Shih Tzu Health Issues in Sydney

The flat face: breathing and heat

The most important thing to understand about Shih Tzu health is the flat face, because it drives both the breathing risk and the heat risk. The Shih Tzu is a brachycephalic breed, which means a shortened muzzle and a compressed airway. In some dogs this causes brachycephalic obstructive airway syndrome (BOAS), where narrowed nostrils, an overlong soft palate and a narrow windpipe make breathing harder work than it should be.

Not every Shih Tzu is badly affected, and many breathe reasonably well, but the signs to know are snoring and snorting, noisy or laboured breathing, poor exercise tolerance, and struggling in the heat. If your dog breathes noisily at rest, tires quickly, or makes a harsh honking or gasping sound, have your vet assess the airway. Keeping the dog lean helps a lot, because extra weight makes any airway problem worse, and the Australian Veterinary Association has campaigned on the welfare issues of flat-faced breeds. For significantly affected dogs, surgery can improve the airway, and your vet is the person to advise.

Because panting is how a dog sheds heat, and a flat face pants less efficiently, the Shih Tzu feels the Sydney summer more than a long-nosed dog. That makes heat management a genuine health issue, not a comfort one, and we cover it fully further down.

The eyes: the breed's most vulnerable feature

Those large, round eyes are part of the Shih Tzu's charm and its biggest vulnerability. Because the eyes sit prominently in shallow sockets, they are exposed to knocks, scratches and drying, so a few problems are common:

• Corneal ulcers: painful grazes or sores on the surface of the eye, which can come from a scratch, a knock, or hair rubbing on the eye.
• Dry eye (keratoconjunctivitis sicca): reduced tear production that leaves the eye sore and prone to infection.
• Irritation from hair: facial hair and any inward-turning lashes rubbing on the eye surface.

The most serious risk is proptosis, where a blow to the head or face, or even rough handling, forces the eyeball forward out of its socket. It looks alarming and it is a genuine emergency. Keep the eye moist with saline or a clean damp cloth, do not try to push it back yourself, and get to a vet immediately, because fast treatment gives the best chance of saving the eye. Sydney has 24-hour specialty and emergency hospitals, including SASH, so know your nearest before you ever need it.

Day to day, watch for squinting, pawing at the eye, redness, cloudiness or discharge, and treat any of these as a reason to see a vet promptly rather than wait, because eye problems can worsen fast. The single best prevention is keeping the hair trimmed away from the eyes, which is where the grooming and the health of the breed meet.

Dental disease: the crowded toy-breed mouth

Dental disease is one of the most common problems in the breed, and it comes down to the mouth. A Shih Tzu has a normal number of teeth crammed into a small, shortened jaw, so the teeth crowd and overlap, trapping food and plaque, which builds into tartar, gum disease and painful infections if nothing is done. Bad teeth are not only a mouth problem: dental disease causes ongoing pain and can affect general health.

The prevention is the same as for any small dog but matters more here. Daily tooth brushing with a dog toothpaste is the gold standard, backed up by vet-recommended dental chews and regular vet dental checks, with a professional clean under anaesthetic when your vet advises. Watch for bad breath, reluctance to eat hard food, pawing at the mouth, drooling or bleeding gums. The RSPCA Knowledgebase has sound general guidance on dental care. Start a routine early with a rescue dog and keep it up; it is one of the highest-value things you can do for a Shih Tzu.

Knees, back and joints

Luxating patella. A slipping kneecap is common in small breeds. It shows as an intermittent skip or hop in a back leg, or the dog holding a leg up for a few steps and then carrying on as normal. Mild cases are managed with weight control and activity management, while more severe ones may need surgery, and your vet grades the knee and advises.

Back and disc problems. The Shih Tzu has a slightly longer-bodied build and can develop intervertebral disc disease (IVDD), where a spinal disc bulges or ruptures and presses on the spinal cord. Signs range from a reluctance to jump, a hunched back or yelping when picked up, through to weakness or dragging of the back legs. Sudden back-leg weakness or paralysis is an emergency and needs a vet straight away. You lower the risk by keeping the dog lean, discouraging jumping on and off high furniture, using ramps or steps, and supporting the whole body when you lift. Databases such as the Orthopedic Foundation for Animals track patella scores in screened breeding dogs, though you rarely know a rescue dog's breeding history.

Hip problems can also occur in the breed, so any persistent limping, stiffness after rest, or reluctance to move as usual is worth a vet check. Across all of these, a lean body condition is the single most protective thing you control.

Ears, skin folds and kidneys

Ears. Shih Tzus have hairy, floppy ears that trap warmth, moisture and hair inside the canal, which invites ear infections. Signs are head shaking, scratching, a smell, redness or discharge. Keep the ears clean and dry, check them regularly, use only a vet-recommended cleaner rather than cotton buds pushed into the canal, and see your vet at the first sign of trouble, because a low-grade infection left alone can become chronic.

Skin and folds. The breed can develop allergies (itchy, inflamed skin, paw licking and recurrent infections), and the facial skin folds and the fold under the tail can trap moisture and become sore or infected if not kept clean and dry. Wipe and dry the folds regularly, keep the coat clean and mat-free, and see your vet for persistent itching or any sore, smelly skin. Good grooming and good skin health go hand in hand.

Kidneys. Renal dysplasia, where the kidneys do not develop normally, is a recognised breed-associated condition in the Shih Tzu and can reduce kidney function, sometimes in a young dog. We are deliberately not attaching a frequency figure, because reliable breed-specific numbers are not something we can verify, but it is worth knowing about. The signs of kidney trouble are increased drinking and urination, poor appetite, weight loss, vomiting and lethargy. If you notice these, especially in a younger dog, see your vet, because a blood and urine test can assess kidney function and early management makes a difference.

Why a Shih Tzu should wear a harness

A well-fitted harness is the sensible default for a Shih Tzu. A collar concentrates pressure on the throat and the front of the neck when the dog pulls, and in a small brachycephalic breed that already has a compromised airway, adding throat pressure is the last thing you want. A harness spreads the pressure across the chest and keeps it off the neck and windpipe, which makes walks more comfortable and protects the airway.

Use the collar for the council registration tag and identification, and clip the lead to a properly fitted harness for walking. It is a simple, cheap change that helps a breed that already works a little harder to breathe. If your dog coughs, gags or breathes noisily on the lead, mention it to your vet.

Heat, ticks and the Sydney climate

Heat is the number one seasonal risk for a Shih Tzu, because the flat face makes cooling by panting far less efficient. In a Sydney summer that means walking only in the cool of the early morning or evening, keeping the dog inside with a fan or aircon on hot, humid days, always providing shade and water, and never leaving the dog in a parked car, which can turn lethal within minutes. A short summer clip helps the dog stay cooler.

Learn the signs of heat stress: heavy, frantic panting that does not settle, drooling, bright red or bluish gums, weakness, distress and collapse. Treat overheating as a true emergency, cool the dog with tepid (not icy) water and airflow, and get to a vet straight away.

The paralysis tick is the other Sydney essential. It lives along the NSW coast and bushland, including the Sydney region, and its neurotoxin causes an ascending paralysis that is fatal without treatment. Keep your Shih Tzu on a vet-recommended monthly tick-prevention product without gaps, and physically check the coat down to the skin after any bush or coastal outing. A tick is easy to miss under a long coat, which is one more reason to keep the coat manageable. If you find a tick, or your dog develops wobbly back legs, a changed bark or trouble swallowing, see a vet immediately.

Budgeting and insurance

A Shih Tzu is a small dog with small-dog food and registration costs, but the breed carries a real chance of specific vet bills: eye surgery or ulcer treatment, dental work under anaesthetic, airway surgery, and management of back, kidney or skin problems. Each of those can run into three or four figures at a Sydney clinic or referral hospital, so the cheap-to-feed small dog is not always cheap to keep.

That is why pet insurance taken out while the dog is young and healthy is a sensible decision with this breed, before anything becomes a pre-existing exclusion. Compare a few Australian providers on chronic and hereditary cover, the annual limit and the excess. It is not a substitute for an emergency fund, but for a brachycephalic breed with predictable eye, dental and airway needs it often pays for itself. We cover the full cost of adopting and keeping the breed in our Shih Tzu adoption guide, and the coat routine that protects the eyes and skin in our grooming and coat care guide.

Frequently Asked Questions

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