies.

Open Fontanel is not the same as a hydrocephalic puppy.  A Hydrocephalic puppy will almost always have a very large open fontanel, there heads will usually look very unusually shaped and will have an obvious bulge. This is a very concerning and serious condition, but has nothing to do with the small open fontanel of an imperial puppy or a puppy that simply has not finished growing.  Do not be alarmed by the open fontanel as a good reputable breeder will know the difference.

Reverse Sneezing

By Jenny Drastura

“Dog owners are often frightened when their shih tzu suddenly begins wheezing and snorting, appearing to be unable to breathe. It is a frightening sight if you have never seen it before. Fortunately it may not be quite as serious as it looks.

This snorting, is called reverse sneezing. Medically speaking, it consists of short periods (one to two minutes) of severe inspiratory dyspnea characterized by extension of the neck, bulging of the eyes and abduction of the elbows. Inspiratory dyspnea simply means a type of†air hunger? Swallowing causes the attacks to stop. It can happen every few days, once a week or once a month.

The sound of a reverse sneeze can be mimicked by a person pressing the base of the tongue upward and then trying to inhale through the nose. (I tried that, and it is very hard to do!) It is the incomplete closure of the nasopharnyx (above the soft palate) that results in the snorting sounds. This closure is normal during swallowing and is inhibited at the end of the swallowing process, which explains why swallowing helps stop an attack of reverse sneezing.

Sometimes irritation of the nasal passages from dust or allergens can cause this. Our Shih Tzu are so close to the ground that it is easy for them to breathe in dust particles.

When you see your shih tzu “snorting” like this, what you need to do is make the dog swallow by massaging the pharyngeal area (the upper throat area) or by briefly closing the nares. (Nares are the two little openings in the nose.) Relief should come almost immediately. We have found the latter method works best for our shih tzu, and is the easiest and quickest method. We just place our fingertips over the little nose openings and the snorting stops almost immediately.

It is important that the shih tzu owner be sure that what the dog is doing is actually reverse sneezing. There are other types of sneezing and coughing that can be more serious. You must differentiate between the sneezing on inspiration – as the dog breathes in like with reverse sneezing – or regular sneezing which occurs as the dog breathes out. Some of the types of cough to watch for are congestive heart failure (usually nocturnal coughing); tracheal collapse (caused by exercise or excitement); problems with major airways (harsh prolonged cough); or pulmonary lung disease (soft, infrequent coughing). A productive cough (fluid or mucous) suggests infections, kennel cough, etc. Rarely reverse sneezing can be caused from a malformation in the nasal passage – but that causes very frequent and severe sneezing.

More than likely what you will be seeing in your Shih Tzu IS the reverse sneezing – it is quite common in this breed and other small breeds. But to be safe, watch the dog very carefully and see if closing off the nostrils makes it stop. If so, it is probably reverse sneezing. If you have any doubts, it is better to ask your vet.

If you are worried about what will happen if your shih tzu does this while you are not around, don’t worry, he will be okay. They look as if they are really struggling, but they can and do recover without us. Yes, it does look sad to see them, but if what your Shih Tzu is indeed doing is reverse sneezing, he WILL be all right if you are not at home!

Luxating Patella or Loose Kneecap

Luxating patella or “patellar luxation” describe a relatively common condition wherein a dog’s kneecap, or “patella,” slips out its normal position within the knee joint. While the patella is dislocated, the dog cannot straighten out its leg and will stand with its leg bent or “skip” for a few strides until the kneecap slides back into its normal position.

Small breeds like the Pomeranian, Chihuahua, Yorkshire Terrier , Pekingese, Maltese, Miniature Pinscher, Papillion, Poodle, Pug , and Shih Tzu are most commonly affected by luxating patellas. Their kneecaps tend to move to the inside of their knees, which is called a medial patellar luxation (MPL).

The luxating Patella under most circumstances often has no or very mild symptoms.  Luxating Patella can and does happen periodically in the smaller breeds, but is generally mild.  Not all luxating Patella need medical intervention.  Luxating Patella have different grades.  Grades 1-2 are considered very mild and the puppy could very likely grow out it or will cause no long term effects or complications (this is most common).  Grades 3-4 Should probably be addressed by a veterinarian.  They could potentially be more serious and need medical intervention and could potentially cause more long term damage and pain for the adult dog.