Creating a Safer Home for Aging Shih Tzus: Tips

Shih Tzus are affectionate, companion-oriented, [brachycephalic](https://seniorpet.org/knowledge/persian-cat-brachycephalic-airway "Brachycephalic Syndrome Guide") toy dogs with a typical lifespan of 10–16 years. Around 9–10 years they commonly enter the senior life stage and begin showing changes in mobility, vision, dental health, breathing, and organ function. Because of their skull shape, compact build, and facial conformation, senior Shih Tzus have breed-specific risks that deserve targeted home modifications, vigilance, and veterinary partnership.

This article explains the most important breed-specific problems (proptosis, dry eye/keratoconjunctivitis sicca, [progressive retinal atrophy](https://seniorpet.org/knowledge/siamese-cat-progressive-retinal-atrophy "Progressive Retinal Atrophy Guide"), periodontal disease, [chronic kidney disease](https://seniorpet.org/knowledge/siamese-cat-kidney-disease "Chronic Kidney Disease Management"), brachycephalic airway syndrome, and intervertebral disc disease), then gives practical, actionable steps you can put in place to reduce injury and improve [quality of life](https://seniorpet.org/knowledge/siamese-cat-quality-of-life "Quality of Life Assessment") for your senior [Shih Tzu](https://seniorpet.org/knowledge/breed/shih-tzu "Senior Shih Tzu Health Guide").

Why Shih Tzus need specialized senior care

• Brachycephalic anatomy predisposes to airway obstruction and ocular exposure (shallow orbit, prominent eyes).
• Small size and short limbs combined with heavier head and long coat increase risk of slips, falls, and spinal stress.
• Small-breed dogs have high lifetime risk of periodontal disease; [dental disease](https://seniorpet.org/knowledge/siamese-cat-dental-disease "Dental Disease in Senior Pets") contributes to systemic illness such as CKD.
• Aging increases the chance of multi-organ disease; Shih Tzus frequently require more frequent monitoring and gentle environmental adaptation than larger or mesocephalic breeds.

Veterinary research into brachycephalic airway syndrome, small-breed dental disease, and chronic kidney disease supports close monitoring and early intervention for long-term health and welfare in older toy breeds (Packer et al., 2015; Harvey, 1998; Polzin, 2013).

Quick reference table: senior Shih Tzu risks and home actions

| Condition | Why Shih Tzu are at risk | Signs to watch for | Practical home actions | |---|---:|---|---| | Brachycephalic airway syndrome (BOAS) | Short muzzle, stenotic nares, elongated soft palate | Noisy breathing, snoring, exercise intolerance, cyanosis, gagging | Keep cool, avoid excitement/heat, weight control, consult surgeon about surgery (nares resection/staphylectomy) | | Corneal proptosis & ulcers | Prominent eyes, shallow orbit | Sudden bulging eye (emergency), squinting, tearing, redness | Keep face trimmed, avoid rough play, protective goggles for trips, emergency cover and vet care | | Dry eye (KCS) | Breed predisposition to tear film disorders | Thick mucous discharge, red conjunctiva, cloudiness | Daily ocular lubrication as prescribed, regular Schirmer tear tests | | Progressive retinal atrophy (PRA) | Breed-associated retinal degenerations reported | Night blindness, dilated pupils, vision loss over months | Night walking aid, avoid stairs, consider ophthalmology referral and DNA testing | | Periodontal disease | Small teeth crowded in a small skull | Bad breath, gingival recession, loose teeth, drooling | Daily brushing, dental chews, professional cleanings under anesthesia, home plaque control | | Chronic kidney disease (CKD) | Age-related renal decline; can be worsened by dental bacteria | Increased thirst/urination, weight loss, decreased appetite | Regular blood/urine monitoring, early diet changes, avoid NSAIDs | | Intervertebral disc disease (IVDD) | Chondroid degeneration risk; short-legged body conformation | Reluctance to jump, back pain, hind limb weakness | Block stairs, ramps, harness support, maintain lean body condition |

(References: Packer et al., 2015; Harvey, 1998; Polzin, 2013; Gelatt & Gilger, 2013)

Setting up a safer home: room-by-room recommendations

Flooring and traction

• Replace slippery floors (tile, hardwood) with non-slip rugs or place low-pile runners on commonly used paths. Secure rugs to prevent movement.
• Use non-skid mats near food/water and bed areas.
• Trim long hair between paw pads to reduce slipping.
• Consider rubber-coated stair treads if stairs are unavoidable.

Sleeping and resting areas

• Provide a firm, orthopedically supportive bed with low entry height. Memory-foam toppers reduce pressure on arthritic joints.
• Place beds on stable, non-slip surfaces; avoid beds with high sides that make turning or standing difficult.
• Keep beds in cool, well-ventilated areas to reduce breathing strain during warm months.

Access to high places

• Install a stable ramp or small pet stairs for access to couches, cars, and beds. For small breeds, pet stairs with 3–4 steps and risers of 5–7 inches are usually appropriate. Non-slip surfaces and handrails for owners help safe transfer.
• Teach and reward ramp/stair use while young; late training can succeed with patience.

Food, water, and feeding stations

• Use a non-tip bowl with shallow sides. For brachycephalic dogs, bowls should be low and wide to allow comfortable breathing while eating.
• Maintain fresh water access everywhere; older Shih Tzus may drink more with early kidney disease.
• Consider a water-fountain device (filtered, running water) that may encourage drinking.

Temperature and humidity control

• Shih Tzus with BOAS tolerate heat poorly. Keep living spaces cool (air conditioning or fans), especially in summer.
• Avoid heavy exercise in warm/humid conditions. Plan walks for early morning/evening.
• Humidifiers may help dogs with dry eyes and airway irritation.

Eye-specific safety and care

Shih Tzus have prominent eyes and are predisposed to corneal ulcers, proptosis (eye displacement), keratoconjunctivitis sicca (KCS/dry eye), and some forms of progressive retinal disease.

Actionable measures:

• Keep facial hair trimmed around the eyes to prevent mechanical irritation and reduce tear staining that hides early problems.
• Perform daily visual checks: look for redness, excessive tearing, squinting, corneal cloudiness, or any change in pupil size or behavior around lights.
• For dogs diagnosed with KCS, use veterinary-prescribed lacrimomimetics (artificial tears) 2–4 times daily or as directed. Before starting treatment, a Schirmer tear test should be performed (Gelatt & Gilger, 2013).
• Proptosis is an emergency — if an eye is protruding, cover the eye with a moistened, clean compress and transport immediately to an emergency veterinarian. Rapid treatment increases chances of saving vision and the globe.
• For progressive vision decline (PRA), reduce fall risks: add night lights, keep furniture placements consistent, and use verbal cues for navigation.

Reference: Veterinary Ophthalmology texts and peer-reviewed reviews emphasize early tear testing and protection in brachycephalic breeds (Gelatt & Gilger, 2013).

Dental care: prevention and practical plans

Periodontal disease is nearly ubiquitous in small-breed dogs by middle age. Dental disease can contribute to systemic inflammation, and bacteria from the mouth can seed kidneys and other organs.

Practical steps:

• Brush teeth daily with canine toothpaste and a soft brush; even 3–4 times per week significantly reduces plaque.
• Use enzymatic toothpaste and vet-recommended dental gels. Avoid human toothpaste (contains xylitol).
• Provide veterinary-approved dental chews and toys that mechanically remove plaque (choose size/texture appropriate for Shih Tzu).
• Schedule professional dental cleanings as recommended by your veterinarian — many senior Shih Tzus benefit from annual or biannual exams/cleanings depending on disease severity.
• Because anesthesia carries higher risk in brachycephalic breeds, request pre-anesthetic bloodwork (CBC, chemistry panel, and ideally SDMA) and discuss airway plans with your vet to reduce perioperative complications.

Reference: Dental health literature and AVDC guidelines recommend [home care](https://seniorpet.org/knowledge/pillar/home-care-guide "Senior Pet Home Care Guide") plus periodic professional cleanings for small breeds (Harvey, 1998; American Veterinary Dental College).

Respiratory health and brachycephalic airway syndrome (BOAS)

Shih Tzus commonly show signs of BOAS: stenotic nares (narrow nostrils), elongated soft palate, hypoplastic trachea, and laryngeal collapse in advanced cases. These changes are progressive and exacerbated by [obesity](https://seniorpet.org/knowledge/golden-retriever-weight-management-obesity "Weight Management for Senior Pets"), heat, and excitement.

Home management:

• Prevent weight gain; even modest overweight worsens airway resistance. Monitor body condition score and muscle condition.
• Avoid strenuous activity and exposure to heat/humidity. Walk during cooler parts of the day and avoid forced exercise.
• Use a front-clip harness rather than a neck collar to avoid pressure on the larynx and neck. Harnesses distribute force across the chest.
• If noisy breathing, cyanosis, or episodes of collapse occur, seek veterinary assessment. Surgical correction (nares resection, staphylectomy/soft palate resection) can significantly improve breathing and quality of life when performed by experienced surgeons (Packer et al., 2015).
• Avoid sedatives or medications that suppress respiration unless prescribed and monitored by your vet.

Reference: Brachycephalic airway research supports weight control, environmental management, and surgical correction in suitable candidates (Packer et al., 2015).

Spine, mobility, and intervertebral disc disease (IVDD)

Shih Tzus can experience spinal disc degeneration and IVDD, especially as they age. Clinical signs range from stiffness and reluctance to jump to pain or neurologic deficits.

Home modifications and actions:

• Eliminate or reduce jumping onto/off furniture; use ramps or pet steps.
• Keep a regular low-impact exercise routine (short leash walks, controlled play) to maintain muscle mass without overloading discs.
• Use a wide, well-padded harness for support rather than a neck collar.
• Consider physical therapy, hydrotherapy, or at-home guided exercises prescribed by a veterinary rehabilitation specialist to maintain mobility and reduce pain.
• Pay attention to early signs: hunching, cry when picked up, reluctance to leap, asymmetric gait. Sudden onset of hind limb weakness or paralysis is an emergency — seek immediate veterinary attention.

Kidney health: monitoring and prevention

Chronic kidney disease (CKD) is common in older dogs and can be exacerbated by systemic inflammation from dental disease, medications (NSAIDs), and dehydration.

Recommendations:

• Annual or semi-annual wellness bloodwork and urinalysis (including SDMA when available) for early detection. In seniors, 2×/year monitoring is reasonable.
• Monitor water intake and urine output; document increases (polyuria/polydipsia).
• Early-stage CKD may benefit from dietary changes (reduced phosphorus, adjusted protein) implemented under veterinary guidance. Once CKD is confirmed, follow IRIS staging for therapy and monitoring (Polzin, 2013).
• Avoid long-term use of NSAIDs where possible; consult your veterinarian for safe analgesic options with renal monitoring.
• Keep vaccinations and parasite control current, as infections can stress kidneys.

Reference: Clinical nephrology reviews and IRIS guidelines stress early detection through bloodwork and urinalysis and diet-based interventions for CKD (Polzin, 2013; IRIS guidelines).

Medication, anesthesia, and veterinary visits

• Seniors benefit from twice-yearly veterinary exams that include weight, body condition score, dental exam, cardiac auscultation, and basic blood/urine testing. More frequent visits if disease is present.
• Before any anesthesia (dental cleaning or surgery), request pre-anesthetic screening (CBC, chem panel, electrolytes, and ideally SDMA and urinalysis). Discuss anesthetic protocols tailored to brachycephalic dogs: preoxygenation, short-acting induction agents, and experienced monitoring (intubation readiness).
• Keep an up-to-date list of medications, supplements, and any adverse reactions. Avoid over-the-counter NSAIDs or human medications without veterinary approval.
• Consider microchipping and ensure microchip/contact info is current in case of escape, especially if vision is declining.

Daily care checklist for the aging Shih Tzu (practical)

• Brush teeth daily or at least several times per week; use vet-approved products.
• Inspect eyes and clean facial hair daily; schedule Schirmer test if eye discharge or redness is present.
• Keep nails trimmed and paw hair trimmed between pads; check paws after walks.
• Provide 2–3 short walks per day in cool conditions; avoid long runs or heat exposure.
• Monitor eating, drinking, urination, stool, activity level, and sleep; record changes and report to your vet.
• Weigh monthly and adjust diet to maintain lean body mass.
• Use a harness, ramps, and non-slip surfaces in the home.

When to call your veterinarian or seek emergency care

Immediate veterinary or emergency care is warranted for:

• Proptosis (eye displaced out of the socket).
• Sudden onset of paralysis, severe weakness, or urinary/fecal incontinence (possible IVDD or neurologic emergency).
• Collapse, severe difficulty breathing, blue/pale gums, or loss of consciousness (airway emergency).
• Uncontrolled bleeding from the mouth, severe oral pain, or tooth avulsion.
• Marked increase in drinking/urination, repeated vomiting, or severe appetite loss (possible CKD or other systemic illness).

Working with your veterinarian and specialists

• Establish a senior care plan with your primary veterinarian that includes frequency of wellness checks, labwork schedule, dental planning, and weight goals.
• Discuss referrals to specialists for advanced issues: veterinary ophthalmologist for complicated eye disease, board-certified surgeon for BOAS correction, and a neurologist or surgeon for IVDD.
• Ask about sedation and airway management options for dental cleanings and minor procedures; experienced teams can often reduce anesthesia time and risks.

Final thoughts

Caring for a senior Shih Tzu requires attention to breed-specific vulnerabilities: breathing, eyes, teeth, kidneys, and the spine. Many of the problems that reduce quality of life in older Shih Tzus are preventable or manageable with careful home modifications, consistent daily care, timely veterinary screening, and early intervention. Small changes — a ramp, a better bed, daily tooth care, a cooler routine — can add months or years of comfortable, engaged life for your companion.

References (select):

• Packer RMA, Hendricks A, Burn CC. Impact of facial conformation on canine health: brachycephalic obstructive airway syndrome (BOAS). Vet Rec. 2015.
• Gelatt KN, Gilger BC. Veterinary Ophthalmology. (Text/reference for KCS, corneal disease).
• Harvey CE. Periodontal disease in dogs and cats: a common and neglected problem. J Vet Dent. 1998.
• Polzin DJ. Chronic kidney disease in small animals. Vet Clin North Am Small Anim Pract. 2013.
• International Renal Interest Society (IRIS) guidelines.