Umbilical and inguinal hernias are very common in the shih tzu. They may be congenital or acquired. In acquired hernias, there generally is some history of trauma such is at birth with the umbilical cord being cut to short or excessive pull on the cord during the cutting process. Congenital hernias involve the diaphragm or the abdominal wall. There are three main types involving the diaphragm. They are peritoneopericardial where abdominal contents are found extending into the pericardial sac; pleuropetioneal, in which abdominal contents are found within the pleural cavity; and hiatal, in which the abdominal esophagus, gastroesophageal junction, and/or portions of the stomach protrude through the esophageal hiatus of the diaphragm into the thoracic cavity.

Clinical signs vary from no symptoms to severe and depend on the amount of herniated tissue and its effect on the organ it is displacing. Hiatal hernias may be "sliding" and result in clinical signs of reflux esophagitis (anorexia, salivation, and/or vomiting) that may come and go. Definitive diagnosis is done through radiology, and contrast studies are need for confirmation. Correction of all the aforementioned hernias is best done through surgery.

Hernias involving the abdominal wall include umbilical, inguinal, or scrotal. An umbilical hernia is secondary to failure of the normal closure of the umbilical ring and result in protrusion of the abdominal wall. In small animals, if the hernia is small, correction is best done at time of spaying or neutering and this is best done no earlier than 6 months of age. Sometimes a small umbilical or inguinal hernia will have closed on its own by the time the dog reaches 6 months of age. If not, then it most usually is recommended to be closed during the sterialization process. If you are not planning to sterialize your animal, then the hernia can be repaired at 6 months of age, and preferably not before then, unless there is a medical reason to do so.