Why Does My Shih Tzu Shake? 11 Causes and When to Worry
How we researched this guide: This article is based on the American Kennel Club, VCA Animal Hospitals, and the U.S. Food and Drug Administration. It is not a substitute for an exam. Last reviewed: September 2026.
Small dogs like Shih Tzus shake for many reasons. Some are harmless, like excitement or feeling cold. Others, like poisoning or low blood sugar, need a vet right away. The key is to look at what else is happening.
Call your vet or an emergency clinic now if shaking comes with: collapse, weakness, vomiting, stumbling, seizures, trouble breathing, or signs your dog ate something toxic. If you think your dog ate chocolate, xylitol, or another toxin, call your vet or a pet poison helpline immediately.
Common, Usually Harmless Causes
- Feeling cold. Small dogs lose body heat quickly. A sweater and a warm bed can help in cold weather.
- Excitement. The AKC notes that happy dogs often tremble in anticipation, for example before a walk or meal. It stops once the excitement passes.
- Drying off. A wet dog shakes to shed water. The AKC notes a dog can shake off about 70 percent of the water in its coat in just four seconds.
Causes That Need Attention
Stress, Fear, and Anxiety
The AKC calls shaking a classic sign of stress in dogs. Vet visits, storms, fireworks, or being left alone can trigger it. If your Shih Tzu often shakes when alone, see our Shih Tzu anxiety guide.
Pain or Nausea
Dogs in pain or feeling sick may shake. The AKC notes that a nauseous dog may shake. Look for other signs such as drooling, lip licking, hunching, limping, or not wanting to be touched.
Ear Problems
Frequent head shaking can point to an ear infection, especially if the ears are red, smelly, or dirty. Shih Tzus have hairy ear canals that can trap moisture. Read our Shih Tzu ear care guide.
Low Blood Sugar
The AKC notes that low blood sugar can cause shaking, especially in toy breeds and puppies. Young Shih Tzu puppies that skip meals are at risk. Diabetic dogs on insulin can also develop low blood sugar. This is an emergency.
Poisoning
Chocolate, xylitol, and some other toxins can cause trembling and seizures. The FDA warns that xylitol can cause a dangerous drop in blood sugar in dogs within 10 to 60 minutes. Call your vet or a pet poison helpline right away.
Old Age
The AKC notes that senior dogs may tremble as they lose muscle and find it harder to stay warm. Tremors in older dogs can also come from pain, such as arthritis. See our senior Shih Tzu care guide.
Generalized Tremor Syndrome (“Shaker Syndrome”)
VCA explains that shaker syndrome is most common in small white breeds but can affect any dog. It usually starts between one and two years of age. Tremors may affect the head or the whole body and often ease during rest. It is diagnosed by ruling out other causes, and VCA notes that most dogs improve within one to two weeks of starting prednisone.
Seizures and Distemper
The AKC notes that seizures can look like uncontrollable shaking, often with collapse and loss of awareness. Canine distemper, a contagious virus in unvaccinated dogs, can also cause tremors. Learn how to tell tremors from seizures in our Shih Tzu seizure guide.
How to Tell What Is Going On
| What you see | Likely cause | What to do |
|---|---|---|
| Shaking before a walk or treat, then stops | Excitement | Nothing, this is normal |
| Shaking outside in cold weather | Cold | Warm your dog up, use a sweater |
| Shaking at the vet, in storms, or when alone | Stress or fear | Comfort, training, talk to your vet |
| Shaking plus head tilting or scratching at ears | Ear problem | Book a vet visit |
| Shaking plus limping, hunching, or drooling | Pain or nausea | Book a vet visit soon |
| Shaking plus weakness, stumbling, or collapse | Low blood sugar, toxin, or other emergency | Go to a vet now |
| Shaking with loss of awareness or paddling legs | Seizure | Keep your dog safe and call your vet |
How to Help a Shaking Shih Tzu
- Stay calm and speak softly.
- Move your dog to a warm, quiet place.
- Check for other signs, such as vomiting, weakness, or pain.
- Think about what your dog may have eaten.
- Write down when the shaking started and how long it lasted, or take a short video.
- Call your vet if you do not know why your dog is shaking, as the AKC recommends.
Frequently Asked Questions
Why is my Shih Tzu shaking?
Common reasons include cold, excitement, stress, pain, and nausea. More serious causes include low blood sugar, poisoning, ear problems, shaker syndrome, and seizures. If you do not know why your dog is shaking, call your vet.
Is it normal for a Shih Tzu to shake?
Brief shaking from excitement or cold is normal. Shaking that lasts, keeps coming back, or comes with other signs such as vomiting or weakness is not normal and needs a vet check.
When is shaking an emergency?
Go to a vet right away if shaking comes with collapse, weakness, stumbling, vomiting, seizures, or trouble breathing, or if your dog may have eaten something toxic.
What is shaker syndrome?
It is a condition that causes body tremors, most often in small white breeds, starting around one to two years of age. VCA notes that most dogs improve within one to two weeks of treatment with prednisone.
Why does my old Shih Tzu shake?
Older dogs may tremble due to muscle loss, feeling cold, or pain such as arthritis. Tell your vet so they can check for pain or other health problems.
Sources
- American Kennel Club: Why is my dog shaking?
- VCA Animal Hospitals: Shaker syndrome in dogs
- U.S. Food and Drug Administration: Paws off xylitol, it is dangerous for dogs
This article is for general information. It is not a substitute for advice from your veterinarian. Read our medical disclaimer.
