Comprehensive Screening Schedule for Senior Shih Tzus

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

Shih Tzus are affectionate, [brachycephalic](https://seniorpet.org/knowledge/persian-cat-brachycephalic-airway "Brachycephalic Syndrome Guide") companion dogs with several breed-specific health sensitivities that become more important as they enter their senior years (roughly 9–10 years). This article gives a practical, veterinary-accurate screening schedule tailored for senior Shih Tzus, explains why each test or check matters for this breed, and offers clear owner actions to reduce disease impact and preserve [quality of life](https://seniorpet.org/knowledge/siamese-cat-quality-of-life "Quality of Life Assessment").

Why a breed-specific screening plan matters for senior Shih Tzus

Shih Tzus are small, short-muzzled dogs with prominent eyes and crowded mouths. As they age they are particularly prone to:

• Ocular disease (exposure-related issues such as proptosis and corneal ulcers, keratoconjunctivitis sicca/dry eye, and some inherited retinal diseases)
• Severe periodontal disease because of crowded teeth
• [Chronic kidney disease](https://seniorpet.org/knowledge/siamese-cat-kidney-disease "Chronic Kidney Disease Management") (CKD) as a common senior problem in many small breeds
• Brachycephalic obstructive airway syndrome (BOAS) and its age-related consequences
• Intervertebral disc disease (IVDD) and other mobility-limiting spinal conditions

Targeted screening improves early detection and allows interventions that are less invasive and more effective than late-stage treatments.

Principles of screening for 9–10 year old Shih Tzus

• Start proactive, regular screening at or before age 9 (if not earlier).
• Use both physical exams and targeted diagnostics (bloodwork, urinalysis, ophthalmic tests, dental evaluation, blood pressure).
• Tailor frequency to findings and stability: increased frequency if disease is present or progressive.
• Consider the risks of anesthesia in brachycephalic seniors; pre-anesthetic screening and airway planning are essential.
• Emphasize owner-performed daily checks and home-care measures to reduce progression of common problems.

Overview screening schedule (quick reference)

The table below gives an actionable screening cadence for otherwise healthy senior Shih Tzus and notes when to increase frequency.

| Screening/Check | Frequency for stable senior (9–10 yrs) | Purpose (Shih Tzu-specific) | When to do more often | |---|---:|---|---| | Physical exam (including weight & body condition) | Every 6 months | Monitor weight (obesity worsens BOAS/orthopedic disease), detect early pain/neurologic signs | Every 3 months if clinical signs | | Full ophthalmic exam (vet ophthalmologist if abnormal) | Every 6–12 months | Detect KCS (dry eye), corneal disease, lens/cataract, retinal disease | Every 3–6 months with eye disease | | Schirmer tear test & fluorescein stain | Annual; sooner if ocular symptoms | Screen for dry eye and corneal ulcers (Shih Tzu have prominent eyes) | Immediately if redness, squinting, discharge | | Dental exam (including periodontal probing/chart) | Every 6–12 months | Identify periodontal disease; Shih Tzu have crowded dentition | Dental cleaning as recommended; exam every 6 months if disease | | Professional dental cleaning (with pre-anesthetic screening) | Every 12–24 months or as recommended | Remove calculus, treat periodontal pockets | Sooner if bone loss or tooth pain | | CBC, chemistry panel (includes creatinine, BUN) + SDMA | Every 6–12 months | Screen for CKD and other organ disease | Every 3–6 months if CKD or abnormal values | | Urinalysis + urine protein:creatinine (UPC) | Every 6–12 months | Detect early kidney disease or proteinuria | Every 3 months if CKD or proteinuria | | Blood pressure | Every visit or at least annually | Hypertension worsens CKD and eye disease | More frequently if high readings | | Thoracic radiographs / BOAS assessment | Baseline once in senior years; sooner if breathing signs | Assess airway anatomy and lung health | If respiratory noise, exercise intolerance | | Neurologic/spinal exam & pelvic limb gait assessment | Every 6 months | Screen for IVDD signs (pain, weakness, hesitancy jumping) | Immediately with stiffness, reluctant to jump, yelping | | Abdominal ultrasound | Baseline once; repeat if abnormalities | Screen for masses or organ changes in older small breeds | As indicated by bloodwork or exam |

Eye disease: what to screen and why

Shih Tzus have large, anteriorly positioned eyes with shallow orbits. This anatomy increases risk of:

• Proptosis and traumatic corneal injury (eyes more easily displaced)
• Exposure keratitis and corneal ulcers
• Keratoconjunctivitis sicca (KCS; “dry eye”) due to immune-mediated lacrimal dysfunction
• [Progressive retinal atrophy](https://seniorpet.org/knowledge/siamese-cat-progressive-retinal-atrophy "Progressive Retinal Atrophy Guide") (PRA) and other retinal degenerations (some lines may carry mutations)

Recommended ocular screening for senior Shih Tzus:

• Complete ophthalmic exam by your veterinarian every 6–12 months. If any corneal clouding, redness, or vision change is noted, referral to a veterinary ophthalmologist is appropriate.
• Schirmer Tear Test (STT) annually, or sooner with discharge/ocular irritation. Early detection of low tear production allows medical therapy (topical cyclosporine or tacrolimus) that can prevent corneal scarring.
• Fluorescein stain and slit-lamp exam to identify corneal ulcers. Corneal ulcers can progress rapidly in brachycephalic breeds and may require surgical repair.
• Baseline fundic exam (dilated pupil) to assess the retina. If PRA is suspected (night blindness, progressive vision loss), an ophthalmology referral and possible electroretinography (ERG) or genetic testing can be pursued.

Practical owner actions for eye protection:

• Keep eyes lubricated with veterinary-approved artificial tears during dry weather or heat.
• Avoid household irritants (direct hair sprays, perfumes near face).
• Trim facial hair that rubs the eyes and clean tear staining to reduce secondary infection.
• For acute proptosis or trauma: keep the eye moist (sterile saline or artificial tears) and seek emergency veterinary care—do not try to replace the eye at home.

(Reference: Gelatt, K. Veterinary Ophthalmology; ACVO resources.)

Periodontal disease: aggressive screening and home care

Shih Tzus’ small jaws and crowded teeth create a high risk of early, severe periodontal disease. Consequences include pain, tooth loss, and bacteremia that may affect the kidneys and heart.

Screening and prevention:

• At-home tooth checks weekly; look for halitosis, red/swollen gums, loose teeth, or drooling.
• Daily toothbrushing with canine toothpaste is the single most effective home preventive measure. Introduce brushing early and use positive reinforcement.
• Dental exams by your veterinarian every 6–12 months. Professional dental cleaning under anesthesia with full probing and dental radiographs is needed to assess and treat periodontal pockets and root disease (radiographs are essential; many pathologies are below the gumline).
• Follow WSAVA dental care recommendations for seniors and discuss anesthetic risk mitigation with your vet (pre-anesthetic bloodwork, BP monitoring, shortened anesthetic times, experienced anesthesia team).

Practical tips:

• If your senior Shih Tzu dislikes brushing, use chlorhexidine oral rinse or gels as adjuncts (under vet guidance).
• Provide appropriate dental chews and diets designed for plaque control if chewing ability is intact.
• Do not postpone dental procedures because of age alone—untreated [dental disease](https://seniorpet.org/knowledge/siamese-cat-dental-disease "Dental Disease in Senior Pets") often causes more anesthetic and systemic risk over time.

(Reference: WSAVA Global Dental Guidelines.)

Kidney disease: early detection with SDMA and urinalysis

Chronic kidney disease is common in older dogs. Early-stage CKD is often asymptomatic but is treatable and manageable if caught early.

Recommended renal screening:

• Blood chemistry (creatinine, BUN) plus SDMA (symmetric dimethylarginine). SDMA can rise earlier than creatinine and improves early detection of decreased GFR (see Nabity et al., 2015 and IRIS CKD guidelines).
• Urinalysis with specific gravity and UPC (urine protein:creatinine ratio) to detect dilute urine or proteinuria.
• Blood pressure measurement (hypertension both contributes to and results from CKD).
• Repeat screening every 6–12 months in stable seniors, more frequent monitoring (every 3 months) if CKD or abnormal tests.

Owner advice:

• Keep fresh water available at all times.
• If CKD is diagnosed, follow your veterinarian’s plan: therapeutic renal diets, phosphate binders if needed, treatment for proteinuria (ACE inhibitor or ARB), and careful medication dosing.
• Monitor appetite, water intake, and urination frequency at home and report changes promptly.

(Reference: IRIS CKD staging guidelines; Nabity MB et al., JVIM 2015 on SDMA.)

Brachycephalic airway syndrome (BOAS): screening, lifestyle, and when to act

Shih Tzus are brachycephalic; while not as extreme as some breeds (e.g., French bulldog), they can still develop clinically significant BOAS that worsens with age, [obesity](https://seniorpet.org/knowledge/golden-retriever-weight-management-obesity "Weight Management for Senior Pets"), dental disease, and neck/facial conformation changes.

Screening and management:

• Auscultation and observation for stertor/stridor, exercise intolerance, heat intolerance, cyanosis, or fainting. Document tolerance on a graded scale (treadmill or walk test supervised).
• Thoracic/airway imaging or specialist airway assessment if significant noise, collapse, or exercise intolerance is present.
• Weight control is crucial: even modest excess weight can dramatically worsen breathing in brachycephalic dogs.
• Consider surgical interventions (e.g., stenotic nares correction, soft palate resection) if BOAS is moderate–severe. These are elective but can significantly improve quality of life. Because Shih Tzus are seniors, pre-op screening must be thorough (cardiac, renal, anesthetic risk).

Owner actions:

• Avoid vigorous exercise in hot/humid weather and provide cool, calm environments.
• Use harnesses instead of collars to avoid pressure on the neck.
• Monitor breathing at home and seek timely veterinary evaluation for any increased respiratory noise, episodes of collapse, or exercise intolerance.

(Reference: Packer et al., studies on BOAS and brachycephalic health reviews.)

Intervertebral disc disease (IVDD) and mobility screening

While IVDD is classically associated with chondrodystrophic breeds, small breeds like Shih Tzus are still at risk for disc degeneration and spinal pain, especially as they age.

Screening and prevention:

• Perform a neurologic/spinal exam at least every 6 months. Look for:

- Reluctance to jump, climb stairs, or rise - Stiffness, yelping when picked up, abnormal gait, or limb weakness - Pain on spinal palpation

• Use ramps, non-slip flooring, and limit high-impact jumping to reduce acute disc injury risk.
• If signs occur (back pain, asymmetry, paresis), get veterinary evaluation promptly—time-sensitive treatments (anti-inflammatories, padding, or surgery) affect outcomes.

Owner actions:

• Provide stable, low-height resting places; avoid letting seniors jump from furniture.
• Strengthening low-impact exercises (short walks, swimming if tolerated) help maintain muscle mass and joint support.
• Consider a physical rehabilitation consult (physiotherapy, hydrotherapy) for chronic spinal or mobility issues.

Putting the schedule into action: a sample yearly plan

Below is a sample timeline for an otherwise healthy 9–10 year old Shih Tzu. Adjust frequency upward when issues are present.

• Every 6 months: full physical exam (weight/BMI), neurologic check, blood pressure, discussion of energy, appetite, breathing, and dental [home care](https://seniorpet.org/knowledge/pillar/home-care-guide "Senior Pet Home Care Guide").
• Every 6–12 months: CBC, chemistry with SDMA, urinalysis + UPC, ophthalmic exam with STT and fluorescein.
• Every 12 months: professional dental exam; dental cleaning under anesthesia as recommended; thoracic radiographs or BOAS assessment at baseline.
• Ongoing daily: toothbrushing, hydrate, eye lubrication as needed, monitor for breathing difficulty or spinal pain.

Practical action list for owners (checklist)

• Schedule veterinary screening visits every 6 months starting at age 9.
• Learn and perform daily toothbrushing; ask your vet for a demonstration.
• Keep a small vial of veterinary-approved artificial tears at home and apply per vet advice if eyes appear irritated.
• Maintain ideal body weight and use a harness for walks.
• Install ramps or steps to reduce jumping and protect the spine.
• Keep a log of appetite, water intake, bowel movements, urination frequency and color, breathing noises, and any changes in mobility or vision to share with your vet.
• For any acute eye injury, respiratory distress, sudden neurological deficits, or severe lethargy—seek immediate veterinary care.

Anesthesia considerations for senior Shih Tzus

Many diagnostic and therapeutic procedures (dental radiographs and cleanings, advanced imaging, surgical corrections for BOAS or spinal disease) require anesthesia. Senior Shih Tzus require careful pre-anesthetic planning:

• Pre-anesthetic bloodwork including chemistry, CBC, and assessment of cardiac/respiratory status.
• Consider thoracic radiographs, ECG, and blood pressure evaluation pre-op.
• Use experienced anesthesia teams and consider shorter anesthetic protocols or sedation alternatives where feasible.
• Post-operative monitoring for airway obstruction in brachycephalic breeds is critical.

When to refer to a specialist

• Any progressive visual loss, inherited retinal disease suspicion, or complex corneal disease → veterinary ophthalmologist.
• Recurrent or advanced BOAS or surgical airway planning → veterinary surgeon with experience in brachycephalic airway surgery or a veterinary ENT specialist.
• Persistent proteinuria, progressive azotemia, or diagnostic uncertainty for CKD → veterinary internal medicine specialist.
• Neurologic deficits, severe back pain, or suspected IVDD → veterinary neurologist or surgeon.

Evidence and resources

• IRIS (International Renal Interest Society) guidelines for chronic kidney disease staging and monitoring provide practical monitoring intervals and treatment frameworks.
• WSAVA Global Dental Guidelines outline dental screening, radiography, and home care practices relevant to small-breed dentistry.
• Veterinary ophthalmology texts and ACVO resources describe diagnosis and treatment of KCS, corneal ulcers, and inherited retinal diseases.
• Peer-reviewed literature supports SDMA as an earlier biomarker for reduced glomerular filtration than creatinine in dogs (e.g., Nabity et al., JVIM 2015).
• Research and consensus reviews on BOAS emphasize the combined role of conformation, obesity, and age in clinical severity (see major reviews in veterinary surgery/medicine literature).

(If you would like full citations or links for the guidelines and studies mentioned above, I can provide a curated reference list with DOIs and URLs.)

Final thoughts

A senior Shih Tzu benefits greatly from a proactive, breed-specific screening schedule. Regular 6–12 month check-ins that include focused eye exams, dental care with radiographs, renal screening with SDMA and urinalysis, airway assessment for BOAS, and neurologic/spinal checks for IVDD allow early, often less invasive interventions. Pair veterinary screening with practical home care—daily toothbrushing, eye protection, weight control, and mobility accommodations—to maintain comfort and function in your Shih Tzu’s golden years.

If you want, I can:

• Create a personalized 12-month monitoring calendar you can print and bring to appointments.
• Provide a step-by-step toothbrushing training plan for your Shih Tzu.
• Summarize recommended pre-anesthetic tests tailored to your dog’s current lab results.