Patellar Luxation
The patellar or kneecap is usually located directly in the center of the knee joint. Luxation, or dislocation of the patella, occurs when the patella slides out of its groove. Patellar luxation occurs mostly in toy and small breeds of dogs weighing 22 pounds or less such as the miniature poodle, the pomeranian, yorkshire terrier, and some other toy breeds. Females are 1.5 times more affected than males. In most cases, luxation is a congenital condition (that appears at birth), but it may appear some time later. It is thought to be inherited although the exact mode of transmission has not been determined. In some cases, the condition is acquired through trauma. An affected dog can lame occasionally, or walk on three legs. Sometimes, a dog will show pain and hold his leg up. Surgery is the treatment of choice. Conservative treatments such as prednisone and/or restricted activity doesn't give much benefit and is recommended mostly for mildly affected or older dogs.
Nose - Stenotic Nares
Stenotic Nares is a condition where the narrow resticted nostril puts a strain on the dog's system and can lead to an enlargement of the heart. When the surgery is performed the veterinarian removes a portion of the nasal cartilage to enlarge the nasal openings. In this disorder, the openings to the nostrils are too small and the puppy has a really hard time breathing through the nose. Stenotic nares is an inherited defect. An early surgical intervention can provide adequate airway flow that helps prevent the development of secondary problems like tracheal collapse and chronic bronchitis.
Mouth - Cleft palate
Dog cleft palate is a failure of the two sides of the palate to fuse correctly during the embryonic stage of developement. It can just be the soft tissue, in which case it is only cosmetic defect, but if the hard palate is affected, a puppy usually dies. It can be congenital or result from intoxication resulting from using steroids (cortisones), Vitamin A in overdosages, and some antibiotics. A cleft palate can be corrected surgically, however the puppy must be old enough to undergo an anesthesia.
Umbilical Hernia
The Umbilical hernia is a small prolapse in the stomach wall, where the umbilical cord was attached. There is the possibility of the intestines stuck inside the hernia being twisted and the puppy dying consequently, especially if the hernia is large. If the hernia is congenital (birth defect), it usually is non-painful, but when the hernia is caused by trauma the dog will be in pain and its overall condition will get progressively worse. Call your veterinarian if you notice an unusual protrusion from your puppy's abdomen to determine whether something needs to be done immediately. Sometimes cutting the umbilical cord too close at birth can cause an umbilical hernia, but it is generally considered an inherited defect.
Bleeding disorders
Von Willebrand disease - Von Willebrand disease is considered to be a mild to moderate bleeding disorder and it results in a reduced quantity of a glycoprotein necessary for normal blood clotting. Clinical signs of bleeding that are typical of the decrease include bleeding from the gums, urinary system, nose bleed, intestinal bleeding, with or without diarrhea. Small haemorrhages on the gums may develop. Dogs affected with this disorder may experience prolonged bleeding at any site of injury, trauma or surgery.
Renal Cortical Hypoplasia
Renal Cortical Hypoplasia is a condition where the kidneys develop inadequately and are smaller than average. It usually results in infection and stone formation. Among other clynical signs are excessive urination, vomiting, convulsions, anemia and weakness. First signs may appear at 10 - 13 weeks of age.
Harderian Gland Prolapse (Cherry eye)
In this condition, the gland of the third eyelid, which produces about one-third of the tear film, prolapses as a pink fleshy mass protruding over the edge of the third eyelid, between the third eyelid and the cornea (clear front part of the eye that provides the first step in the collection of light). The condition usually develops during the first year of life. The cause of the prolapse is unknown but is considered to be a weakness of the connective tissue around the gland. The gland starts to move and becomes irritated. Irritation leads to swelling and discharge. The third eyelid can become bloody and ulcerated and develops conjunctivitis. The treatment envolves a surgical procedure where the prolapsed gland is pushed back in its pocket. This procedure can be performed under local anesthesia.
Lagophthalmos
An inability to properly close the eyelid over the cornea. Lagophthalmic dogs generally have an enlarged palpebral fissure-- the space between the upper and lower eyelids. Brachiocephalic dogs classically have all their cornea exposed when the eyes are open and generally they have the white of the eyeball exposed also. This conformation causes two clinically serious consequences to the Shih Tzu.
First they are more prone to exposure
Keratitus
inflammation of the cornea. In its most severe form, it is ulcerative. A deep ulcer can cause the cornea to rupture. Chronic low grade exposure keratitus leads to central scarring of the cornea and pigmentary changes on the surface of the cornea that can decrease vision.
The second big problem related to brachiocephalic skull conformation in Shih Tzu is
Proptosis
When a globe moves forward out of the orbit, as happens with proptosis, the eyelids clamp behind the eyeball itself and cause the venous blood from the eye not to be able to return. This causes a lack of oxygen to the retina and can lead to blindness within minutes. If a Shih Tzu has a proptosed globe it is an emergency! Veterinary care has to be sought immediately (within 20 minutes) in order to attempt to save vision and save the eye. This can also be caused by pulling back on the skin on your dogs neck. You should never pick a Shih Tzu up by its hackles
Other problems found in the Shih Tzu include eyelash disease, which consists basically of two conditions.
The first condition is Distichiases
The eyelashes abnormally located at the eyelid margin which may cause ocular irritation. Distichiasis may occur at any time in the dog's life. The hereditary basis of the condition is not established. Distichiasis can cause severe scarring of the cornea and/or ulcers that could lead to blindness.
The second condition is Ectopia cilia
Ectopic cilia is like distichiasis in that ectopic cilia are eyelashes that emerge through the eyelid conjunctiva. They most commonly occur in the upper central eyelid. These are found in younger dogs and can cause significant pain as exhibited by squinting and facial wetness. Like distichiasis, corneal ulcers can occur.
Hypothyroidism
Hypothyroidism is a thyroid malfunction that occurs when the thyroid gland stops functioning and producing thyroid hormone responsible for proper metabolism. This mulfunction is commonly attributed to immune system problems. It is usually affects middle-aged dogs and is seen in all breeds. Symptoms include hair loss, weight gain, muscle loss, and lethargy. If left untreated, it can result in heart problems. This disease is usually diagnosed through blood tests. It can be effectively treated with drug therapy.
General Respiratory Problems
Shih Tzu have a lot of respiratory problems related to the shape of their face and head (the brachycephalic syndrome) which affects mostly dogs with a short nose (brachycephalic breeds). Due to an obstruction in the upper airways, the dog is forced to labored breathing. Not every brachycephalic dog will develop respiratory problems but most will to some degree or the other. Severe problems may require surgery.
Intervertebral Disk Disease - Back Problem
Intervertebral Disk Disease (IVD) in the dog is a common disorder manifested by acute pain, loss of movement coordination and paralysis. It commonly occurs in certain breeds of dogs called chondrodystrophoid breeds, such as Dachshund, Pekingese, French bulldog, Beagle, Basset Hound, American Cocker spaniel, Shih Tzu, Lhasa Apso, Welsh Corgi.