Do Shih Tzus have health problems?

Known health concerns in Shih Tzus

These are the conditions most commonly seen in the breed — not guarantees, but things to be aware of:

• Brachycephalic Obstructive Airway Syndrome (BOAS): The flat-faced structure of the Shih Tzu causes narrowed nostrils, an elongated soft palate, and a narrowed trachea — which together restrict airflow. Symptoms include snoring, rapid breathing, exercise intolerance, and overheating. Mild cases are managed with weight control and limiting exercise in heat; severe cases require surgical correction. This is not a minor cosmetic issue — it affects quality of life.
• Eye conditions: Including dry eye (KCS), hereditary cataracts, and corneal ulcers. Annual eye checks at the vet are sensible, and reputable breeders will have eye test results for their breeding stock.
• Dental disease: Small breeds have the same number of teeth as large breeds in a much smaller jaw. Teeth are crowded, harder to clean, and more prone to plaque buildup and periodontal disease. Dental hygiene (brushing, dental chews, professional cleans) is important for small breeds.

How to reduce health risks in Shih Tzus

Most health problems are either hereditary (managed by choosing a responsible breeder) or lifestyle-related (managed by the owner). Here's what actually moves the needle:

• Choose health-tested parents: Ask breeders for relevant health test results — BOAS assessments, eye tests where relevant. A responsible breeder won't be offended.
• Maintain a healthy weight: Obesity is the most preventable health issue in dogs and it compounds everything — joints, heart, and lifespan. Weigh your Shih Tzu monthly and adjust food accordingly.
• Annual vet check-ups: Not just for vaccines. A thorough annual exam checks heart, weight, teeth, eyes, and joints. Most problems caught early are far cheaper and more treatable.
• Appropriate exercise: Regular moderate exercise keeps weight controlled and muscles supporting joints. Consistent exercise throughout life maintains condition better than irregular bursts.
• Pet insurance from puppyhood: Even a generally healthy Shih Tzu can develop a condition requiring expensive treatment. Insuring before any issues arise avoids pre-existing condition exclusions. Lifetime cover is worth the premium over accident-only policies.

The lifetime vet cost of a dog depends far more on diet, weight management, and preventative care than on the breed. A well-kept Shih Tzu will nearly always outlive and outperform a neglected one from the same litter.

Pet insurance for Shih Tzus

UK insurance for a Shih Tzu typically costs £20–£45 per month. Given their health profile, lifetime comprehensive cover is worth the premium. A single BOAS surgery or orthopaedic procedure can cost £3,000–£8,000 — significantly more than years of insurance premiums.

Premiums increase with age. Insuring at puppyhood locks in lower rates and prevents exclusions for conditions that develop later.