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Shih Tzu is getting old.

Species: Dog
Breed: shih tzu
Age: 11-15 years
Edward is 14 years old

We have noticed a couple of issues with him lately. About 1 month ago he started losing hair on his groin, there was a black mark on the skin where the hair was lost, it was sort of dry skin that flaked off. It continued and is now on a large part of his groin area and under some of his legs.

The important issue that we are concerned about appeared to happen for the first time on thursday. He went up two flights of stairs, to our bedroom, reached the top, and then fell over to one side. Struggled with his right side to upright himself. He got out of breath, and then calmed down and got up. This lasted about 2-3 mins. That night his breathing was very irregular. He panted and then had deep breaths, then shallow breaths and so on. The next morning he appeared fine, but fell over on his right side and repeated the same process, but not as long in duration.

He also appears to have lost weight in the last few weeks (about 2-3 lbs). His spine is very pronounced. His tail is mostly down, excep for small moments when it wags. His posture is low. I mean by this that his front shoulder is fairly low where as it used to be straight.

His eyes look sad. This might not be relevant but he has a large bump on his left rump. It is about 1.5 inches in size. When he walks it is as though his rear legs, skate. He had two more incidents today, One where his front paws sort of slid forward and he could not gain his footing. The other one is his left pay, curled below him and he tripped due to it.

He is eating and going to the bathroom regularly. He is also able to go up and down the stairs on his own. He is sleeping a lot, perhaps more then usual.

He also has a large lump on his throat. About a quarter in size.

We are wondering if this is the end. He has not been to a vet in about 13 years. He had no other issues and has been a carefree dog. He also has not had any accidents in the house for years.

Please let me know your thoughts.

thank you

Online vet, Dr. Marie

Dr. Marie replied:

Oh, Poor Edward. It sounds like he really is starting to have some health issues.

I can think of a few reasons for him to be having the falling down episodes. A few of the things that you mentioned could indicate that he has a problem with the veterbrae in his neck. If there is inflammation in between the vertebrae then this can push up on the spinal cord and cause him to have pain and have difficulties with one or both of his front legs. One of the symptoms of having inflammation pushing up on the spinal cord in the area of the neck is when a front paw curls.

I'd like you to try something with him. Have him stand on all four legs. Put your hand under his chest to support him and then see if it is possible for you to knuckle each one of his front legs over so that he stays standing on it while it is knuckled? If so then this is a sign of a neurological problem.

Sometimes a problem like this can be treated with anti inflammatory medication from the vet. But sometimes they can be more serious. They can even mean a tumor near the spinal cord.

It's also possible that he has a heart condition. Does he cough at all? If this is the case then he could be helped greatly with medication.

It would be really great if you could have a vet examine Edward and possibly do some blood work on him. Your vet will be straightforward with you as to whether or not they would be able to help him.

Hopefully this is just some minor pain that can be treated with medication.

Let me know if you have more questions!

Dr. Marie

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Customer reply:

Thank you for your prompt response.

We took his front paws, had him rest on the knuckle of it. He stayed with his paws on the knuckle form. He was not able to put a lot of weight on it.

Previously when we put him on his side or his back, he quickly righted himself, now he lays there for a while.

He does not cough much. However, when he sleeps, he previously never snored. He has started in the last few months to snore very loudly. He does the reverse sneeze that shih tzu do, but no more then average.

Can you tell us any more about his skin condition. I assume it is more a cosmetic issue compared to these other more serious problems.

Online vet, Dr. Marie

Dr. Marie replied:

OK, so a normal dog would not be able to stand on his paw knuckled like that. It is an automatic reflex that when a dog's paw is knuckled they will instantly un-knuckle it. So, this means that there is a neurological issue there.

I think it's really important to have your vet look at him. It's possible that the source of his neurological problem is arthritis in his neck or upper back and this could be treated with medication. On the other hand, if your vet finds that there is significant pain in his neck then it may be time for the family to have a discussion about his quality of life.

I think that the skin issues are likely separate from the neurological issues. It's always hard to talk about skin problems without actually seeing them, but there are a few things that could match your description. The black skin usually means that there is something chronic going on (as opposed to a sudden problem). It could be a bacterial skin infection. If this is the case it can be treated with oral antibiotics. Another possibility is if he has a thyroid problem. Dogs with thyroid issues will often get black skin in the groin and sometimes the armpit too. Thyroid problems can be treated quite easily with medication. However, he would need blood tests first to determine how low his thryoid level is.

Customer reply:

thank you

He has had very erratic breaths at night. Panting, shallow breaths, deep breaths and so on. Each lasting for a few minutes.

Is this relevant?

He has several bumps on his body. Would these be lesions or oil build up?

Online vet, Dr. Marie

Dr. Marie replied:

It can be relevant. It's possible that he is breathing like this because of pain. Sometimes dogs will have more pain at night time - I'm not sure why.

It's also possible that the breathing is related to a heart problem, but this sounds less likely if he doesn't have a nasty cough.

Odd breathing could be a sign of cancer in the chest. If there was a tumor in the spinal cord that has spread to the lungs then this is possible. However, most dogs with cancer in the chest don't have many respiratory symptoms until they are very very sick with cancer.

I'm guessing that the bumps are likely not connected to his other problems. Shih Tzus can get all kinds of warts, sebaceous cysts and other non-worriesome bumps.

Customer reply:

IS there anyway I can tell how much pain he is in? You mentioned that if his spine is inflammed it is a sign of pain. Can I check this?

Online vet, Dr. Marie

Dr. Marie replied:

Not really. Dogs are experts at hiding their pain. Your vet should be able to help you to determine whether there is pain by palpating in certain types of ways.

It happens often that I'll have a client say that they have felt every single bone and joint and couldn't find pain. But, when I do a good exam I can determine where the pain is. This is mostly because of experience though - because I examine dogs all day long. It's really hard for an owner to find most sources of pain.

Customer reply:

I know this is a difficult question.

Based on the description I have given you. What would the odds be of it being a simple treatment or something that is more serious?

Online vet, Dr. Marie

Dr. Marie replied:

I really wish I could say, but this could go many ways. I can tell you that I am quite concerned by the knuckling as this can mean a serious problem in the neck or upper back. But again, it's possible that the knuckling could be treated with medication.

I think it is quite evident that he is getting older and I do think that we need to start preparing ourselves for bad news.

But again, please, please see if you can have a vet see him soon. An in person exam is so much better than an online consult!

Customer reply:

We just did the knuckling movement and he responded well.

We will bring him to the vet tomorrow afternoon.

I realize he is an old dog and that may dictate some of the problems he is having.

I thank you for your time.

Online vet, Dr. Marie

Dr. Marie replied:

You're very welcome. I hope all goes well at your appointment.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.