Health/ Breed Tendencies
(Most are puppy ailments)
Our goal is to place healthy, happy Shih Tzu puppies into caring forever homes. As a potential pet owner, we know you also hope to adopt a new Shih Tzu puppy who will be part of your family for many years to come. Before you ever consider bringing a new puppy into your home, you should familiarize yourself with the Health/ Breed tendencies of the Shih Tzu breed. Fortunaltey, some of these breed tendenices will be things your puppy may never experince, or may outgrow before they reach adulthood.
Our Imperial sized Shih Tzu typically have a long lifespan of 12-18 years. A well bred smaller size Shih Tzu from a reputable breeder will have no shorter of a lifespan than a standard size Shih Tzu. They are simply miniature versions of the standard size and will have the same lifespan and the same health issues/breed tendencies that a standard size Shih Tzu will have. Shih Tzu are one of the closest related domestic dogs to wolves and therefore are very healthy. But like all dogs, Shih Tzu will be more prone to certain health conditions and breed tendencies than others. All of the listed health concerns are fairly common to small and toy dog breeds in general, however this page is written for purebred Shih Tzu, with a special focus on tiny size Shih Tzu. A mixed breed Shih Tzu may have very different health concerns.
As a loving pet owner the best you can you do for your family member is to be an informed one. Don't be afraid to ask questions, read and learn. Starting with a good quality puppy from a responsible, reputable breeder is just the beginning.
All of our dogs go home with a Five Year health guarantee against life threatening inherited genetic defects. We increased our guarantee from two years to five because that is how confident we are in our dog's and puppies' health and in the lines we are breeding. We do not just buy two dogs and pair them together and hope for the best, our puppies are carefully bred from quality breeding stock. Most of our puppies are multiple generations are own lines and the outside lines we use are from experienced breeders who also focus on health and quality.
All of our puppies include our lifetime home guarantee and will always be happy to answer any questions you may have about one of our babies.
Shih Tzu are one of the healthiest purebred dogs and while the health issues or breed tendencies are not specific to only Shih Tzu and are in fact common to many other breeds of toy dogs or "brachyphelic" aka flat faced dogs or even some cats we have found that Shih Tzu often react differently to these ailments. This page is written to discuss how these ailments or tendencies affect Shih Tzu. We have found that not all veterinarians are familiar with these breed tendencies or common puppy ailments and will often misdiagnose them. It is important to remember that veterinarians are general practitioners like human doctors. They see a range of different breeds of dogs and more often than not see mixed breed dogs as the majority of their patients. Many of the health issues discussed are more issues of raising a puppy Shih Tzu and most of these issues will resolve themselves into adulthood, which may be different from other breeds.
Common Health/ breed tendencies
Delayed closure or Hernia?
Most of what we call hernias are in fact delayed closures, which are extremely common in the Shih Tzu breed. Many champion show dogs have them and some breeders will produce entire litters where every puppy in the litter has them. We try not to produce hernias or delayed closures, but even when neither parent has them they can still be produced. A delayed closure will reduce and sometimes close on their own, a true hernia will not. Delayed closures are much more common than actual hernias. We call them hernias because it is the most recognized term by most veterinarians and also because we just can not make the distinction between a hernia or a delayed closure on a very young puppy.
Hernias feel and look like outie belly buttons and for the most part are purely a cosmetic flaw, which a dog can live their whole lives with having, especially if they are a delayed closure. They feel like a small bump on the belly button area and that is soft and can easily be pressed in. As humans, we all have belly buttons, where our umbilical cords were attached to our mothers. For most of us, the spot on our stomachs where our umbilical cord was attached to our mothers, heals into what we refer to as our belly buttons. I don't know of any human who has ever had their belly button "repaired" or "closed". An umbilical hernia or delayed closure on a dog is much like human outie belly buttons. An umbilical hernia will most typically reduce itself as the puppy grows and will look like an outie belly button. A delayed closure will typically reduce itself so significantly that it will look and feel much more like an innie belly button than an outie.
Some vets will also sometimes refer to a delayed closure as a reducible hernia. It is very difficult to distinguish between a umbilical hernia and a delayed closure, unless the hernia is particularly large. What we have noticed a subtle difference between delayed closure and reducible hernias in comparison hernias however. Hernias which may close or may reduce in size are soft and when you press on them will often temporarily recede back into the belly button area.
Delayed closures are very common in the Shih Tzu breed and are most typically caused by either the mommy dog or ourselves cutting the cord too short. In comparison to true hernias, delayed closures and reducible hernias are thought to not be inherited and are caused by "trauma" to the umbilical cord during whelping. Shih Tzu are a very flat faced breed therefore often will cut cords too short, due to both their flat face and uneven bite. Most of what we call hernias, are actually tiny bubbles of fatty pockets which are slowly closing and these fatty pockets are located in either the belly button area ( for umbilical hernias, which are most common) or in the groin area ( for inguinal hernias.)
Umbilical Hernias ( can be delayed closures):
We typically see them appear at somewhere between 2-6 weeks of age. Once in a great while one may pop out later. While they are not a health issue , per say, they are included here because of how common they are. They are a cosmetic "flaw" only and your can dog can live its entire life with MOST types of hernia and it will not impact their lives in any way. Many people will choose to have hernias or delayed closures "repaired" at the time of spay or neuter. It is very easy for most vets to repair a small umbilical hernia and is really only a few extra stiches. The cost for a hernia repair will vary by location and veterinarian but our past clients have paid anything from no cost to $100 for this to be done. Most vets average between $25-$50 extra dollars. If you are quoted more than $100 than you need to call other vets and find one who is more comfortable doing this and therefore charges less. Hernias are VERY common in many different breeds and it would be a red flag for me if I didn't feel a vet was familiar with them. You should be concerned about a hernia if it is very large and hard, this is extremely rare ( we have yet to experience it for ourselves) but should it happen to you please seek medical attention. In all other hernia cases they can wait to be "repaired" the time of spay/neuter.
Inguinal Hernias:
Please keep in mind that you can not tell if your puppy has a true inguinal hernia until they are at least 5 months of age. Dogs with true inguinal hernias should not be bred but for the most part what appear to be inguinal hernias are in fact fatty pockets. An Inguinal Hernia is the result of the abdominal organs, fat or tissue which is protruding through the inguinal ring. They feel like small bulges and are located in the groin area and can be either bilateral or unilateral. They are generally soft and can be pushed back in. If the inguinal hernia (s) are hard, very large or do not push back in, please seek vet attention. Otherwise, these can be repaired at the time of spay or neuter. Some tiny inguinal will close up on their own. If your dog has a fatty pocket rather than a hernia, the fatty pocket will close on its own. Fatty pockets are generally common especially with chubby puppies and the puppies will out grow this as they age.
We have found vets in general to be much less familiar with inguinal hernias the umbilical. While you should expect an extra cost to repair one of these I have heard some crazy price quotes. My recommendation is to shop around. Talk to different vets and not only get price quotes but also talk to them about past experience with inguinal hernias. Some vets just do not have the experience or the comfort to repair these. From my understanding they shouldn't be that much harder to repair than an umbilical hernia but because they are much less common than umbilical's it can be harder to find a knowledgeable vet who will repair them at a reasonable price.
If the inguinal hernia does not close on its own you should not breed a female with this issue, because not only can it be hereditary but it can also be dangerous to both the female and puppies during whelping.
There are several different types of hernias so if you would like to read about them further please refer to the following articles which are both great resources:
http://www.showdogsupersite.com/kenlclub/breedvet/umbilical.html
Stenetoic Nares, Pinched Nostrils, Tight Nostrils during teething and Reverse Sneezing
Stenetoic Nares, Pinched Nostrils, Tight Nostrils ( during Teething), and Reverse Sneezing are all terms are something used interchangeably but in reality are very different things. We have seen other breeders and even vets mix these things up. Some vets have misdiagnosed puppies as needing very expensive surgeries only to see that same puppy weeks later and be amazed that their nostrils had open and no longer needed the surgery. Some puppies have been misdiagnosed as being ill or having allergies, one vet even misdiagnosed a puppy as having asthma.
Stenetoic Nares-
Stenetoic nares is the most serious of these conditions. Puppies are born with stenotic nares which are caused by the malformation of the nose cartilage which can happen with brachycephalic breeds. Stenetoic Nares are present at birth though occasionally they are not noticed immediately. Puppies are born with Stenetoic nares which are caused by a malformation of cartilage which can block the dog's upper respiratory tract. This is a condition which can happen with the
brachycephalic breeds. This condition is characterized by a defect in the flow of air through the dog's upper respiratory tract. Puppies with sten tic nares, also sometimes called collapsed nostrils, process small, narrow nasal openings with floppy nasal cartilage. These abnormal aberrations often cause the nostrils to collapse as the puppy take in air during inspiration. The collapsed nostrils lead to obstruction of the dog's airways which is manifested by noisy breathing, mouth breathing and sometimes nasal discharge.
Puppies suffering from severe cases of Stenetoic nares may have flattened chests and sometimes the nostrils are so tight and the nasal openings are so narrow that the nose is nearly closed. Because this condition is present at birth and the nostrils are so tight the puppy often has trouble nursing because they sometimes are unable to nurse and breathe at the same time. In this case the puppy can hardly breathe and will often have slow to no weight gain and is much more prone to get pneumonia, for example. Many of these puppies do not even make it to weaning time. I have not personally had one of these though I have seen a couple of pictures. These puppies should NOT be bred, their siblings should not be bred and their parents should not be bred together again either. Should the puppy live the puppy will very likely need surgery to enlarge the nasal openings in order to improve the dogs' respiration. The surgical procedure involves the removal of the cartilage and skin of the nose. in some cases, the nasal cartilage may harder satisfactorily before the puppy reaches six months of age.
Pinched/ Tight Nostrils during Teething
Shih Tzu have full dentition for tiny little mouths. People are surprised at how strong the jaws of Shih Tzu are and how strong their bite is for their size. I have a friend with a Boxer that has an incorrect bite, we have been surprised to watch our little Shih Tzu eat treats and chew sticks that larger dogs are not able to. Shih Tzu have what is called a reverse scissor bite. What this means is that the bottom teeth should be just slightly behind the top teeth. This is referred to as an under bite. We do not like or breed for dogs that have large under bites where their teeth show all the time or they can not properly close their jaw.
Shih Tzu teeth very slowly, sometimes they are still teething at six months old. Because they have a lot of teeth for tiny little mouths their noses will often swell and tighten during teething. The nostrils may appear pinched but will gradually widen and open back up again as the puppy grows. During this time the puppy may have clear discharge on their nose. They may snore, snort, sniffle or make noises which found very much like a pug dog. I have found the difference between a Shih Tzu versus a pug for example is that a Shih Tzu almost always out grow these symptoms while a pug will often have them for a lifetime. I have heard of some Shih Tzu who snore but the majority do not. I am a very light sleeper and the Shih Tzu have slept in bed with me or in my room and I have never been woken up to snoring or other similar noises.
While the Shih Tzu is teething you will typically hear the noises more often when your puppy is playing hard or nervous. Part of how you can distinguish your Shih Tzu teething symptoms versus a puppy who is actually sick, is by looking at the following list.
A teething Shih Tzu versus a sick Shih Tzu
1. A teething Shih Tzu will not be running a temperature or fever
2. A teething Shih Tzu will play and act normally, a sick Shih Tzu will be lethargic and listless
3. A teething Shih Tzu will have a normal appetite, a Shih Tzu who is sick will eat very little or not at all and may vomit or have diarrhea
4. Any discharge from the nose will be clear on a Shih Tzu who is teething, a sick Shih Tzu will have mucus colored discharge.
5. A puppy who is teething typically rests peacefully and often loves to find things to chew when awake.
Please note: We have had many puppies who we never see any of the teething symptoms with. We have had other puppies who might have only one symptom. Common sense and behavior are telltale signs of your puppies health and by using these as well as educating yourself you should know if your puppy is just teething or if there is a further problem.
Reverse Sneezing
Sometimes you will hear a puppy reverse sneeze and they will continue to reverse sometimes during teething ( some grow out of it) but often Shih Tzu will not begin reverse sneezing until they are a mature adult. I have had some that didn't begin to do this until they will already a few years old.
What is a Reverse Sneeze?
When you sneeze, air is pushed out through the nose. When your dog reverse sneezes, air is pulled rapidly and nosily through the nose sounding much like honking, snorting, gasping or even an asthma attack. Many Shih Tzu owners mistake the sound for an asthma attack or chocking. The first time I ever heard it I thought my dog was chocking to death. It probably lasted a minute but felt like five. I was just calling the vet to rush her in and she stopped and looked at me with her tail wagging. I learned that this particular dog did this occasionally when she got really excited. Sometimes she would do this a couple times in a single day, other times it would be six months between reverse sneezes. Reverse sneezing is more common in small dogs than large dogs. For some dogs this is a totally normal event. Just as sneezing is part of everyday life, reverse sneezing is also part of every day life. If a dog is alone and has a reverse sneezing attack it will stop on its own. If you are with them while they are having a reverse sneezing attack, remain calm. Pet them and try to reassure them that everything will be okay. Our dogs are sensitive to our reactions and if you remain calm and help calm your pet down the reverse sneeze will be much shorter.
Joint issues
"Loose knees or Joints"
It is amazing how quickly puppies go from newborn puppies weighing just a few ounces or so to being a running, playing silly puppy just weeks later. Not every puppy develops the same way and sometimes joints don't develop as quickly as puppies do. I like to think of it like horses, sometimes a yearling will be 16 hands ( very tall) at that age, but despite that height we don't start riding them at that age because their knee caps haven't closed and their joints haven't closed and severe damage can be done to them by riding them to early. Puppies, particularly tiny puppies or very large breed dogs are the same way. Sometimes their joints are not fully closed at 8 weeks, and their knee caps may still be a bit loose. This is NOT the same as luxating patella, which is an inherited condition. Luxating Patella are rated on a 1-5 scale. Puppies with loose joints which will later correct as the puppies age, will be rated as 1 if the vet were to give a rating. Most puppies that have been given a 1 should outgrow this, but if there is more than one puppy in the litter or the vet suspects an actual luxating patella, than the parents should be rechecked ( to make sure they don't have this condition themselves) and shouldn't be bred together in the future.
Luxtating Patellas ( Not a breed tendency, could be considered a health issue depending on severity)
Remember, even if every breeding dog in the breeding program has great knees, they could still be a carrier for luxtating patellas BUT you are much more likely not to produce luxtating patellas if you dogs do have great knees and joints. We breed for strong bone and substance in a smaller package. Our dogs are not fragile. Even our tiniest adults have short legs, wide bodies and thick bones in proportion to their tiny sizes. I have seen Imperials with fine bones and they do not have any place in our breeding program.
Luxtating patella is a condition where the knee or patella joints dislocates and generally occurs in smaller breeds under 22 pounds. Though Luxtating patellas do periodically occur, they are generally mild. Not all luxtating patellas need medical intervention and the majority of time low grade luxtating patellas have little if any impact on the dog's every day life. Luxtating Patellas are given different grades. Grades 1-2 are considered very mild and it is likely that the dog will out grow this as they mature and their joints fully close. Even if as an adult they still have a luxtating patella of 1-2 it is unlikely to cause more than an occasional lameness or misstep. If a dog has a grade 3-4 they should be taken to a vet, who will likely do x rays and other similar testing to determine how serious the issue is. This could be potentially very serious and may need surgery or other medical intervention, because this can potentially cause long term damage to the dog's joints and can also be very painful for the dog.
Heart Murmurs ( in puppies)
Before becoming a breeder if I had heard the word heart murmur and puppy in the same sentence I might have panicked. Now, after having bred for awhile, I have been made aware that very low level heart murmurs in young puppies is much more common than originally thought. Probably because of the word "heart" this isn't something that breeders like to talk much about. But murmurs can be caused by growing pains or nerves or a low level murmur can be something that an animal lives with their whole lives and doesn't bother them in any way, like humans with low level murmurs. Heart murmurs are in extra vibrations which are produced as a result of a disturbance in the blood flow, enough to cause an audible noise.
Occasionally a vet will hear a "heart murmur" in a young puppy, otherwise healthy active puppy. If the murmur is a level one it is typically caused by excitement, nerves, stress and fear that the puppy is experiencing while at the vet. We have had a few that have had this and kept them an additional time and brought them back to the vet for a recheck only for the vet to never hear it again. In fact, we have never had a single puppy that has had a level one heart murmur where the murmur didn't go away within a couple weeks at most.
Though a level two heart murmur is still a very low murmur and also typically doesn't pose an issue, our belief is that the dog should be taken to a cardiologist to get an EKG or ultrasound to find out what is causing the murmur. It may be nothing, could be something medication will help or there is always a chance that it could be more serious. That is why it is our policy that anything above a level one heart murmur goes to a cardiologist.
Grading Scale for Murmurs
Grade I—barely audible
Grade II—soft, but easily heard with a stethoscope
Grade III—intermediate loudness; most murmurs which are related to the mechanics of blood circulation are at least grade III
Grade IV—loud murmur that radiates widely, often including opposite side of chest
Grade V—very loud, audible with stethoscope barely touching the chest; the vibration is also strong enough to be felt through the animal's chest wall
Grade VI—very loud, audible with stethoscope barely touching the chest; the vibration is also strong enough to be felt through the animal's chest wall
Open Fontanels ( soft spots)
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 Fontanels does NOT make the puppy more prone to a rare condition called hydrocephalus. The soft spot will close slowly on its own and the puppy doe snot need any special care other than not being dropped directly on their head.
Hypoglycemia
Hypoglycemia-
A little note about Hypoglycemia. If you have done any reading on the internet you have likely read about Hypoglycemia and how tea cup puppies are unhealthy and are prone to it. We do everything we can to not send home puppies who have recurring hypoglycemic attacks. This is the primary reason that we will not send a puppy home, not matter what its age, until it has reached at least two pounds. Puppies who have not reached at least two pounds can not regulate their blood sugar yet. We do not force our puppies to wean. Every puppy is an individual and is treated as such. Some puppies have interest in food at 4 or 5 weeks of age, others have no interest at all. Some of the puppies are eating or sampling food but are not anywhere near weaning at 8 weeks, others are fully weaned at the at time. Our puppies do not go home at 8 weeks so it is no big deal to us if they are weaned our not. Since we take our time weaning, hypoglycemia is almost never an issue during weaning time for us.
Hypoglycemia can occur in any age or size dog but most typically occurs in tiny puppies. Hypoglycemia attacks is often blamed when dogs little dogs have similar symptoms. Speaking from personal experience I highly recommend working with your vet to try to discover the source of this issue rather than just say the dog has hypoglycemia issues. I say this not to scare you because it is very common for tiny puppies of many different breeds to have hypoglycemia issues, but some of the symptoms can also be symptoms to a more serious issue. A very tiny dog should not have to live on medication or have frequent hypoglycemic issues. If this is happening with your dog I recommend to start with a complete vet check and a fecal sample. I then recommend a liver shunt panel and bile acid test. I have also found a round of antibiotics and making a temporary switch to antioxidant food to be in some cases lifesaving. Even our tiniest dogs have normal diets and are not prone to having hypoglycemic attacks.
Preventing Hypoglycemia: You can help prevent hypoglycemia by making sure he or she is getting small, frequent meals. While we hold onto our little ones longer to ensure that they are able to eat hard food by themselves, are consistently gaining weight and don't require 8 feedings a day they are still a lot like bringing a newborn baby home. Most of our puppies will need to be fed 2 or 3 times daily but some of our tiniest babies may need to eat 3 or 4 times a day because their little tummies and their appetite may be better with smaller more frequent feedings. Puppies will need access to plenty of fresh, clean water, especially after playing. even though it is very exciting having a new little one in the house puppies of all sizes need plenty of rest. They should not be brought out in public until they have finished their complete shot series at about 4 months of age. This not only prevents hypoglycemia and other germs but is mandatory to prevent parvo, which highly contagious and deadly.
If Hypoglycemia occurs : Sometimes no matter how careful you are a puppy may still have a hypoglycemic episode. You need to act FAST! You need to get sugars and fluids into your puppy very quickly!! While Nutrical is best, sugar water, Karo syrup, honey, even regular syrup needs to be administered as soon as possible. Start with a very small amount under the tongue and continue to give a little bit more every 5- 10 minutes or so until your puppy comes out of it completely. Sugar shock can be a very scary thing so your best course of action is prevention!
Stool eating
If I had to pick a fault in the breed I would pick this one as Shih Tzu, particularly puppies, are very prone to this. Because of stool eating puppies will often require another round of worming after they go their new homes. My recommendation is to keep stool picked up as soon as you see your dog go the bathroom and if you see them eating stool let them know that this is not okay behavior.. The vets also sell a product called Forbid which is very effective. I use Accent, which can be purchased at the grocery store. It has the same active ingredients as Forbid but is a fraction of the price. This needs to be sprinkled on all dogs food whose feces are getting consumed, not just the one doing it. I have also heard of others having great success with feeding pineapple tidbits or with pumpkin. There is not unfortunately a one solution fits all with stool eating.
Vaccine Reactions
It was surprising to find out that a Great Dane and a Chiuahua get the exact same dose of a vaccination. Unlike antibiotics or other medications which are dosed by weight, vaccines are used to simulate an immune system, which is not something measured by weight.
We always wait a few days after the puppies have had their vaccines before sending them home, and are careful to mointer them for reactions to vaccines. Sometimes you may notice a small bump on their shoulder blade. This is a mild reaction to the shot ( swelling of the skin) and will take a few days to a week or so to gradually go down. Sometimes the puppies lymph note may swell slightly as well. These are considered normal, minor reactions and will go away on their own.
What we have noticed about small dogs, is that shots need to be given one at a time. Do not give Rabies and the DHPP shot at the same time. Our vets reccomend that puppies get a series or DHPP shots beginning at 8 weeks of age and spaced every four weeks apart. Some vets give 3 shots to complete the series, other vets give 4. The vets may offer you a choice of a either giving a 5 way shot or giving a 7 way shot. The seven way shot contains Lepto and Corona. We DO NOT give Seven way vaccines! Small/ toy dogs often have severe reactions to these shots including life threatening reactions. We are so serious about not giving our puppies Lepto that if you do so, you violate out health contract.
Please discuss this vaccination schedule with your veterinarian before getting any vaccinations for your tiny puppy. Any ethical veterinarian that really cares about the well being of your pet should be willing to listen and discuss any alternate treatments with you. If your vet is unwilling to discuss this information with you , then for the health and safety of your pet, you should find another vet..
Our goal is to place healthy, happy Shih Tzu puppies into caring forever homes. As a potential pet owner, we know you also hope to adopt a new Shih Tzu puppy who will be part of your family for many years to come. Before you ever consider bringing a new puppy into your home, you should familiarize yourself with the Health/ Breed tendencies of the Shih Tzu breed. Fortunaltey, some of these breed tendenices will be things your puppy may never experince, or may outgrow before they reach adulthood.
Our Imperial sized Shih Tzu typically have a long lifespan of 12-18 years. A well bred smaller size Shih Tzu from a reputable breeder will have no shorter of a lifespan than a standard size Shih Tzu. They are simply miniature versions of the standard size and will have the same lifespan and the same health issues/breed tendencies that a standard size Shih Tzu will have. Shih Tzu are one of the closest related domestic dogs to wolves and therefore are very healthy. But like all dogs, Shih Tzu will be more prone to certain health conditions and breed tendencies than others. All of the listed health concerns are fairly common to small and toy dog breeds in general, however this page is written for purebred Shih Tzu, with a special focus on tiny size Shih Tzu. A mixed breed Shih Tzu may have very different health concerns.
As a loving pet owner the best you can you do for your family member is to be an informed one. Don't be afraid to ask questions, read and learn. Starting with a good quality puppy from a responsible, reputable breeder is just the beginning.
All of our dogs go home with a Five Year health guarantee against life threatening inherited genetic defects. We increased our guarantee from two years to five because that is how confident we are in our dog's and puppies' health and in the lines we are breeding. We do not just buy two dogs and pair them together and hope for the best, our puppies are carefully bred from quality breeding stock. Most of our puppies are multiple generations are own lines and the outside lines we use are from experienced breeders who also focus on health and quality.
All of our puppies include our lifetime home guarantee and will always be happy to answer any questions you may have about one of our babies.
Shih Tzu are one of the healthiest purebred dogs and while the health issues or breed tendencies are not specific to only Shih Tzu and are in fact common to many other breeds of toy dogs or "brachyphelic" aka flat faced dogs or even some cats we have found that Shih Tzu often react differently to these ailments. This page is written to discuss how these ailments or tendencies affect Shih Tzu. We have found that not all veterinarians are familiar with these breed tendencies or common puppy ailments and will often misdiagnose them. It is important to remember that veterinarians are general practitioners like human doctors. They see a range of different breeds of dogs and more often than not see mixed breed dogs as the majority of their patients. Many of the health issues discussed are more issues of raising a puppy Shih Tzu and most of these issues will resolve themselves into adulthood, which may be different from other breeds.
Common Health/ breed tendencies
Delayed closure or Hernia?
Most of what we call hernias are in fact delayed closures, which are extremely common in the Shih Tzu breed. Many champion show dogs have them and some breeders will produce entire litters where every puppy in the litter has them. We try not to produce hernias or delayed closures, but even when neither parent has them they can still be produced. A delayed closure will reduce and sometimes close on their own, a true hernia will not. Delayed closures are much more common than actual hernias. We call them hernias because it is the most recognized term by most veterinarians and also because we just can not make the distinction between a hernia or a delayed closure on a very young puppy.
Hernias feel and look like outie belly buttons and for the most part are purely a cosmetic flaw, which a dog can live their whole lives with having, especially if they are a delayed closure. They feel like a small bump on the belly button area and that is soft and can easily be pressed in. As humans, we all have belly buttons, where our umbilical cords were attached to our mothers. For most of us, the spot on our stomachs where our umbilical cord was attached to our mothers, heals into what we refer to as our belly buttons. I don't know of any human who has ever had their belly button "repaired" or "closed". An umbilical hernia or delayed closure on a dog is much like human outie belly buttons. An umbilical hernia will most typically reduce itself as the puppy grows and will look like an outie belly button. A delayed closure will typically reduce itself so significantly that it will look and feel much more like an innie belly button than an outie.
Some vets will also sometimes refer to a delayed closure as a reducible hernia. It is very difficult to distinguish between a umbilical hernia and a delayed closure, unless the hernia is particularly large. What we have noticed a subtle difference between delayed closure and reducible hernias in comparison hernias however. Hernias which may close or may reduce in size are soft and when you press on them will often temporarily recede back into the belly button area.
Delayed closures are very common in the Shih Tzu breed and are most typically caused by either the mommy dog or ourselves cutting the cord too short. In comparison to true hernias, delayed closures and reducible hernias are thought to not be inherited and are caused by "trauma" to the umbilical cord during whelping. Shih Tzu are a very flat faced breed therefore often will cut cords too short, due to both their flat face and uneven bite. Most of what we call hernias, are actually tiny bubbles of fatty pockets which are slowly closing and these fatty pockets are located in either the belly button area ( for umbilical hernias, which are most common) or in the groin area ( for inguinal hernias.)
Umbilical Hernias ( can be delayed closures):
We typically see them appear at somewhere between 2-6 weeks of age. Once in a great while one may pop out later. While they are not a health issue , per say, they are included here because of how common they are. They are a cosmetic "flaw" only and your can dog can live its entire life with MOST types of hernia and it will not impact their lives in any way. Many people will choose to have hernias or delayed closures "repaired" at the time of spay or neuter. It is very easy for most vets to repair a small umbilical hernia and is really only a few extra stiches. The cost for a hernia repair will vary by location and veterinarian but our past clients have paid anything from no cost to $100 for this to be done. Most vets average between $25-$50 extra dollars. If you are quoted more than $100 than you need to call other vets and find one who is more comfortable doing this and therefore charges less. Hernias are VERY common in many different breeds and it would be a red flag for me if I didn't feel a vet was familiar with them. You should be concerned about a hernia if it is very large and hard, this is extremely rare ( we have yet to experience it for ourselves) but should it happen to you please seek medical attention. In all other hernia cases they can wait to be "repaired" the time of spay/neuter.
Inguinal Hernias:
Please keep in mind that you can not tell if your puppy has a true inguinal hernia until they are at least 5 months of age. Dogs with true inguinal hernias should not be bred but for the most part what appear to be inguinal hernias are in fact fatty pockets. An Inguinal Hernia is the result of the abdominal organs, fat or tissue which is protruding through the inguinal ring. They feel like small bulges and are located in the groin area and can be either bilateral or unilateral. They are generally soft and can be pushed back in. If the inguinal hernia (s) are hard, very large or do not push back in, please seek vet attention. Otherwise, these can be repaired at the time of spay or neuter. Some tiny inguinal will close up on their own. If your dog has a fatty pocket rather than a hernia, the fatty pocket will close on its own. Fatty pockets are generally common especially with chubby puppies and the puppies will out grow this as they age.
We have found vets in general to be much less familiar with inguinal hernias the umbilical. While you should expect an extra cost to repair one of these I have heard some crazy price quotes. My recommendation is to shop around. Talk to different vets and not only get price quotes but also talk to them about past experience with inguinal hernias. Some vets just do not have the experience or the comfort to repair these. From my understanding they shouldn't be that much harder to repair than an umbilical hernia but because they are much less common than umbilical's it can be harder to find a knowledgeable vet who will repair them at a reasonable price.
If the inguinal hernia does not close on its own you should not breed a female with this issue, because not only can it be hereditary but it can also be dangerous to both the female and puppies during whelping.
There are several different types of hernias so if you would like to read about them further please refer to the following articles which are both great resources:
http://www.showdogsupersite.com/kenlclub/breedvet/umbilical.html
Stenetoic Nares, Pinched Nostrils, Tight Nostrils during teething and Reverse Sneezing
Stenetoic Nares, Pinched Nostrils, Tight Nostrils ( during Teething), and Reverse Sneezing are all terms are something used interchangeably but in reality are very different things. We have seen other breeders and even vets mix these things up. Some vets have misdiagnosed puppies as needing very expensive surgeries only to see that same puppy weeks later and be amazed that their nostrils had open and no longer needed the surgery. Some puppies have been misdiagnosed as being ill or having allergies, one vet even misdiagnosed a puppy as having asthma.
Stenetoic Nares-
Stenetoic nares is the most serious of these conditions. Puppies are born with stenotic nares which are caused by the malformation of the nose cartilage which can happen with brachycephalic breeds. Stenetoic Nares are present at birth though occasionally they are not noticed immediately. Puppies are born with Stenetoic nares which are caused by a malformation of cartilage which can block the dog's upper respiratory tract. This is a condition which can happen with the
brachycephalic breeds. This condition is characterized by a defect in the flow of air through the dog's upper respiratory tract. Puppies with sten tic nares, also sometimes called collapsed nostrils, process small, narrow nasal openings with floppy nasal cartilage. These abnormal aberrations often cause the nostrils to collapse as the puppy take in air during inspiration. The collapsed nostrils lead to obstruction of the dog's airways which is manifested by noisy breathing, mouth breathing and sometimes nasal discharge.
Puppies suffering from severe cases of Stenetoic nares may have flattened chests and sometimes the nostrils are so tight and the nasal openings are so narrow that the nose is nearly closed. Because this condition is present at birth and the nostrils are so tight the puppy often has trouble nursing because they sometimes are unable to nurse and breathe at the same time. In this case the puppy can hardly breathe and will often have slow to no weight gain and is much more prone to get pneumonia, for example. Many of these puppies do not even make it to weaning time. I have not personally had one of these though I have seen a couple of pictures. These puppies should NOT be bred, their siblings should not be bred and their parents should not be bred together again either. Should the puppy live the puppy will very likely need surgery to enlarge the nasal openings in order to improve the dogs' respiration. The surgical procedure involves the removal of the cartilage and skin of the nose. in some cases, the nasal cartilage may harder satisfactorily before the puppy reaches six months of age.
Pinched/ Tight Nostrils during Teething
Shih Tzu have full dentition for tiny little mouths. People are surprised at how strong the jaws of Shih Tzu are and how strong their bite is for their size. I have a friend with a Boxer that has an incorrect bite, we have been surprised to watch our little Shih Tzu eat treats and chew sticks that larger dogs are not able to. Shih Tzu have what is called a reverse scissor bite. What this means is that the bottom teeth should be just slightly behind the top teeth. This is referred to as an under bite. We do not like or breed for dogs that have large under bites where their teeth show all the time or they can not properly close their jaw.
Shih Tzu teeth very slowly, sometimes they are still teething at six months old. Because they have a lot of teeth for tiny little mouths their noses will often swell and tighten during teething. The nostrils may appear pinched but will gradually widen and open back up again as the puppy grows. During this time the puppy may have clear discharge on their nose. They may snore, snort, sniffle or make noises which found very much like a pug dog. I have found the difference between a Shih Tzu versus a pug for example is that a Shih Tzu almost always out grow these symptoms while a pug will often have them for a lifetime. I have heard of some Shih Tzu who snore but the majority do not. I am a very light sleeper and the Shih Tzu have slept in bed with me or in my room and I have never been woken up to snoring or other similar noises.
While the Shih Tzu is teething you will typically hear the noises more often when your puppy is playing hard or nervous. Part of how you can distinguish your Shih Tzu teething symptoms versus a puppy who is actually sick, is by looking at the following list.
A teething Shih Tzu versus a sick Shih Tzu
1. A teething Shih Tzu will not be running a temperature or fever
2. A teething Shih Tzu will play and act normally, a sick Shih Tzu will be lethargic and listless
3. A teething Shih Tzu will have a normal appetite, a Shih Tzu who is sick will eat very little or not at all and may vomit or have diarrhea
4. Any discharge from the nose will be clear on a Shih Tzu who is teething, a sick Shih Tzu will have mucus colored discharge.
5. A puppy who is teething typically rests peacefully and often loves to find things to chew when awake.
Please note: We have had many puppies who we never see any of the teething symptoms with. We have had other puppies who might have only one symptom. Common sense and behavior are telltale signs of your puppies health and by using these as well as educating yourself you should know if your puppy is just teething or if there is a further problem.
Reverse Sneezing
Sometimes you will hear a puppy reverse sneeze and they will continue to reverse sometimes during teething ( some grow out of it) but often Shih Tzu will not begin reverse sneezing until they are a mature adult. I have had some that didn't begin to do this until they will already a few years old.
What is a Reverse Sneeze?
When you sneeze, air is pushed out through the nose. When your dog reverse sneezes, air is pulled rapidly and nosily through the nose sounding much like honking, snorting, gasping or even an asthma attack. Many Shih Tzu owners mistake the sound for an asthma attack or chocking. The first time I ever heard it I thought my dog was chocking to death. It probably lasted a minute but felt like five. I was just calling the vet to rush her in and she stopped and looked at me with her tail wagging. I learned that this particular dog did this occasionally when she got really excited. Sometimes she would do this a couple times in a single day, other times it would be six months between reverse sneezes. Reverse sneezing is more common in small dogs than large dogs. For some dogs this is a totally normal event. Just as sneezing is part of everyday life, reverse sneezing is also part of every day life. If a dog is alone and has a reverse sneezing attack it will stop on its own. If you are with them while they are having a reverse sneezing attack, remain calm. Pet them and try to reassure them that everything will be okay. Our dogs are sensitive to our reactions and if you remain calm and help calm your pet down the reverse sneeze will be much shorter.
Joint issues
"Loose knees or Joints"
It is amazing how quickly puppies go from newborn puppies weighing just a few ounces or so to being a running, playing silly puppy just weeks later. Not every puppy develops the same way and sometimes joints don't develop as quickly as puppies do. I like to think of it like horses, sometimes a yearling will be 16 hands ( very tall) at that age, but despite that height we don't start riding them at that age because their knee caps haven't closed and their joints haven't closed and severe damage can be done to them by riding them to early. Puppies, particularly tiny puppies or very large breed dogs are the same way. Sometimes their joints are not fully closed at 8 weeks, and their knee caps may still be a bit loose. This is NOT the same as luxating patella, which is an inherited condition. Luxating Patella are rated on a 1-5 scale. Puppies with loose joints which will later correct as the puppies age, will be rated as 1 if the vet were to give a rating. Most puppies that have been given a 1 should outgrow this, but if there is more than one puppy in the litter or the vet suspects an actual luxating patella, than the parents should be rechecked ( to make sure they don't have this condition themselves) and shouldn't be bred together in the future.
Luxtating Patellas ( Not a breed tendency, could be considered a health issue depending on severity)
Remember, even if every breeding dog in the breeding program has great knees, they could still be a carrier for luxtating patellas BUT you are much more likely not to produce luxtating patellas if you dogs do have great knees and joints. We breed for strong bone and substance in a smaller package. Our dogs are not fragile. Even our tiniest adults have short legs, wide bodies and thick bones in proportion to their tiny sizes. I have seen Imperials with fine bones and they do not have any place in our breeding program.
Luxtating patella is a condition where the knee or patella joints dislocates and generally occurs in smaller breeds under 22 pounds. Though Luxtating patellas do periodically occur, they are generally mild. Not all luxtating patellas need medical intervention and the majority of time low grade luxtating patellas have little if any impact on the dog's every day life. Luxtating Patellas are given different grades. Grades 1-2 are considered very mild and it is likely that the dog will out grow this as they mature and their joints fully close. Even if as an adult they still have a luxtating patella of 1-2 it is unlikely to cause more than an occasional lameness or misstep. If a dog has a grade 3-4 they should be taken to a vet, who will likely do x rays and other similar testing to determine how serious the issue is. This could be potentially very serious and may need surgery or other medical intervention, because this can potentially cause long term damage to the dog's joints and can also be very painful for the dog.
Heart Murmurs ( in puppies)
Before becoming a breeder if I had heard the word heart murmur and puppy in the same sentence I might have panicked. Now, after having bred for awhile, I have been made aware that very low level heart murmurs in young puppies is much more common than originally thought. Probably because of the word "heart" this isn't something that breeders like to talk much about. But murmurs can be caused by growing pains or nerves or a low level murmur can be something that an animal lives with their whole lives and doesn't bother them in any way, like humans with low level murmurs. Heart murmurs are in extra vibrations which are produced as a result of a disturbance in the blood flow, enough to cause an audible noise.
Occasionally a vet will hear a "heart murmur" in a young puppy, otherwise healthy active puppy. If the murmur is a level one it is typically caused by excitement, nerves, stress and fear that the puppy is experiencing while at the vet. We have had a few that have had this and kept them an additional time and brought them back to the vet for a recheck only for the vet to never hear it again. In fact, we have never had a single puppy that has had a level one heart murmur where the murmur didn't go away within a couple weeks at most.
Though a level two heart murmur is still a very low murmur and also typically doesn't pose an issue, our belief is that the dog should be taken to a cardiologist to get an EKG or ultrasound to find out what is causing the murmur. It may be nothing, could be something medication will help or there is always a chance that it could be more serious. That is why it is our policy that anything above a level one heart murmur goes to a cardiologist.
Grading Scale for Murmurs
Grade I—barely audible
Grade II—soft, but easily heard with a stethoscope
Grade III—intermediate loudness; most murmurs which are related to the mechanics of blood circulation are at least grade III
Grade IV—loud murmur that radiates widely, often including opposite side of chest
Grade V—very loud, audible with stethoscope barely touching the chest; the vibration is also strong enough to be felt through the animal's chest wall
Grade VI—very loud, audible with stethoscope barely touching the chest; the vibration is also strong enough to be felt through the animal's chest wall
Open Fontanels ( soft spots)
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 Fontanels does NOT make the puppy more prone to a rare condition called hydrocephalus. The soft spot will close slowly on its own and the puppy doe snot need any special care other than not being dropped directly on their head.
Hypoglycemia
Hypoglycemia-
A little note about Hypoglycemia. If you have done any reading on the internet you have likely read about Hypoglycemia and how tea cup puppies are unhealthy and are prone to it. We do everything we can to not send home puppies who have recurring hypoglycemic attacks. This is the primary reason that we will not send a puppy home, not matter what its age, until it has reached at least two pounds. Puppies who have not reached at least two pounds can not regulate their blood sugar yet. We do not force our puppies to wean. Every puppy is an individual and is treated as such. Some puppies have interest in food at 4 or 5 weeks of age, others have no interest at all. Some of the puppies are eating or sampling food but are not anywhere near weaning at 8 weeks, others are fully weaned at the at time. Our puppies do not go home at 8 weeks so it is no big deal to us if they are weaned our not. Since we take our time weaning, hypoglycemia is almost never an issue during weaning time for us.
Hypoglycemia can occur in any age or size dog but most typically occurs in tiny puppies. Hypoglycemia attacks is often blamed when dogs little dogs have similar symptoms. Speaking from personal experience I highly recommend working with your vet to try to discover the source of this issue rather than just say the dog has hypoglycemia issues. I say this not to scare you because it is very common for tiny puppies of many different breeds to have hypoglycemia issues, but some of the symptoms can also be symptoms to a more serious issue. A very tiny dog should not have to live on medication or have frequent hypoglycemic issues. If this is happening with your dog I recommend to start with a complete vet check and a fecal sample. I then recommend a liver shunt panel and bile acid test. I have also found a round of antibiotics and making a temporary switch to antioxidant food to be in some cases lifesaving. Even our tiniest dogs have normal diets and are not prone to having hypoglycemic attacks.
Preventing Hypoglycemia: You can help prevent hypoglycemia by making sure he or she is getting small, frequent meals. While we hold onto our little ones longer to ensure that they are able to eat hard food by themselves, are consistently gaining weight and don't require 8 feedings a day they are still a lot like bringing a newborn baby home. Most of our puppies will need to be fed 2 or 3 times daily but some of our tiniest babies may need to eat 3 or 4 times a day because their little tummies and their appetite may be better with smaller more frequent feedings. Puppies will need access to plenty of fresh, clean water, especially after playing. even though it is very exciting having a new little one in the house puppies of all sizes need plenty of rest. They should not be brought out in public until they have finished their complete shot series at about 4 months of age. This not only prevents hypoglycemia and other germs but is mandatory to prevent parvo, which highly contagious and deadly.
If Hypoglycemia occurs : Sometimes no matter how careful you are a puppy may still have a hypoglycemic episode. You need to act FAST! You need to get sugars and fluids into your puppy very quickly!! While Nutrical is best, sugar water, Karo syrup, honey, even regular syrup needs to be administered as soon as possible. Start with a very small amount under the tongue and continue to give a little bit more every 5- 10 minutes or so until your puppy comes out of it completely. Sugar shock can be a very scary thing so your best course of action is prevention!
Stool eating
If I had to pick a fault in the breed I would pick this one as Shih Tzu, particularly puppies, are very prone to this. Because of stool eating puppies will often require another round of worming after they go their new homes. My recommendation is to keep stool picked up as soon as you see your dog go the bathroom and if you see them eating stool let them know that this is not okay behavior.. The vets also sell a product called Forbid which is very effective. I use Accent, which can be purchased at the grocery store. It has the same active ingredients as Forbid but is a fraction of the price. This needs to be sprinkled on all dogs food whose feces are getting consumed, not just the one doing it. I have also heard of others having great success with feeding pineapple tidbits or with pumpkin. There is not unfortunately a one solution fits all with stool eating.
Vaccine Reactions
It was surprising to find out that a Great Dane and a Chiuahua get the exact same dose of a vaccination. Unlike antibiotics or other medications which are dosed by weight, vaccines are used to simulate an immune system, which is not something measured by weight.
We always wait a few days after the puppies have had their vaccines before sending them home, and are careful to mointer them for reactions to vaccines. Sometimes you may notice a small bump on their shoulder blade. This is a mild reaction to the shot ( swelling of the skin) and will take a few days to a week or so to gradually go down. Sometimes the puppies lymph note may swell slightly as well. These are considered normal, minor reactions and will go away on their own.
What we have noticed about small dogs, is that shots need to be given one at a time. Do not give Rabies and the DHPP shot at the same time. Our vets reccomend that puppies get a series or DHPP shots beginning at 8 weeks of age and spaced every four weeks apart. Some vets give 3 shots to complete the series, other vets give 4. The vets may offer you a choice of a either giving a 5 way shot or giving a 7 way shot. The seven way shot contains Lepto and Corona. We DO NOT give Seven way vaccines! Small/ toy dogs often have severe reactions to these shots including life threatening reactions. We are so serious about not giving our puppies Lepto that if you do so, you violate out health contract.
Please discuss this vaccination schedule with your veterinarian before getting any vaccinations for your tiny puppy. Any ethical veterinarian that really cares about the well being of your pet should be willing to listen and discuss any alternate treatments with you. If your vet is unwilling to discuss this information with you , then for the health and safety of your pet, you should find another vet..