Shih Tzu Breed Guide: Care, Grooming and Health

Reviewed by Dr. Jamshed Bilal, DVM

The Shih Tzu is one of the most recognisable small dogs in the world — that flowing double coat, the chrysanthemum face, the confident little trot, and the unmistakable sense that this dog believes it belongs on a velvet cushion. For centuries, these dogs lived exactly that life in the imperial palaces of China, and the self-assurance of that heritage has never entirely left them. Today they are among the most popular companion dogs in the United States, prized for their affectionate temperament, adaptability to apartment life, and endearing personality. But the Shih Tzu's beauty comes with genuine responsibility: they are one of the highest-maintenance breeds when it comes to grooming, they have real health vulnerabilities tied to their brachycephalic structure, and they have a streak of stubbornness that will test a first-time owner's patience. This guide covers everything you need to know about life with a Shih Tzu — the joys, the demands, and the daily realities.

Shih Tzu Breed History and Overview

The Shih Tzu is one of the oldest toy breeds in existence, with a history stretching back over a thousand years to the imperial courts of China. The name "Shih Tzu" means "lion dog" in Mandarin, a reference to the breed's resemblance to the lion as depicted in ancient Chinese art — and to its association with the Buddhist mythology surrounding the lion as a sacred protector. The breed was highly prized by Chinese emperors and was kept exclusively within the walls of the Forbidden City for much of its early history, treated as a living treasure and never sold or given to commoners. Early specimens were likely crossed with Tibetan dogs, possibly including the Lhasa Apso and Pekingese, to produce the breed as it developed.

The Shih Tzu came very close to extinction in the early twentieth century. During the Communist Revolution in China, the breeding programme was effectively ended, and by the time the breed reached the West — mainly through British and Scandinavian diplomats who brought dogs back from China in the 1930s — the entire world's Shih Tzu population numbered only a handful of animals. All modern Shih Tzus descend from fourteen individuals. The breed was recognised by the American Kennel Club in 1969 and has been consistently popular ever since, currently ranking among the top twenty most registered breeds in the United States.

The Shih Tzu is classified as a toy breed, typically weighing between nine and sixteen pounds and standing nine to ten and a half inches at the shoulder. They have a distinctively round head, large dark eyes, a short flat muzzle, dropped ears covered in long hair, and a tail that curves over the back. The double coat is long, dense, and silky when properly maintained, and comes in an enormous variety of colours and colour combinations.

Personality and Temperament

The Shih Tzu's personality is one of its greatest assets. These are genuinely affectionate dogs — they form strong bonds with their families and love human company with a sincerity that is hard to manufacture. They are not the kind of dog that attaches to one person and merely tolerates the rest of the household; they tend to love everyone, making them well-suited to family life in homes with multiple people. They are playful, often retaining a puppyish energy well into adulthood, and they have an endearing sense of their own importance — a breed characteristic that owners either find charming or slightly maddening, depending on temperament.

Shih Tzus are alert little dogs. They notice what is happening around them, they respond to changes in the home environment, and they will bark to announce arrivals at the door. This alertness makes them decent watchdogs in the sense of notifying you when something unusual is happening, though they have no guarding instinct whatsoever — their response to a stranger is more likely to be enthusiastic greeting than deterrence. Their alertness also means they adapt well to reading family routines and moods, and many owners describe their Shih Tzu as unusually perceptive about human emotions.

The stubborn streak is real and should not be minimised. Shih Tzus were bred to be companions, not workers, and they do not have the same ingrained desire to please a handler that working breeds carry. They will happily ignore a command if they do not see the point of it, and they are quite capable of appearing to have forgotten perfectly well-established training when motivation is low. This is not defiance for its own sake — it is simply a dog that operates according to its own logic and requires consistent positive reinforcement to engage reliably. Punishment-based approaches will not work and will damage trust.

For apartment dwellers, families with older children, retirees, and anyone who wants a genuinely affectionate companion without the demands of a high-energy working breed, the Shih Tzu is an excellent match. They adapt readily to smaller living spaces, do not need large gardens, and are content with moderate daily activity as long as they have company and engagement. They do not tolerate being left alone for long periods well, and a Shih Tzu that is regularly isolated will develop separation anxiety.

Shih Tzu Grooming — The Most Important Section

Grooming is the central practical demand of Shih Tzu ownership, and it deserves more attention than it typically receives in breed overview articles. The Shih Tzu's double coat — a soft, dense undercoat beneath a long, silky outer coat — is one of the breed's most striking features and also one of its most demanding care requirements. This coat does not shed in the way that many other breeds' coats do; instead, dead hair becomes entangled in the living coat and forms mats if not brushed out regularly. Left unattended, mats develop close to the skin, pulling on the skin with every movement and causing genuine discomfort. Severe matting can trap moisture and debris against the skin, creating conditions for infection.

For owners who want to maintain the traditional long coat, daily brushing is not optional — it is a daily requirement without exception. The correct tools are a pin brush and a metal comb, used systematically through all sections of the coat including the legs, behind the ears, under the "armpits," and around the sanitary area where matting tends to concentrate. The technique matters as much as the frequency: brushing from the tips of the hair upward and working gently through tangles before they become mats is more effective and less uncomfortable for the dog than driving a brush through the coat from root to tip. Many owners with dogs in full coat also use a conditioning spray to reduce friction during brushing.

The most practical choice for the majority of companion Shih Tzu owners is the puppy cut — a clipped style in which the coat is trimmed short all over the body, typically to one to two inches in length. The puppy cut dramatically reduces the daily maintenance burden: brushing every two to three days is adequate rather than daily, and the coat is far less prone to matting. The trade-off is the cost and frequency of professional grooming appointments, needed every six to eight weeks to keep the cut looking neat. Most owners find this a far more manageable routine than maintaining a full-length coat.

Eye care is one of the most important and often overlooked aspects of Shih Tzu grooming. The breed's large, prominent eyes produce discharge naturally, and this discharge — combined with the long hair around the face — creates the conditions for tear staining and, more seriously, skin fold irritation and infection. The eye area should be cleaned gently with a damp cloth or dedicated eye wipes every day, removing any dried or fresh discharge before it accumulates. Tear stains — the reddish-brown discolouration below the inner corner of the eye — are primarily a cosmetic concern but can indicate excessive tearing from blocked ducts, entropion, or chronic eye irritation, which warrants veterinary assessment. The hair over the eyes is typically tied up in the traditional topknot or trimmed back to prevent it from falling into the eyes and causing irritation.

Ear care is equally important. Shih Tzu ears are dropped and well-covered in hair, creating a warm, low-airflow environment ideal for the growth of yeast and bacteria. Weekly ear inspection — checking for redness, odour, or abnormal discharge — and cleaning with a veterinary ear cleaner as needed helps prevent the chronic ear infections to which the breed is prone. Many groomers and veterinarians also remove hair from the ear canal, though there is some debate about whether this is always beneficial. Regular dental care — daily tooth brushing with dog-specific toothpaste — is also essential, as dental disease is nearly universal in the breed without consistent home care. Read more about bathing frequency and routine in our guide on how often to bathe a dog.

Exercise Needs

The Shih Tzu has low to moderate exercise needs compared to many other breeds, which is one of the factors that makes them so well-suited to apartment living and to owners with less active lifestyles. Two short walks per day, totalling around thirty to forty-five minutes, is generally sufficient to meet a healthy adult Shih Tzu's physical exercise requirements. They enjoy indoor play sessions and brief garden romps, and they are content to spend a substantial portion of the day simply resting with their family.

However, there is an important caveat that must always accompany any discussion of Shih Tzu exercise: brachycephalic breathing. The Shih Tzu's flat face and compressed airway anatomy mean that the breed is genuinely vulnerable to respiratory distress in warm weather and during intense exercise. They overheat more quickly than non-brachycephalic breeds because their ability to pant efficiently — the primary mechanism by which dogs cool themselves — is compromised by the narrowed airways. In warm weather, exercise should be restricted to the cooler parts of the day, kept short, and immediately followed by rest in a cool environment. Any signs of laboured breathing, excessive panting, pale or blue-tinged gums, or obvious distress should be treated as an emergency.

On humid, hot days, the safest choice is indoor activity — play sessions, training exercises, and enrichment activities — rather than outdoor walks. Shih Tzus should never be left in hot cars or warm spaces without ventilation. Their moderate exercise needs are genuinely moderate, but those needs must always be met in a way that takes their breathing limitations into account.

Common Health Problems

The Shih Tzu is a generally healthy breed with a lifespan of ten to sixteen years, but there are several heritable and structural conditions that owners should understand before acquiring one. Many of these are directly related to the breed's anatomy, particularly its flat face and large, prominent eyes.

Brachycephalic obstructive airway syndrome, commonly known as BOAS, is the most significant structural health issue in Shih Tzus. The condition encompasses a combination of anatomical abnormalities — stenotic nares (narrowed nostrils), an elongated soft palate that partially obstructs the airway, a narrowed trachea, and everted laryngeal saccules — that collectively restrict airflow. Mild BOAS manifests as snoring, noisy breathing, and reduced exercise tolerance. Severe BOAS causes genuine respiratory distress, collapse during exercise or in heat, and significantly reduced quality of life. Surgery to widen the nostrils and shorten the soft palate is available and, in moderate to severe cases, produces meaningful improvement. Responsible breeders work to select for less extreme facial structure to reduce the severity of BOAS in breeding lines.

Eye conditions are a constant concern in Shih Tzus. The large, prominent eyes are inherently more vulnerable to injury and to conditions such as corneal ulcers, which can develop from minor scratches or chronic irritation from facial hair. Dry eye (keratoconjunctivitis sicca), in which the tear film is inadequate, is common and requires lifelong treatment with lubricating eye drops or cyclosporine. Progressive retinal atrophy, a degenerative condition leading to blindness, occurs in the breed and has a DNA test available. Entropion — inward rolling of the eyelid — can cause chronic corneal irritation and requires surgical correction. Any change in eye appearance, discharge, or behaviour around the eyes warrants prompt veterinary assessment.

Dental disease is perhaps the most prevalent health issue in Shih Tzus, affecting the vast majority of the breed to some degree. The small jaw contains a full complement of adult teeth, which are often crowded and misaligned, creating pockets where plaque and tartar accumulate and periodontal disease develops. Without consistent dental home care and regular professional dental cleaning under anaesthetic, dental disease progresses to painful tooth loss and, in severe cases, jaw bone damage and systemic infection. Daily tooth brushing is the single most impactful intervention for Shih Tzu dental health.

Hip dysplasia — abnormal development of the hip joint — occurs in Shih Tzus, though it tends to be less severe than in larger breeds. Ear infections are common due to the anatomy described above. Some Shih Tzus also develop renal dysplasia, an inherited condition affecting kidney development, which can present as kidney failure in young dogs — health testing for this condition should be part of responsible breeding programmes.

Training a Shih Tzu

Training a Shih Tzu is a genuinely mixed experience. On the positive side: they are highly food-motivated, which gives you a reliable lever for positive reinforcement. They are social and enjoy interaction with their owner, which means training sessions can be pleasant for both parties when structured correctly. They are quick to learn when properly motivated — they are not unintelligent dogs by any measure. On the less positive side: they have a stubbornness that can be extraordinary, and they are very skilled at selective deafness when they have decided that compliance is not in their interest.

The most effective approach is consistent positive reinforcement using high-value food rewards. Keep training sessions short — five to ten minutes at a time — as Shih Tzus lose focus quickly and will disengage from a session that goes on too long. End every session on a success, even if that means asking for something simple that you know they can do. Never use punishment, raised voices, or physical correction — these approaches damage trust and produce a dog that is anxious and avoidant rather than responsive. Clicker training works very well with Shih Tzus because the clear, immediate marker sound helps them understand exactly what behaviour earned the reward.

Housetraining deserves special mention because Shih Tzus have a reputation for being difficult to housetrain, and this reputation is at least partly deserved. Consistency and patience are essential. Crate training is highly effective as a housetraining tool — the crate provides a secure space and leverages the dog's natural instinct not to soil its sleeping area. Taking the puppy outside at frequent, predictable intervals (after waking, after eating, after play, and every hour or two in between) and rewarding outdoor elimination immediately and enthusiastically builds the habit. Accidents inside should be cleaned with an enzymatic cleaner that eliminates the scent; any odour trace will encourage return to the same spot. Housetraining a Shih Tzu may take longer than housetraining some other breeds, but with consistent effort it is absolutely achievable. For a comprehensive new dog checklist, see our new dog owner checklist.

Feeding Recommendations

Shih Tzus do well on high-quality commercial dog food — either dry kibble, wet food, or a combination — formulated for small breeds. Small breed formulas are worth choosing because they tend to have smaller kibble sizes suited to the Shih Tzu's small mouth and teeth, and energy densities calibrated to the smaller body size and metabolic rate of toy breeds. Adult Shih Tzus are typically fed twice daily, with the total daily amount divided between the two meals rather than fed all at once.

Portion control is important because Shih Tzus can easily become overweight, and excess weight places additional strain on an already compromised respiratory system. Follow the feeding guidelines on the food packaging as a starting point, adjusting based on the individual dog's body condition. You should be able to feel the ribs easily with light finger pressure but not see them prominently. A clearly visible waist when viewed from above, and a tucked abdomen when viewed from the side, are signs of appropriate weight. Treats should be counted as part of the daily calorie allowance rather than added on top of full meals.

Shih Tzu puppies require more frequent feeding — three to four times daily — to maintain stable blood sugar and support growth. Transition to twice-daily feeding can occur around the age of six months. Fresh water should always be available. Because of their flat faces, some Shih Tzus find it easier to eat and drink from shallow, wide bowls rather than deep ones — this simple adjustment can reduce gulping of air and the digestive discomfort that sometimes accompanies it.

Is a Shih Tzu Right for You?

The Shih Tzu is right for someone who genuinely enjoys the grooming process, or who is willing to commit to the time and cost of regular professional grooming. It is right for someone who wants an affectionate, sociable companion that is happy in an apartment or a smaller home, that does not require long runs or vigorous exercise, and that wants to be close to its people throughout the day. It is right for families with older children, for retirees, for people who work from home, and for anyone who values a dog with a big personality in a small package.

The Shih Tzu is not right for someone who wants a low-maintenance dog — this breed requires consistent grooming investment regardless of coat length. It is not right for someone who is away from home for long hours every day without arrangements for the dog's company and care, as Shih Tzus are prone to separation anxiety. It is not right for someone who wants a robust outdoor adventure companion, as the brachycephalic structure limits what is safe in terms of heat, humidity, and exertion. And it is not right for someone who is easily frustrated by a dog that will test their training patience with cheerful, comical stubbornness.

For those who are a good match, the Shih Tzu is a genuinely wonderful companion: funny, warm, adaptable, and deeply attached to the people it loves. These are dogs that have been bred for thousands of years to do one thing exceptionally well — to be a companion — and they do it brilliantly. Go in with clear expectations about the grooming commitment and the health considerations, and you will be well prepared for life with one of the most charming small breeds in the world. You can also explore the full overview of dog ownership in our complete dog care guide.

Frequently Asked Questions

Are Shih Tzus high maintenance?

Yes — Shih Tzus are considered one of the higher-maintenance dog breeds, primarily because of their coat. If kept in a long coat, daily brushing and professional grooming every four to six weeks are non-negotiable. Even in a shorter puppy cut, trimming every six to eight weeks is required. Beyond the coat, their eyes, ears, and teeth all need regular attention. For owners who enjoy the grooming routine and are prepared to invest the time and money, the Shih Tzu is deeply rewarding — but the commitment should not be underestimated before bringing one home.

How often does a Shih Tzu need to be groomed?

A Shih Tzu in a long coat needs brushing every single day — skipping even a few days allows the fine, silky hair to mat, and mats close to the skin are painful to remove. A Shih Tzu in a puppy cut needs brushing every two to three days and a professional trim every six to eight weeks. The eye area should be cleaned daily, ears checked and cleaned weekly, and teeth brushed daily or at least several times a week. Professional grooming appointments typically include a bath, blow-dry, trim, nail clip, ear clean, and anal gland expression.

Do Shih Tzus bark a lot?

Shih Tzus can be moderately vocal but are not among the most relentlessly barking breeds. They tend to bark at strangers, unfamiliar sounds, or when seeking attention — they are alert and will let you know when something has caught their notice. With early training and socialisation, excessive barking can be managed effectively. They are generally well-suited to apartment living from a noise perspective. However, a Shih Tzu left alone for extended periods may develop separation anxiety, which can manifest as persistent barking.

Are Shih Tzus good with children?

Shih Tzus are generally good with children, particularly older children who handle small dogs respectfully. They are affectionate, playful, and sociable — qualities that serve them well in family settings. The main concern is their small size: rough handling or accidental falls can cause injury, so very young toddlers require close supervision around a Shih Tzu. With appropriate introductions, most Shih Tzus form warm bonds with children in the household and are surprisingly sturdy in temperament despite their small physical frame.

What health problems do Shih Tzus commonly have?

Shih Tzus are prone to several conditions that prospective owners should know about. Brachycephalic obstructive airway syndrome (BOAS), caused by the flat-faced structure, is the most significant and can range from mild snoring to severe breathing difficulty requiring surgery. Eye conditions are common — corneal ulcers, dry eye, and progressive retinal atrophy all occur in the breed. Dental disease is nearly universal due to crowded teeth in a small jaw. Hip dysplasia and ear infections also occur. Regular veterinary check-ups and responsible breeding health testing are essential for managing these risks.

---

Disclaimer: This article is for educational purposes only. Always consult a licensed veterinarian for your pet's health and medical needs.