The Georgia Shih Tzu

Sheralyn Milton~ A California Shih Tzu Breeder

Concerning Health


shih tzu outline
Shih Tzu Health Problems
Last Modified: 13 Apr 2013
All dogs have health issues that may or may not develop in their later years. Some may develop problems while they are still young. Every breed of dog has its general, possible problems. Rottweilers are prone to joint stiffness; dachshunds to back problems. The shih tzu has its own list of possible issues. Where your dog came from can determine your dog's health in later life. Many are hereditary and many are because of their body structure. For instance, many breeds are tested for hip dysplasia, a genetic disease in which the dog's hip joint does not form properly. Many small breed dogs are prone to pinched nostrils, in which the nasal passages are too confined to allow for proper breath intake caused by the flat face. The shih tzu are a very healthy breed. Most of the severe problems that I list are unlikely to happen and rarely seen. Others are possibilities that depend on how you care for your dog. So... is there a list for the Shih Tzu? Yes there is, unfortunately. Before I explain what these terms mean, I think it best to, simply, list them. There will be a link from every term to its explanation if you are not up to reading the entire page. Please do not freak out, some problems are serious while others are nothing to worry about. If it is not serious, you may need to make a few changes in your lifestyle, but nothing dramatic. Those serious problems are usually unlikely in a well bred and well cared for dog. If you need more information on general health probelms that affect all breeds this information can be found at the following link. You can also find home remedies for many common ailments at Home Remedies.
Your Pet's Universe - Pet Supplies & Information A universe of information about our faithful and furry four legged companions
According to many sites on the internet and the books I have at my disposal, the following issues are all possible in the shih tzu, most on the list concern the eyes.
Pyometra
Stenotic Nares (Pinched Nostrils)
Umbilical Hernias
Liver Disease
Cataracts
Corneal Ulcers
Ectopic Cilia
Retinal Detachment
Chronic Renal Failure (Kidney Failure)
Dental Problems
Hypothyroidism
Patent Ductus Arteriosus (PDA)
Hypoglycemia
Skin Allergies
Otitis Externa (Ear Infection)
Keratoconjunctivitis Sicca (Dry Eye)
Distichiasis
Entropion
Harderian Gland Prolapse
Juvenile Renal Dysplasia
Patellar Luxation
Intervertebral Disk Disease
Collapsing Trachea Syndrome
Hip Dysplasia
Paroxysmal Respiration (Reverse Sneezing)
Heat Stroke
Lagophthalmos
Trichiasis
Progressive Retinal Atrophy
Proptosed Globes
Renal Cortical Hypoplasia
Von Willebrand Disease
Heart Disease
Allergies
Again, please do not worry before you know what all these terms mean, the possibility it will affect your dog and, most of all, how serious the problem. Do not let the large names scare you. I cannot stress enough that Shih Tzu are a very hearty and healthy breed. They are capable of living from 14 to 16 years and live well. The description of all these diseases will include the possibility your dog faces, its seriousness and prevention tactics.

Stenotic Nares (Pinched Nostrils)

Narrow, closed nasal passages. The soft nasal cartilage will be be smaller than in other breeds and will cause sniffling, sneezing, snoring, snorting, grunting and clear nasal discharge. This is a common occurrence in shih tzu, as well as all flat faced breeds. It is not life threatening and very rarely a cause for worry. Most puppies will need to labor a little more to get a good breath or will need to rest for a short period, once in a while during play. They will make noises when they breathe and will often snore in their sleep. I would say that about 95% of dogs with this problem will grow out of it by the time they are a year old and about 1% will not be able to breathe well enough to live a comfortable life. If your puppy cannot play for more than a few minutes without needing a rest, has very pale to white gums, and obviously cannot breathe there is surgery available. This procedure includes cutting the cartilage between the two nares (nostrils). I never recommend this surgery unless it is an absolute last resort and your puppy cannot breathe. The best way to keep your dog breathing easy is to replace its water bowl with a water bottle. The bottle stops your dog putting its head into the water to lap and eliminates the possibility of snorting water into its lungs and will reduce the amount of nasal noises it makes.

Hypoglycemia

Low Blood Sugar. Low blood sugar is very common in all toy breeds. Blood sugar levels are most likely to drop during the ages of birth to 9 weeks and 12 yrs to death. A puppy's sugar level will drop for any reason and no reason. They will breathe harder, play less, not play at all or in worst cases become lethargic. The condition can also be brought about by stress and can affect your dog at any age. If you are really close to your dog you will notice that they just do not seem quite normal. The likelihood for your dog is very high, but the treatment is easy and fast- acting. The minute you notice your dog is acting slower than normal, bring out the Clear Caro Corn Syrup. It is pure, natural sugar and will take affect within 15 minutes, depending on the severity of the condition. If you have got it in the beginning, slight change in activity, one dose will clear it up. If you are later on the up-take, heavily lethargic, it may take two or three daily doses until your dog is back to normal.

Hip Dysplasia

The ball of the hip joint is flat, rather than round and does not fit properly into the socket. Hip dysplasia can be caused by the presence of several genes from one or both parents, poor diet, abnormal growth rate or all. The disease was first diagnosed in 1937. It is a common problem in many breeds and can be devastating to your dog. It is a developing disease, as it does not display in birth, but may start at 6 months. The disease can, potentially, affect 10-30% of dogs and tests are available to determine if a bitch or stud carry one or more of the necessary genes. I have noticed that it is more prominent among breeders who inbreed their dogs to keep a line pure or out of ignorance. The best way to not buy a puppy with this problem is to work with a breeder who knows the history of their dogs and does not inbreed. There are treatments available in some states, but there is no cure.

Umbilical Hernias

An opening in the wall of the stomach where the umbilical cord once was. This can be a mild to moderate problem and can easily be fixed during spay and neuter procedures, though the surgery will be more expensive. Usually, only fat fills the bubble in the stomach, but there is a rare threat that the intestines may become locked in the gap and blocked. Most hernias will heal with age or may disappear and reappear over time. This type of hernia is caused by stress to the umbilical cord during whelping and is pretty common.

Skin Allergies

Hot spots or irritated skin areas where the dog continually bites and scratches causing hair loss. This is not the same as ringworm, which shows as a ring on the skin. Usually, hot spots will just be a bald, irritated spot on the skin. Allergies can be caused by food, air quality, deposits on material fibers from cleaning, excessive heat or stress. About 35% may develop skin allergies and the treatment depends on the problem. Try changing the food to a more natural brand with no preservative or a raw diet. You can also shave your dog's coat in the summer, change your carpet cleaner or detergent and clean the air. Smoking is a huge cause for allergies, as are high pollen count days. Treat your dog as an asthmatic and be careful that he/she has a clean environment. For more information please visit Allergies.

Paroxysmal Respiration (Reverse Sneezing)

Collapsing trachea and/or upper airway obstruction. This is often called a reverse sneeze because it looks like your dog is inhaling a sneeze. There is really no known cause for it and is not threatening. There has been no sign of permanent damage to your dog, but there is a possibility that constant attacks could lead to Collapsing Trachea Syndrome. I have never seen this type of attack and have only heard of it once. I would assume that it is an uncommon occurrence and nothing to worry about. If it happens on a continual basis and you are worried, try to film it with a camera to show your vet. It is possible that rubbing your dog's neck close to their head can help to ease the episode.

Liver Disease

The liver is one of the most important organs a living mammal has. It is the body's defense against toxins and without it there is no life. The best I can do is lead you to the sites I found that help to describe the symptoms and your vets options. The major causes for liver failure are poor diet, toxins in the environment, bacterial infections, ingested materials, genetics or existing health conditions, over- vaccinating and unnecessary prescriptions. Meaning that your dog's chances depend, entirely, on you. There are ways to treat the liver if it is caught soon enough. The following sites are a wealth of information and should answer any questions you have.

About & Prevention From: Canine Epilepsy
Healthy Happy Dogs
Dog Pro
WSAVA
German University Site

Otitis Externa (Ear Infection)

You should know what this is without my having to tell you that it is a bacterial infection starting in the outer ear. The causes are pretty numerous: wet ears not completely dried, built up ear wax, untreated ear mites, build up of foreign matter (seeds or pollen), using cotton tips to clean ears, and growth in the ear canal are a few. The signs are painful head, aggression when one touches head or ears, scratching, waxy or bloody ears, holds head lopsided or rubs ears/shakes head and poor balance. Do not allow your groomer to pluck the hair in your dogs ears. The matter that seeps from the pores after the hair is plucked can breed infection. The hair should never be plucked without medical reason and by no one, but your vet. I do not recommend trying to clear the infection on your own as all my research shows it is safer to call your vet. Ear infections are not life threatening if you get it medicated early. Beware some dogs are allergic to neomycin, a medication normally prescribed for infections. As with Liver Disease, your dog's chances depend, entirely, on you.

Heat Stroke

Heat stroke is dangerous and should be treated immediately. Cause is extreme exposure to excessive heat and the signs are very heavy and lobored panting, high rectal temperature (over 106), bright red tongue, thick saliva, and frantic breathing. If untreated the dog will stagger, have bloody diarrhea and become weaker. Eventually, a coma will ensue. Move your dog to a cooler surrounding or if they are staggering put them in a cold bath. If you cannot reach a tub, get out the garden hose. In extreme cases your dog may need a cold water enema or a shot of cortisone (stroke may cause the throat to swell) from your vet. Watch your dog in the summer. All over the country we are facing increasingly hotter temperatures and forcing your dog to stay outside or in a car without air circulation, shade and ample water supply is cruelty. As shih tzu have such long, thick coats it is common for owners to shave them in the summer. If your dog will be at home all the time and air conditioned you may keep the coat long, but please shave their belly between the four legs to allow them to lie on a cool surface for comfort. Whether or not you shave them, do not allow them to spend their days outside. Your dog's probability for heat stroke depends on you.

Cataracts

A clouding within the lens of the eye. Cataracts are, mainly, hereditary, but can also be linked with age, retinal diseases, diabetes and trauma. It may develope at birth or not until later in life. The only treatment is surgery. I am afraid that cataracts are common in this breed as they age. The surgery can be beneficial and there is no real health risk unless ignored as it will, eventually, cause blindness.

Keratoconjunctivitis Sicca (Dry Eye)

Decreased or no tear production. I have experience with this. I was brought an aging shih tzu found wandering the streets. He had only one eye which was so dry that when you pulled the lid back to look at the whites, you had to push the lid back down to its place. Causes are unknown and the treatment is affective, though it may be permanent. The treatment is drops that take the place of tear production and are administered directly to the eye, two to three times daily, depending on the severity. After a week of treatment your vet will want to reevaluate to determine if the drops will need to be a permanent medication. It is not a very common problem and happens, mainly, in aging dogs. There is no other damage unless you fail to treat in the first place and there is no preventative.

Lagophthalmos (Rabbit Eye)

The inability to close the eyelids completely. The ability to blink is impaired and the dog is unable to moisten its eye. You may notice they sleep with their eyes open. You may not see signs immediately, but over the years increased pigmentation will develop near the nose corner of the eye. Surgery is available that will help to correct the problem, but there is no cure, no known cause and no prevention. Lagophthalmos can lead to:

Corneal Ulcers

The cornea is the clear shiny membrane protecting the eye like a window. It is a rupture in the layers of the cornea that allow the eye's fluids to leak and the eye collapses. The most common cause is trauma from rubbing eyes on the carpet or other surface, a cat scratch or chemical irritation from dips and shampoo. Other causes could be bacterial and viral infections or other diseases. Treatment varies, but most ulcers can be cured in 3-5 days. More than one type of medicated drops may be prescribed to ward off infections while the eye heals. The probability depends on your dog's behavior and susceptibility to infection, but it is somewhat common.

Distichiasis

Extra hair growing on the edge of the eyelid. This causes discomfort and irritation, which can led to other eye diseases and disorders. It is very common, occurring in puppies, and the most diagnosed of all eye disorders and diseases. It is assumed to be inherited, but it is not proven. The treatments could include surgery, freezing or electrolysis. A friend of mine had a puppy displaying this problem and she tried plucking the extra hairs, causing only more irritation and they kept growing back worse then before. I know she was trying to avoid surgery and I am afraid I do not know the outcome, but I do know that all treatments are not permanent cures. I am sorry that there is not much else to be done and you may be looking forward to repeat problems in the future.

Trichiasis

Ingrown eyelashes. Eyelashes grow in the wrong direction and will, normally, be soft and fine and not harm your dog. In some cases the hair is coarse and stiff and irritates the eye. The cause may be infection, inflammation, the body attacks itself or trauma like burn or eyelid injury. It, usually, happens with the upper eyelid and is treated with electrolysis, laser or other surgery; Cryosurgery is the most effective if you do not want the problem to reoccur. If untreated, these hairs could cause Corneal Ulcers.

Ectopic Cilia

Very related to Distichiasis and I'm afraid the cause, treatment, probability and outcome are the same.

Entropion

Rolling in of the eyelids caused by abnormal eyelid position. Very rare in shih tzu, it is hereditary or caused by recent eye surgery. Chances are pretty slim unless the breeder is stupid and breeding dogs with the problem. Surgery is the treatment, and the sooner the better. It can lead to other eye problems so it must be monitered.

Progressive Retinal Atrophy

Recessive hereditary blinding disorder. It is a retinal disease that affects the rods in the back of the eye that allow for vision in dim light. As it progresses, it spreads to the cones that make regular vision possible. The first signs would be that your dog has trouble seeing in the dark. In shih tzu the disease does not develop until adulthood. between 2-5 years. There is no cure. I am not sure how common this disease in shih tzu; I have found no information to indicate whether it is common or not. It was not a disease that I was familiar with, but there were plenty of sites that I found dedicated to education. It is more common in other breeds, but the shih tzu is still on the possible list. The result is blindness, but since blindness is not a tragedy, your dog can learn to cope and live a healthy, long life. Here are the sites I found helpful.

University of Prince Edward Island
Net Pets
Veterinary Medical Database
Animal Eye Care
WSAVA

Retinal Detachment

This one is harder to explain. The retina is the innermost layer of the back of the eye and is attached to the choroid. The choroid is the darkly colored layer that nourishes the retina. When the retina detaches from the choroid, it is due to many instances including, disease, infection, trauma, and old age. Blindness is the result, but this is such a serious consequence of something else that the eye is, probably, the least of your problems. Surgery is a possibility, but will not bring back sight. If this is happening you need to be spending your time finding out what the cause was, as this does not happen without a much bigger and more dangerous reason. The only prevention is to catch whatever may cause it before it causes it. It is not restricted to age or health, since trauma can be one underlying reason and there is no possible probability that I can give you because there are so many factors that can lead to retinal detachment. I found one site that has been a help and was understandable without a medical dictionary.

Pet Place

Harderian Gland Prolapse (Cherry Eye)

Also called Third Eyelid Eversion, it looks like a big pink bubble mass in the lower corner of the eye. It is a gland of the third eyelid in the lower corner of the eye that protrudes, or flips out of the corner of the eye. This third eyelid is what produces tears and protects the eye. If its gland moves out of place it will easily become irritated and swell. If it happens to one eye it may happen to the other and shows itself in the second year of life. Cherry eye is only a cosmetic problem and nothing to be scared of. Causes are unknown, but is probably genetic. There is surgery available to replace the gland, do not have it removed, but if it keeps popping out of place it is best to leave it alone. It rarely impairs the vision and does not really cause discomfort.

Proptosed Globes

I will warn you that this can be scary. Proptosed globes are eyes that come out of their sockets. Shih Tzu have small eye sockets and really large eyes. Any head trauma can result in the loss of an eye. The eye can be replaced if a vet is reached within 15 minutes, otherwise the dog will go blind. The problem is not as common as you would fear, but it still remains a good possibility. Genetics play a huge part. Dogs whose eyes show more than the tiniest sliver of white are in more danger of losing an eye as their eyes are not set as deeply into their sockets as is healthy. The less white the better. There is no other prevention except to keep your dog away from any dog that would induce severe fighting and do not allow them to leave your home without a leash. They should not be allowed to hang their heads out of a moving vehicle or allowed to jump from high distances.

Chronic Renal Failure (Kidney Failure)

Often called CRF, it is a common and difficult disorder to manage. It is seen in aging dogs and cats and has a huge variety of causes. Probability for your dog depends on how you care for them. Diet is a key ingredient for prevention, though it will not guarantee your dog's health later. The cause of many, suffering kidney failure, can only be explained as old age. There is no probability as the causes are so numerous and there is no cure.

Juvenile Renal Dysplasia

A recessive, genetic kidney disease. It affects puppies to young dogs and is devastating. Easiest to spot signs are excessive water drinking, frequent urination and colorless, odorless urine. You may notice that it is nearly impossible to housebreak your puppy as they seem to constantly need to urinate. Even if caught early, the damage is irreversible, but you may be able to extend your dog's life and keep them comfortable. If caught later some signs are vomiting, weight lose, lethargy and muscle weakness. Treatment may be a change of diet to a low protein prescription food and occasional IV fluids. Both parents have to carry the gene. It may not show itself more than once and is, gratefully, not common. The chances are slim, if the parents have been bred many times before with unaffected puppies. I am afraid litter mates of the affected dog are 66% likely to carry the gene and the parents are 50% likely to produce another affected dog. Even aunts and uncles, or grandparents of an affected puppy are 50% likely to carry the gene. If not seen previously, chances are good. Once seen, expect to spay and neuter all related dogs.

Renal Cortical Hypoplasia

The cortex of the Kidneys develops incompletely. The cortex is the layer of the kidney that handles the finest filtration. The kidneys will be smaller than is normal and will be unable to perform properly causing stones or infection. First signs appear from 10- 13 weeks of age and there is no cure. Kidney failure will, most likely, occur before the puppy has the chance to live a normal life span. This is a developmental problem only and, therefore, there is no prevention.

Dental Problems

All dogs are common for dental problems. Plaque can destroy any healthy dog's teeth and cause pain or discomfort. Keep your dog's teeth clean as is recommended and watch what you feed them. A good diet is key to healthy teeth and gums.

Patellar Luxation

Also called Slipped Stifles, it is a common orthopedic problem in small dogs. The stifle is the dog equivalent of the human knee. Dislocation happens when the bones and muscles in the stifle are not aligned and the patella, one of the bones, slips out of its groove and rubs against the femur. In time this rubbing will result in arthritis. Many dogs are affected in more than one leg. Signs appear as early as weaning age and may go unnoticed, slowly developing with age as lameness. There is no possible prevention except to not breed dogs carrying this deformity and treatment requires surgery. The chances for your dog depend on the breeder he/she came from. If your breeder was responsible the chances are slim, but genetics is not sole cause for the deformity. Do not immediately blame your breeder if the problem presents itself.

Von Willebrand Disease

A common, mild to severe bleeding disorder, in which the blood takes longer to clot then normal. It is genetic and does not always appear in the parents if they have never been injured. The disease is more commonly mild and little more than a nuisance. In more severe cases, a transfusion of blood for any pre-surgery procedure will be necessary. In mild cases it can be treated with prolonged pressure to the wound. Dogs with mild cases will have occasional episodes that may go unnoticed. They may have blood in normal bowl movements or bleed heavier during whelping or have a cut that takes longer than normal to clot. It is not treatable, but manageable and rarely a cause for concern.

Hypothyroidism

The thyroid is responsible for several functions of the body, most commonly known for metabolism. The condition occurs when not enough thyroid hormone is produced. It shows as trouble with gaining weight or obesity, chronic, recurring skin problems or hair loss. Many dogs can be mildly affected and live without needing treatment. If treatment is necessary, a drug called Soloxine may be prescribed and is well received. There is no prevention and it is not considered a threat to your pets quality of life. The chances your dog may be affected are about 30%, but only 20% may be noticeable while less will need treatment.

Intervertebral Disk Disease

A common neurologic syndrome, meaning a set of symptoms or conditions that affect the central nervous system of your dog. A spinal disk will degenerate over time causing a rupture which will show itself as back pain in mild cases and wobbly legs or weakness in the hind probabilitylegs in more severe cases leading to complete paralysis. Because of differences of back use and where the spinal cord ends, the disease is more severe in dogs then in humans, whom will suffer nothing more than a pinched nerve. There are only two treatment options which are surgery and complete confinement. There is no preventative and can be seen early in life. The probability your dog will be affected is unknown and does not seem to be genetically related.

Heart Disease

Can be aquired at birth or in older aged dogs. The disease is very common affecting many dogs, but is highly preventable if your dog is seeing a vet regularly, on a healthy diet and getting the recommended amount of excursive. For the shih tzu, this is not much, but you should be encouraging your dog to play or follow you around rather than sleep all day. Early heart disease is not easily detectable, but if caught early can be manageable. There is no cure. Early warning signs are only detectable with a clinical evaluation from your vet, but may include coughing, lethargy and difficulty breathing. There are many treatment options available that are constantly updating.

Patent Ductus Arteriosus

A complicated heart problem that is hereditary. It is not considered prominent in the Shih Tzu breed, but it is possible. At birth, we all must adapt from life in fluid to life in the open. Oxygen must then be obtained through lungs rather than mother's blood. At this time, the heart must also adapt to work with the lungs. The artery responsible for this adaptation is called the Ductus Artery. It is a temporary bypass until the lungs are stong enough to support proper blood flow. Once the lungs are ready the duct slowly closes and the lungs take over. Then the artery closes and is no longer used. If this artery fails to close, as planned, it leads to abnormal flow of blood through the heart and possibly too much blood flow to the lungs, leading to congestive heart failure. If the artery is only slightly open you may never notice a problem. The likelyhood of a dog having this problem depends on family history and then about maybe 50%, but I am guessing. Dogs are still being tested and studies are inconclusive at the moment. Dogs wih family histry of PDA should not be bred and if your dog is diagnosed, suregery may be recommended.

Collapsing Trachea Syndrome

Improper formation of the tracheal rings. These rings in the trachea are weak and and causes the trachea to collapse and the result looks like the attack I mentioned above called the reverse sneeze. The result will be a fit of coughing and you will want to discuss the problem with you vet. It is not common, but it is not rare and it is developmental, not genetic. It is manageable and most dogs who suffer will live normal, but restricted lives. The condition is very rarely cured, but controlled with medication and lifestyle alterations. It can show itself in any age dog.

Allergies

A minor to severe reaction to anything. Reactions can range from upset stomach to hair loss and even open wounds. Dogs can be allergic to anything, but most common complaints include lotions, soaps, perfumes, food, cleaners, plants and pests. If you cannot find the reason for skin, stomach, sleeping or behavioral problems, start looking into allergies. There is no cure and most medications only help to alleviate discomfort. For best results start with cataloguing any changes you have made in cleaners, soaps or food and change back to the previous brand or try a new one. Do not change more than one thing at a time and no faster than two weeks apart. For more information on Allergies please visit my Allergies page.

Pyometra

Deadly and fast, Pyometra is a severe bacterial uterine infection caused by changes in the lining of the uterus (so... females only). The infection can appear at any age regardless of whether or not she has ever been bred. Your female is most susceptible when her cervix closes after her heat, and is caused by icreased cell growth. It is also common among females that have been administered estradiol, an abortion drug. The most obvious symptom is a mucus discharge from the vulva after heating, vomiting, depression, increased drinking, increased urination, and fever in some. If bloodwork is done results would show increased white blood cells and dehydration, xrays will see an engorged uterus and ultrasounds will see fluid buildup in the uterus. If diagnosed early enough intravenous fluids, antibiotics and spay surgery can save the dog. If left unattented or unnoticed too long it will result in a painful death.

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