A 4-year-old Shih Tzu has pyometra, vaginitis or hyper-estrogenism?
Channel: Dr David Sing
Date: 2015-03-19

Mar 19, 2015. This 4-year-old female, not spayed Shih Tzu licked her vulval areas till it became swollen 10X. I did advise the owner to spay her around the 7th month but she said she had "no time". This is a likely case of pyometra. It could be hyper-estrogenism. 

In either medical situations, spaying her young would have prevented such illnesses. Now, the dog has no appetite. Antibiotic is given.