Type your paraCommon Shih Tzu Problems Hernias and Pinched Nostrils are NOT life-threatening issues, Much of the information provided below came from the American Shih Tzu club website as well as many other breeders in the USA.
 
Hernias

HERNIAS IN SHIH TZU PUPPIES as well as other breeds is very common and is not a medical condition or cause for immediate concern. Please be informed before you agree to surgical hernia repair on your SHIH TZU PUPPY. The following information is copied from www.Bullwrinkle.com and is being offered as an educational tool: A hernia is a protrusion or bulge of a part of the body tissue, fat, or an organ through an abnormal opening of the surrounding tissue. There are numerous types of hernias, each type named after its affected area. A hernia that can be pushed back into the abdomen is called reducible. Hernias that are not reducible are called incarcerated. If the blood supply to an incarcerated hernia is pinched off, the hernia becomes strangulated. A strangulated hernia is an emergency situation and must be brought to the attention of your veterinarian. The most common types of hernias in Shih Tzu puppies are: An umbilical hernia is the most common type of hernia found in puppies. In the case of umbilical hernias, a portion of fat or internal organs protrudes through an incompletely closed umbilical ring.  Umbilical hernias may be present at birth or may be acquired. The most common means of acquiring an umbilical hernia is a result of the umbilical cord being severed too close to the abdominal wall. In most cases, umbilical hernias are small and reduce as the puppy grows. Generally, by the time the pup is six months old, the umbilical hernia will shrink and disappear on its own. An inguinal hernia is the result of abdominal organs, fat, or tissue protruding through the inguinal ring. Inguinal hernias are presented as skin-covered bulges in the groin. They can be bilateral, involving both sides, or unilateral, involving only one side.  Inguinal hernias are more common in females than males but do occur in both sexes. As with umbilical hernias, most inguinal hernias will shrink and disappear as the puppy grows. Inguinal hernias can also occur in unspayed, middle-aged female dogs. This may occur as the result of stretching of abdominal tissue due to pregnancy. I have heard of many Champion show dogs that have umbilical hernias and most experienced breeders know they are part of the breed and nothing to get all upset over. The smaller ones can be left alone if they are not bothering the dog and larger ones can be repaired at the time of a spay/neuter. If your puppy has one, just keep an eye on it and if it changes, let your vet know. Most dogs live their whole lives with smaller ones and never have a problem. As long as it is not causing a problem and can be pushed back in it is ok to wait until spay/neuter to have repaired. If you read the official site for the English Toy Spaniel you will see they actually state that the umbilical hernia is part of their breed and NOT considered a health problem. This is also true of the Shih Tzu and many other breeds. Vets without a lot of experience with the
breed often make a big deal about them because they do not understand this breed or the breeds with these specific problems.
 
Pinched Nostrils and Teething

Shih Tzu puppies often have slightly pinched nostrils that generally open with time. The bubbly discharge from a Shih Tzu puppy’s nose is NOT serious if the discharge is clear and watery and the dog is otherwise thriving. This problem is most acute during the teething stage. Even the nostrils of a dog that has difficulty simultaneously eating and breathing or is lethargic at this time may open satisfactorily as the dog matures, but a few dogs this severely affected may require surgery later on. Pinched nostrils and teething go together.

TEETHING PROBLEMS
 
Some puppies in this breed experience teething trouble. The noses swell and pinch off some and they may have a little clear discharge. They make some snorting and snuffling sounds. They will usually outgrow this after the adult teeth come in. As long as they are playful and active and eating and drinking well, they are ok.  If they can't eat or drink well and are lethargic or the discharge changes color, they may have developed an infection and need to be checked and treated. Most Shih Tzu pups are fine after adult teeth have come in. As long as pups are eating and drinking well and can play they are fine. The official book of this breed recommends not letting any surgery be done until after adult teeth are in as most will then resolve Many Shih Tzu puppy's noses will become tight during the teething phase. It will often cause them to snort and mouth breathing. This will go away usually around 12-16 weeks of age sometimes longer. It is very different from the Stenotic Nares (Pinched Nostrils). Which is noticed from birth. Many Vets will try to talk you into unnecessary surgery. Though I have been Blessed again, Not to have Stenotic Nares. I thought I
would share this info with you.

REVERSE SNEEZING

Most of you are probably aware of it, but in case you aren’t, here is what happens; The doggie sniffs something or gets a drink. Suddenly they suck their nostril shut as a result of a quick breath, dust, pollen, or a drop of water. They often act like they are choking or they may even get scared and slide to the floor. They may snort loudly and act very frightened. The novice owner gets frightened too and thinks the dog might die. It is usually only a “reverse sneeze”. The nostrils are stuck shut. It’s like a vacuum in the nasal passages. Shih Tzu's are brachycephalic, they have a very short face and nose. This short nose apparently makes them more susceptible to this common phenomenon. Simply talk calmly to your pet, stroke his or her throat to make them swallow, and at the same time gently hold their nostril closed for a moment to help release the vacuum. Reverse sneezing in Shih Tzu is quite common and is not life-threatening!!!
About Umbilical Hernias and Pinched Nostrils The following is an excerpt from THE OFFICIAL BOOK OF THE SHIH TZU, by Jo Ann White, regarding umbilical hernias and pinched nostrils, which are quite common in Shih Tzu puppies: The Shih Tzu is a brachycephalic (short-faced) breed. Many Shih Tzu puppies, especially those with very short noses, have slightly pinched nostrils, particularly when they are teething. They may snort and snuffle, snore, and have a watery, clear nasal discharge... This problem generally clears up with age... Small umbilical (belly button) hernias are quite common in Shih Tzu puppies. If the opening is small, it will likely close by itself as the puppy matures. As with slightly pinched nostrils, many vets unfamiliar with our breed are much too quick to recommend corrective surgery.
 
Hypoglycemia If you are going to become a toy dog owner you will want to familiarize yourself with the symptoms of hypoglycemia. Hypoglycemia is often seen in young toy puppies, and most of the time the symptoms can be controlled by eating, or by giving some glucose such as honey water to the puppy. Glucose is what the body uses as fuel and is necessary for the brain tissue and muscles to function. Hypoglycemia is when the blood sugar levels (glucose) fall well below normal. It can cause your puppy to become confused, disoriented, drowsy, have shivers, stagger about, collapse, fall into a coma, or have seizures. Episodes of hypoglycemia often occur without warning. A puppy may be stressed by shipping, or a missed meal, being chilled, or even exhaustion from too much play. Because of their tiny size, toy puppies cannot eat a lot at one time and literally run out of fuel quickly. Puppies should be fed several times a day a high-quality diet. Most puppies will outgrow the problem. Some very tiny dogs will continue to have bouts of hypoglycemia throughout their life. If your puppy experiences episodes of hypoglycemia it is important to restore the blood levels of glucose as quickly as possible.  Call me if your pup is having any of these symptoms Always keep Nutri-Cal on hand Typical symptoms: Weakness Listlessness Depression Staggering Gait Tremors If your puppy is conscious, give him/her a little White Karo Syrup, or Honey under its tongue, or rubbed on its gums. Do NOT pour into the mouth as the puppy could easily choke. You can also mix honey, or corn syrup with Pedialite, stir to dissolve and dribble it into the puppy's mouth. Nutri-Cal also works extremely well in an emergency. The puppy should begin to improve within about ten minutes, if not contact your vet as quickly as you can. NOTE: BREEDERS CAN NOT BE RESPONSIBLE FOR HYPOGLYCEMIA.graph here.