Shih Tzus are sturdy, affectionate lapdogs that have been companions for centuries. They're less extreme than some brachycephalic breeds but still carry the flat-face risk profile, plus the dental and eye concerns common to toy breeds. Here's the realistic picture for Canadian owners.
Common Shih Tzu health issues
| Condition | How common | Typical treatment cost (CAD) |
|---|---|---|
| Dental disease (crowded small jaw) | Very common — the dominant ongoing cost | Moderate per cleaning, recurring; extractions add up |
| Eye conditions (prominent eyes, ulcers, dry eye) | Very common | Moderate to high; some need ongoing management |
| Brachycephalic breathing issues | Common but usually milder than Pugs | Moderate to high if surgical |
| Patellar luxation | Common in toy breeds | Moderate to high if surgical |
| Intervertebral disc disease (IVDD) | Elevated — long-backed toy build | Catastrophic if surgery required |
| Ear infections | Common — hairy, floppy ears | Low per episode, recurring |
| Hip dysplasia | Moderate | Moderate to high |
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Our Recommendation
For a Shih Tzu, comprehensive coverage plus a wellness add-on is a strong match — the wellness portion offsets the frequent dental and eye maintenance, while the comprehensive base covers the occasional surgery (breathing, knee, or back). Enrol early to lock in coverage before dental or eye conditions become documented pre-existing exclusions.
Frequently asked questions
Are Shih Tzus expensive to insure?
They sit in the moderate range — higher than the healthiest small breeds because of the brachycephalic and dental risks, but generally lower than Pugs or French Bulldogs.
Why do Shih Tzus need so much dental care?
Like most toy breeds, they have a full set of teeth crowded into a small jaw, which traps food and accelerates periodontal disease. Regular professional cleaning and home brushing are essential, and a wellness add-on helps with the cost.
Do Shih Tzus have breathing problems like Pugs?
They're brachycephalic, so yes, but typically to a milder degree. Many Shih Tzus breathe reasonably well; some need BOAS-related surgery. Heat and exertion tolerance is still reduced — be careful in Canadian summers.
Is the long back a real concern?
Yes — their relatively long spine gives them elevated IVDD risk. Discourage jumping from furniture and keep them lean. IVDD surgery is one of the few catastrophic-cost scenarios for the breed.