A yearly minimum, with good reasons
Every healthy adult Shih Tzu should have a full wellness exam at least once a year. Puppies start with several visits in their first months, and seniors step up to twice a year. For most breeds the annual exam is good practice; for a Shih Tzu it is closer to essential maintenance, because this breed's charming features, the short face, large round eyes, and long coat, each carry health points that only a hands-on exam checks properly.
Eyes, breathing, and teeth lead the list
A Shih Tzu's eyes sit forward in shallow sockets, which leaves them exposed to scratches, dryness, and irritation that an owner may read as ordinary tear staining. At the annual visit the veterinarian examines the eye surface, checks tear production and lids, and can tell normal wetness from early trouble. Breathing is assessed too: the vet listens to the airway and will ask about snoring, snorting, exercise tolerance, and how your dog copes in warm weather, since a flat-faced dog's breathing can narrow gradually and be missed at home.
The small jaw crowds a full set of teeth, so dental disease arrives early and hides under that long facial hair. The oral exam is where tartar, loose teeth, and gum pain are found. Skin under the coat, especially around the face folds, ears, and belly, gets checked for the irritation and yeast-type problems this breed is prone to, and weight is recorded, because a companion dog who is carried often can gain quietly.
Puppies and seniors on their own schedules
Shih Tzu puppies need their early series of visits for vaccines, growth checks, and a look at the bite, the soft spot on the skull in very young pups, and how the airway sounds as the face develops. Those visits also set baselines for the eyes that later exams will be compared against.
A senior Shih Tzu should be seen twice a year. Vision changes, heart sounds, kidney-related bloodwork trends, and mobility all shift faster in an older dog, and a small breed's long lifespan means senior care can span many years. Report increased thirst, nighttime restlessness, coughing, or a dog who bumps into furniture in dim light rather than saving it for later.
Signs that should not wait for the annual visit
Call promptly if your Shih Tzu squints, paws at an eye, or develops a cloudy or bulging eye, because eye injuries in this breed escalate quickly. Labored, noisy breathing at rest, collapse in heat, or repeated gagging also warrants a same-day call. Persistent scratching, a sour ear smell, or skipping meals for more than a day are all reasons to be seen sooner rather than later.
Arriving prepared
Bring a note of breathing and snoring changes, eye discharge patterns, appetite, and the foods and treats your Shih Tzu eats, and keep the face trimmed enough that the veterinarian can see the eyes clearly. Recording each visit in KinsLe's Pet Passport keeps your Shih Tzu's eye findings, dental notes, and vaccine history in one place, so the next exam starts from facts rather than recollection.