Normal Shih Tzu puppies are plump and firm at birth. They have good muscle and skin tones. The skin on the abdomen, feet and mouth is pink. If Shih Tzu puppies cry continuously or constantly squirm and crawl, these are signs of infant distress. Well-nourished, healthy Shih Tzu puppies are warm, quiet and sleep most of the time. They yawn at awakening. Do not excessively handle newborn Shih Tzu puppies. Do not allow others to handle newborn Shih Tzu puppies. Only the breeder or caretaker should handle newborn Shih Tzu puppies. Excessive handling of more than one person increases the chance of transmission of infections to the newborns.

Unthrifty Puppies

Unthrifty Shih Tzu puppies have poor muscle tone. Obvious signs of discomfort are constant crying and initially high levels of activity. Unthrifty Shih Tzu puppies appear thinner than siblings and are limp to touch because of poor muscle and skin tones. Unthrifty Shih Tzu puppies may feel cold to your touch or cooler than their siblings. The skin over the abdomen, feet and mouth interiors may appear reddish purple or paled when compared to other siblings.

An unthrifty Shih Tzu puppy is usually incapable of sustained nursing and readily loses nipple contact with the dam. They become easily chilled. Such unthrifty Shih Tzu puppies may respond positively to a few milliliters of raw liver juice fed daily for their first few weeks. Supplementary tube or bottle feeding for three or four days every four hours around the clock may be necessary. If you notice a weak, unthrifty Shih Tzu puppy, remove it from the litter and maintain it in the puppy box. You can place the Shih Tzu puppy back on the dam at regular intervals under your close supervision. This way the dam is able to stay in touch with the weak unthrifty Shih Tzu puppy. She will stimulate elimination, clean and nurture them at this time. This regular periodic tactile time helps avoid failure-to-thrive syndrome. Many weak and unthrifty Shih Tzu puppies can be successfully saved.

Premature Puppies

The first 24 hours are critical to premature Shih Tzu puppies. They must be maintained on an hourly schedule. The next 48 hours requires an every 2 hour schedule around the clock. The following 48 hours can be stretched to a 3-hour schedule around the clock. By the fifth day, premature Shih Tzu puppies, can be changed to 4-hour intervals. At one week, the night feedings only can be set to a 6-hour schedule, resuming 4-hour intervals during the day. This is a highly intense schedule for a breeder or Shih Tzu puppy mid-wife. It must be maintained until the premature Shih Tzu puppies are ready for their first semisolid foods at about 13 days of age and after their eyes have opened. Many premature Shih Tzu puppies can be saved on this routine.