Shih Tzus are generally healthy, but like all breeds of dogs, they're prone to certain conditions and diseases:

• Allergies are a common ailment in dogs. There are three main types: food allergies, which are treated by eliminating certain foods from the dog's diet; contact allergies, which are caused by a reaction to a topical substance such as bedding, flea powders, dog shampoos, or other chemicals; and inhalant allergies, which are caused by airborne allergens such as pollen, dust, or mildew. Treatment may include dietary restrictions, medications, and environmental changes.
• Canine hip dysplasia, an abnormal formation of the hip socket that can cause pain and lameness.
• Patellar luxation, which means dislocation (luxation) of the kneecap (patella). The knee joint (often of a hind leg) slides in and out of place, causing pain. This can be crippling.
• Juvenile renal dysplasia (JRD) is a genetic defect of the kidneys seen in young dogs. The dog is excessively thirsty and urinates frequently. He loses weight, vomits, and lacks vigor. Currently, there is only one definitive test for the disease that can be performed on breeding dogs--a wide-wedge biopsy of the kidney, which is very invasive and carries a lot of risk. There have been swab tests developed by geneticists, but, to this date, none of them appear to be 100 percent reliable.
• Bladder stones and bladder infections can be caused by many factors, such as excessive protein, magnesium, and phosphorus in the diet, or long periods of time between urination. Bladder infections can be caused by bacterial or viral infections. If your Shih Tzu needs to urinate frequently, has bloody urine, seems to have difficulty urinating, or suffers a loss of appetite, take him to the vet for a checkup.
• Eye problems are not uncommon among Shih Tzus because their large eyes bulge. Disorders include keratitis, an inflammation of the cornea that can lead to a corneal ulcer and blindness; proptosis, when the eyeball is dislodged from the eye socket and the eyelids clamp behind the eyeball; distichiasis, an abnormal growth of eyelashes on the margin of the eye, resulting in the eyelashes rubbing against the eye; ectopia cilia, a condition similar to distichiasis; progressive retinal atrophy, a degenerative disease of the retinal visual cells that progresses to blindness; and dry eye (keratoconjunctivitis sicca), a dryness of the cornea and the conjunctiva. Contact your vet right away if you notice any redness, irritation, or excessive tearing.
• Ear infections strike the Shih Tzu because his drop ears create a dark, warm ear canal--a perfect environment for infection. Check and clean the ears weekly to avoid problems.
• Retained baby teeth and tooth and gum problems are not unusual because the Shih Tzu's baby teeth may remain intact when the permanent teeth emerge. Sometimes it is necessary for the veterinarian to extract the baby teeth. Because of the Shih Tzu's undershot jaw, he also can have missing or misaligned teeth. It's important to brush puppy teeth regularly and report dental problems, such as bad breath and loose teeth, to your veterinarian.
• Umbilical hernias are common among Shih Tzus. Quite often, these are caused by delayed closure of the abdominal midline. If the hernia is small, it may close as the puppy matures. Sometimes surgery is necessary to correct it, usually while the puppy is being spayed or neutered.
• A portosystemic liver shunt is a congenital abnormality in which blood vessels allow blood to bypass the liver. As a result, the blood is not cleansed by the liver as it should be. Surgery is usually the best treatment.
• Snuffles mayplague the Shih Tzu because teething tends to be difficult. At about four months, the gums swell; since the gums are directly under those pushed-in noses, there isn't a lot of room. Puppies may snort, snuffle, snore loudly, or wheeze during this time, and may even have a clear nasal drainage.
• Reverse sneezing occurs when the dog is overly excited, gulps his food too fast, or allergens are present. Nasal secretions drop onto the soft palate, causing it to close over the windpipe. The dog makes a wheezing sound and may become alarmed. Talk soothingly to him and try to get him to relax to shorten the episode. Some say that pinching the nostrils closed, so the dog is forced to breathe through its mouth, is the quickest way to stop the reverse sneezing.

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