A dog's respiratory system runs from the nose to the air sacs in the lungs. Any part of this system can become diseased. Pneumonia, for example, means 'inflammation of the lungs', and is caused by infections or parasites such as lungworm. Dogs like Shih Tzus with short, broad heads can also suffer from a condition known as brachycephalic airway syndrome, which makes breathing more difficult. Narrow nostrils, a long soft palate at the roof of the mouth and a collapsing larynx combine to partially obstruct the passage of air through the upper airways. Treatment may include surgery if the dog's breathing is severely compromised.
Like other dogs, Shih Tzus can suffer from allergies that lead to dermatitis (skin inflammation). Allergies can be caused by many different items, including things that are inhaled, such as pollen or dust mites, items that are eaten (for example, wheat), items that the dog comes into contact with, like washing powders, or bites from parasites such as fleas. Another skin problem, pyoderma, is usually caused by bacteria, fungi or yeasts. Skin disorders can be managed using various treatments, usually required long-term, which means the dog can get on with enjoying life.