All You Should Know About Shih Tzu Hypoplastic Trachea

Shih Tzu with bow in front of yellow background

All You Should Know About Shih Tzu Hypoplastic Trachea

The Shih Tzu breed is an ancient dog breed dating as far back as 1000 years ago, and you can trace its roots back to China. One could even call this dog a celebrity dog because it’s one of the most popular breeds on the planet. Many celebrities and popular names have this adorable animal for a pet, and with its classy attitude, it’s no wonder why.

“While the name “Shih Tzu” might mean ‘little lion,” there’s absolutely nothing dangerous about this brachycephalic dog. On the contrary, Shih Tzus are lovable dogs that crave nothing more than your companionship. So, you’ll see them following their owners all over the place, sometimes even sitting on their laps.

We have a lot of things to say about the Shih Tzu, but there’s one thing we would like to focus on – their health. As sweet as these creatures are, they suffer from some diseases unique to brachycephalic dog breeds, such as a hypoplastic trachea.

Brachycephalic Animals and Brachycephalic Airway Syndrome Explained

Brachycephalic dogs are short-nosed dogs because they have short skull bones and a pushed-in face. Since these animals have shorter bone structures, some parts of their anatomy are altered, leading to some physical problems in the animal called brachycephalic airway syndrome.
A brachycephalic breed may experience laryngeal paralysis, stenotic nares, everted laryngeal saccule, hypoplastic trachea, elongated soft palate, etc. These diseases affect the dog’s airway, and a pet with brachycephalic syndrome can suffer from one or more of these syndromes. However, our focus is on the Shih Tzu breed and how the hypoplastic trachea affects them.
The brachycephalic syndrome can cause a lot of problems in an animal. For one, it can affect the lungs and the gastrointestinal tract. Dogs suffering from this situation can also suffer from other health problems like chronic gastritis, bronchial collapse, and gastroesophageal reflux. The gastroesophageal reflux condition has to do with intestinal fluids flowing back into the esophagus.

Hypoplastic Trachea Explained

Hypoplastic trachea or tracheal collapse is respiratory distress characterized by honking cough, wheezing, and aspiration pneumonia. Generally, the affected Shih Tzu suffers from breathing problems that dog owners and medical personnel have difficulty handling.
The hypoplastic trachea affects animals in different ways. It depends on the degree of upper airway obstruction, how bad the clinical signs are, and other underlying conditions the affected dog might have. Brachycephalic animals with this condition need to maintain an average weight to help manage the syndrome. A Shih Tzu with abnormally narrowed nostrils and breathing difficulty should be kept in cool and calm environments. This will help reduce stress and anxiety, and they won’t have to pant excessively.
As a Shih Tzu owner, you should also avoid letting your dog engage in too many activities, worsening the situation. Shih Tzus of every age is prone to the hypoplastic trachea. That implies that puppies are not exempted from this brachycephalic obstructive airway syndrome. However, the condition doesn’t become a problem until the Shih Tzu is much older. Thankfully, some dogs outgrow hypoplastic trachea, and that’s usually due to normal development that helps lessen the effect of the upper airway obstruction.

shih tzu running on beach

Causes Of Hypoplastic Trachea In Shih Tzu

Now that we all know that hypoplastic trachea is a common syndrome in Shih Tzu, let’s discuss how this issue starts in the first place.
The upper respiratory system contains a tube called the trachea, located below the larynx to the bronchi. The trachea is the passageway for oxygen used to flow into and out of the lungs. That is why any form of tracheal collapse or abnormality can be fatal to a Shih Tzu.
The hypoplastic trachea is a condition where an overlapping or fusion of the cartilaginous material makes up the trachea. This condition results in a narrowed windpipe, making it difficult for the Shih Tzu to breathe normally. This breathing difficulty even gets worse if the Shih Tzu falls ill.

How Hypoplastic Trachea Can Affect Your Shi Tzu

There are four levels at which hypoplastic trachea can affect a Shih Tzu, and they are:

1st Grade

The tracheal cartilage is still normally shaped. However, there’s a 25% reduction of the essential cells that form the tracheal lumen.

2nd Grade

There’s a 50% reduction of the tracheal lumen in this case, and the cartilage is not typically shaped.

3rd Grade

The cells are reduced by 75%, and the cartilage is almost flat.

4th Grade

There’s a total collapse of the tracheal lumen, and the cartilage is completely flat.
You need to check with your dog’s vet to know how far along your Shih Tzu is. Then, the doctor can administer the proper treatment for it.

Life Expectancy of a Shih Tzu With Hypoplastic Trachea

A healthy Shih Tzu will live for about 10 to 18 years. Tracheal collapse or abnormal airway syndromes might not affect the life expectancy of a Shih Tzu. Still, you must be careful to take note of anything that might indicate an emergency. If you don’t act fast when your pet begins to suffer from some terrible respiratory distress, it might prove fatal to the dog. The best option is to request assistance from your vet.

Signs That Your Shih Tzu Might Have Hypoplastic Trachea

Shih Tzu suffering from airway resistance may experience several symptoms, some worse than others. Some of the possible signs that your pet might be suffering from hypoplastic trachea are labored or noisy breathing, kennel cough, vomiting or choking, and loss of appetite. An affected Shih Tzu might show apparent signs of respiratory distress, pneumonia, excessive panting, and weakness.

How To Care for and Treat Your Shih Tzu

Before you begin treating your Shih Tzu, you have first to diagnose the dog. Some things must be considered when diagnosing hypoplastic trachea in your Shih Tzu. Some of them are symptoms reported by the pet owner and the dog’s health history. You also need the existence of clinical signs in the animal to make the proper diagnosis. Clinical signs are symptoms based on medical facts or noticed by a medical officer.
Most times, vets need thoracic radiographs to ascertain just how bad things are in the respiratory system. So, an x-ray is usually carried out on the Shih Tzu to confirm the size of the trachea and how narrow the airway is. Besides x-ray, your doctor can conduct other tests like fluoroscopy, a kind of x-ray testing that examines the situation in the dog’s respiratory system as it breathes through a real-time image. Other tests include blood tests, urinalysis, heartworm testing, and so on.
Sometimes, hypoplasia can occur in your pet as a standalone breathing issue. Other times, it can be associated with other brachycephalic airway obstruction syndromes such as stenotic nares, elongated soft palate, and laryngeal collapse.
Stenotic nares occur as a result of narrowed nostrils in the animal. This condition makes it difficult for the pet to take in enough air through the nostrils.
Elongated soft palate, as the name implies, is a situation that occurs when the soft palate is too long for the mouth. This causes an obstruction at the back of the throat, which is the entrance to the windpipe. In this case, your dog might need soft palate surgery.
Laryngeal collapse or laryngeal paralysis occurs when too much stress is placed on the larynx’s cartilage due to the presence of other airway abnormalities. When this happens, the larynx won’t open as wide as it should, leading to breathing problems.
There is also the issue of everted laryngeal saccules, which occurs when the tiny sacs below the larynx are sucked into the dog’s airway due to respiratory problems caused by the elongated soft palate stenotic nares. This everted saccule also causes more airflow restriction in the upper respiratory system.
If this syndrome is left unattended, it might lead to worse respiratory illnesses and, finally, death.

shih tzu sitting in grass How To Treat Hypoplastic Trachea In Shih Tzu

There’s no one-size-fits-all treatment for this breathing problem. Usually, treatment is given based on the level of each pet’s respiratory problem. Since some cases are worse than others, doctors need to verify the degree of hypoplastic trachea before doing anything. That is why an x-ray is essential.
Also, remember that other respiratory diseases can accompany hypoplasia, and in this case, one type of treatment might not treat all the airway abnormalities. Some pets also suffer from heart disease or pulmonary infections that make this breathing condition even worse.
These factors will determine what kind of treatment the Shih Tzu needs, if it even requires treatment. For instance, Shih Tzus with only a slight narrowing of the trachea might not need treatment. A vet would only need to prescribe ways that you can manage the situation. In other severe cases, three available treatment options are medical treatment, surgical treatment, and non-treatment.

Medical Treatment

The vet can prescribe medical treatment such as antibiotics, oral steroids, or inhaled medication to the affected dog. When dogs suffer from airway abnormalities, there may be increased cases of respiratory diseases. Therefore, vets must administer medicine to clear the airway and reduce inflammation.
The doctor may also administer sedatives to reduce the coughing cycle and eliminate the irritation that comes with consistent coughing.
Here’s a breakdown of some of the medical treatments that can be administered on the affected dog:


This medicine is given to the pet to reduce possible inflammation in the trachea. Drugs like this are either taken orally or inhaled by the pet. The inhaled option is better because it has fewer side effects than the one that’s taken orally.


Stress and anxiety in an affected dog usually make the condition worse. When this happens, light sedation can help reduce the effect of the excitement.

Cough Suppressants

Apart from the fact that coughing makes matters worse, dogs also get irritable when they cough. That’s double trouble. A cough suppressant will help control the cough and also stop the animal from being grumpy.


Bronchodilators help to clear blockages in the airway and create more space in the passageway. This treatment will relieve the pressure on the stressed trachea.

Anabolic Steroids

This kind of steroid is said to have anti-inflammatory properties and is helpful for dogs suffering from tracheal hypoplasia. Doctors might also administer this kind of medicine to strengthen tracheal cartilage.


Respiratory infections are usually on the heels of tracheal collapse and other airway abnormalities. Antibiotics are administered to animals that show signs of a possible respiratory infection.

Surgical Treatment

Medical officers seldom recommend this mode of treatment because anesthesia will be used during surgery, which is a risk that some are not ready to take. Anesthesia might compromise the already affected airway. However, there are instances and cases when surgery is the only way to deal with collapsed trachea in the animal.
A surgical correction becomes necessary in life-threatening situations or when it looks like the dog’s quality of life is becoming poor. Surgery is carried out on the Shih Tzu to expand particular – or all – areas of the trachea and nasal openings.


Some brachycephalic animals outgrow this situation and end up living a normal life like every other dog. Your Shih Tzu might be a part of the lucky ones and overcome the airway abnormalities. In that case, no treatment is required.
On the flip side, some pets have it so bad that there’s no solution. Most of the time, the situation gets worse when the pet has other health issues like cardiac or pulmonary effects. What the vet does is administer euthanasia on the animal. Euthanasia is the painless killing of animals suffering from a painful and often incurable disease. It’s better to let the pet go instead of subjecting it to more pain.

How To Help You Shih Tzu Live a Fulfilling Life With Hypoplastic Trachea

Besides medical treatments, there are ways to help your dog manage airway abnormalities. If you take the proper steps, you can help your pet outgrow the condition and live a normal life.
The first thing you can do to make the situation better in your animal is to keep your Shih Tzu away from things that can irritate its airway. Examples of such irritants are smoke, gas, and other pollutants. Instead of using a collar on your pet, you can use a chest harness. A collar might restrict the airflow of your pet and may worsen their breathing problems. A chest harness will give your dog enough leeway to breathe appropriately and still keep the animal secure like a collar would.
Due to their small size, you might be tempted to overfeed the Shih Tzu. Once this happens, your pet can end up becoming obese, and this can be harmful to dogs with breathing issues. Feed your dog a healthy diet so that it won’t end up becoming overweight. If your animal is already obese, a weight-loss plan might be right for the pet. You can do this by introducing a raw food diet or a canned food diet to your pet.
Keep your pets in cool and calm environments to reduce the number of times they will be exposed to situations that might want to stress the dog out. Stress and anxiety also worsen hypoplasia in a dog, so you might want to take your pet far away from situations that might trigger it. Also, be careful about taking your dog on stressful exercises. Limit their daily workout sessions to calm walks, and only walk in places that are not dusty and crowded.
The most important thing to do is always to observe your pet. Once you notice changes in breathing patterns, noisy breathing, or other collapsing trachea symptoms, you should take the animal to the doctor for an examination. You should take your pet to the vet for a regular checkup to make sure that things don’t even reach this point. The doctor will see if everything is well with the pet and note clinical signs that your pet might be ill when you do that. They will also check the trachea and other parts of the pet’s body for other possible diseases or infections.

Final Thoughts

Shih Tzus are sweet, adorable, and a companion that every dog lover would like to have in their corner. Sadly, their small size makes them prone to some diseases and conditions that can sometimes harm their health.
Tracheal hypoplasia and brachycephalic airway obstructive syndrome are prevalent in toy and small-sized breeds like the Shih Tzu. Still, some larger species are also susceptible to this airway condition. Although there is no perfect remedy for this respiratory distress, you can help your pet manage the disease. Regular checkups, weight loss, a healthy diet, and keeping them in calm environments are ways you can ensure that this airway abnormality does not get the better of your pet.
You can also hope you’re one of the lucky few with pets that outgrow the condition. However, if your pet doesn’t outgrow it, you can help to reduce the effect by taking your Shih Tzu to the vet, where it will receive the best treatment.
Remember, sometimes you might have to make a tough decision – euthanasia. When there’s no other option for your pet, this might be the only way out. Overall, your pet’s health should be critical to you, and you should treat it as such.
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