Maintain the Shih Tzu puppies in an incubator environment with a temperature of at least 90 degrees Fahrenheit to start out. Reduce the temperature to 85 degrees after three or four successful days and you see the Shih Tzu puppies are stable. Slowly decline the temperature by small increments. After a week the temperature can be slowly declined to 80 degrees Fahrenheit. Maintain this temperature until the Shih Tzu puppies are three to four weeks of age. After four weeks the temperature may be reduced to 75 degrees.

Orphaned Shih Tzu puppies are prime candidates for failure-to-thrive syndrome. Under normal conditions, the Shih Tzu puppy is bumped and shoved instinctively with littermates. These natural instincts insure that the Shih Tzu puppies use their body, pushing toward the dam for nursing, pushing in rivalry against littermates. The dam vigorously washes her offspring, cleaning the Shih Tzu puppies and bringing about elimination. This tactile stimulation is crucial to the development of a strong healthy puppy.

You must effect stimulation by gentle periodic stroking with one or two fingers, awakening the Shih Tzu puppies directly prior to feeding. During feeding periods it is necessary to snuggle the Shih Tzu puppies to simulate the same type of nurturing the dam would have provided. You become a surrogate dam to orphaned Shih Tzu puppies.

Shih Tzu puppies are born with sealed eyes. The Shih Tzu puppy is unable to hear at birth. You as the surrogate dam will need to artificially stimulate the orphaned Shih Tzu puppy to defecate and urinate. You can do this easily by using a cotton swab dipped in baby oil. Gently swab the genitalia and anus area until the Shih Tzu puppy urinates and defecates. The surrogate dam must stimulate Shih Tzu puppies to elimination on the same regular basis as feeding intervals. The orphaned Shih Tzu puppy must be stimulated to urinate and defecate at each feeding interval until able to independently perform these functions.

Consult with your vet as to which puppy milk formula you should use, and the type of feeding method.