7 Common Yorkie Health Issues and What to Do About Them

Written by Dr. Marcelle Landestoy, DVM

Yorkshire Terriers are a courageous and intelligent breed and have come a long way from their working dog roots catching rats.

Now, a typically pampered pup, the Yorkie is a popular and sought-after breed.

The average life expectancy of a Yorkie is relatively high (11-15 years), yet that does not mean that there are no genetic weaknesses that make them susceptible to ill health. 

Some common Yorkshire Terrier health issues include diabetes, brachycephalic conditions, such as tracheal collapse, and heart defects, such as patent ductus arteriosus. They are also prone to liver shunts, luxating patellas, and Legg–Calvé–Perthes disease—a degenerative disease of the femoral head.

Using my experience as a veterinary doctor, I’ve compiled the following list of common Yorkie health issues, their symptoms, how they’re diagnosed, and the best course of action.

Unfortunately, this breed is prone to most pedigree dogs’ genetic curse, which is a congenital weakness.

If you are considering a Yorkie as a pet or wish to learn more about potential health issues in the breed, this article will give you some of the most common congenital conditions found in Yorkshire Terriers. 

Yorkshire Terriers History

The Yorkshire Terrier is the smallest of the terrier breeds, and their diminutive size belies their charismatic and confident natures.

The Yorkshire Terrier arose in the mid-19th century in Yorkshire, England, and originated from various Scottish terrier breeds. 

Unlike the pampered pooches we see today, Yorkshire Terriers were originally a working dog, bred as fearsome rat-catchers and used in the textile mills and even mining shafts.

Soon after the Kennel Club recognized them in 1886, their hard work changed to pampered lapdogs as the breed’s popularity began to grow.

The AKC hails the Yorkie as one of the top ten favorite dogs since 2013, which is no surprise considering the intelligence, fierceness, and loving nature of these little scamps.

Although they are a long-lived breed and are healthier than many of their pedigreed peers, such as Bulldogs, they still suffer the consequences of inbreeding and genetic susceptibility to disease. 

Common Yorkie Health Issues

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Diabetes Mellitus

In a study of veterinary data in the UK, researchers discovered that Yorkshire Terriers have the most significant risk of diabetes mellitus, which was almost five times higher than their crossbreed cousins.

Diabetes mellitus is a condition that affects the glucose or sugar levels in their bloodstream.

When a dog eats, their food is converted into simple sugars such as glucose. 

Glucose is absorbed into the blood from the intestines and fuels the rest of the body.

Like humans, dogs require insulin to transfer glucose from the blood into the body’s cells so that the body might use it as energy.

If there is too little insulin, the glucose cannot transfer to the cells and builds up in the bloodstream instead. 

The cells become depleted of energy despite eating nutritious food, and glucose spills over into the urine, drawing a large volume of water and causing thirst and excessive urination. 

Researchers found a link between cytokine gene polymorphisms associated with cell signaling in the body (and potentially influence glucose uptake or insulin in the cells) and diabetes mellitus in the Yorkshire Terrier breed.

Symptoms

The earlier a vet treats your pet for diabetes, the less likely they will suffer from secondary conditions associated with diabetes.

The most noticeable signs of diabetes in dogs are:

• Excessive water drinking and urination (polydipsia and polyuria)

• Weight loss and increased appetite

• Decreased appetite

• Cloudy eyes

• Chronic and recurring infections such as skin and urinary infections

Diagnosis and Treatment

Diagnosis hinges on typical clinical signs and persistently high blood glucose levels (hyperglycemia) and glucose and ketones in the urine (glycosuria and ketonuria).

Typically, the treatment of canine diabetes is a multi-tiered system, including diet and lifestyle changes and insulin treatments.

• Diet: Your vet will recommend a specialized low-fat diet for your diabetic dog, including fiber and complex carbohydrates to slow glucose absorption.

• Exercise routine: Exercise is essential to prevent spikes or drops in glucose levels, and regular yet moderate exercise is vital to your diabetic pet.

• Insulin: Most diabetic dogs require a daily shot of insulin under the skin. 

Brachycephalic Related Disease

Yorkshire Terriers are moderately brachycephalic, making them more susceptible to upper respiratory tract disorders (URT). 

Brachycephalic syndrome or ‘short-headed’ syndrome occurs in dog breeds with short muzzles and noses, which cause the throat and breathing passages to be undersized or flattened. 

One of the conditions associated with this syndrome, common in moderately brachycephalic breeds, is the trachea or windpipe’s narrowing.

A scientific survey conducted over 1200 extremely brachycephalic breeds and Yorkshire Terriers found that they were 9.7% likely to suffer from a URD in their lifetime. 

Although not as high as the extreme brachycephalic breeds such as the Bulldog (22%), the survey found Yorkshire Terriers to have a substantially higher risk of trachea-related URT disorders than extreme brachycephalic breeds (6.3% vs. 5%).

Tracheal Collapse

Tracheal collapse is a common airway obstruction condition in toy breeds, particularly the Yorkshire Terrier.

The trachea consists of cartilage rings where the air moves to and from the lungs.

When these rings begin to collapse, your Yorkie may exhibit a characteristic honking cough.

Tracheal collapse is a congenital abnormality where the tracheal ring cartilage is less cellular and weaker than healthy dogs.

Respiratory disorders rank the highest on the organ systems responsible for mortality in the Yorkshire breed.

Symptoms

Yorkshire Terrier’s susceptibility to tracheal collapse makes it particularly important that owners treat the throat area with sensitivity.

As a general rule of thumb, owners should walk this breed on a harness rather than on a lead to prevent tracheal damage.

Tracheal collapse may occur at any age but is more common in dogs aged six to seven.

You seek medical attention if your Yorkshire Terrier exhibits the following signs:

• Labored breathing

• Exercise intolerance 

• A bluish tint to the gums

• Persistent cough

Diagnosis and Treatment

Although a honking cough is a primary symptom of tracheal conditions in toy breeds, it is necessary to conduct additional tests for a definitive diagnosis. 

Radiographs may help but do not always show tracheal collapse clearly because it does not always remain closed.

However, fluoroscopy allows a view of the trachea as the dog inhales and exhales, enabling confirmation of the condition. 

Tracheal collapse treatment is not curative. However, studies show that 71-93% of dogs respond well to medical management for more than 12 months, and 50% can gradually withdraw the medication.

Veterinarians typically treat most cases with:

• Cough suppressants

• Bronchodilators 

• Corticosteroids

• Antibiotics

In severe cases, your vet might recommend surgery, and there are various surgical techniques to correct tracheal collapse.

The most favored method is to apply extraluminal ring prostheses to the outside of the trachea.

Studies show a 75-85% success rate for dogs under six years old.

Patent Ductus Arteriosus

Yorkshire Terriers are prone to several heart conditions that may occur at any stage of their lives.

You must look for signs and symptoms of heart disease in your pet and ask your veterinarian to check for heart murmurs and abnormal heart rhythms.

Annual heart check-ups are a good idea, including ECG, X-rays, and echocardiograms to eliminate genetic risk factors.

Patent ductus arteriosus (PDA) is common in Yorkshire Terriers and is a heart condition caused by the ductus arteriosus failing to close properly at birth. 

The ductus arteriosus is an arterial shunt between the two main blood vessels leading from the heart and is expected during fetal development.

The shunt allows blood to bypass the lungs until birth, usually shutting down when a puppy takes its first breath.

When the ductus arteriosus does not close correctly, it causes a difference in pressure between the pulmonary artery and aorta.

This imbalance causes the blood to flow through the ductus arteriosus into the pulmonary artery. 

The pulmonary artery then recirculates the oxygenated blood back into the lungs.

With the aorta pumping less blood to the main circulation, the heart’s left side must work harder to oxygenate the body. 

This misplacement causes the left lung to work harder than the right, leading to moderate to severe heart enlargement that may lead to congestive heart failure.

Symptoms

Younger pups may show no clinical signs at a young age besides mild exercise intolerance and stunted growth, but as the PDA increases in size, the symptoms become more evident. These signs may include:

• Difficulty breathing

• Heart murmurs

• Abnormal heart rate

• Higher sleep rates 

• Thinner bodies than average (in pups)

Severe cases of PDA may include symptoms such as:

• Abnormal heartbeat

• Blueness of the footpads on the hind legs

• Hind leg collapse

• Weakness and lethargy

Diagnosis and Treatment

Initially, your vet will check for heart murmurs. The vet will then recommend:

• Chest radiographs (x rays)

• Electrocardiogram to assess heart rhythm 

• Blood tests for unusual red blood cell values

Your vet will use a cardiac ultrasound or echocardiography for a moving image of your dog’s heart for a definitive diagnosis.

Doppler echocardiography will isolate the speed of blood flow and locate the shunt.

You would then consult a veterinary cardiovascular surgeon who will decide the best surgical technique to prevent blood from diverting through the shunt.

This process may involve surgery to tie off the ductus, or less invasive surgical options such as blocking the ductus arteriosus via cardiac catheterization with:

• Transarterial coil

• Ductal occluder

Legg–Calvé–Perthes Disease (LCPD)

Legg-Calvé-Perthes, also known as avascular necrosis, is a condition where the femur head begins to degenerate and leads to potential hip collapse. 

In LCPD, the bone starts to weaken, leading to small fractures and developing scar tissue.

Then, it changes the bone structure, leading to arthritis.

A genetic cause is suspected but as yet unproven for this condition, although studies suggest it is related to blood flow to the hip or blood clots in the blood vessels.

Legg-Calvé-Perthes Diseases or LCPD is found commonly in the Yorkshire Terrier breed.

A study of LCPD cases, 1996-2008, at the Governador Laudo Natel Veterinary Hospital of the School of Agrarian and Veterinary Sciences at Jaboticabal, found 22% of the reported cases were Yorkshire Terriers.

Symptoms

The primary symptom of LCPD is a gradual limp that progresses over several weeks on the affected leg.

The dog will eventually avoid placing weight on the affected limb in the later stages of the disease.

However, the onset may be sudden but typically affects one side of the hip rather than both hips simultaneously. 

Your dog will exhibit pain when the affected leg is handled or moved, and the pain becomes more severe as the LCPD progresses.

The signs of LCPD typically occur in younger dogs, between five and eight months of age but may be seen from three to eighteen months of age.  

Diagnosis and Treatment

Your vet will typically perform multiple radiographs of the affected area over time because the hip may change throughout the disease. 

In the early stages of the LCPD, the femur head’s flattening may be subtle, but damage to the femur head becomes evident as the bone deteriorates.

Late-stage LCPD will show distinct deformation of the femoral head and reveal evidence of arthritis. 

You may manage mild LCPD by medicine such as painkillers to keep the dog more comfortable.

Your vet may also recommend lifestyle changes such as diet, as weight places extra strain on the affected area.

If the condition is severe, your vet will recommend surgery.

The most common surgical procedures for LCPD are:

• Femoral head and neck surgery or FHO: The surgeon removes the femoral head, allowing the body to develop healing scar tissue.

• Total hip replacement (THR): It uses implants to recreate a functioning hip joint.

After surgery, care includes physical therapy, pain medication, and chondroprotective agents, such as glucosamine, to protect the cartilage. 

Portosystemic Shunt or Liver Shunt

A liver shunt occurs when the portal vein’s blood flow is allowed to bypass or ‘shunt’ around the liver.

The portal vein carries blood from the gastrointestinal system, pancreas, and spleen and moves it into the liver, where the liver removes toxins and byproducts.

This disorder is mainly due to a congenital disability called a portosystemic shunt.

The ductus either fails to collapse at birth, or an abnormal blood vessel outside of the liver stays open after the ductus venosus should close.

Both conditions are potentially serious without professional veterinary intervention. 

Symptoms

The most common signs of a portosystemic shunt include:

• Stunted growth

• Poor muscle development

• Disorientation, head pressing, and seizures

• Excessive drinking and urination

• Vomiting 

• Diarrhea 

• Recurrent kidney/bladder infections (older dogs)

Diagnosis and Treatment

Your vet will base their diagnosis on your pet’s medical history as well as the clinical signs of the disease.

The diagnostic tools most commonly used are:

• Complete blood count and serum chemistries will find abnormal levels of urea nitrogen, albumin, and increases in liver enzymes.

• Urinalysis will show urine dilution and evidence of infection or crystals.

• Bile acid test will determine if your pet has elevated bile levels, which is a symptom of liver shunts.

Your vet may include additional tests such as:

• Ultrasound with doppler flow analysis

• Computed tomography

• Portography

• Magnetic resonance imaging

• Exploratory surgery

Treatment for portosystemic shunt improves quickly with proper diet and medication, and one-third of treated dogs will live a relatively long life.

Unfortunately, owners will often euthanize dogs with severe clinical symptoms. Treatment typically includes:

• Dietary changes such as reduced protein and highly digestible food sources.

• Lactulose sugar changes the pH in the large intestine to minimize ammonia and toxin absorption.

• Antibiotics are often prescribed to decrease intestinal bacteria growth.

Surgical options for liver shunts include:

• Ameroid constrictor is a metal band with an inner ring of casein which absorbs abdominal fluid and swells.

• Cellophane bands cause inflammation and scarring in the shunt to make it close.

• Intravascular clot-inducing devices

Luxating Patella

Luxating patella is a common condition in Yorkshire Terriers and can take a mild or severe form with complications.

The patella (or kneecap) rests in a groove on the end of the femur just above the knee (stifle). 

The term luxate means ‘out of place’ and refers to a kneecap that moves out of its standard location.

Yorkshire Terriers are prone to this condition where their patella moves, and they experience difficulty in bearing their weight on the affected leg.

Patellar luxation may be mild when the patella only luxates when force is applied, top moderate luxation where the kneecap pops out frequently.

In severe luxation, the patella will be out of position most of the time.

Luxation may affect one or both kneecaps, and the incidence is roughly 50-50 between the two. 

Symptoms

Your Yorkshire Terrier may not exhibit any signs of pain when experiencing this condition, and they often learn to kick their legs out to the side and snap the patella back in place.

Typical symptoms of luxation include:

• Skipping a step 

• Running on three legs

• Hyperextension of the knee during motion

Diagnosis and Treatment

There are several patella luxation degrees, and the severity depends on whether one or both legs are affected.

Vets typically grade luxation between Grade I-IV. Some Yorkies can live with the condition without serious issues for their lifespan; however, severe patella luxation may lead to:

• Torn cruciate ligaments

• Changes of the hip, thigh, and shin bones due to weight-bearing stress

• Arthritis (in later stages of the condition)

If your pet shows persistent lameness or secondary knee injuries, your vet may recommend surgery.

Surgery is uncommon in type I luxation, but surgeons may repair type II-IV surgically. Surgery involves three steps:

1. A surgeon moves the point of attachment of the patellar ligament to the shin bone to the correct position.
2. A surgeon deepens the groove in the patella so the kneecap will stay in place.
3. A surgeon may tighten the capsule surrounding the joint to decrease luxation. 

The surgeon may also place an implant inside the knee to prevent the patella from slipping out of position. 

Conclusion

Yorkies will continue to find a place in the public’s heart. As more people learn their strong personalities and particular brand of pluck, their popularity will only increase.

However, prospective owners should be aware of the potential health problems associated with the breed. 

Understanding the potential health risks makes for early detection and ensures you will get the full 17 years out of this unique companion. 

Sources

• AKC: Yorkshire Terrier (Yorkie) Dog Breed Information
• Biomed Central: Epidemiological associations between brachycephaly and upper respiratory tract disorders in dogs attending veterinary practices in England
• ACVS: Brachycephalic Syndrome
• Trudell Animal Health: Tracheal Collapse In Dogs: What It Is, Symptoms To Look For, And How To Treat It
• Wiley Online Library: Mortality in North American Dogs from 1984 to 2004: An Investigation into Age‐, Size‐, and Breed‐Related Causes of Death – Fleming – 2011 – Journal of Veterinary Internal Medicine
• University of Missouri: What is Fluoroscopy?
• Wiley Online Library: Canine tracheal collapse – Tappin – 2016 – Journal of Small Animal Practice
• Cornell University: Patent Ductus Arteriosus in Dogs
• Vetfolio: Patent Ductus Arteriosus in Dogs
• PubMed: Transarterial coil embolization of patent ductus arteriosus in small dogs with 0.025-inch vascular occlusion coils: 10 cases
• Infiniti Medical: Canine Duct Occluder (ACDO)
• VCA Hospitals: Portosystemic Shunt in Dogs
• UFAW: Yorkshire Terrier – Diabetes Mellitus
• VCA Hospitals: Luxating Patella in Dogs
• VCA Hospitals: Diabetes Mellitus in Dogs

Read more about the Yorkie

Marcelle Landestoy Veterinary Hospital Director at UCE Dr. Marcelle is a general veterinarian with a Small Animal Medicine Specialty | Director of the UCE School of Veterinary Medicine | Certified by the International Veterinary Acupuncture Society