Like all other breeds there are a few common issues that can occur in our breed. I have put this page together to help answer your questions and hopefully ease you mind.
Delayed Closure or Hernia?
Delayed closures are VERY common in the Shih Tzu. Most so called "hernias" are actually delayed closure of the umbilical or inguinal (groin) area.  We call it a hernia, because at that time, that is what it is. Sometimes I do not mention on my website if a puppy has an inguinal or a umbilical hernia at first because most of the time it is actually already closed by the time they go home.  If small, sometimes they are closed by 8-12 weeks.  If it seems as if it won't be closed when the puppy is old enough to go home, I will let you know.  You really cannot tell the difference between a true hernia and delayed closure unless the hernia is severe.  
It is not uncommon for a Umbilical Hernia not to close, almost all are simply cosmetic and do not cause any health concern what so ever, but can be stitched closed for very minimal cost at the time of spay/neuter, if desired.

Almost all "inguinal hernias" are simply delayed closures and require no medical help.

True inguinal hernias are actually rare in Shih Tzu's.

Almost all inguinal hernias (actually delayed closures) are completely healed by 4-6 mos. of age. Delayed closures are very common in the Shih Tzu, and even though I have had delayed closures of the Umbilical, I have never had an  Inguinal hernia. If I do and I feel it will need to be surgically repaired, I will let you know before the puppy is purchased.

Umbilical Hernias
Umbilical hernias really are of little concern and are very common in the Shih Tzu breed. They 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).  If it is large enough that it is "in the way" then it probably should be closed up when the puppy is spayed/neutered if it hasn't closed on it's own, very large hernias should always be closed up so the muscle doesn't close up around it and cause internal injury (however this is very rare to have a umbilical hernia that is large enough to become strangulated or harm the dog).  A lot of Vets will do it free of charge or for a small fee as long as they are already spaying or neutering the dog. An umbilical hernia is usually a small soft bump where your puppies umbilical cord was (their belly button) and for whatever reason the muscle failed to close up.  There are a couple of reasons why a puppy gets an umbilical hernia. Because of a shih tzu's uneven bite, sometimes the moms tend to have a harder time "cutting the cord" and will tug, pull or even chew to close to the skin or sometimes a difficult delivery and the puppy had to be pulled out.  Most breeders will not allow the mom to chew the cord as to prevent a hernia. If you get hernias consistently from the same dog and the breeder has cut the cords and not allowed the mom to chew them, then this is most likely inherited (but could be from the mom or dad or the combination of both)  Sometimes they just simply pop up out of no where. Very rarely is an umbilical hernia any health concern what so ever.  They are quite common in the Shih Tzu and are easily fixed if so desired.

+++++Spay and Neuter Clinics throughout Arizona and perhaps in Other States are closing any type hernia during spay/neuter for $5.00/$10.00 extra. Some vets are charging over $100.00. I highly recommend a Spay Neuter Clinic for your pup’s surgery, as this is what they DO. It is not necessary to spend $400 plus on a surgery such as this! You have been given a copy of the Spay/Neuter Clinics and Prices in the Valley(PHX) as part of your PARENTS PACKET!

Tight Nostrils or Stenotic Nares?

Tight nostrils are very VERY common in the Shih Tzu breed.  A lot of people think that tight nostrils and Stenotic Nares (pinched nostrils) are the same thing.  In reality they are very different.  Tight Nostril’s will generally come on when the puppy is teething and sometimes not go away until the adult teeth have fully come in (even up to a year old).  Sometimes it will come and go as the puppies gums are swelling off and on from the teething process.  Some puppies can't hardly breath out of their noses at all during this time, but as long as they are active and eating and drinking normally it is of little concern.  Never have surgery done on a puppy that just simply has tight nostrils as it will eventually go away.  Some dogs will have tighter nostrils than others and some will snore and snort more than others during their entire life, but tight nostrils to the will generally go away with time. 

Stenotic Nares  on the other hand are completely different and are present at birth.  From the time the baby is born he has difficulty breathing through his nose and struggles with nursing from early on due to the inability to breathe and eat at the same time (this can happen with tight nostrils also, however the pup is generally almost weaned by this time).  Some of the time (but not always) surgery will need to be done on Stenotic Nares as the puppy may always have this issue and over time could cause other health concerns.  However, even with Stenotic Nares the puppy can outgrow the condition.  I would wait to have surgery done until the puppy is over a year old as it is a possibility as they mature that they could outgrow the condition.  Some Vets are way to eager to perform surgery, when it may not be needed.
I have never had a puppy with ACTUAL STENOTIC NARES!
However, I have had MANY VETS tell my clients that when there is a pinched nostril that it is STENOTIC NARES and it is not. Some clients have allowed their vet to perform the surgery to open the nose at a very early age and the pup has DIED!!! Trust me as your Breeder. Wait and air on the side of caution! Vets cannot know each and every breed as well as your Breeder can! That is my Disclaimer!

Pinched Nostrils and Teething
Shih Tzu puppies often have slightly pinched nostrils that generally open with time. The bubbly discharge from a Shih Tzu puppy’s nose is NOT serious if the discharge is clear and watery and the dog is otherwise thriving. This problem is most acute during the teething stage. Even the nostrils of a dog that has difficulty simultaneously eating and breathing or is lethargic at this time may open satisfactorily as the dog matures. ♥ Pinched Nostrils and Teething go together ♥
 Teething Problems Some puppies in this breed experience teething trouble. The noses swell and pinch off some and they may have a little clear discharge. They make snorting and snuffling sounds. They will usually outgrow this after the adult teeth come in.( 6 mos.) As long as they are playful and active and eating and drinking well, they are ok.  If they can’t eat or drink well and are lethargic or the discharge changes color, they may have developed infection and need to be checked and treated.  Most Shih Tzu pups are fine after teething, and it is recommended not letting any surgery be done until after adult teeth are in.

Reverse Sneezing
Reverse sneezing describes a condition in which the dog seems to be unable to get its breath and begins to honk or snort. It is most often caused by a slightly elongated soft palate that “sticks” until the dog takes a deep breath through its mouth. The most effective way to stop this is to put a finger over the dog’s nostrils, thereby forcing it to breathe through its mouth. Sometimes just a hug and some reassurance will do the trick! Unlike more serious problems found in brachycephalic (short-faced) dogs, reverse sneezing in Shih Tzu is quite common and is not life-threatening.

Understanding Heatstroke
A Shih Tzu is very sensitive the heat.  Some owners may be surprised just how dangerous this is, until it happens.  Most people know to never keep their dog in the car when parked; however, your Shih Tzu can get heatstroke if:
  • They run around too much if the temperature is over 85 degrees F (29.4 C) (Whether inside or outside)
  • Your dog walks for over an hour without water
  • You have your Shih Tzu in your car and are driving, but the car heats up inside
Symptoms will be dizziness, confusion, faintness and finally passing out.  If you do not bring down your dog's temperature, death can occur.  This must be done by applying cool towels to your dog's body, running a fan over him or her and supplying water.  Only after your have your dog stabilized should you then rush to the vet.

Shih-Tzu puppies do not have a large fat reserve, so it is essential that these puppies eat small meals frequently.  Missing a meal, change in their environment, vacationing/travel, parties, excessive play, and stress, can cause these puppies to have dangerously low glucose levels (hypoglycemia). Once a puppy’s glucose levels are low, he might become too confused to eat and could refuse food even though it is the only thing that will help him. Even a brief period of fasting in a toy breed puppy can trigger a hypoglycemic “attack”.  The symptoms of hypoglycemia are weakness, confusion, excessive drinking with vomiting, listless, or wobbly gait. We recommend giving a finger length dab of NUTRICAL and to always have this on hand. Our initial instructions are to give this to your new puppy for the first 3 days at his new home for prevention of Hypoglycemia. NUTRICAL can also be used to stimulate appetite and stop diarrhea.
1/2 tsp of Karo syrup, maple syrup, or honey all ALSO work quickly IF YOU FIND YOUR SELF OUT OF THE NUTRICAL!  If the puppy doesn't immediately receive treatment in the form of sugar the puppy will progress to having seizures and will eventually be comatose, if a puppy’s glucose levels are allowed to drop too low.  This is why it is so critical that your new puppy has consent access to food and water.  Although hypoglycemia does not occur frequently, it could happen and early detection is the key to preventing any serious problems.

If your Shih-Tzu puppy does not seem to be interested in eating then he MUST be coaxed to eat.  If he doesn't show interest in the dry food then there are several different foods we recommend to stimulate their appetite:  Soft can puppy food, chicken baby food, cottage cheese, cooked diced chicken breast, all will work well and entice them to eat.  If your Shih-Tzu puppy is not interested in eating this from the bowl, try putting the food on your finger for the puppy to lick off, or place the food in the puppy’s mouth with a syringe or medicine dropper. Do not let your puppy go without food in some form. Please contact me if you have any questions. I am here for you!

Patellar luxation or Luxating patella is a condition where the kneecap (patella) moves out of its normal position.  Luxating patella is one of the most common knee joint abnormalities of dogs, but it is only occasionally seen in cats.  It may affect one or both of the knees.   In some cases it moves (luxates) towards the inside of the knee, and in other cases it luxates towards the outside of the knee.  Luxation to the inside of the knee is the most common form seen; it is most commonly seen in the small or miniature breeds of dogs such as Lhasa apso, shih-tzu, Poodles, Maltese, Yorkies, and Chihuahuas.  Luxations towards the outside of the knee are seen less frequently.  It can be present in many breeds, but is seen especially in Newfoundlands.
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