Shih Tzu Health Problems: What a Large Vet Study Found
How we researched this guide: This article is built around a 2024 Royal Veterinary College VetCompass study of Shih Tzus under primary veterinary care in the UK, plus the Merck Veterinary Manual. It is not a substitute for an exam. Last reviewed: September 2026.
What health problems do Shih Tzus really get? The best answer comes from a large 2024 study by the Royal Veterinary College (RVC). Researchers reviewed the veterinary records of Shih Tzus seen in UK general practices, using the VetCompass program.
The headline is encouraging. The authors concluded that Shih Tzus appear to be relatively long-lived, with a median age at death of 12.7 years. But the study also found clear breed weak spots, especially teeth, eyes, and anal glands.
The Most Common Problems in Shih Tzus
| Problem | Share of Shih Tzus affected in one year | Our guide |
|---|---|---|
| Periodontal (gum) disease | 9.5% | Teeth care |
| Anal sac impaction | 7.4% | Poop and anal glands |
| Ear disorders | 5.5% | Ear care |
By broader group, the study found skin problems in 16.6 percent of Shih Tzus, dental problems in 13.3 percent, and eye problems in 11.9 percent.
The researchers also reported that Shih Tzus had a higher prevalence of anal sac impaction, umbilical hernias, and eye problems than previously reported in dogs overall. They highlighted oral hygiene as a healthcare priority for the breed.
1. Dental Disease
Periodontal disease was the single most common problem in the study. Daily brushing, dental chews with the Veterinary Oral Health Council seal, and regular vet dental exams make a big difference. See our treats guide for dental chews.
2. Skin Problems
Skin conditions were the most common group overall. Itching, redness, and recurring infections are often linked to allergies. Read our itchy skin guide and our guide to food for allergies.
3. Eye Problems
Shih Tzus have large, prominent eyes and short faces, which leave the eyes more exposed to injury and dryness. Eye problems affected almost 12 percent of the dogs studied. Squinting, redness, cloudiness, or discharge always need a prompt vet visit. See our eye care guide.
4. Anal Sac Problems
Anal sac impaction was the second most common specific problem. Scooting, licking under the tail, or a fishy smell are common signs. Our poop and anal gland guide explains when to see a vet.
5. Ear Problems
Hairy, heavy ears can trap moisture and debris. Head shaking, scratching, odor, or discharge are signs to watch for. See our ear care guide.
Other Conditions Every Owner Should Know
- Breathing problems. As a short-faced breed, Shih Tzus can have breathing difficulties. See our breathing problems guide.
- Umbilical hernias, which the RVC study found more often in Shih Tzus. See our umbilical hernia guide.
- Bladder stones. The Merck Veterinary Manual lists Shih Tzus among breeds more commonly affected by calcium oxalate stones. See our urinary problems guide.
- Kidney disease, including juvenile renal dysplasia. See our kidney disease guide.
- Digestive problems. See our vomiting guide.
- Cancer, more common with age. See our cancer guide.
What Shih Tzus Died Of
In the RVC study, the most common grouped causes of death were enteropathy (bowel disease), heart disease, and poor quality of life, each accounting for 7.9 percent of recorded deaths. Regular senior checkups help catch problems early. See our senior care guide.
How to Keep Your Shih Tzu Healthy
- Brush teeth daily and schedule dental checkups.
- Groom regularly and check skin, eyes, and ears each week.
- Keep your dog at a healthy weight.
- Visit your vet at least once a year, and once or twice a year for seniors.
- Buy from breeders who health-screen their dogs, or adopt from a reputable rescue.
- Learn the emergency warning signs that need a vet right away.
Safety first: Go to a vet right away if your Shih Tzu has trouble breathing, blue or gray gums, collapses, has a seizure that lasts more than 5 minutes, strains to urinate with little or no urine, vomits again and again, or has a sudden eye injury or cloudy eye. Small, short-faced dogs can get worse fast.
Frequently Asked Questions
What are the most common health problems in Shih Tzus?
A 2024 Royal Veterinary College study found that the most common specific problems were periodontal disease (9.5 percent), anal sac impaction (7.4 percent), and ear disorders (5.5 percent). Skin, dental, and eye problems were the most common groups.
Are Shih Tzus a healthy breed?
Largely, yes. The RVC study concluded that Shih Tzus appear relatively long-lived, with a median age at death of 12.7 years. They do have breed weak spots, especially teeth, eyes, and anal glands.
What do Shih Tzus usually die from?
In the RVC study, the most common grouped causes of death were bowel disease, heart disease, and poor quality of life, each at 7.9 percent of recorded deaths.
Why do Shih Tzus get so many eye problems?
Their large, prominent eyes and short faces leave the eyes more exposed to injury and dryness. Any redness, squinting, cloudiness, or discharge needs a prompt vet visit.
How can I prevent health problems in my Shih Tzu?
Brush teeth daily, groom and check eyes, ears, and skin regularly, keep your dog at a healthy weight, and schedule regular vet checkups.
Sources
- Dale F, Brodbelt DC, West G, Church DB, Lee YH, O’Neill DG. Demography, common disorders and mortality of Shih Tzu dogs under primary veterinary care in the UK. Companion Animal Health and Genetics, 2024
- Merck Veterinary Manual: Urolithiasis in dogs
This article is for general information. It is not a substitute for advice from your veterinarian. Read our medical disclaimer.
