Intervertebral Disc Disease (IVDD) in Shih Tzus — Complete Guide

Overview

Intervertebral Disc Disease (IVDD) is one of the most significant orthopedic and neurological conditions affecting Shih Tzus, a chondrodystrophic (dwarf-limbed) breed genetically predisposed to premature disc degeneration. Studies estimate that chondrodystrophic breeds face an IVDD incidence rate roughly 10 to 12 times higher than non-chondrodystrophic breeds, and the Shih Tzu consistently ranks among the top breeds diagnosed. Owners should understand that IVDD can range from mild back pain to complete paralysis, and early recognition dramatically improves outcomes. With prompt veterinary care and appropriate management, many Shih Tzus with IVDD recover well and continue to live comfortable, happy lives.

Why Shih Tzus Are Susceptible to Intervertebral Disc Disease (IVDD)

Chondrodystrophy and the FGF4 Retrogene

The Shih Tzu's characteristic short legs and long back are the result of chondrodystrophy — a form of dwarfism driven by an FGF4 retrogene insertion on chromosome 12 (CFA12). This same gene that gives the breed its distinctive proportions also causes chondroid metaplasia, a process in which the normally gel-like nucleus pulposus of the intervertebral disc is gradually replaced by calcified, brittle cartilage. By the time many Shih Tzus reach 2 to 3 years of age, a significant percentage of their discs have already undergone this degenerative change, making them vulnerable to herniation under forces that would be harmless to a disc in a non-chondrodystrophic breed.

Anatomical Factors

Beyond genetics, the Shih Tzu's compact body structure contributes to spinal stress. Their relatively long vertebral column in proportion to their short, sturdy legs creates unfavorable biomechanics during jumping, climbing stairs, or rough play. The thoracolumbar region (mid-to-lower back) bears the greatest mechanical load, which explains why approximately 65–75% of IVDD cases in Shih Tzus involve disc spaces between T11 and L3. Cervical (neck) IVDD also occurs, though less frequently.

Prevalence Data

In a large veterinary insurance database study, Shih Tzus showed an IVDD prevalence of approximately 3.5–5% over their lifetime, compared to fewer than 0.5% in non-chondrodystrophic breeds. Swedish and UK breed health surveys have similarly identified IVDD as a top-five health concern in the breed. Male Shih Tzus appear slightly overrepresented in some datasets, though the difference is modest.

Recognizing Intervertebral Disc Disease (IVDD) in Your Shih Tzu

IVDD in Shih Tzus can present suddenly or develop gradually, and the symptoms vary depending on the location and severity of the disc herniation.

Thoracolumbar IVDD (Most Common)

• Reluctance to jump onto furniture, beds, or into laps — often the earliest sign owners notice
• Hunched posture with a tense, arched back and tucked abdomen
• Yelping or crying when picked up, particularly under the ribcage
• Shivering or trembling that is unrelated to temperature — frequently mistaken for anxiety or cold
• Wobbly or uncoordinated hind legs (ataxia), progressing to dragging or inability to walk
• Loss of bladder or bowel control in severe cases

Cervical IVDD

• Stiff, lowered head carriage — the dog avoids looking up or turning the neck
• Reluctance to eat from a floor-level bowl or drink water
• Crying out when the head is touched or moved
• Front-leg lameness that may shift between sides or be intermittent

Shih Tzu–Specific Considerations

Because Shih Tzus are naturally calm, lap-oriented dogs, early signs of pain — such as decreased activity, reluctance to play, or simply wanting to be held more — can be easily dismissed as normal temperament. Owners should treat any sudden change in mobility or uncharacteristic vocalization as a potential emergency.

IVDD Grading Scale

| Grade | Clinical Signs | Urgency | |-------|---------------|---------| | I | Pain only, no neurological deficits | Urgent — see vet within 24 hours | | II | Wobbly walk (ataxia), able to stand | Urgent — same-day evaluation | | III | Can move legs but cannot walk unassisted | Emergency | | IV | Paralyzed but can feel deep pain | Emergency — surgery within 24–48 hours | | V | Paralyzed with no deep pain perception | Critical emergency — surgery within 12–24 hours |

Age of Onset in Shih Tzus

IVDD in Shih Tzus follows a predictable pattern driven by the chondrodystrophic disc degeneration timeline:

• 2–4 years: Disc calcification is already underway. Clinical signs are rare at this age, but spinal radiographs may reveal calcified discs. This is the window where preventive management has the greatest impact.
• 4–7 years: The peak incidence period. The majority of first-time IVDD episodes in Shih Tzus occur within this range. Disc material has become sufficiently calcified and brittle that a jump, a twist, or even a vigorous shake can trigger an acute herniation.
• 7–10 years: A second, smaller peak may occur as additional discs degenerate. Shih Tzus that have recovered from an earlier episode are at heightened risk of a new herniation at a different disc space.
• 10+ years: IVDD can still occur, though age-related fibrosis of the disc annulus may paradoxically make acute extrusions slightly less common. Chronic, slowly progressive disc bulging (Hansen Type II) becomes more prevalent.

Early Warning Signs by Age

Owners of Shih Tzus under 4 years should be watchful for intermittent stiffness after play, occasional yelps when jumping down, or subtle changes in gait. These transient episodes can indicate early disc instability and warrant a veterinary evaluation before a full herniation occurs.

Diagnostic Process

Initial Veterinary Examination

A thorough neurological examination is the cornerstone of IVDD diagnosis. Your veterinarian will assess gait, proprioception (paw-placement awareness), spinal reflexes, and deep pain perception to localize the lesion and determine severity. In Shih Tzus, the dense double coat can make subtle muscle atrophy or swelling difficult to detect by visual inspection alone, so careful palpation along the spine is essential.

Imaging

• Spinal radiographs (X-rays): Often the first imaging step. In chondrodystrophic breeds like the Shih Tzu, calcified disc material is frequently visible on plain radiographs, providing supportive evidence. However, X-rays alone cannot confirm active disc herniation or assess spinal cord compression.
• MRI (Magnetic Resonance Imaging): The gold standard for IVDD diagnosis. MRI reveals the exact location of disc herniation, the degree of spinal cord compression, and the presence of spinal cord edema or hemorrhage — all critical for surgical planning. Shih Tzus require general anesthesia for MRI, which introduces breed-specific considerations discussed below.
• CT myelography: An alternative when MRI is unavailable. Contrast dye is injected into the spinal canal, and a CT scan maps the compression site. This technique is slightly more invasive but still highly accurate.

Genetic Screening

A commercially available DNA test for the FGF4 retrogene on CFA12 (associated with chondrodystrophy and IVDD risk) can confirm genetic predisposition. While virtually all Shih Tzus are expected to carry this variant, the test can be useful for mixed-breed dogs with Shih Tzu ancestry to assess their IVDD risk profile. Testing is available through laboratories such as UC Davis VGL and Embark Veterinary.

Treatment Approach for Shih Tzus

Conservative (Non-Surgical) Management — Grades I–II

Conservative treatment is appropriate for Shih Tzus presenting with pain and mild neurological deficits:

• Strict crate rest for 4–6 weeks — this is the single most important component. The crate should be just large enough for the dog to stand, turn, and lie down. Shih Tzus generally tolerate confinement better than high-energy breeds, but owners should provide enrichment such as frozen stuffed Kongs and gentle interaction.
• Anti-inflammatory medications: Non-steroidal anti-inflammatories (NSAIDs) such as meloxicam or carprofen are first-line choices. Shih Tzus do not carry known breed-specific drug sensitivities (unlike the MDR1 mutation in herding breeds), but their small size (typically 9–16 pounds) requires careful weight-based dosing. Corticosteroids (prednisone, dexamethasone) may be used as an alternative but carry a higher side-effect burden and should not be combined with NSAIDs.
• Muscle relaxants: Methocarbamol can help relieve painful muscle spasms along the spine.
• Gastroprotection: Shih Tzus on NSAIDs or corticosteroids should receive a gastroprotectant (omeprazole or famotidine) to reduce the risk of gastrointestinal ulceration.
• Gabapentin: Increasingly used for neuropathic pain control, gabapentin is well tolerated in small breeds and can be combined with NSAIDs.

Surgical Management — Grades III–V

Surgery (typically hemilaminectomy for thoracolumbar IVDD or ventral slot for cervical IVDD) is recommended for Shih Tzus with significant neurological deficits:

• Anesthesia considerations: Shih Tzus are a brachycephalic breed, meaning their shortened skull and narrowed airways increase anesthesia risk. Pre-anesthetic assessment should include evaluation of the upper airway, and the anesthesia team should be prepared for potential intubation difficulties, increased airway secretions, and a slower recovery from sedation. Preoxygenation and rapid, smooth induction are essential.
• Surgical success rates: For grades I–IV, surgical success rates are generally 85–95%. For grade V (loss of deep pain), the success rate drops to approximately 50–60%, and outcomes are highly time-dependent — surgery performed within 12–24 hours of deep pain loss yields the best results.
• Post-operative recovery: Shih Tzus typically require 6–8 weeks of restricted activity after surgery. Physical rehabilitation, including underwater treadmill therapy, passive range-of-motion exercises, and laser therapy, significantly improves recovery speed and quality.

Size-Specific Notes

At their typical weight of 9–16 pounds, Shih Tzus fall into the small-breed dosing category for all medications. Liquid formulations or precisely compounded doses may be needed to avoid over- or underdosing with standard tablet sizes.

Managing Intervertebral Disc Disease (IVDD) Day-to-Day

Environmental Modifications

• Ramps, not stairs: Place pet ramps at sofas, beds, and any elevated surfaces the dog uses. Shih Tzus are habitual furniture jumpers, and eliminating jumping is the single most impactful lifestyle change.
• Non-slip surfaces: Hardwood and tile floors are hazardous. Use area rugs, yoga mats, or adhesive paw pads (toe grips) to provide traction.
• Raised food and water bowls: Particularly beneficial for cervical IVDD, reducing the need to lower the head to floor level.
• Supportive bedding: Orthopedic memory foam beds help distribute body weight evenly and reduce pressure on the spine.

Exercise Modifications

• Leash walks only: No off-leash running, roughhousing, or play with larger dogs during recovery and long-term management.
• Harness, not collar: A well-fitted harness (ideally a back-clip or step-in design) distributes forces away from the neck and spine. Avoid neck collars entirely.
• Controlled, low-impact exercise: Short, flat-surface walks of 10–15 minutes, 2–3 times daily, maintain muscle tone without stressing the spine.

Weight Management

Excess weight dramatically increases spinal load. Shih Tzus are prone to obesity, and maintaining a lean body condition (body condition score 4–5 out of 9) is a critical part of IVDD management. Work with your veterinarian to calculate appropriate caloric intake, and resist the breed's characteristically persuasive begging.

Supplement Considerations

• Omega-3 fatty acids (EPA/DHA): Anti-inflammatory effects may support spinal cord health. Use a veterinary-grade fish oil product dosed at approximately 75–100 mg EPA+DHA per kg body weight daily.
• Glucosamine/chondroitin: While evidence for disc-specific benefits is limited, these supplements may support overall joint health.
• Adequan (polysulfated glycosaminoglycan): An injectable prescription product with some evidence of benefit for degenerative disc disease — discuss with your veterinarian.

Breeder Screening & Prevention

Genetic Testing

All Shih Tzu breeding stock should be tested for the FGF4 retrogene on CFA12. While the variant is essentially fixed in the breed (virtually all Shih Tzus carry it), documentation of test results contributes to breed health data and supports long-term breed improvement strategies.

Spinal Radiographic Screening

Some progressive breeders obtain spinal radiographs of breeding dogs at 24 months of age to assess the degree of disc calcification. Dogs with extensive early calcification across multiple disc spaces may warrant removal from breeding programs to reduce the incidence of severe, early-onset IVDD in offspring.

Responsible Breeding Practices

• Select breeding pairs with documented longevity and no personal or close-family history of clinical IVDD
• Maintain detailed health records across generations and participate in open health registries
• Avoid breeding dogs that have required surgical intervention for IVDD
• Prioritize moderate, balanced conformation — dogs with excessively long backs relative to leg length may be at heightened risk

Puppy Buyer Guidance

Prospective Shih Tzu owners should request documentation of parental health screening, ask about IVDD history in the pedigree, and begin preventive management (weight control, avoiding excessive jumping) from puppyhood.

Support & Resources

• American Shih Tzu Club (ASTC): The AKC parent club maintains a health committee and publishes breed health information, including IVDD guidance — [www.americanshihtzuclub.org](https://www.americanshihtzuclub.org)
• Shih Tzu Health Foundation: Supports research into breed-specific health conditions
• Dodgerslist (dodgerslist.com): The premier online community and information resource for owners of dogs with IVDD, offering detailed care guides, recovery timelines, and an active support forum
• Canine Health Information Center (CHIC): Maintains a searchable database of health testing results for registered breeding dogs — [www.caninehealthinfo.org](https://www.caninehealthinfo.org)
• Orthopedic Foundation for Animals (OFA): Provides health testing programs and a public database — [www.ofa.org](https://www.ofa.org)
• Veterinary specialty directories: The American College of Veterinary Internal Medicine (ACVIM) and American College of Veterinary Surgeons (ACVS) maintain referral directories to find board-certified neurologists and surgeons in your area

FAQs

Is IVDD hereditary in Shih Tzus?

Yes. IVDD in Shih Tzus is directly linked to their chondrodystrophic genetics — specifically the FGF4 retrogene on chromosome 12 that causes premature disc degeneration. While environmental factors like obesity and high-impact activity influence when and whether a disc herniates, the underlying susceptibility is inherited. This is why virtually all Shih Tzus are genetically predisposed, though not all will develop clinical disease.

Can my Shih Tzu recover from IVDD without surgery?

Many Shih Tzus with grade I–II IVDD recover well with strict conservative management, including 4–6 weeks of crate rest combined with appropriate pain medication. Studies report that roughly 50% of dogs managed conservatively for mild-to-moderate IVDD recover successfully, though the recurrence rate is higher than with surgical intervention. The decision between conservative and surgical management should be made collaboratively with your veterinarian based on the severity of neurological signs.

How can I prevent IVDD in my Shih Tzu?

While you cannot eliminate the genetic predisposition, you can significantly reduce the risk of a clinical episode. Maintain your Shih Tzu at a lean body weight, use ramps instead of allowing jumping, walk with a harness rather than a collar, and avoid high-impact activities like catching toys mid-air or rough play with larger dogs. Starting these practices in puppyhood is ideal.

My Shih Tzu was just diagnosed with IVDD. How long is recovery?

Recovery timelines vary by severity. Grade I–II cases managed conservatively typically show significant improvement within 2–4 weeks, with full crate rest lasting 4–6 weeks. Surgical cases require 6–8 weeks of restricted activity, with many dogs regaining functional mobility within 2–4 weeks post-surgery. Grade IV–V cases may require months of rehabilitation, and some dogs may have permanent deficits. Physical rehabilitation therapy can substantially shorten recovery times.

Should I get a wheelchair or cart for my Shih Tzu with IVDD?

A wheelchair or cart can be an excellent option for Shih Tzus with persistent hind-limb paralysis, particularly those who do not recover full function after surgery or who are not surgical candidates. Custom-fitted carts (such as those from Eddie's Wheels or Walkin' Wheels) are available in sizes appropriate for Shih Tzus and allow affected dogs to maintain mobility, exercise, and quality of life. Many dogs adapt remarkably well within days.

Does pet insurance cover IVDD treatment for Shih Tzus?

Most comprehensive pet insurance plans cover IVDD diagnosis and treatment, including surgery, MRI, hospitalization, and rehabilitation, as long as the policy was in place before signs appeared. Because IVDD is a known risk in Shih Tzus, some insurers may impose breed-specific waiting periods or exclusions for pre-existing spinal conditions. Enrolling your Shih Tzu in a comprehensive plan as a young puppy — before any signs develop — provides the broadest coverage.