Meet Tai 

Tai is a 15 lb, 14 year old, male neutered Shih Tzu.  He is an indoor dog that enjoys being outside and walking around the park on nice days.  He is spoiled beyond compare.  He is hand-fed special food, has more toys than most children, sleeps on the bed and basically demands most of "his peoples" attention.

Tai first came to CAWC in February 2005.  He was a healthy, senior citizen with devoted pet parents.  We saw him during 2005 for routine senior consultations, screening and dental care. Things were about to change, but because Tai’s folks are believers in prevention the issues were detected early and because they’re also very observant Dr. Lisa has been given the information she needs to adjust treatment to Tai’s unique responses.

During a routine blood screening in late February of 2006, Dr. Lisa detected the early signs of kidney disease.  Kidneys remove waste products from the digestion of protein from the blood.  She recommended a urinalysis to get further information on how well Tai’s kidneys were functioning.  The urinalysis showed a low specific gravity.   She recommended that Tai’s diet be changed to one low in protein and phosphorus to decrease the kidney’s workload.  She added an Omega-3 fatty acid to his diet to help the kidneys by increasing the blood flow to them.  Dr. Lisa recommended that Tai’s blood pressure be checked as the kidneys play an important role in blood pressure regulation.

Tai’s blood pressure was very high and he had developed a low-grade heart murmur. The kidney disease was likely causing the high blood pressure which was likely causing the heart murmur showing how body systems are very interrelated.   However, it was also possible that unrelated and as yet undetected problems (such as heart disease) were playing a role.  Dr. Lisa and Tai’s folks had their work cut out for them as they began to try to help Tai’s body get back on track.

In early March 2006, a medication to manage the high blood pressure was added to Tai’s routine. Tai began coming in for regular blood pressure checks.  His readings improved slightly, enough so that the murmur was no longer detectable, but were still not within normal limits.  A blood screening at the end of the month, showed that the diet and supplement were helping his kidneys as those values were now within normal limits.  Dr. Lisa tried different medications and dosages.  Tai’s body continued to not respond as hoped and the hypertension remained unregulated.

In mid-May, Tai gave everyone a big scare by totally collapsing on his way home from a walk in the park.  He was rushed to the emergency hospital and stabilized.  An ultrasound of his abdomen and heart were performed.  The following day, Tai and his folks met with Dr. Lisa.

Dr. Lisa examined Tai and the records of his emergency room visit.  They reviewed everything tried to date.  They considered taking Tai to WSU where multiple specialists were available in one place.  Dr. Lisa consulted further with specialists via phone.  The consensus was to give Tai’s body more time to adapt to the medications, but be ready to take him to WSU if things did not improve.  An appointment was made at WSU, but at Tai’s check prior to going he finally began to show the long awaited for signs of responding to the medications. 

Phew!!!  It was now the end of May and Tai’s blood pressure was finally regulated.  However, there was to be no resting for Dr. Lisa and Tai’s folks.  Tai became reluctant to eat in early June.  Being a Shih Tzu, Tai had always needed extra attention to his dental care.  His folks felt that he was not eating because his mouth was uncomfortable.  He had developed gingival hyperplasia (overgrowth of gum tissue) over the last few months.  It is unknown whether or not this was a reaction to the blood pressure medication.  It was also possible that the medications were causing him to lose his appetite.  Of course, Tai wasn’t telling which was the real problem.

Dr. Lisa and Tai’s folks began considering the pros and cons of anesthesizing Tai to address the mouth issues.  The blood pressure problems made Tai a very risky anesthetic patient, but not eating was adversely affecting his quality of life.   Tai’s bloodwork showed that his kidneys values were once again higher than normal further increasing the risk of anesthesia.  Tai’s folks decided that the potential improvement to Tai’s quality of life was worth the risk.   Dr. Lisa and the nurses developed a special anesthetic and monitoring protocol for Tai.  Tai had a dental at the end of June where his small teeth and the excess gum tissue were all removed.  He did great under anesthesia!

The patience of “Team Tai” paid off!  Tai did well throughout the summer, fall and winter.  He decided that he did not like the special food anymore.  His folks decided that even though it would shorten his life, he would have a higher quality of life without forcing the special food.  At the end of September it seemed his blood pressure readings were increasing. Tai's dad noticed that he seemed much more stressed at CAWC, so Peter was dispatched to Tai's house with his blood pressure monitoring gear in hand.  Sure enough, Tai's readings were much lower at home.  The feedback from Tai's folks was critical in helping Dr. Lisa manage Tai's condition.  Good thing Tai is so demanding of their attention!

At Tai’s exam in January 2007, his bloodwork showed minimal progression of the kidney disease and his blood pressure continued to be well regulated.  Tai returned in February because his folks felt that he seemed painful when eating.  His gums were angry and inflamed again.  This time a course of antibiotics was used to get him back on track. 

Tai’s April bloodwork showed significant progression of his kidney disease.  Dr. Lisa and his folks are considering their next moves in managing Tai’s disease.   Their primary consideration is the quality of Tai’s life.

Tai’s dad says, “Tai sees Dr. Lisa regularly to make sure we respond promptly to any changes in his condition.  Even though we know we can't cure Tai's illnesses, we have made considerable progress in managing his problems.  We are helping him to maintain a good quality of life for as long as possible.” 

Inspite of all the issues, Tai enjoys a great quality of life and continues to rule his people with an iron paw.   His story is a great illustration of how teamwork between owners and doctors can help a senior pet live a long, happy life.
For additional information on the conditions discussed in this article read these articles in the pet info library.
Renal Disease. 
Glomerulonephritis. 
Hypertension: secondary to renal disease. 
Gingival Hyperplasia