Daily Routine Adjustments for Senior Shih Tzus' Health

[Shih Tzu](https://seniorpet.org/knowledge/breed/shih-tzu "Senior Shih Tzu Health Guide") | Senior age: 9–10 years | Lifespan: 10–16 years Category: daily_care

Shih Tzus are a beloved toy breed with distinctive [brachycephalic](https://seniorpet.org/knowledge/persian-cat-brachycephalic-airway "Brachycephalic Syndrome Guide") facial anatomy, large prominent eyes, a dense double coat, and compact mouths. At 9–10 years of age many Shih Tzus enter their senior life stage and become at increased risk for several breed-relevant health issues: ocular disease (including proptosis, keratoconjunctivitis sicca/dry eye, and progressive retinal atrophy), periodontal disease, [chronic kidney disease](https://seniorpet.org/knowledge/siamese-cat-kidney-disease "Chronic Kidney Disease Management"), brachycephalic obstructive airway syndrome (BOAS), and intervertebral disc disease (IVDD). Daily routine adjustments tailored to the Shih Tzu's body and common conditions can reduce pain, slow disease progression, and maintain [quality of life](https://seniorpet.org/knowledge/siamese-cat-quality-of-life "Quality of Life Assessment"). This article gives practical, veterinary-accurate, breed-specific guidance you can implement at home and coordinate with your veterinarian.

Why routines matter for senior Shih Tzus

As toy-breed seniors, Shih Tzus show subtle changes more easily than larger dogs. Small weight changes, minor mobility restrictions, or early vision changes can have outsized effects on function. Routine adjustments help to:

• Minimize risks of acute emergencies (eye injuries, airway collapse, acute disc herniation).
• Reduce chronic disease progression (periodontal disease, CKD).
• Improve safety and mobility (ramps, harnesses).
• Make veterinary treatments safer and more effective (pre-op stabilization for dental or airway surgery).

Routine care should be coordinated with semi-annual or annual veterinary rechecks tailored to your dog’s health status.

Recommended check schedule for senior Shih Tzus

| What to check | Frequency (senior Shih Tzu) | Why it matters | |---|---:|---| | Full physical exam & weight | Every 3–6 months | Early detection of weight loss/gain, heart/respiratory changes, pain | | CBC, serum chemistry, electrolytes, SDMA | Every 6 months (or as directed) | Baseline and monitoring for CKD, liver disease, electrolyte imbalances | | Urinalysis ± urine culture; urine protein:creatinine ratio | Every 6 months | Detect early kidney disease and urinary protein loss (CKD progression) | | Dental exam under anesthesia + dental charting/X-rays | Annually or every 6–12 months depending on periodontal stage | Small mouths = rapid periodontal disease; radiographs reveal root disease | | Basic ophthalmic exam (by GP vet) | Every 6–12 months; earlier if symptoms | Shallow orbits and exposed corneas predispose to dry eye, ulcers, proptosis | | Ophthalmology referral | If persistent ocular signs, vision changes, or for PRA screening | Specialized management of corneal disease, medical or surgical options | | Thoracic/neck/vertebral imaging (if any signs of pain/paresis) | As-needed | Assess IVDD or other spinal problems | | BOAS assessment (clinical) | If snoring, exercise intolerance, gagging, cyanosis | Determine need for surgical correction and peri-anesthetic planning |

These are starting points; your veterinarian will adjust frequency based on stage of disease and individual needs.

Eyes: everyday adjustments and warning signs

Shih Tzus’ large, prominent globes and shallow orbits make them vulnerable to several eye issues common in seniors.

Common breed-relevant eye problems:

• Proptosis: the globe can be pushed partially or completely out of the orbit with even mild trauma.
• Keratoconjunctivitis sicca (KCS, “dry eye”): decreased tear production leading to persistent corneal inflammation.
• [Progressive retinal atrophy](https://seniorpet.org/knowledge/siamese-cat-progressive-retinal-atrophy "Progressive Retinal Atrophy Guide") (PRA): inherited degenerative disease causing progressive vision loss.

Daily care and practical steps:

• Keep face hair trimmed away from the eyes. Loose hairs cause chronic irritation and contribute to corneal ulcers. Use blunt-ended scissors or have a groomer trained in handling senior dogs.
• Clean ocular discharge gently twice daily with a soft, lint-free cloth and saline (sterile isotonic). If discharge is thick, colored, or odorous, seek veterinary attention.
• Use prescribed lubricating drops/ointments as directed. For KCS, long-term treatment with cyclosporine 0.2% or tacrolimus 0.02% ophthalmic drops is common and science-based; artificial tears are used multiple times daily for symptomatic relief (see Gelatt, Veterinary Ophthalmology).
• Protect eyes from drafts, sharp toys, or other dogs’ paws. Use short-sleeved shirts or protective eye visors (e.g., goggles) during high-risk activities.
• Monitor for signs of vision loss: bumping into furniture, hesitation on stairs, wandering at night. Have a veterinary ophthalmologist evaluate suspected vision changes.
• Emergency: proptosis is an ocular emergency. If the eye pops forward, keep it moist with saline and seek immediate veterinary care—timely treatment (within hours) can sometimes save the globe (repair or repositioning) but enucleation may be needed.

Practical at-home schedule:

• Eye cleaning: daily or more if discharge.
• Artificial tear application: 2–6× daily depending on tear film status.
• Prescription immunomodulators (cyclosporine/tacrolimus): as prescribed by your vet; expect weeks for improvement.

References: Gelatt's Veterinary Ophthalmology; clinical guidance from veterinary ophthalmologists on KCS and trauma management.

Dental care: small mouths need big attention

Shih Tzus have crowded teeth and a high risk of periodontal disease. Periodontal disease contributes to chronic inflammation, bacterial spread to the kidneys and heart, and pain that can be hidden.

Daily routine adjustments:

• Tooth-brush daily with canine toothpaste and a soft brush. Even 3–4× weekly reduces plaque progression.
• Use enzymatic toothpaste or oral rinses approved for dogs if brushing is difficult.
• Offer safe dental chews sized for toy breeds and supervised to avoid choking; avoid large hard chews (hooves, large bones) that can fracture teeth.
• Implement water additives or dental diets if recommended by your veterinarian; these can reduce plaque but do not replace brushing.
• Schedule regular veterinary dental cleanings with full-mouth radiographs. Because Shih Tzus are brachycephalic, anesthetic plans should be individualized (see airway and anesthesia precautions below).

Signs that require urgent dental attention:

• Halitosis, inflamed gums, pawing at mouth, reluctance to chew, visible loose teeth, or facial swelling.

Reference: American Veterinary Dental College (AVDC) guidance on periodontal disease prevention and management.

Kidneys: monitoring and medication safety

Chronic kidney disease (CKD) is common in older dogs. Because Shih Tzus are small and may have [dental disease](https://seniorpet.org/knowledge/siamese-cat-dental-disease "Dental Disease in Senior Pets") and comorbidities, vigilance is important.

Routine monitoring and daily adjustments:

• Baseline and serial bloodwork every 6 months: chemistry panel including BUN/creatinine and SDMA (Symmetric Dimethylarginine) which detects early decreased renal function.
• Urinalysis every 6 months and urine protein:creatinine ratio if proteinuria suspected. Blood pressure measurement is important—hypertension both causes and worsens CKD.
• If CKD is diagnosed, follow IRIS staging-guided therapy (dietary phosphorus and protein management, phosphate binders, anti-proteinuric drugs if indicated) and more frequent lab monitoring.
• Avoid NSAIDs and other nephrotoxic medications unless judged safe by your veterinarian; many over-the-counter and prescription drugs can worsen kidney function. If pain control is needed (for IVDD or osteoarthritis), discuss alternatives and check renal values before and during use.
• Encourage regular, small, palatable meals; many Shih Tzus prefer multiple small meals which can help maintain hydration and appetite.
• Monitor drinking and urination: increased thirst/urination (polyuria/polydipsia) or decreased appetite/wasting warrant prompt veterinary evaluation.

Reference: IRIS (International Renal Interest Society) CKD guidelines; veterinary nephrology consensus statements.

Airway and anesthesia: special precautions for brachycephaly

Shih Tzus are brachycephalic; they commonly have a narrow nostril (stenotic nares), elongated soft palate, and sometimes hypoplastic trachea—features that contribute to BOAS. Senior Shih Tzus may have reduced respiratory reserve.

Daily management and prevention:

• Avoid vigorous exercise, especially in heat or high humidity. Walk early morning/evening in warm months.
• Prevent [obesity](https://seniorpet.org/knowledge/golden-retriever-weight-management-obesity "Weight Management for Senior Pets"): extra weight worsens respiratory compromise. Weigh monthly and adjust portions as needed.
• Use a well-fitting harness instead of a collar to avoid pressure on the trachea and neck—this reduces coughing and tracheal collapse risk during leash walks.
• Recognize BOAS signs: loud snoring, inspiratory stridor/gagging, cyanosis, collapse, exercise intolerance, and prolonged recovery after exercise. Consult your veterinarian for formal BOAS evaluation.
• If surgery is recommended (widening nares, staphylectomy), discuss perioperative risks with a vet experienced in brachycephalic anesthesia. Pre-oxygenation, short anesthesia times, careful fluid and temperature control, and postoperative monitoring in an oxygen-enriched environment reduce complications.

Dental cleanings and other anesthetic procedures require special planning:

• Request a pre-anesthetic workup (bloodwork, chest auscultation, possible chest radiographs).
• Consider consult with an anesthesiologist or a clinic that frequently manages brachycephalic breeds.
• Plan for slower, supervised recovery with muzzle/airway care and elevation if swelling is a risk.

Reference: Reviews on brachycephalic airway syndrome and anesthesia considerations (see Packer et al. and anesthesia textbooks).

Spine and mobility: preventing and managing IVDD

Intervertebral disc disease causes back pain and neurologic deficits and can affect small breeds like Shih Tzus. Preventing sudden disc injuries and recognizing early signs are important.

Daily routine adjustments:

• Prevent jumping onto/off furniture. Use ramps, steps, or pick-up/put-down routines to avoid sudden spinal loading.
• Use non-slip rugs on slippery floors; maintain footholds to reduce twisting or slipping that can precipitate disc injury.
• Keep body weight ideal. Extra pounds increase axial load on the spine.
• Short, controlled leash walks are preferable to vigorous running or twisting play. Avoid sudden starts/stops and rough play with larger dogs.
• Consider physiotherapy or controlled exercise programs (core strengthening, balance work) guided by a veterinary rehab specialist; hydrotherapy is beneficial for muscle support with low impact.
• If your Shih Tzu shows back pain, reluctance to jump, hunched posture, or hindlimb weakness, seek veterinary evaluation promptly. Early anti-inflammatory therapy, strict crate rest, or surgical referral may be indicated.

Reference: Veterinary neurologic/orthopedic texts and IVDD management guidelines.

Practical daily routine: a sample day adjusted for senior Shih Tzu health

Morning

• Brief leash walk (10–15 minutes) in cool hours; monitor breathing and gait.
• Eye check: clean discharge with saline; apply prescribed ophthalmic meds if scheduled in morning.
• Small measured breakfast appropriate for kidney/weight/dental recommendations.
• Brush teeth or provide 5–10 minutes of supervised dental chew.

Midday

• Short indoor mental enrichment (gentle puzzle feeder) to stimulate appetite without heavy exertion.
• Take vitamins or medications as prescribed; check for side effects.
• Grooming: quick face/eye hair tidy; inspect for skin mats, which can be painful.

Evening

• Gentle walk or potty break; avoid heat.
• Light massage and gentle range-of-motion exercises for comfort and circulation (ask your vet for specific moves).
• Evening meds/eye drops as prescribed.
• Nighttime: ensure sleeping area is at floor level (no high beds), with a ramp if your dog uses furniture.

Throughout the day

• Monitor for changes: respiratory noise, coughing, appetite change, decreased water intake (CKD concern), halitosis, dental pain signs, vision behavior changes, or limping/reluctance to move.

Medication and treatment interactions to watch for

• NSAIDs and CKD: many NSAIDs can worsen kidney function. If your Shih Tzu has renal disease or borderline renal values, discuss alternatives (gabapentin, amantadine, cautious opioid use, local therapies) and ensure frequent bloodwork.
• Topical ophthalmic drugs: some immunomodulators (cyclosporine/tacrolimus) can take weeks to work—don’t stop treatments prematurely. Combine with lubricants for symptomatic relief.
• Anesthesia risk: brachycephalic airway changes and possible cardiac/renal comorbidities require a tailored anesthetic plan and postoperative monitoring.

Always supply your veterinarian with a full list of supplements and medications (human medications can be toxic to dogs).

When to seek emergency care

Seek immediate veterinary attention for:

• Eye proptosis (globe displaced from socket) — keep moist and go to ER.
• Severe respiratory distress: open-mouth breathing with collapse, blue/pale gums.
• Acute onset of paresis (hindlimb weakness), severe back pain, or incontinence.
• Refusal to eat/drink with vomiting or known kidney disease.
• Severe bleeding or facial trauma.

Working with your veterinarian and specialists

• Share a written list of daily routines, medications, and any home observations (snoring, coughing, appetite changes, mobility). Small changes are often the earliest indicators of disease.
• For complex eye, airway, or neurologic problems, seek referrals: board-certified veterinary ophthalmologists, surgeons with brachycephalic experience, and neurologists/neurological surgeons.
• Ask about preventive genetic testing if you are planning breeding—PRA testing resources and breed clubs can provide guidance. For an affected dog, an ophthalmology consult helps confirm the diagnosis and plan for long-term care/adaptation.

Grooming and environment adjustments that matter

• Keep coat trimmed around the eyes and mouth—less irritation and easier monitoring of ocular health.
• Avoid aerosol irritants and cigarette smoke, which exacerbate airway disease.
• Provide non-slip flooring or rugs to reduce slips that could precipitate IVDD.
• Maintain comfortable indoor temperature and avoid heat stress; brachycephalic dogs are poor heat dissipaters.
• Use a harness rather than collar for leash control; choose a harness that fits well and doesn’t compress the trachea.

End-of-life planning and quality-of-life assessment

Senior Shih Tzus may maintain excellent quality of life with good daily management, early detection, and appropriate veterinary care. Use validated quality-of-life questionnaires (available from veterinary oncologists/ethicists) and discuss palliative options, pain control, and hospice care with your veterinarian if chronic disease progresses. Decisions about surgery for BOAS or IVDD in a senior Shih Tzu must weigh potential benefits against anesthesia risk and the dog's overall medical status.

Summary: practical takeaways for everyday care

• Eye protection and frequent cleaning are crucial; keep face hair trimmed and use prescribed ophthalmic therapy for KCS.
• Aggressive dental [home care](https://seniorpet.org/knowledge/pillar/home-care-guide "Senior Pet Home Care Guide") plus regular professional cleanings reduce progression of periodontal disease that affects systemic health.
• Monitor kidney function with bloodwork and urine testing every 6 months; avoid nephrotoxic drugs.
• Adapt activity to protect the airway and spine: harness use, avoid heat/overexertion, ramps instead of jumps, and maintain ideal body weight.
• Coordinate anesthesia and surgery with veterinarians experienced in brachycephalic patients; plan for pre-/post-op care.

Implementing these daily routine adjustments — small, consistent changes to grooming, feeding, exercise, and monitoring — will help your senior Shih Tzu stay comfortable and safe through their golden years. Work closely with your veterinarian to tailor frequency of checks, diagnostics, and treatments to your dog’s individual needs.

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References and resources (select reading)

• Gelatt, K. N. (ed.). Veterinary Ophthalmology. (Textbook covering proptosis, KCS, and PRA management.)
• IRIS (International Renal Interest Society) guidelines for staging and managing CKD.
• American Veterinary Dental College (AVDC) resources on periodontal disease prevention and treatment.
• Packer, R. M. A., Hendricks, A., & Burn, C. C. Reviews on brachycephalic airway syndrome and breed-related conformation concerns (see recent veterinary literature on BOAS).
• Consultations with board-certified specialists: ACVO (ophthalmology), ACVIM/AVCA (internal medicine), ACVS/ACVSMR (surgery/rehab).

If you’d like, I can create a one-week printable checklist tailored to your Shih Tzu’s current diagnoses (eye drops schedule, medication times, exercises, and vet follow-up calendar).