The eyes speak first in a Shih Tzu
A Shih Tzu in discomfort very often signals through her large, prominent eyes before anything else changes. Squinting or holding one eye partly closed, pawing or rubbing that eye against carpet or bedding, increased tearing, or a cloudy or reddened look to the surface all need prompt attention in this breed, because those shallow-set eyes are easily scratched and a scratch is painful even when the dog still wags for dinner.
Watch her face at rest in good light rather than only during play. A Shih Tzu who keeps turning one side of her face away from you, blinks far more on one side, or has started sleeping with a paw draped over her face is guarding something, and the guarding itself is the sign.
Breathing, panting and restlessness at rest
Panting in a settled Shih Tzu deserves a second look, because this short-faced breed already works harder to breathe and pain pushes that effort up further. A dog who pants while lying in a cool room, cannot seem to get comfortable, changes position every few minutes, or gets up and resettles through the night may be hurting rather than hot — especially if the panting comes with a tense belly or a hunched, tucked posture.
What lifting, grooming and the sofa reveal
A Shih Tzu who yelps, stiffens or snaps when lifted under the chest after years of accepting it is flagging pain in the back, ribs or abdomen, and the reaction matters more than whether she still trots happily afterwards. Change how you lift in the meantime — support chest and rear together and keep her level — and stop testing the sore lift to see if it happens again.
Daily grooming is your built-in examination for this breed. A Shih Tzu who suddenly pulls a leg away from the brush, cries when a mat is touched, or will not tolerate the usual face wipe may have sore skin under that coat, an ear problem under the hair, or a tender mouth. The step up matters too: refusing the small jump or step to a favourite sofa spot, in a dog who has always made it, points to pain on landing or pushing off.
Eating, chewing and the sore mouth
A Shih Tzu with mouth pain often still comes to the bowl — this is a companion breed that loves routine — but eats differently once there. Kibble dropped from one side of the mouth, chewing turned to one side, a new preference for soft food, or pawing at the muzzle after eating all suggest discomfort that a quick look at the lips and front teeth may only partly explain.
Bad breath that is noticeably stronger than her usual, drooling that is new, or one cheek looking slightly fuller than the other should move a vet visit up the list. Note which side she favours, because owners see the pattern across meals that a single examination cannot reproduce.
When this Shih Tzu needs a vet, and how soon
A squinting or pawed-at eye in a Shih Tzu is a same-day call, as is yelping when lifted, panting and pacing at rest, a tense or swelling belly, or repeated vomiting. Eye problems in this breed can worsen quickly, and waiting a weekend to see whether a squint clears is a gamble with her sight.
For quieter changes — the grooming protest, the abandoned sofa step, the one-sided chewing — book within days and bring notes on when each began, which side is affected, and a photo of the eye if that was a sign. A single organised packet in KinsLe Pet Passport spares you reconstructing weeks of small changes from memory while a worried dog waits on the table.