Dog health

Shih Tzu health problems and costs

The health issues a real source ties to the Shih Tzu, what each one is, and what it tends to cost, so you can plan ahead.

Last updated: October 2026 · 18 sources · see sources

Quick answerThe breed club and AKC point to 5 health issues to plan for: hip dysplasia, luxating patella, progressive retinal atrophy, cataracts and entropion. A typical vet bill for a small dog runs $273 – $1,110.

Health problems linked to the Shih Tzu

Conditions and what they can cost
ConditionWhat it isRelated costs
Hip dysplasiaNamed by: AKC breed page [1]The hip joint forms loosely, so the ball and socket rub and wear. Over time this usually leads to arthritis and pain. [2]Hip surgery (owner bills): $2,500–$5,500 (estimate) [3]
Ongoing arthritis care: $500–$2,500 total [4]
Luxating patella (slipping kneecap)Named by: AKC breed page [1]The kneecap slips out of its groove. Mild cases may only cause an odd skip in the step; severe cases can need surgery. [5]Surgery, median invoice: $1,284 (typical $578–$3,229) [6]
Dog X-rays (owner bills): $130–$300 [7]
Progressive retinal atrophy (PRA)Named by: AKC breed page [1]The cells at the back of the eye slowly wear out, starting with night vision. It isn't painful, but it can lead to blindness. [8]Sick visit (owner bills): $160–$525 [9]
CataractsNamed by: AKC breed page [1]The lens of the eye turns cloudy and vision fades. Some cataracts can be removed surgically by a veterinary eye specialist. [10]Sick visit (owner bills): $160–$525 [9]
Surgery, median invoice: $1,284 (typical $578–$3,229) [6]
Entropion (rolled-in eyelids)Named by: AKC breed page [1]The eyelid rolls inward so lashes rub the eye. It is usually fixed with a small surgery. [11]Surgery, median invoice: $1,284 (typical $578–$3,229) [6]

Costs are national figures from our sourced cost guides, not breed-specific prices. Being on this list doesn't mean a pet will get the condition.

Here is how the AKC breed page puts it: Most Shih Tzu are generally healthy, and responsible breeders screen their stock for health conditions such as such as hip dysplasia, patellar luxation (a slipped kneecap), eye anomalies including cataracts, progressive retinal atrophy, retinal detachment, and corneal dryness and inflammation from excessive exposure to the air because of improperly closing eyelids. [1]

Health screening

The UC Davis Veterinary Genetics Laboratory lists 1 DNA health test for the Shih Tzu, including Progressive Rod-Cone Degeneration (PRA-prcd). [12] One health test costs $58 there. [13]

What to budget

For a small dog like the Shih Tzu, a typical vet bill runs $273 – $1,110 (median $508), and surgery, when needed, runs $435 – $1,484. [14]

Lifetime cost, roughly. Our yearly estimate for an adult Shih Tzu at US-average prices, before insurance, is $880–$1,400. Multiply that by a life expectancy of 10–18 years and you get roughly $8,800–$24,900 over a lifetime, before inflation and before any major illness. The low end is the ASPCA's yearly cost of care; the high end adds one typical vet bill a year. [14][15] It's simple math on sourced figures, not a quote.

Insurance and savings

The average accident and illness policy cost $836 a year for a dog in the US in 2025. [16] Timing matters more than the price. A condition that shows up before you enroll is usually treated as pre-existing and isn't covered. [17] Many plans also have a 6 to 12 month waiting period for orthopedic problems like knees and hips. [18]

Prefer saving instead? Putting money aside each month works too; see insurance vs a savings fund.

Common questions

What health problems are common in the Shih Tzu?

Based on the AKC breed page and the national breed club's screening list, the conditions to know about are hip dysplasia, luxating patella, progressive retinal atrophy, cataracts and entropion. That doesn't mean every Shih Tzu will get them.

How much are vet bills for a Shih Tzu?

Breed-specific bills are rare, so VetReceipt groups dogs by size. For small dogs, a typical vet bill runs $273 – $1,110 (median $508).

Should I get pet insurance for a Shih Tzu?

It's a personal call. The average accident and illness policy was $836 a year in 2025 (NAPHIA). If you want it, enroll while your pet is young and healthy, because conditions found before enrollment are usually excluded.

How long does a Shih Tzu live?

The AKC lists a life expectancy of 10–18 years.

Shih Tzu breed guideHip dysplasia in dogsLuxating patella surgery cost for dogsCarprofen (Rimadyl)Dog ACL (TPLO) surgery costArthritis treatment cost

This page is general information for planning, not veterinary advice. Talk to your vet about your own pet.

Sources (18) — tap to show
  1. AKC – Shih Tzu breed page (with the national breed club)
  2. VCA – Hip dysplasia in dogs
  3. VetReceipt – Dog Hip Surgery Cost (owner bills, 2026)
  4. VetReceipt – Dog Arthritis Treatment Cost (owner bills, 2026)
  5. VCA – Luxating patella in dogs
  6. VetReceipt – Vet care cost by category (2026)
  7. VetReceipt – Dog X-Ray Cost (owner bills, 2026)
  8. VCA – Progressive retinal atrophy in dogs
  9. VetReceipt – Dog Sick Visit Cost (owner bills, 2026)
  10. VCA – Cataracts in dogs
  11. VCA – Eyelid entropion in dogs
  12. UC Davis Veterinary Genetics Laboratory – Shih Tzu DNA tests
  13. UC Davis Veterinary Genetics Laboratory – Dog DNA test prices (effective Aug 3, 2026)
  14. VetReceipt – Dog breed vet costs by size
  15. ASPCA – Cutting Pet Care Costs (2021 table)
  16. NAPHIA – State of the Industry 2026 report highlights (2025 premiums)
  17. RealVetCost – Feline diabetes treatment cost
  18. VetReceipt – Dog TPLO Surgery Cost (owner bills, 2026)