Shih Tzu Health Problems: Symptoms and When to Worry
The most common Shih Tzu health problems are brachycephalic airway syndrome, eye problems, and intervertebral disc disease. Shih Tzus typically live 10–16 years. This page is organized by symptom, so you can jump straight to breathing, eye, joint, and dental problems, see what each one looks like in a Shih Tzu, and know whether it is a vet visit this week, a vet visit today, or an emergency right now.
Quick answer: when to worry about your Shih Tzu
Go to an emergency vet now if you see any of these:
- Breathing: Blue or gray gums, open-mouth breathing at rest, gasping, or collapse is an emergency. Go now; do not wait for an appointment.
- Eye: Sudden blindness, a bulging or very painful eye, or an eye injury is an emergency. Glaucoma, a scratched cornea, or a prolapsed eye can cost the eye within hours.
- Joint, back, and mobility: Sudden inability to use the back legs, dragging the hindquarters, or crying out when touched along the spine is an emergency. A ruptured disc has a window of hours for the best outcome.
- Dental: Refusing food entirely, facial swelling, or a fractured tooth with exposed pulp needs a vet within a day.
- Any pet: collapse, seizures lasting more than five minutes, uncontrolled bleeding, or an inability to stand.
Book a vet visit this week if you see any of these:
- Breathing: Noisy breathing at rest, a cough lasting more than a few days, or tiring quickly on walks all warrant a visit.
- Eye: Book a vet visit for any cloudiness, redness, squinting, discharge, or a change in how they navigate a room, especially at dusk.
- Joint, back, and mobility: Limping for more than a day or two, stiffness after rest, reluctance to jump or climb stairs, or a change in gait.
- Dental: Bad breath, drooling, dropping food, chewing on one side, or red gums.
Keep watching if: the change is mild, your Shih Tzu is still eating, drinking, and moving normally, and it resolves within a day or two. Write down what you saw and when; a dated list is the most useful thing you can bring to a vet.
Breathing problems in Shih Tzus
Brachycephalic Airway Syndrome
The flat face causes narrowed airways, making breathing difficult. Most Shih Tzus have some degree of this.
What it looks like in a Shih Tzu:
- Noisy breathing
- Snoring
- Heat intolerance
- Exercise intolerance
- Gagging
Outlook: this is one of the conditions that can shorten a Shih Tzu's life. Managed early it is often years, not months, but it belongs on the list of things that eventually lead to end-of-life decisions.
When to see a vet: Noisy breathing at rest, a cough lasting more than a few days, or tiring quickly on walks all warrant a visit.
When it is an emergency: Blue or gray gums, open-mouth breathing at rest, gasping, or collapse is an emergency. Go now; do not wait for an appointment.
Eye problems in Shih Tzus
Eye Problems
Prominent eyes are vulnerable to injury, ulcers, and other issues. Eye emergencies are common.
How common in Shih Tzus: Very common due to eye structure
What it looks like in a Shih Tzu:
- Excessive tearing
- Squinting
- Redness
- Cloudiness
- Eye popping out (proptosis)
When to see a vet: Book a vet visit for any cloudiness, redness, squinting, discharge, or a change in how they navigate a room, especially at dusk.
When it is an emergency: Sudden blindness, a bulging or very painful eye, or an eye injury is an emergency. Glaucoma, a scratched cornea, or a prolapsed eye can cost the eye within hours.
Joint, back, and mobility problems in Shih Tzus
Intervertebral Disc Disease (IVDD)
Disc problems affecting the spine. Their relatively long backs make them susceptible.
What it looks like in a Shih Tzu:
- Back pain
- Reluctance to jump
- Weakness in legs
- Paralysis in severe cases
When to see a vet: Limping for more than a day or two, stiffness after rest, reluctance to jump or climb stairs, or a change in gait.
When it is an emergency: Sudden inability to use the back legs, dragging the hindquarters, or crying out when touched along the spine is an emergency. A ruptured disc has a window of hours for the best outcome.
Dental and mouth problems in Shih Tzus
Dental Disease
Crowded teeth in a small, flat mouth lead to severe dental problems.
How common in Shih Tzus: Nearly universal without intervention
What it looks like in a Shih Tzu:
- Bad breath
- Red gums
- Loose teeth
- Pain eating
When to see a vet: Bad breath, drooling, dropping food, chewing on one side, or red gums.
When it is an emergency: Refusing food entirely, facial swelling, or a fractured tooth with exposed pulp needs a vet within a day.
Kidney and urinary problems in Shih Tzus
Kidney Disease
Shih Tzus can be prone to kidney problems, especially as they age.
What it looks like in a Shih Tzu:
- Increased thirst
- Frequent urination
- Weight loss
- Vomiting
Outlook: this is one of the conditions that can shorten a Shih Tzu's life. Managed early it is often years, not months, but it belongs on the list of things that eventually lead to end-of-life decisions.
When to see a vet: Drinking and urinating more than usual, weight loss, a poor coat, blood in the urine, or reduced appetite.
When it is an emergency: Straining to urinate with little or nothing coming out, especially in a male, is an emergency. A blocked bladder can be fatal within a day or two.
Warning signs to watch for in a Shih Tzu
These are the early signals owners most often miss, or dismiss as age:
- Any eye injury or change - treat as emergency
- Increased breathing difficulty
- Back pain or reluctance to move
- Increased drinking or urination
- Changes in eating or dental pain
Shih Tzu lifespan: what is normal
Shih Tzus typically live 10-16 years, often reaching the upper range. If your Shih Tzu lived into their mid-teens, that's a full life. Their longevity is one of the breed's strengths.
Genetic factors
The flat face (brachycephalic) and prominent eyes are the source of most health issues. Their long backs can also cause problems. Responsible breeding can minimize but not eliminate these issues.
What Shih Tzus usually die from
Knowing what typically ends a Shih Tzu's life is not morbid. It tells you which of the symptoms above deserve the fastest response.
- Age-related decline (about 35%): Many Shih Tzus live long lives and eventually decline from old age.
- Kidney disease (about 20%): Chronic kidney disease in senior dogs.
- Heart disease (about 15%): Valve disease becomes more common with age.
- Cancer (about 15%): Various cancers.
- Respiratory issues (about 10%): Complications from brachycephalic syndrome.
When it may be time: from managing symptoms to saying goodbye
Some of the conditions above (brachycephalic airway syndrome and kidney disease) are managed for years. Each one, though, has a point where treatment prolongs the decline rather than the life. If you are reading this page because your Shih Tzu is older and the bad days are starting to outnumber the good, that is worth saying plainly: you may not be looking for a diagnosis anymore. You may be looking for permission.
Signs the balance has shifted in a Shih Tzu:
- Increased breathing difficulty
- Significant decrease in appetite
- Withdrawal from family interaction
- Confusion or disorientation
The when to say goodbye to your Shih Tzu guide walks through the quality-of-life scale vets use, what euthanasia actually involves, and how to prepare. If you are weighing costs and options, the pet end-of-life services guides by city cover in-home euthanasia and cremation prices, and the coping with losing a Shih Tzu guide is there for afterward.
Preventive care for Shih Tzus
- Keep them cool - they can't handle heat well
- Protect their eyes - they're vulnerable to injury
- Regular dental cleanings
- Maintain healthy weight for breathing and back health
- Use a harness, not a collar
- Daily face cleaning to prevent skin fold infections
Sources
This page is compiled from veterinary references and breed-specific health studies. It is general information, not a diagnosis; your vet knows your Shih Tzu.
- https://www.americanshihtzuclub.org/health
- https://www.ufaw.org.uk/dogs/shih-tzu
- https://www.ofa.org/diseases/breed-statistics
If this has stopped being about symptoms
Many people land here when their Shih Tzu is old or ill and they are trying to work out whether what they are seeing is the end. If that is you, the health details above matter less than the question underneath them.
Shih Tzu Health FAQs
- What are the most common health problems in Shih Tzus?
- The conditions most often seen in Shih Tzus are brachycephalic airway syndrome, eye problems, intervertebral disc disease, and dental disease. The flat face causes narrowed airways, making breathing difficult. Most Shih Tzus have some degree of this.
- What do Shih Tzus usually die from?
- The leading causes of death in Shih Tzus are age-related decline, kidney disease, and heart disease. Many Shih Tzus live long lives and eventually decline from old age. Shih Tzus typically live 10–16 years.
- Do Shih Tzus have breathing problems?
- Yes. The breathing conditions seen in Shih Tzus are brachycephalic airway syndrome. Noisy breathing at rest, a cough lasting more than a few days, or tiring quickly on walks all warrant a visit. Blue or gray gums, open-mouth breathing at rest, gasping, or collapse is an emergency. Go now; do not wait for an appointment.
- Do Shih Tzus have eye problems?
- Yes. The eye conditions seen in Shih Tzus are eye problems. Book a vet visit for any cloudiness, redness, squinting, discharge, or a change in how they navigate a room, especially at dusk. Sudden blindness, a bulging or very painful eye, or an eye injury is an emergency. Glaucoma, a scratched cornea, or a prolapsed eye can cost the eye within hours.
- At what age do Shih Tzus start having health problems?
- Inherited conditions can show up in the first few years. Age-related problems like arthritis, kidney decline, and cancer cluster in the last third of a Shih Tzu's 10–16 years lifespan, so twice-yearly checkups from about 6 years old catch most things early.
- What are the signs a Shih Tzu is dying?
- The signs that a Shih Tzu is nearing the end are refusing food and water, being unable to stand or get to the bathroom without help, pain that medication no longer reaches, withdrawing from the family, and more bad days than good over two weeks. Our when-to-say-goodbye guide for the Shih Tzu walks through the quality-of-life scale vets use and what euthanasia involves.
- How often should I take my Shih Tzu to the vet?
- Annual wellness exams for adult Shih Tzus, twice yearly for seniors (typically 7+ for dogs). More frequent visits if your Shih Tzu has known health conditions. Preventive care catches issues before they become emergencies.
- What vaccinations does my Shih Tzu need?
- Core vaccines are essential for all Shih Tzus. Your vet will recommend additional vaccines based on your dog's lifestyle, location, and risk factors. Keep vaccination records current and follow the recommended schedule.
Keep their memory close
If you're facing a difficult time, these may bring comfort.