Shih Tzu

Katie Grzyb, DVM
By Katie Grzyb, DVM on Dec. 6, 2022
white and brown shih tzu lounging on couch

In This Article

General Care

The Shih Tzu is a Tibetan toy breed born to be a furry companion. This breed dates back to the 15th century, though the dogs weren’t formally recognized by the American Kennel Club until 1969. These little “lion dogs,” as their name means, were associated with Buddhism and, because Tibet did not have indigenous lions, the spiritual leaders bred their dogs to look like lions, according to the Shih Tzu Club. Imperial rulers bred this type of dog to alert people of visitors with their sharp bark.

Eventually, this breed became a companion animal instead of a working dog, as people in China began breeding them with Western breeds such as Pugs and Pekingese. The first breeding pair of Shih Tzu was exported to England around 1930, and the breed made its way to the U.S. in the following decades. Shih Tzu quickly became popular with the upper class and remain one of the most popular dog breeds in the United States.

The Shih Tzu is an active and friendly breed. They are sturdy dogs, weighing anywhere between 9–16 pounds with an average height of 10 inches. They have long, smooth haircoats, a squished muzzle, a pronounced underbite, and short, floppy ears. Their heads are round with bulbous, expressive eyes. 

Caring for a Shih Tzu

chart depicting shih tzu traits

Shih Tzu are pleasant, energetic companions. They are generally happy and sociable with people (and other animals!) of all ages and prefer to not spend their time alone. Shih Tzu should be socialized at a young age to avoid any anxiety, otherwise they might bark or dig.

This breed requires little exercise (less than 30 minutes daily) but they do enjoy getting out for short walks. Shih Tzu love to be spoiled with attention and treats; they love to please their pet parents and are usually quick to learn new tricks to get the treats and praise they crave.

Most of a Shih Tzu’s upkeep deals with his long, luxurious double haircoat that continuously grows. The dogs don’t shed much, but their coat is prone to tangling and matting. This coat is often shaved short into a "puppy cut” to avoid continuous grooming, because if left uncut, the fur can grow so long that it drags on the ground. If a Shih Tzu’s coat is kept longer, brushing and bathing will be a weekly chore, with professional grooming appointments sprinkled in every few weeks.

Another thing to know about Shih Tzu: They are brachycephalic, meaning they have a short, squished muzzle. This can put them at a higher risk for overheating or heat stroke, so they need to stay out of the hot summer weather.

Shih Tzu Health Issues

The average Shih Tzu lifespan is 10–18 years, and they are considered a healthy breed overall, though they can be prone to certain medical conditions. Some medical problems that this breed is predisposed to include:


Shih Tzu aren’t exactly athletes, and because of this, they can often become overweight. It’s important to limit treats and make certain that 20-30 minutes of controlled exercise—such as walks and playtime—are done daily. Obesity in dogs can lead to other issues such as diabetes, arthritis, heart disease, and difficulty breathing. 

Luxating Patellas

Patellar luxation is a condition where the kneecap slips out of its normal position, causing discomfort, limping, and eventually arthritis. Dogs with luxating patellas will be seen occasionally skipping and holding up a back leg during walking.

Often, the patella will return back to position on its own, but sometimes surgery is recommended in severe cases.

Periodontal Disease

Periodontal disease, or dental disease, is commonly seen in Shih Tzu dogs because their teeth can easily overcrowd their small mouths. This overcrowding leads to tartar and plaque development. Routine teeth brushing, professional dental cleanings, and surgical removal of any lingering baby teeth will help keep your Shih Tzu’s mouth healthy.   

Hip Dysplasia

Hip dysplasia results when the hip joints don’t properly fit together, eventually leading to arthritis, trouble walking, and pain. Hip dysplasia is often diagnosed via radiographs and treated with oral medications to decrease inflammation and pain, joint supplements, and in severe cases, surgery. 

Eye Problems

Shih Tzu have many inherited eye conditions, including glaucoma, chronic dry eye, and cataracts. Eye conditions can be quite painful, and signs include:

Contact a veterinarian if you have any concerns about your dog’s eyes.

Liver Shunts

Portosystemic shunt (PSS) is a liver disease that causes toxins the blood stream to bypass the liver, the organ that normally filters these toxins out of the body. The toxins build up, eventually causing chronic gastrointestinal issues, stunted growth, and even neurologic signs such as ataxia (a “drunken sailor gait”) or seizures

Blood testing is performed to diagnose this condition, along with abdominal imaging and often surgery to repair the shunt, if possible.  Diet changes and oral medications can also be used to manage dogs with milder signs.

Ear Infections

Shih Tzu ears are floppy, which presents two issues:

  • It does not allow air flow into the ear canals

  • It allows fur to grow inside of their ears

This combination can trap moisture in the ears, leading to red, painful, or itchy ears. Your veterinarian will assess for ear infections with a thorough examination and by obtaining a sample to assess for bacteria or fungus. These infections are often treated with topical and/or oral medications.


This is a type of kidney disease that’s inherited in this breed. It causes excess protein to be lost from the body and may cause the kidneys to malfunction at an early age. Clinical signs can include:

  • Lack of appetite

  • Vomiting

  • Diarrhea

  • Increased thirst and urination

  • Weight loss

  • Muscle wasting

Chronic therapy with diet changes, oral medications, and sometimes fluid therapy is required for treatment.

Brachycephalic Syndrome

Dogs with flat faces, such as the Shih Tzu, have brachycephalic syndrome. This is characterized by upper airway abnormalities such as:

  • Small nostrils

  • A long, soft palate

  • Collapsing trachea

  • Extra tissue in the back of the throat

All of these aspects can cause trouble breathing and make Shih Tzu more prone to overheating.  If severe, your veterinarian may discuss surgery to help correct some of these issues when your Shih Tzu is a puppy.

What To Feed a Shih Tzu

longhaired shih tzu terrier at a dog show
Photo credit: Adobe/justyna

Shih Tzu are prone to obesity, so it’s important to feed them a well-balanced diet and to avoid too many treats throughout the day. A twice-daily, balanced adult small bite diet is recommended. Pet parents should also feed their Shih Tzu dry kibble instead of canned food to lessen the risk of periodontal disease, as dry kibble is abrasive and can remove some plaque buildup.

How To Feed a Shih Tzu

Shih Tzu puppies should be fed frequent meals (about three or four every day) to avoid risks of hypoglycemia, depending on veterinary recommendations. High-fat, protein, and complex carbohydrate meals will lessen the risk of low blood sugar issues, and well-formulated puppy small breed diets usually contain all of these components.

How Much Should You Feed a Shih Tzu?

Your veterinarian can help to calculate the appropriate daily calories your pet should eat to avoid weight gain. When choosing a diet for your Shih Tzu, choose a small-breed food to allow for easy chewing.  These formulated diets will have recommendations for how much food to offer with each feeding. 

Nutritional Tips for Shih Tzu

Dog supplements that may support the health of this breed include omega fatty acids, which are heart-, brain-, skin-, and joint-healthy. Also, dental chews and supplements may be recommended by your vet to lessen the risk of periodontal disease.

Behavior and Training Tips for Shih Tzu

Shih Tzu Personality and Temperament

shih tzu running on a beach
Photo credit: Adobe/everydoghasastory

Shih Tzu are small in size but have big personalities. They make loyal, loving companions for families with children and other animals. Shih Tzu are playful, intelligent, and want to please their pet parents. They are quite adaptable and can range from a sedentary lifestyle cuddling indoors to a more adventurous walk in the park. No matter what you do, they just want to be with their people.  

Shih Tzu Behavior

Shih Tzu were originally bred to be “alert dogs,” and they will still bark to alert that someone or something new is coming into their environment all these centuries later. Despite their built-in alarms, they have a sweet disposition and need love and attention.

Shih Tzu Training

Shih Tzu are people pleasers and are usually easy to train. They prefer high-reward treats and positive reinforcement when training

Shih Tzu make wonderful emotional support dogs due to their small stature, loyalty, and calm spirit. They can be curious and dig if left unattended, so it’s important to monitor them closely in new or outdoor environments. 

Fun Activities for Shih Tzu Dogs

  • Walks

  • Backyard or indoor playtime

  • Learning tricks

  • Cuddling with their family

Shih Tzu Grooming Guide

white and tan longhaired shih tzu being groomed
Photo credit: Adobe/hedgehog94

Shih Tzu are minimal shedders, but don’t confuse that with having minimal grooming needs.

Skin and Coat Care

Because their coats grow long, making them prone to matting and skin irritation, Shih Tzu dogs need to be bathed once a week and brushed once or twice a week. Routine professional grooming should be part of your budget, to either maintain the long hair coat or to shave it into a cute Shih Tzu haircut periodically. 

Eye Care

A Shih Tzu needs the hair around his eye trimmed or pulled up with a hair tie to avoid any eye irritation.  Their eyes are prominent and can easily become inflamed if hair is allowed to rub against them.

Shih Tzu are a breed that can be prone to tear staining because of their flat face. Excessive tear production or blocked tear ducts lead to a buildup of a reddish-brown pigment at the inner corners of the eyes, often extending toward the muzzle. Keeping this area clean and dry is the best way to avoid staining. If staining is excessive or if your dog’s eyes are red, swollen, or painful, contact your veterinarian.

Ear Care

Shih Tzu dogs are prone to ear infections due to hair growing inside of their ear canals. This hair holds onto moisture, which can cause inflammation and infection by bacteria, fungus, or both. Routine cleaning with an ear cleaner that contains a drying agent is helpful to avoid moisture buildup. If excessive hair is noted inside the ear canals, your veterinarian or groomer may recommend removing it to avoid irritation. 

Considerations for Pet Parents

Shih Tzu do not require a great deal of exercise and are happy to just be with you. But it is necessary for this breed to find a home where their pet parents are willing to perform routine grooming. Like all dogs, they need attention and playtime to be happy. If you love them, they will love you unconditionally and try to please you in any way that they can.  As long as they are socialized at a young age, this breed is great with children and other animals as well. 

Shih Tzu FAQs

Is a Shih Tzu hypoallergenic?

Shih Tzu don’t shed much and are sometimes referred to as a “hypoallergenic” dog. But no dog is 100% hypoallergenic, as skin and salvia still contain allergens. That said, Shih Tzu can be a good fit for some people with dog allergies.

Potential pet parents should spend time with the breed to see how their allergies react before bringing home a Shih Tzu puppy.

How much does a Shih Tzu cost?

A typical Shih Tzu price ranges from $1,000–$3,000, depending on breeding lines.

How big do Shih Tzu get?

Shih Tzu are small dogs, weighing between 9–16 pounds and standing about 10 inches tall.

What were Shih Tzu bred for?

Shih Tzu were initially bred to alert monarchs and spiritual leaders of unwanted visitors, though it was soon discovered that their affectionate personalities made them great companion animals.

Featured Image: iStock/Drazen Zigic

Katie Grzyb, DVM


Katie Grzyb, DVM


Dr. Katie Grzyb received her Doctorate of Veterinary Medicine from Ross University in 2009. She continued her clinical training at...

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