One of the most important things to remember about a tiny Shih Tzu is that when they are babies they have a habit to be hypoglycemia. That means that their sugar level gets very low, they get weak, and they could die(I nearly lost one of my first puppies because no one told me). If this should happen just put a little Karo syrup on their gums and they should get better. The puppies need to ear three or four times a day, with a little Karo Syrup on maybe the second meal until they get to two or three lbs.

Shih Tzu's also have a tendency to have hernias. This is not life threatening and usually will disappear with age.

If you have any health problems check with your local veterinarian.