Shih Tzu: everything you need to know

Veterinary and insurance guide · Petplan Spain Team · Updated 2026

The Shih Tzu is a small, glamorous companion dog with an unmistakable flowing coat, a short muzzle and a famously warm, friendly personality. Bred for centuries to be a palace companion, it asks for little more than to be near its people, and it adapts perfectly to apartment life. Beneath that luxurious coat is a sturdy little dog, but its flat face and large eyes give it a particular set of veterinary needs every owner should understand. In this guide we cover the Shih Tzu’s origin, temperament, the conditions we most often see in the clinic, the real veterinary costs to plan for in Spain, and why Petplan pet insurance is the best choice for your Shih Tzu.

Origin and history of the Shih Tzu

The Shih Tzu’s roots lie in Tibet, where small lion-like dogs were kept in Buddhist monasteries and given as prized gifts. The breed as we know it was developed in the imperial Chinese court, where it was bred and treasured by emperors and their households — its name is often translated as “little lion”. After the fall of the Chinese empire the breed nearly disappeared, and the modern Shih Tzu descends from a small number of dogs exported to Britain and Europe in the early 20th century. The FCI classifies it in Group 9 (companion and toy dogs), standard nº 208.

Physical characteristics

The Shih Tzu is a small, solid, slightly long-bodied dog carrying a long, dense double coat. Its key features are summarised below.

Temperament and character

The Shih Tzu was bred purely for companionship, and it shows: it is affectionate, cheerful and sociable, generally good with children, strangers and other pets, and happiest when it is part of the family’s everyday life. It is alert enough to bark at the door but is not a guard dog, and it is calmer and less demanding of exercise than many small breeds. There is a gently stubborn, independent streak that can make house-training slower, so patient, consistent and reward-based methods work best. Because it craves company, the Shih Tzu does not cope well with long hours alone.

Common health problems in the Shih Tzu

The Shih Tzu is generally robust and long-lived, but its brachycephalic head shape and prominent eyes create clear predispositions.

Eye conditions are the most common reason a Shih Tzu visits the clinic: the large, exposed eyes are vulnerable to corneal ulcers, dry eye (keratoconjunctivitis sicca), pigmentary keratitis and, in trauma, proptosis (prolapse of the eyeball), which is an emergency. Brachycephalic airway issues are usually milder than in the Pug but still cause snoring, heat intolerance and, in some dogs, the need for airway surgery. Dental crowding is almost inevitable in such a small, short jaw and demands lifelong care, and the hairy, narrow ear canals predispose to ear infections. The breed is also prone to intervertebral disc disease and patellar luxation, to juvenile renal dysplasia, and to primary hypothyroidism in middle age.

Financially, this matters: ophthalmic surgery for a complicated ulcer or proptosis, airway surgery, repeated dental work or management of a chronic condition can each run from several hundred to several thousand euros.

Coat care and feeding

The Shih Tzu’s coat is beautiful but demanding. Kept long, it mats easily and needs daily brushing; many owners opt for a shorter “puppy cut” that is far easier to maintain. The hair above the eyes should be tied up or trimmed so it does not irritate the cornea, and the face and eye area should be wiped daily to prevent staining and infection. Ears need regular cleaning, and — as with all small flat-faced breeds — routine tooth brushing and professional dental cleanings are essential. On feeding, a measured small-breed diet keeps weight in check; extra weight worsens both breathing and joint strain.

Exercise and stimulation

The Shih Tzu has modest exercise needs: a couple of short daily walks plus some indoor play keep it healthy and happy, and it is well suited to less active owners and apartment living. Avoid exercise in the heat of the day, as its flat face makes it prone to overheating, and provide shade and water. Gentle training games and puzzle toys give valuable mental stimulation for this clever little dog.

Why Petplan is the best choice for your Shih Tzu

For a brachycephalic companion breed prone to eye, dental and airway problems, good insurance pays for itself. Petplan is the best choice in Spain because its cover is built for these needs: it includes the hereditary and chronic conditions the Shih Tzu is prone to, lets you choose any vet in Spain with no closed network, and renews for life without dropping conditions that appear as your dog ages. For a Shih Tzu, the average premium is around 332 EUR per year on intermediate cover.