Observe your dog. There may be a few puppies inside her, but note that it is possible for these puppies to be born a few hours apart. If your dog seems to be relaxed, you can bring her and her puppies to your veterinarian. They might use ultrasound to check if you still have puppies in your dog’s womb.
Now you know what to do when you give birth to Shih-Tzu. Once you reach a vet or animal clinic, you can relax a lot. What usually happens is that the puppies get milk from your dog and put it in a box that has a bulb overhead to keep the puppies warm-something like an incubator.
Now remember that the hard part is not the birthing process, but the nurturing process-when you bring the puppies home and try to make sure they thrive their crucial first two months.
Source: Sunnybelle Shih Tzus