Maltese Guide

Maltese Health Problems: What to Know Before You Buy

Maltese health problems are mostly the ones seen across toy breeds, plus a few that are especially associated with this dog. The breed is generally sturdy and long-lived, but small bodies and tiny teeth bring particular risks that are worth understanding before a puppy comes home.

Below is each condition in plain language: what it is, how common it tends to be, which signs to notice and which tests exist. None of this means your dog will develop any of them. It means you will know what to look for. How long the breed typically lives is covered separately in the Maltese lifespan guide.

What are the most common health problems in Maltese?

The conditions that vets and breed clubs most often discuss are:

Patellar luxation, a kneecap that slips out of place.
Portosystemic (liver) shunt and the related microvascular dysplasia.
Dental disease, including early tooth loss.
Hypoglycemia (low blood sugar) in very small puppies.
White dog shaker syndrome, also called generalized tremor syndrome.
Reverse sneezing and a collapsing windpipe.
Eye conditions, including dry eye and eyelash problems.
Heart conditions, such as patent ductus arteriosus in puppies and valve disease in older dogs.

Most Maltese will meet few of these, and several are manageable with good care. The sections below explain them one at a time.

What is patellar luxation in Maltese?

The patella, or kneecap, normally sits in a groove at the front of the knee. In patellar luxation it slides out of the groove, usually toward the inside of the leg. It is common in small breeds.

Signs: a sudden skip or hop in the back leg, holding the leg up for a few steps, then walking normally.
Grades: vets grade it from one (mild, the kneecap pops out and back by itself) to four (the kneecap stays out and cannot be put back).
Treatment: mild cases may need only weight control and monitoring. Severe cases are corrected with surgery.
Testing: a vet can examine the knees by hand, and the Orthopedic Foundation for Animals records patella results for breeding dogs.

A grade one dog can live comfortably for years. The goal of testing is to avoid breeding dogs with higher grades.

What is a liver shunt, and can it be tested for?

A portosystemic shunt is an abnormal blood vessel that lets blood bypass the liver, so toxins are not filtered. Toy breeds, including the Maltese, are among those affected. A milder related condition, microvascular dysplasia, involves tiny vessels inside the liver and often causes few or no signs.

Signs of a shunt: poor growth, odd behavior such as staring or head pressing, vomiting, drinking and urinating heavily, and seizures. Signs often appear in the first year.
Tests: a bile acids blood test, taken before and after a meal, is the usual screen. Ultrasound or other imaging confirms a shunt.
Treatment: diet and medication can help, and surgery can close a shunt in some dogs.

Bile acid testing in breeding dogs is a sensible precaution, although a normal result does not guarantee that an offspring will never develop a shunt.

How common is dental disease in Maltese?

Very. Small mouths crowd teeth together, so plaque and tartar build up quickly and gum disease can start young. Left unchecked it leads to pain, bad breath, lost teeth and infection, and bacteria from the mouth can affect other organs.

Brush the teeth with a dog toothpaste, ideally daily, and ask your vet about chews that are safe for a small mouth. What your dog eats matters too, as the Maltese feeding guide explains.
Have the vet check the mouth at every visit, and schedule cleanings under anesthesia when advised.
Watch for bad breath, drooling, dropping food or pawing at the mouth.
Retained baby teeth, where a puppy tooth stays beside the adult tooth, can crowd the mouth and may need removal.

Good dental habits are among the best ways to protect the long-term health of a toy breed.

Why is low blood sugar a risk for tiny Maltese puppies?

Very young and very small puppies have little body fat and use up energy fast. If a puppy goes too long without food, becomes chilled or is stressed, its blood sugar can fall. Signs include weakness, wobbling, glassy eyes, tremors, and in serious cases collapse or seizures.

Feed small meals several times a day, as your vet advises.
Keep the puppy warm and calm, especially after travel or a big change.
Know the signs, and have your vet's emergency number ready.
Ask your vet what to do if the puppy seems weak, as a quick dab of corn syrup on the gums is sometimes advised before an urgent visit.

Most dogs outgrow the risk as they mature, and the very smallest puppies are the ones most affected. This is one reason to ask your vet how to feed and warm a small puppy. See the guide to caring for a Maltese puppy for feeding routines.

What is white dog shaker syndrome?

White dog shaker syndrome, or generalized tremor syndrome, causes whole-body tremors in small, often white, dogs such as the Maltese and West Highland White Terrier. It usually begins between roughly nine months and two years of age. The dog is typically awake and aware but trembles, sometimes with unsteady walking or darting eye movements.

The cause is not fully understood, and tremors can also come from poisoning, low blood sugar or other conditions, so any shaking needs a vet visit. Many dogs respond well to treatment, often steroids, and the condition is not generally thought to be painful. There is no routine genetic screening.

Are reverse sneezing and a honking cough serious?

They are different things. Reverse sneezing looks alarming, with loud snorting and the head stretched out, but it is usually harmless and ends within a minute. Staying calm and, as many vets suggest, gently stroking the throat may help. Tell the vet if it becomes frequent.

A dry honking cough, especially one that comes when the dog is excited or pulls on the leash, can signal a collapsing trachea, where the windpipe rings soften. A harness instead of a collar, a healthy weight and avoiding smoke and irritants help. Some dogs need medication or surgery.

Which eye and heart conditions affect Maltese?

For the eyes, the common concerns are dry eye, extra or ingrown eyelashes, eyelid problems and persistent tearing. A veterinary ophthalmologist can examine a breeding dog, and the CAER examination is recorded through the Companion Animal Eye Registry. For the staining side of tearing, see the Maltese tear stain guide.

For the heart, two forms matter. Patent ductus arteriosus is a vessel that fails to close after birth and is usually found in puppies by a vet listening to the heart. Mitral valve disease develops in older small dogs and causes a murmur, then possibly coughing and tiredness. A cardiac examination by a vet can find a murmur in a breeding dog and in a new puppy.

What can a buyer ask a breeder about health?

Any responsible breeder should be able to answer these plainly:

Which tests were done on both parents: knees, heart, eyes and bile acids, and what the results were.
Whether the certificates can be seen, not only described.
Whether a vet examined the puppy before it left, and for what.
What the written health guarantee covers, for how long and what you need to do.
Whether the breeder will take a dog back at any age.

Be careful with anyone who says a puppy is guaranteed healthy. No living animal can be, and testing lowers risk instead of removing it. Ask for the contract in advance. You can see how this works at the puppies available at Divine Maltese and on the health testing and guarantee page.

Quick Answers

Are Maltese a healthy breed?

Generally yes, and they are long-lived, but they are prone to certain conditions such as kneecap, liver, dental and eye problems. Choosing a breeder who tests the parents and keeping up with vet care both help.

Do Maltese have more health problems than other dogs?

Not necessarily. Their problems are those common to small breeds. Large breeds face different ones, such as hip dysplasia and bloat.

What health tests should Maltese parents have?

The usual tests are a knee examination for patellar luxation, a cardiac examination, an eye examination by an ophthalmologist and bile acids for liver shunt. Ask to see the certificates.

Is a Maltese puppy shaking a sign of illness?

It can be, from low blood sugar, cold, stress or other causes. A shaking puppy that is also weak, wobbly or unresponsive needs a vet quickly.

When should a Maltese puppy first see a vet?

Within the first few days to a week of coming home, which is also the window many written health guarantees require. The vet will check the heart, eyes, knees and mouth and set up the vaccination schedule.

Does pet insurance help with Maltese health problems?

It can help with unexpected bills for illness or injury, but most plans exclude conditions that existed before enrollment. Compare terms before you buy.