Maltese Health Problems: What Every Owner Should Know

If you share your home with a Maltese, you already know just how special these silky-coated little companions truly are. They’re affectionate, lively, and full of personality — but like every breed, they come with a set of health considerations worth understanding. Being informed about common Maltese health problems means you can catch issues early, advocate confidently at the vet, and give your dog the longest, healthiest life possible.

Common Causes

Maltese dogs are a purebred toy breed, and like many small breeds, they are genetically predisposed to certain health conditions. Their compact size, delicate bone structure, and centuries of selective breeding all contribute to vulnerabilities that owners should be aware of from the start.

Some of the most common health problems seen in Maltese dogs include:

• Dental disease: Because of their small mouths, Maltese dogs are prone to overcrowded teeth, plaque buildup, and early-onset periodontal disease.
• Luxating patella: This condition, in which the kneecap slips out of its normal position, is extremely common in toy breeds, including the Maltese.
• Portosystemic shunt (liver shunt): A congenital condition in which blood bypasses the liver, leading to a buildup of toxins in the body. It is seen more frequently in Maltese than in many other breeds.
• Hypoglycemia: Low blood sugar is a significant concern in Maltese puppies and small adults, particularly if meals are skipped or stress levels are high.
• Eye and tear duct issues: Maltese dogs are well known for tear staining, but the underlying causes can include blocked tear ducts, allergies, or chronic eye irritation that may require veterinary attention.

Dental disease in particular tends to progress silently. Many owners don’t realize how advanced their dog’s periodontal disease has become until a professional cleaning reveals significant bone loss or loose teeth beneath the gumline. Vets typically diagnose dental disease through oral examination under anesthesia combined with full-mouth dental X-rays, which can reveal what isn’t visible to the naked eye. The condition tends to worsen with age, which makes early intervention — ideally starting in the first year of life — critically important for this breed.

Luxating patella is graded on a scale from I to IV, with Grade I being a kneecap that slips only when manipulated manually and Grade IV being a kneecap that is permanently displaced. Many Maltese live comfortably with a low-grade luxating patella, while higher grades may require surgical correction. Your vet can assess the severity during a routine physical exam. Symptoms often become more noticeable in colder months when joint stiffness increases, and in older dogs whose surrounding muscle mass has decreased.

Portosystemic shunts are typically congenital in Maltese, meaning the abnormal blood vessel is present from birth rather than developing later in life. Signs often emerge in young puppies but can sometimes go unnoticed until early adulthood, particularly in cases where the shunt is small. Diagnosis usually involves a combination of blood work, bile acid testing, and abdominal ultrasound. When caught early, many dogs with liver shunts can be managed with diet and medication, and some are excellent candidates for surgical correction with very good long-term outcomes.

Symptoms to Watch For

One of the challenges of owning a small dog is that symptoms can sometimes be subtle or easy to dismiss as quirky behavior. Knowing what to look for allows you to act quickly when something is genuinely wrong.

Keep a close eye on your Maltese for any of the following warning signs:

• Limping, skipping, or favoring a leg, which may suggest a luxating patella or joint discomfort
• Lethargy, weakness, trembling, or disorientation, which can signal hypoglycemia and require prompt attention
• Excessive tear staining, eye discharge, or frequent pawing at the face, which may point to an underlying eye condition
• Bad breath, difficulty chewing, or visible tartar buildup, all of which are signs of dental disease that is progressing
• Stunted growth, vomiting after meals, excessive drooling, or unusual neurological behavior in a young dog, which can be associated with a liver shunt
• Itchy skin, chronic ear infections, or digestive upset, which may indicate food or environmental allergies
• Frequent urination, increased thirst, or changes in appetite, which can be early signs of kidney or metabolic concerns

Because Maltese dogs are so small, certain conditions can escalate quickly. Trusting your instincts as an owner matters — if something feels off, it usually is worth a closer look.

Symptom Severity at a Glance

Symptom	Risk Level	Action Required
Mild tear staining with no eye irritation	Mild	Monitor at home; keep eye area clean daily
Occasional limping or skipping on one leg	Moderate	Schedule a vet appointment within a few days
Bad breath, visible tartar, or difficulty chewing	Moderate	Call your vet to schedule a dental evaluation
Trembling, weakness, or glassy-eyed behavior	Serious	Offer honey or Karo syrup immediately; seek emergency care
Vomiting after meals, poor growth, or neurological signs in a young dog	Serious	Call your vet urgently; liver shunt screening needed
Collapse, seizure, or loss of consciousness	Serious	Seek emergency veterinary care immediately
Increased thirst, frequent urination, or sudden appetite changes	Moderate	Schedule a vet visit within 24–48 hours

Breeds Most at Risk

While the focus of this article is on Maltese-specific health concerns, it is worth noting that several related toy breeds share similar vulnerabilities — which speaks to how anatomy and breeding history shape health outcomes.

Yorkshire Terriers are among the breeds most frequently diagnosed with portosystemic shunts, right alongside the Maltese. Their similarly small body size and shared ancestry in the toy breed category appear to contribute to this predisposition. Yorkies are also prone to luxating patellas and dental crowding for the same anatomical reasons as the Maltese.

Chihuahuas are highly predisposed to hypoglycemia, dental disease, and luxating patellas — conditions that overlap significantly with the Maltese health profile. Their extremely low body weight makes blood sugar regulation especially fragile, and their small jaws create the same dental crowding challenges seen in Maltese dogs.

Shih Tzus share the Maltese’s brachycephalic-adjacent facial structure and are similarly prone to eye and tear duct issues, including epiphora (excessive tearing) and blocked nasolacrimal ducts. Shih Tzus are also frequently affected by dental disease and patella problems, making them a useful comparison breed when discussing toy breed health as a broader category.

What You Can Do at Home

While professional veterinary care is always the gold standard, there is quite a bit you can do at home to support your Maltese’s health and help prevent problems from developing in the first place.

Establish a dental care routine early. Daily tooth brushing with a dog-safe toothpaste is the single most effective thing you can do to prevent dental disease in your Maltese. If brushing is a challenge, dental chews, water additives, and prescription dental diets can all play a supporting role. Regular professional cleanings performed by your vet are also essential for this breed.

Feed small, frequent meals. To help prevent hypoglycemia, especially in puppies and very small adults, offer measured meals two to three times per day rather than allowing extended periods without food. Keeping a small amount of Karo syrup or honey on hand can be helpful in an emergency if your dog shows signs of low blood sugar.

Keep their eyes clean. Gently wiping the area around your Maltese’s eyes each day with a damp, soft cloth can help minimize tear staining and reduce the risk of skin irritation. Use only products specifically formulated for dogs around the eye area.

Monitor weight carefully. Maintaining a healthy weight reduces strain on your dog’s joints, which is particularly important given the Maltese’s predisposition to luxating patellas. Avoid overfeeding and limit high-calorie treats, especially as your dog ages.

Schedule regular wellness exams. Twice-yearly vet visits allow your veterinarian to catch developing issues before they become serious problems, which is especially important for a breed with as many known predispositions as the Maltese.

When to See a Vet

Some situations call for a scheduled appointment, while others require you to act right away. Knowing the difference can make a critical difference in your dog’s outcome.

Seek emergency care immediately if your Maltese is trembling uncontrollably, has collapsed, is having a seizure, is disoriented, or is unresponsive. These symptoms can indicate severe hypoglycemia or neurological complications and should never be waited out at home.

Schedule an urgent appointment if you notice your dog is limping consistently, has stopped eating, is vomiting repeatedly, or shows signs of significant eye discomfort such as squinting or excessive discharge. Any sudden behavioral change — unusual lethargy, hiding, or a reluctance to move — also warrants a prompt call to your veterinarian.

For a young Maltese that seems slow to thrive, gains weight poorly, or appears confused after meals, please speak with your vet about screening for a liver shunt. Early diagnosis significantly improves treatment outcomes for this condition.

When in doubt, always err on the side of calling your vet. A brief conversation is always worth it when your dog’s health is on the line.

How Pet Insurance Can Help

Caring for a breed with known health predispositions can sometimes mean unexpected veterinary bills, and the costs associated with conditions like liver shunts, orthopedic surgery for luxating patellas, or ongoing dental care can add up quickly. Having a pet insurance plan in place before problems arise means you can make medical decisions based on what is best for your dog rather than what your budget allows in a moment of crisis. Enrolling your Maltese while they are young and healthy is the best way to ensure maximum coverage when you need it most.

Protective Care: Get a free pet insurance quote and protect your dog today

For times when you need immediate guidance from a licensed veterinarian without leaving home, telehealth services can be a lifesaver.

For more clinical details on canine health, you can refer to the professional guidelines from the Merck Veterinary Manual.

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Your Maltese depends on you to be their advocate, and the fact that you are taking the time to learn about their health needs says everything about the kind of owner you are. With regular veterinary care, a watchful eye at home, and the right support systems in place, your Maltese can enjoy a long, vibrant, and deeply happy life by your side.