OPEN FONTANEL

(Common in small Shih Tzu)

An open Fontanel is the puppies soft spot on top of the head.  Typically soft spots close by the time the puppy is 2-3 months old.  Sometimes you will have a puppy that takes longer to close.  This is usually of little concern and can be very common in the smaller Shih Tzu.  If the soft spot is unusually large and never heals over then you do have to be careful with the puppies head, just like a human baby.  It isn't common though that a soft spot is large enough to cause a concern.  If it is large enough that extra caution has to be taken then you need to look at other health concerns.

A Hydrocephalic puppy will almost always have a very large open font, their head will look unusually shaped and will have an obvious bulge.  This is a serious condition but has nothing to do with a small open fontanel of a healthy puppy that just hasn't finished growing yet.  Some veterinarians that aren't familiar with small breeds will jump to conclusions just because they feel a slight open fontanel.  Plesae do not be alarmed by an open fontanel as a good breeder will know the difference.

TIGHT NOSTRILS OR STENOTIC NARES

Tight nostrils are very common in Shih Tzu.  Tight nostrils and stenotic nares are not the same thing.  Tight nostrils come on when a puppy is teething and will open up after the puppy is done teething.  Sometimes tight nostrils come and go as the puppy's gums swell off and on during the teething process.  Some pups can hardly breathe out of their noses during this time.  As long as they are active and eating and drinking normally there is no concern.  Never have surgery done on a puppy that simply has tight nostrils from teething (as it will eventually go away).  Some dogs will have tighter nostrils than others and will snore and snort their entire life.

Stenotic nares are different and are present at birth.  From the time the pup is born they have trouble breathing through their nose and struggle with nursing due to the inability to breathe and nurse at the same time.  This can happen with tight nostrils too, but the pup is usually weaned by the time they are teething.  Sometimes (not always) surgery will be needed for stenotic nares.  If the pup's stenotic nares are so severe that they can not breathe at all or very little through their nose and they exhibit lethargic behavior you should see your vet to decide if surgery is a good option.  In my opinion, it is always better to wait until the pup is spayed or neutered to have the surgery done so they don't have to go under anesthesia numerous times.  

HERNIA OR DELAYED CLOSURE?

Delayed closures are very common in the Shih Tzu breed.  A lot of "hernias" are actually delayed clsure of the umbilical or inguinal (groin) area.  We call it a hernia because at that time that is what it is.  If the "hernia" is small you can't tell the difference if it is a true hernia or a delayed closure.  If, as the puppy gets older, the hernia is getting better then most likely it is just a delayed closure.  Sometimes a breeder just knows based on years of experience.  It is not uncommon for an umbilical hernia not to close but mostly all are simply cosmetic and do not cause any health concerns.  They can be stitched for a minimal cost at the time of spay.  Again, I don't recommend the pup going through a separate surgery for this.  Almost all "inguinal hernias" are delayed closures and require no medical help.

True inguinal hernias are actually rare in Shih Tzu.  Almost all are completely healed (closed) by 4-6 months old.  

UMBILICAL HERNIAS

Umbilical hernias are of little concern and are very common in this breed.  I can usually tell by 4-7 weeks old if a pup has one and I will let you know.  Some will close by 6 months of age if they are actually just a delayed closure and very small.  If it is large then it can easily be repaired when the puppy is spayed/neutered.  An umbilical hernia is usually a small soft bump where your puppy's umbilical cord was (belly button) and for some reason the muscle never closed.  There are a couple of reasons why this could happen.  Somes the moms have a hard time biting the cord because of their flat faces and underbite so they will tug a lot.  Sometimes the pup needs a little pulling to help get it out therefore tugging on the cord.  I cut the cords myself to try and limit the number I get but the mom's still try to get at the left over piece.  Very rarely are they a cause for concern.  

INGUINAL HERNIAS

You can not tell if a puppy has a true hernia until they are at least 5-6 months old.  They are delayed closures most of the time.

An inguinal hernia is the result of abdominal organs, fat or tissue protruding through the inguinal ring.  Inguinal hernias are skin-covered bulges in the groin area.  They can be vilateral, involving both sides or unilateral, involving one side.  Most will shrink and disappear as the pup grows.  It is good to push the tissue back into the cavity a couple times a day.  As with an umbilical hernia if it doesn't close by the time the pup is spayed you can have it done at that time.