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The American Shih Tzu Club has a very nice section on Health issues in Shih Tzu. Click below for more information.


An umbilical hernia is the most common type of hernia found in puppies and is not a medical condition or cause for immediate concern. A hernia is a protrusion or bulge of a part of the body tissue, fat, or an organ through an abnormal opening of the surrounding tissue. There are numerous types of hernias, each type named after its affected area. A hernia which can be pushed back into the abdomen is called reducible. Hernias which are not reducible are called incarcerated. If the blood supply to an incarcerated hernia is pinched off, the hernia becomes strangulated. A strangulated hernia is an emergency situation and must be brought to the attention of your veterinarian. The most common types of hernias in Shih Tzu puppies are: An umbilical hernia is the most common type of hernia found in puppies. In case of umbilical hernias, a portion of fat or internal organs protrudes through an incompletely closed umbilical ring. Umbilical hernias may be present at birth, or may be acquired. The most common means of acquiring an umbilical hernia is a result of the umbilical cord being severed too close to the abdominal wall. In most cases umbilical hernias are small and reduce as the puppy grows. Generally, by the time the pup is six months old, the umbilical hernia will shrink and disappear on its own.

An inguinal hernia is the result of abdominal organs, fat or tissue protruding through the inguinal ring. Inguinal hernias are presented as skin-covered bulges in the groin. They can be bi-lateral, involving both sides and unilateral, involving only one side. Inguinal hernias are more common in females than males, but do occur in both sexes. As with umbilical hernias, most inguinal hernias will shrink and disappear as the puppy grows. Inguinal hernias can also occur in unspayed, middle-aged female dogs. This may occur as the result of stretching of abdominal tissue due to pregnancy.

Vets without a lot experience with the breed often make a big deal about them because they do not understand this breed or the breeds with these specific problems.


Shih Tzu puppies often suffer from pinched nostrils when they are teething. This can take place from about six weeks until approximately six months. Stenotic Nares is simply a term used when the nostrils are pinched upon examination. This term is used VERY frequently by vets and clients are encouraged by vets to do surgery to open the nasal passages. A sure sign of an inexperienced vet is one who examines a brachiocephalic breed and observes pinched nostrils during the teething stage and states the puppy needs surgery. 

Shih Tzu are bred to have flat faces and therefore the flatter the face the more likely your new puppy will suffer from pinched nostrils when he or she is teething. Just like human babies swelling takes place as the puppy teethes. Swelling of the bronchial tubes, gums, ear canals, and nostrils as well as a low grade fever, are all common. Snorting and stuffy sounds accompanied by tearful eyes and a clear runny nose with the occasional bubble are common place when a Shih Tzu puppy is teething. Again, the flatter the face the more likely your puppy will have extreme symptoms.


Some puppies in this breed experience teething trouble. A clear discharge from the nostrils and sometimes little bubbles. Eyes will tear and face may stay wet during this period. They make some snorting and snuffling sounds. They will usually outgrow this after the adult teeth come in. As long as they are playful and active and eating and drinking well, they are ok. If they can’t eat or drink well and are lethargic or the discharge changes color, they may have developed infection and need to be checked and treated. Most Shih Tzu pup are fine after adult teeth have come in. AS long as pups are eating and drinking well and can play they are fine. Many Shih Tzu puppies nose's will become tight during the teething phase. It will often cause them to snort and mouth breath. This will go away. It is very different the Stenotic Nares (Pinched Nostrils). Which is noticed from birth. Many Vets will try to talk you into an unnecessary surgery. 

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