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Common Small Breed / Shih Tzu Issues


All dogs have the potential as living breathing things to develop genetic health problems, just as all people have the potential to inherit a particular disease.  A reputable breeder will be honest and open about the health problems in the breed.  All breeds have particular issues that are more prevalent or more commonly seen within the breed.

Careful breeders breed only the healthiest and best looking specimens, but sometimes Mother Nature has other ideas and a puppy develops one of these diseases despite good breeding practices.  Advances in veterinary medicine mean that in most cases the dogs can still live a good life.

Below you will find information that I have gathered over the years of being a breeder, none meant to supersede your veterinarian as I like them have formed my own opinions based on knowledge and experience. 


Pinched / Tight Nostrils associated with teething VS: True Stenotic Nares

Tight nostrils are frequently see in the Shih Tzu breed, commonly seen in ALL Brachycephalic (flat faced) breeds Pugs, Pekinese, Boston Terrriers, English Bulldogs, French Bulldogs, Japanese Chin, Affenpinscher, Brussels Griffon, additionally seen in your flat faced cat breeds such as your Persians, Himalayans and Exotic Short Hairs. This is referred to as Brachycephalic Syndrome. Stenotic or Narrowing of the nares / nostril holes are one aspect of brachycephalic syndrome. As we started to breed for the beloved flat faces in these many breeds with the change in the facial structure this has created the change in the nose / nostril shape and the elongated palates, the later not seen as much in our Shih Tzu breed.

When teething at this time a puppy with previously nice open nostrils can become very snuffy, tighter nostrils and be mouth breathing a bit (same as when you have a head cold) due to the swelling tissues from teething, sometimes not going away fully until all the adult teeth have come in (even up to a year old), but as long as they are active, eating and drinking normally it is of little concern. These should be the first questions a vet should ask you in regards to your puppy if he or she has a tighter nose. If your puppy is doing all of these things then they are in no way in need of immediate surgery for something that they may outgrow as they go through the teething process and additionally as your puppy grows in general as growing changes the head and face and nose shape and size!! YES if a puppy is lethargic, not active, struggling to eat and drink, not gaining weight then absolutely this needs to be addressed immediately!

Most vets are aware of the changes that can take place in the nose shape and size due to growth of the puppy in general as it ages and will not jump to surgery, as long as a puppy is active and doing well they will just continue to monitor this and will reassess at around 6 months of age when your puppy is due to be spayed or neutered. At that time they may address this if they feel the need is still there or they may just continue to monitor and reassess once again when your puppy is 1 year of age as at this age they will be even bigger and if surgical intervention is deemed necessary there is much more nose to work with so surgical procedure is much easier to perform.

There are a number of surgical procedures that your Veterinarian can perform to open up and make the nares wider and easier to breathe through. The techniques that can be performed vary from the Vertical Wedge, Lateral Wedge, or Alar Surgical Amputation / Excision or Laser Ablation to Alar folds (also called the wing of the nostril or the lateral cartilage). Information that I have gathered from talking with the Vets that I know both Family Practice Vets and Surgical Specialists all seem to agree that the Vertical Wedge is the most preferred technique. It was additionally mentioned that the Vertical Wedge gives you the best cosmetic outcome leaving the nose shape looking very much untouched just with more nice open nostrils! It also appears widely agreed upon that the appropriate age if no urgent presents being 6 months to 1 year of age to be sure that it will not self-correct itself on its own with growth and there will also be more “nose” to work with making it easier to perform the procedure. I personally have never had to have a nose on any of my Shih Tzu yet surgically corrected, that said, your vet is going to be your deciding factor on your case whether this would need to be performed and what technique would work best for your pet! I don’t have much knowledge when it comes to the elongated soft pallet that additionally is considered to be a problem with the Brachycephalic breeds as this is more associated with your Bully type breeds not so much in our Shih Tzu and I exclusively breed Shih Tzu.


Retained Baby Teeth / Teeth in general in Small Breeds

A retained or persistent deciduous (baby) tooth is one that is still present despite the eruption of the permanent tooth (between three to seven months of age). This can cause the permanent teeth to erupt in abnormal positions, resulting in an incorrect bite pattern / over crowding. Retained teeth are more common in small breed dogs, and in dogs that have brachycephalic (pushed-in faces) such as Bulldogs, Pugs, Boston Terriers, and Boxers.   So the Shih Tzu breed falls into both those categories.  Please have your veterinarian perform a complete oral exam / inspection of your dog's mouth just prior to Spay / Neuter as any retained baby teeth can easily be removed at that time while your dog is already under anesthesia.  If baby teeth are still present at 6 months spay / neuter time they can be considered retained, they are not coming out, delaying will not change this. 

All Small Breeds in general are notorious for having bad teeth, by this I mean no matter if you have your dogs teeth cleaned every, single, year, of their life at the vet they will lose or have pulled a good number of teeth in their lifetime.  Due to small size they sit very shallow and in small mouths are over crowded and are prone to decay because of this.  Good news is dogs have 48 teeth so even losing a good number of teeth don’t honestly matter much, additionally dogs are not truly really “chewing type” animals and do not chew there food more like one crunch and swallow so the majority of the time even as a dog ages and loses teeth rarely do they ever have to be switched to soft foods in their lifetime.  


Umbilical Hernia

Umbilical hernias really are of little concern and are very common in the Shih Tzu breed. They usually can be noticed at around 2-5 weeks of age and some of them will close on their own by around 6 mos of age (delayed closure).  It is important to note that ALL puppies have this opening at birth as this is an opening into the body were the umbilical cord (belly button) was and how they received nutrients in utero.  An umbilical hernia is a soft reducible bump (meaning you can push it back in) were the muscle failed to close back up.  

Umbilical hernias can be viewed as either birth related as at the time of birth there is some degree of pulling on the cord or inherited as we do see them at a higher rate in this particular breed.  Very rarely is an umbilical hernia any health concern what so ever, and are easily fixed if so desired.  Small umbilical hernias really need no addressing, but most all vets will recommend closure (for any size hernia) at the time Spay / Neuter is performed, most vets will charge a small additional fee at this time as they are already under anesthesia.  Perfect time also to have your vet remove any retained baby teeth that your puppy may have, so be sure he or she checks for any retained  baby teeth in case this needs to be address additionally at the time of spay / neuter.  Very large hernias should always be closed up so the muscle doesn't close up around it and cause internal injury, however this is very rare indeed to have an umbilical hernia that is large enough to become strangulated or harm the dog and certainly not before a 6 month spay / neuter time would roll around.


Inguinal Hernia 

An inguinal hernia is the result the inguinal rings still being slightly open and not fully closed yet. So inguinal hernias present as skin-covered bulges in the groin area. They can be bilateral, involving both sides, or unilateral, involving only one side. Inguinal hernias are more common in females than males, but do occur in both sexes.  You cannot tell if a puppy has a true inguinal hernia until they are at least 5-6 months old and it is still present. They are almost always just delayed closures or even just simple fatty pads that occur in that area which is totally different, and there is no opening in the actual inguinal ring at all!  Only your vet will be able to tell the difference as a hernia is always reducible were a fat pad is just that fat, and disappears as your puppy grows. 

Small Inguinal hernias are of little concern and do generally close up on their own. As with an umbilical hernia, if it has not closed up on its own by the time it is time to spay or neuter your puppy then I recommend having your vet close it up at that time.  I have never seen an inguinal hernia large enough that needed addressing as a younger puppy here by me the breeder.  Surgery on a puppy less that 4-5 months of age is very risky business and should only be performed if it is a life threatening situation.  


Innocent or physiologic heart murmur

An innocent or physiologic heart murmur is a heart murmur that has no impact on the dog's health.

It is very common for young puppies, especially large breed puppies but we do see it in the smaller breeds, to develop an innocent heart murmur while they are growing rapidly. The murmur may first appear at 6-8 weeks of age, and a puppy with an innocent heart murmur will usually outgrow it by about 4-5 months of age. This type of murmur is benign.


Open Fontanel (most common in tinys)

Like human babies, all puppies are born with a soft spot in their skull, which closes with age. This is called the fontanel.  A puppy’s skull is actually made up of several separate plate-like bones that start out somewhat soft, small, and separated.  During birth, these plates allow the skull to flex as the head passes through the birth canal. As a puppy grows, the plates gradually grow around the brain, become more rigid (ossify) as the bones meet, they fuse together.  Four of these bones meet up at the center top of the skull; this center is the last open space to fill in with bone tissue. This space is known as the fontanel (or fontanelle) and will usually close when the puppy is four to six weeks of age, or may close more slowly over a three to six month period.  Sometimes, the fontanel never closes, leaving a hole in the top of the skull. 

With breeding the Shih Tzu breed to a smaller standard (a size more similar to your other tiny toy breeds such as Chihuahuas, Maltese, Pomeranian’s and Yorkshire Terriers) I find that if a puppies font is closing fairly quickly and is closed in that four to six week range then it is a good indication that they will be on the bit bigger side more like 7-8# range.  I find in my puppies that are tracking towards the smaller side in the 4-6# size the fontanel will still be open as they are in turn growing at a slower rate hence why the font will be more in the range of the later three to six month period before it is fully closed.  Some Veterinarians are not used to working with the smaller toy breeds, they see mostly your common breeds such as Labrador Retrievers ect. and without proper working knowledge of the small breeds will jump to conclusions just because they feel a slight open fontanel. Please do not be alarmed by the open fontanel as a good reputable breeder does and will know the difference.

Open fontanels can occur in any dog, but are most prevalent in the toy breeds.  Hydrocephalus on the other hand is NOT the same as just having an open font that will close as the puppy ages.  Hydrocephalus is an actual condition where fluid accumulates in the brain, causing neurological signs.  Hydrocephalus can actually be the cause for a fontanel that does not close.  The presents of the fluid in/on the brain prevents the bone plates from being able to come together and therefore they cannot fuse.  There are always other neurological signs associated with Hydrocephalus not just your common open font. 

There is no treatment for an open fontanel.  Besides being seen more prevalently in toy breeds it is also more common in your more dome headed type breeds such as Chihuahua or your brachycephalic (flat faced breeds) as this look pushes the forehead up and gives more of the round dome headed appearance.  In the Chihuahua breed an open font is actually listed as one of their actual characteristics in there AKC breed description; as it is that prevalent in the breed.   Keep in mind that many dogs with an open fontanel live normal active lives. Dogs with this condition should be closely watched and not allowed to jump off of things or any activity where the spot could be injured.


Reverse Sneezing    

Reverse sneezing (also called backwards sneezing or by the medical term Inspiratory Paroxysmal Respiration) is a fairly common respiratory event in dogs, but is rarely seen in cats. Small and brachycephalic breeds are more prone to the condition than other dogs. In a regular sneeze air is pushed out through the nose, in a reverse sneeze air is instead pulled rapidly and noisily in through the nose.

Its exact cause is unknown but may be due to nasal, pharyngeal, or sinus irritation (such as an allergy), the dog's attempt to remove mucus, or from over excitement due to present activity.   I have honestly only observed reverse sneezing at bath time so would definitely characterize it as brought on by over excitement / nervousness or possibly water in the nose leading to an episode.  It is characterized by rapid and repeated forced inhalation through the nose, sounding like a duck to me.  During a reverse sneeze, the dog will make rapid and long inhalations, stand still, and extend its head and neck.  A loud snorting sound is produced.  Though it may be a bit distressing to the animal, it is not known to be harmful in any way so just let them finish and continue on with what you were doing.  Most dogs are completely normal before and after episodes.  In addition, most dogs will have repeat episodes of reverse sneezing throughout their lives.

Reverse sneezing also commonly occurs while the dog is asleep or immediately following a long nap.  Other dogs may experience it following play, exercise, or meals.  However, episodes are typically random.  Though smaller dogs seem slightly more susceptible to reverse sneezing, any dog can develop it, regardless of size.


Coprophagia (poop eating)

Sounds bad huh?  Well as gross as it sounds, it is actually more common than you think and certainly heard of and known as a “dog/canine” thing seen in all breeds and sizes.   I have read much on this topic over the years and it is truly still a mystery to me as I like clear cut facts and fixes, and this is not one of them. 

Back when I was naïve I thought it was a habit from owners / breeders who don’t clean up regularly after their puppies hence they have more access to their poops and out of boredom they start this bad habit.  WELL, I did find that not to be the case as I became a breeder myself who is always on top of things and keeping poops picked up nonstop is my middle name!  I also have had over the years a few dogs (2 actually) that just for some reason no matter what practice coprophagia if given the chance!!  

What is mentioned on the subject is puppies may simply begin to investigate, play with, and even eat stools as a play, investigative or scavenging behavior.  A lot has also been said about it being seen as an indication to dietary deficiency.  We also have the learned behavior theory from watching their mother clean up after them, but I don’t agree too much with that, as once the puppies start eating solids their mother usually will stop cleaning up after them and prior to that they were too young to remember.  We could also add the anxiety cause, low protein /poor quality food, and boredom, not to mention a few I probably have forgot to mention.

Here is a list of options that I have ran across over the years; Bananas thought to be K+ potassium deficit, B1 (all B vitamins), Pineapple chunks, cooked Carrots, Pumpkin, cooked Spinach, Black Licorice, Yogurt, Cottage Cheese, Certs candy, being sure you are feeding a super High Quality dog food, switching to a dog food with a different protein say Lamb instead of Chicken, access to Food at All Times “ Free Feed”, MSG (found in “Adolphs” brand meat tenderizer) this MSG might be the main ingredient in some of the store bought products you can purchase such as For-Bid, Deter by Excel, Nasty Habit by Nutri-Vet and then general Probiotics.  I think most of all these are set on making your dogs poo taste bad so as to not make it appealing for them to want to  partake in it a second time around!  Many will after a while just become accustomed to the “new taste” and for the most part these food additives only work as long as you are using them.  There is a lot of information out there on the Internet that you can research so please feel free to do so! 

The next paragraph is just my personal take and experience with this habit. I believe that the best way to combat this is to just NOT GIVE THEM A CHANCE!!!  Meaning just not giving them access to poops!  This is much easier to accomplish once you start potty training your puppy to go outside, as with a small breed you will be outside with your puppy. Positive reinforcement works great here!  Like Clicker and Treat reinforcement training!  The instant as you see them finish call them to you as a distraction and give them a treat!  And being diligent about keeping your yard a poop free zone!  Simple as that, denied access.  Is is a bit harder when you have a young puppy that still needs to be in an Iris pen therefore may have access to their poops as no matter how hard we try we can’t get em all the minute they exit the poop shoot, but we can darn sure try!

Therefore I really do recommend potty training your puppy as soon as possible that way you can pick up after your pet as this to me is truly the only real way to prevent your dog from partaking is just not giving access to poops and keeping your yard picked up! 


Luxating Patella (loose knee cap)

A luxating patella occurs when the knee cap moves / slips out of its natural position. The patella (knee cap) lies in a cartilaginous groove at the end of the femur at the stifle. The patella in dogs is shaped like an almond and its purpose is to assist in knee extension. The patella resides in the tendon of the quadriceps muscle group which attaches to the bone below the femur, the tibia. When this muscle group contracts, it pulls on the tendon and the knee cap, thereby extending the stifle. If the patella is pulled out of its normal groove with knee extension, this is called a luxating patella.

The causes of this condition can be congenital and/or traumatic. Breeds with a predisposition for luxating patella are commonly small breeds even though there are a number of large breeds on this list in addition to short legged breeds.  This condition is not usually diagnosed in puppyhood but more so in early adults.  The initial symptoms include occasional limping, an intermittent skip in the gait, sudden loss of support on the limb, all of which are usually intermittent.

The luxating patella under most circumstances often has no or very mild symptoms.  Not all luxating patella needs medical intervention.  Luxating patella has different grades.  Grades 1-2 is considered very mild and will cause no long term effects or complications (this is most common).  Grades 3-4 should probably be addressed by a veterinarian.  They could potentially be more serious and need medical intervention and could potentially cause more long term damage and pain for the adult dog such as osteoarthritis.  Options for luxating patellas can range from supportive nutrients and exercise to surgical intervention.


Kidney / Juvenile Renal Disease (JRD)

The Shih Tzu breed unfortunately in one of the breeds that is known to be effected by JRD.  JRD is a known genetic disease that there is not a known test that we can test for as breeders in our breeding dogs to know if they are carriers of this genetic disorder.  This is one of the diseases covered in most all good breeders health guarantee.  There have been a number of laboratory’s that have over the years announce that they have identified the gene marker and developed a test for it and that now we as breeders can test for JRD in our breeding dogs and try to cull this disease from our programs by breeding only clear/clear or clear/carrier dogs but never carrier/carrier so we will Never have any puppies that could actually be Effected with the disease, only to be told a year or two into it that OOPS SORRY wrong gene series… and unfortunately many a breeder by then have already culled dogs from their programs due to false results.  This has already occurred not once but twice.  There are still laboratories that are actively receiving grants to continue their research. 

Early symptoms of Juvenile Renal Disease include drinking copious amounts of water, something that might not be readily apparent in a house with more than one dog, frequent urination, and dilute urine which has little color or odor.  Some affected puppies leak urine, many do not.  As the disease progresses, vomiting, weight loss, anorexia, lethargy, and muscle weakness are seen. There is often a chemical odor to the breath because his kidneys are not expelling waste from his body as they should and teeth are sometimes discolored. Some puppies grow normally until they are diagnosed, and some appear as failures to thrive some die in utero.  Urinalysis can help your vet evaluate kidney function as can a blood BUN test.  A tissue biopsy of the kidneys is consider extremely risky and not necessary unless you are a breeder. This disease carries a poor prognosis.

Treatment for JRD consists of a low protein prescription diet, Hill's K/D, and, in addition, IV fluids can be given to act as a kind of dialysis. Epogen, an expensive drug which needs to be carefully monitored, can be also be given to treat the hypoproliferative anemia of chronic renal failure. Some Veterinary schools are experimenting with kidney transplants, but transplanted kidneys in dogs are commonly rejected.

These treatments are palliative at best, and the prognosis for JRD is grim. Puppies usually die within several months of being diagnosed, almost always before age two.

Dogs who have JRD with less severe kidney involvement, can be maintained on low protein diets.  In some cases, juvenile renal disease affects only one kidney.  When only one kidney is affected, the sick dog can typically live a normal, healthy life, free of symptoms, with no noticeable reduction in longevity. 


Liver Shunt / Portosystemic shunt (PSS)


A portosystemic shunt (PSS) or liver shunt is a condition where the normal flow of blood, to and through the liver, is markedly reduced or absent. Normally, blood returning from the puppy's digestive tract is routed to the liver through the portal vein. The blood flows through the liver and then exits the liver and joins the venous blood flowing back to the heart. A liver shunt is a blood vessel that connects the portal vein with the main systemic blood stream. This causes the blood to bypass the liver. Without adequate blood flow to the liver, the puppy's body cannot thrive as the liver is a main source for purifying and cleaning toxins from the blood.

Liver shunts in dogs occur as a result of a birth defect (congenitally) and therefore are cover in my and most breeders Health Guarantee same as JRD.  A liver shunt can be intrahepatic, when blood is diverted in a vessel within the liver, or it can be extrahepatic when blood is diverted in a vessel around the outside of the liver.  Larger dogs are more prone to intra-hepatic (inside the liver).  Shunts (outside the liver) extra-hepatic shunts, occur more commonly in small dog breeds.

To make up for the fact that the fetal liver is not functional, the fetus's blood is carried from its body to the mother's and back again through the umbilical cord, which is made up of the umbilical artery, the umbilical vein and the placenta. The placenta is where the fetal blood and the mother's blood interact; although they never actually comingle. Here nutrients from the mother's system are passed to the fetus and waste products from the fetus are taken up by the mother and processed through her kidneys and liver. 

When the puppy is born, the umbilical cord is severed and is no longer functional. Shortly after birth, the ductus venosus contracts, constricts and closes. Once this vessel is closed off, the newborn's blood is forced to pass through its now developed liver. If the ductus venosus fails to close, then a portion of blood will continue to be shunted around the liver through the still patent ductus venosus. This would be an example of a congenital intrahepatic liver shunt. In some cases, an anomalous vessel will form connecting the portal vein with a vein that carries blood away from the liver. This anomalous vessel remains patent even after the ductus venosus has closed and continues to shunt blood around the liver. This would be an example of a congenital extrahepatic portosystemic shunt.

When blood is shunted around the liver rather than to and through it, the liver is not able to perform its many important tasks and therefore, metabolic wastes such as ammonia, reach unhealthy levels in the animal and threaten the dog's health. The degree to which blood is shunted around the liver is dependent on the size of the shunting blood vessel. Liver shunts may be large allowing a large amount of blood to bypass the liver, or they may be partially closed allowing only small amounts of blood to shunt around the liver. The extent of blood shunting varies with every dog / case.

The symptoms of liver shunts vary and are directly related to the extent of blood by-passing the liver. If the liver is receiving and processing 95% or greater of the dog's blood, the symptoms may be few, if any. As the amount of blood by-passing the liver increases, the symptoms of this condition will become more pronounced.

The most common clinical signs include "stunted" growth, poor muscle development, abnormal behaviors such as disorientation, staring into space, circling or head pressing, and seizures.  Less common symptoms include drinking or urinating too much, vomiting and diarrhea.  Pets with a liver shunt often take a long time recovering from anesthesia.  Behavioral clinical signs may only occur after eating high protein meals.  Some pets do not show signs until they are older, when they develop urinary problems such as recurrent kidney or bladder infections or stones.  Dogs with less severe liver shunts may not exhibit any clinical signs until the puppy is much older, even up to one year of age.

Diagnosis is based on medical history and clinical signs.  Common diagnostic tests include the following blood word, Complete Blood Count (CBC) and Serum Chemistries BUN and Albumin, and liver enzymes (AST, ALT).   Urinalysis may be performed as urine may be dilute (low urine specific gravity) or there may be evidence of infection. The urine may contain small spiky crystals known as ammonium biurate crystals.   Bile Acid Test as most dogs with liver shunts have elevated bile acids.  Additional diagnostic tests may include Ultrasound with Doppler Flow Analysis, Computed Tomography (CT) Scan or Nuclear Scintigraphy - a nuclear scan that measures blood flow through the liver), Portography - an x-ray showing the blood vessels supplying and/or bypassing the liver, using radio-opaque dye injected directly into the portal vein, Magnetic Resonance Imaging (MRI), and Exploratory surgery (laparotomy).

Dogs with portosystemic shunts are usually stabilized with special diets and medications, which attempt to reduce the amount of toxins that are produced and absorbed in the large intestines.  Most pets improve almost immediately with proper diet and medication. About one-third of the dogs treated medically will live a relatively long life. Unfortunately, over half of the dogs treated medically are euthanized within ten months of diagnosis because of uncontrollable neurological signs such as seizures, behavioral changes, or progressive liver damage. Dogs that tend to do well with long-term medical management are usually older at the time of diagnosis, have more normal blood test values and have less severe clinical signs.  Thus to me indicating that a much higher percentage of their blood in going thru their liver and being cleaned of toxins.

Surgery though for others is the only viable option.  A repair of the liver shunt thru surgery provides the best chance for a long, healthy life in most dogs with extrahepatic shunts. If ameroid constrictor placement is performed, survival rate is over 95%. Many dogs are clinically normal within four to eight weeks following surgery.

The prognosis for a dog with a PSS depends on the size and location of the shunting vessel(s). Owners and veterinarians should thoroughly discuss the seriousness, expense, and expected outcome associated with this condition. The cost and results of surgically correcting liver shunts are variable and depend on the anatomical location of the shunt, the degree of shunting and the age of the dog.

Tear / Face Staining (Red Yeast)


White or light coated breeds many at some point in their life will develop those very distracting, ugly, red-brownish tear stains underneath their eyes, around their muzzles, and in between their toes.

The cause can be related to health issues, shape of the eye, blocked tear-ducts, puppy teething, ear infection, allergies (either food or environmental), and so on. Therefore if your normally white-faced puffball develops aggressive staining seemingly out of the blue, first consult your veterinarian, and possibly a veterinary ophthalmologist, to rule out any underlying health concern.  After confirming that your dog is indeed healthy, the following tips and suggestions from my own experience will hopefully restore and maintain that beautiful, white furry face!

First it is generally agreed upon that although there are numerous and passionate opinions about brands (and further passion about kibble versus raw), a high-quality, grain-free diet works best for this problem. The corn, wheat, and meals that are used as fillers in inferior-quality foods just don’t ensure long-term good health and can cause allergic reactions, resulting in excess tearing and other problems.

Next you may have to examine the quality of your water.  A dog can they develop staining pretty quickly in response to excess minerals. Use purified, distilled, or reverse-osmosis water sources.  Try using glass water bottles (such as made for birds) instead of water bowls, or use paper towels to absorb the excess water around your dog’s mouth after he drinks from a bowl and dry around the eyes any moisture. Cornstarch can also be dusted underneath the eye, around the muzzle, and in between toes.

A Quick Daily “face grooming” will go a long way in keeping those stains at bay. Some tips:

• Flush eyes with an appropriate canine eye-wash, such as saline eye-wash solutions or Terra Septic eye drops.

• Moisten a cotton ball with the same eye wash or a contact lens solution, and rub underneath and around the eye area. Opti-Clear and Bio True are two pre-made options; a do-it-yourself option is to mix one tablespoon boric acid powder boiled in one cup distilled water. (Be sure to keep refrigerated, and remake a fresh batch weekly.)

• Wash the muzzle hair with dry shampoo or waterless shampoo and a wet washcloth.   Comb and blow-dry afterwards.

• Keep the hair around the eyes trimmed to avoid it irritating the eye and causing tearing.

Two things that have worked for me are adding one teaspoon of either organic apple-cider vinegar added to water or buttermilk powder to meals. I-Stain, a probiotic enzyme, is another product with reportedly good results.

Mild antibiotics can be used for short periods of time, naturally, after consulting with your vet. Those commonly prescribed include Lincosin, Tylosin, and/or neomycin-polymyxin or chloramphenicol eye drops. Vetericyn opthalmic gel is available over the counter and may be enough without a vet trip.

Stain removal is another chapter to itself, but it’s important to mention that neither I nor anyone I spoke with have had much success with the expensive products advertised for this purpose. A little mild hydrogen peroxide applied directly to the hair only (being sure at all times to avoid the eyes) or Visine (applied to the fur, not the eyes) can lighten the color enough to live with it until it grows out. 

The short of the story is that unfortunately there isn’t just one foolproof preventative, and each dog responds a little differently, so it often takes a little experimenting and patience!

Please contact me personally if you have a need and I will share my OWN personal products, experiences, ideas, and regimen with you if you are a client of mine.


Prapso Shih Tzu

Reference; Enchanted Mountain Shih Tzu

Most people have not heard of this condition and it used to be primarily thought of as a Lhasa Apso Condition, because that is where it was seen most often.  They called them “smooth haired” Lhasa’s.  The word “Prapso” started in Australia.  From the phrase “perhaps an Apso” This “condition” however is not limited to the Lhasa Apso.  It is periodically seen in the Shih Tzu as well as other Tibetan breeds.

So just what is a Prapso?  Prapso puppies are an interesting occurrence.  You generally don’t notice this until the puppy is around 6 weeks old and sometimes later depending on whether you have a partial or a full Prapso puppy. They are perfectly healthy little babies.  A Prapso puppy will mature faster than his litter mates, usually will open their eyes earlier than normal, they will get a full set of teeth much earlier than their littler mates.  In general they tend to have a more rambunctious personality.  They also for whatever reason are thought to be slightly smarter than other dogs of their breed.  But what is most noticeable is their shorter than average hair for their breed.  In a full Prapso they will have shorter smooth hair, generally over their entire body however their muzzles and legs are generally shorter than their body, a Lhasa Apso looks almost identical to a Tibetan Spaniel if he/she is a full Prapso puppy.   You can also have a partial Prapso, which is what I have seen in the Shih Tzu.  A partial Prapso will generally have longer hair on the body, but it may not grow to the ground like a flowing show coat.  There may be long hair on the face and head where your typical top knots can be done, but generally right around the muzzle will stay short and the legs will be shorter than the body, they can grow longer than a “smooth hair” look, but generally will not grow as long as typically seen on a Shih Tzu, but their hair will still have a straighter/smoother appearance with a slightly different texture than a typical Shih Tzu.  Prapso puppies/dogs make excellent pets. You get the loving, fun, playful and loyal personality of the Shih Tzu without all the hard work of the long coat and profuse hair.  If you keep your Shih Tzu in the shorter coat then the shorter hair is a non-issue. 

Prapso’s are not uncommon, yet nor are they common in my opinion. pl   Reputable breeders that are aware of this will simply sell the Prapso as a pet and educate potential buyers about how their puppy will be different if it is possible to tell before the puppy goes to his/her new home.

The Prapso puppy makes an absolutely wonderful, smart, affectionate, playful, somewhat low maintenance alternative to their breed standard counterparts.  People that have owned Prapso’s are known to ask for another one as they realize what a joy they really are.  The Prapso puppy is nothing to be ashamed of.

On the breeder side of things, obviously most breeders do not produce a Prapso puppy on purpose. Some people just believe it is a genetic mutation that for whatever reason results in this characteristic.  Regardless, it is not recommended to cull a dog that has produced a Prapso out of a breeding program, however it is advised that the particular breeding not be duplicated and if that dog produces a Prapso from a different breeding then it can be assumed at that point that he/she is the carrier.  From known knowledgeable breeder experience it only takes one parent to produce a prapso puppy, both parents do not have to carry for it.   A female that produces Prapso’s is very limited in the amount of puppies she can produce and because of this should just be bred to a different male to see if it was her or the male that carried for it.  A male that produces Prapso puppies should be handled a little more careful as obviously they can produce many many offspring.  Litters that a male produces should be closely tracked and bred carefully, just because he is a carrier doesn't mean all of his puppies will be however there is that chance of the carrying for it.  Another words just because a litter is born with a Prapso you cannot assume both parents carried for it as mostly likely only one of the parents were a carrier. 

There are those breeders that have actually got requests for another Prapso and therefore have purposely produced Prapso’s.  This has been seen mostly with the full Lhasa Prapso’s as you get the temperament of the Lhasa, without the hassle of all the hair.  This would generally be frowned upon with most show breeders, however most breeders each have their own reasons as to why they breed and what their goals are for their programs. 

In the end a Prapso puppy is a perfectly healthy pet that can bring you years of love and affection!


Retained / Undescended Testicle (Cryptorchidism)

Cryptorchidism is the medical term that refers to the failure of one or both testicles (testes) to descend into the scrotum.

In most cases of cryptorchidism, the testicle is retained in the abdomen or in the inguinal canal (the passage through the abdominal wall into the genital region through which a testicle normally descends). Sometimes the testicle will be located just under the skin (in the subcutaneous tissues) in the groin region, between the inguinal canal and the scrotum. In cases of abdominal cryptorchidism, the testicle cannot be felt from the outside. Abdominal ultrasound or radiographs may be performed to determine the exact location of the retained testicle. Most dogs will only have one retained testicle, and this is called unilateral cryptorchidism. 

Neither location prevents a quality Vet from neutering your puppy in his regularly scheduled/ recommended time frame!  Your vet may charge a minimal additional fee for removal of an abdominally retain testicle as it is a bit more work and time consuming on their part.

The testes develop near the kidneys within the abdomen and normally descend into the scrotum by two months of age.  In certain dogs it may occur later, but rarely after six months of age.  Cryptorchidism may be presumed to be present if the testicles can’t be felt in the scrotum after two to four months of age.  Cryptorchidism occurs in all breeds, but the toy breeds, are at higher risk.  Approximately seventy-five percent of the cases of cryptorchidism involve only one retained testicle while the remaining twenty-five percent involve failure of both testicles to descend into the scrotum.  The right testicle is more than twice as likely to be retained as the left testicle.  Cryptorchidism affects approximately 1.2% of all dogs.  The condition can be consider inherited since it is commonly seen in families of dogs, but this is not a given as the exact cause is not fully understood.


Dry Eye Syndrome

Keratoconjunctivitis sicca (KCS) is also known as Dry Eye Syndrome. It is a common eye condition resulting from inadequate production of the aqueous portion of the tear film by the lacrimal gland and/or gland of the third eyelid gland. The result is severe drying and inflammation of the cornea (the transparent front part of the eye) and conjunctiva (the clear membrane that covers the sclera -- the white part of the eye).

This condition is relatively common in dogs, particularly Cocker Spaniels, Bulldogs, West Highland White Terriers, Lhasa Apsos, Shih Tzu, and a good number more.
Most dogs with this condition present with painful, red and irritated eyes. They often squint, blink excessively or hold the eyes shut. There is often a thick, yellowish, mucoid discharge present as a result of the decrease in the aqueous (watery) component of the tear film. Corneal ulceration is often present. In chronic cases, there is often a history of recurrent eye injuries, ulcers or conjunctivitis. Many dogs will develop corneal scarring called hyperpigmentation that can be seen on close observation. Corneal scarring often looks like a dark film covering the eyes. You can often see tiny blood vessels coursing across the cornea called neovascularization. Vision may be reduced if scarring is extensive. The eyes often have a dull, lusterless appearance due to the corneal drying. KCS most commonly affects middle aged to older dogs. Both eyes are usually affected although one eye may appear worse than the other.

Diagnosis is based on medical history, clinical signs and decreased tear production tests. The most common tear production test is the Schirmer tear test (STT). This simple test uses a special wicking paper to measure the amount of tear film produced in one minute. Additional diagnostic tests that may be performed include corneal staining to check for corneal ulcers, intraocular pressure (IOP) to determine if glaucoma is present and tear duct examination or flushing to ensure normal tear drainage.

The treatment of "dry eye" has two objectives: to stimulate tear production and to replace tear film, thereby protecting the cornea. There are two commonly used ophthalmic medications to stimulate tear production, cyclosporine and tacrolimus. Both are easily placed in the eyes once or twice daily. If you are unable to administer your dog's eye medications there is surgical correction which involves repositioning the salivary duct so that it secretes saliva onto the eyes. This surgery is usually performed by to a board-certified veterinary surgeon or ophthalmologist. This procedure has significant risk of complication so it should not be pursued unless all other treatments have failed.

With today's tear stimulating drugs, the prognosis for dogs diagnosed with KCS has never been better. "Dry eye" requires life long medical care. With diligent attention and monitoring, most dogs are able to enjoy a pain-free life. If the condition is diagnosed late in the course of the disease and if extensive corneal scarring has developed, the pet may not respond fully or regain its vision. Once corneal scarring has developed, there is little that can be done to reverse it. This is why it would be of utmost importance to notice any changes in your dogs eyes early on.


Eyelid Entropion

Entropion is an abnormality of the eyelids in which the eyelid "rolls" inward. This can cause an eyelash or hair to irritate and scratch the surface of the eye, leading to corneal ulceration or perforation if left long enough. Most dogs will squint, hold the eye shut and tear excessively. You may notice inner eye inflammation (keratitis), eye tics, or discharge of pus from eye.

Entropion is almost always diagnosed around the time a puppy reaches its first birthday. Interestingly, many flat-faced dogs with medial entropion (involving the corner of the eyes near the nose) exhibit no obvious signs of discomfort. In most cases, both eyes are affected. While the exact genetics are unknown, many breeds literally 35+ of all shapes and sizes are identified as having this problem.

The treatment for entropion is a simple surgical correction. A section of skin is removed from the affected eyelid to reverse its inward rolling. Most dogs will not undergo surgery until they have reached their adult size at six to twelve months of age. The prognosis for the surgical correction of entropion is good, most dogs enjoy a pain-free normal life.



A cataract is an opacity in the lens of a dogs eye, causing them to have blurry vision. If the cataract is small, it wont likely disturb the dogs vision too much, but cataracts must be monitored because the thicker and denser they become, the more likely it is they will lead to blindness.

If your dogs eyes look cloudy or bluish-gray, you should take them to the vet for an exam. Be aware, though, that it’s natural for a dogs lens to become cloudy, or gray, with age. This condition, called nuclear sclerosis, doesn’t put a dogs vision in as much danger as cataracts might, and treatment isn’t usually recommended. However, any cloudiness at all in your pets eye is a sign for you to take him to the vet for an assessment. An eye exam by your veterinarian will tell you whether you are dealing with a true cataract or another condition that causes cloudiness in the eye such as even a simple eye scratch.

Cataracts can develop from disease, old age, trauma to the eye, or inherited conditions. Genetically inherited cataracts may be present at birth or develop when a dog is very young between one and three years of age. A high-incidence of cataracts is also often attributed to diabetes and or injury.

Although dogs of all ages and breeds can develop cataracts, the Shih Tzu breed in not a breed that is looked upon as being highly susceptible genetically to cataracts. Same with deafness, we just don’t really see a lot of it.

Vision loss due to cataracts can often be restored through surgery. A veterinary ophthalmologist will surgically remove the lens, replacing it with a plastic or acrylic lens. Cataract surgery generally has a good success rate, but your veterinarian will need to determine whether your dog is a good surgical candidate.

Note: If your pet has an underlying condition such as diabetes, treating the underlying condition will be necessary.







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