Signalment
- Age: 8 years
- Sex: female spayed
- Breed: Labrador Retriever
- Species: dog
Disease Notes
- Certainty: confirmed
- Comments: Poss allergic rxn? V dinner last week, then face swelling for 1 day. Day after she developed lameness RR leg. Not eating well last 4-5 days. C gave bit C, echinacea, detox formula. Normal stools. Adopted 5 yrs ago...2 yrs old. No blood work. Had ACL injury 3 yrs ago, but seemed to heal OK. No more ball playing. Feeding cooked chicken, w/ bones, oats, carrots.
Exam: Quite calm, reserved, possibly moderately depressed, but ate treats well. Moderately thin body condition. HR 88. N on abd palp. LNs N.
Sens BL18. T 102. Joints N on palp. T-pink, P- toned, weak
* Catch urine sample: Red-tinged. UA in house: Blood 4+; Prot 3+; SG 1.015; pH 6.5; Gluc Neg
Sediment: Field or RBCs' with larger cells...poss WBCs and epith cells. Poss. a few cocci bact.
A) Hematuria, poss low-grade pyelonephritis? Kidney damage from toxicity? TCM: Qi Def
P) Acp Tx: BL18,22,23; ST36, GB26 L ; KI3, SP6 L *15 min
Rx: 1) Bu Zhong Yi Qi Tang 15ml
Rehmannia 8 15ml
* 4 df tid
2) Ars 30c TID 3 days
* Submit Vet Screen / CBC
- Final Status: worse as of day 70 of treatment
Treatment and Outcome
Problem Notes
- Anorexia: Poss allergic rxn? V dinner last week, then face swelling for 1 day. Day after she developed lameness RR leg. Not eating well last 4-5 days. C gave bit C, echinacea, detox formula. Normal stools. Adopted 5 yrs ago...2 yrs old. No blood work. Had ACL injury 3 yrs ago, but seemed to heal OK. No more ball playing. Feeding cooked chicken, w/ bones, oats, carrots.
Exam: Quite calm, reserved, possibly moderately depressed, but ate treats well. Moderately thin body condition. HR 88. N on abd palp. LNs N.
Sens BL18. T 102. Joints N on palp. T-pink, P- toned, weak
* Catch urine sample: Red-tinged. UA in house: Blood 4+; Prot 3+; SG 1.015; pH 6.5; Gluc Neg
Sediment: Field or RBCs' with larger cells...poss WBCs and epith cells. Poss. a few cocci bact.
A) Hematuria, poss low-grade pyelonephritis? Kidney damage from toxicity? TCM: Qi Def
P) Acp Tx: BL18,22,23; ST36, GB26 L ; KI3, SP6 L *15 min
Rx: 1) Bu Zhong Yi Qi Tang 15ml
Rehmannia 8 15ml
* 4 df tid
2) Ars 30c TID 3 days
* Submit Vet Screen / CBC
- Azotemia: BUN (102), Creat (6.4), Phos 10.4, Alb (2.5), Glob (4.2)
HCT (31)
Urine Protein / Creat Ratio: 1.7 (N <..5)
- Hyperphosphatemia: ?? Phos 10.4
- Hypoalbuninimia: 2.5 on 10/3/14; 2.7 on 10/10/14
Treatments
- Bai Wei Di Huang Wan / Liu Nun Zi Tang
- Ba Wei Di Huang Wan Xiao Chai Hu Tang
- Eucommia and Rehmannia Combination
- Six Gentlemen Combination
- Dang Gui
Notes:
Re-ck: Not eating, and V liquid this AM. Had BM this AM.
Exam: Bright, alert. Thin body condition. T-pink, P- full, toned
A) Severe glomerulonephritis. Anorexia. Poor prognosis.
P) Acp Tx: BL20, 23; CV14; ST36 R, KI3 L *15 min
Rx: 1) Ba wei di huang wan 60g
Liu jun zi tang 40g
* 2 tsp rectally bid via feeding tube and 60 ml syringe
2) Amino- B Plex Bottle: 1 tsp bid
3) Nux V 30c tid 3 days
* Recc slippery elm bark, aloe gel orally; Force feed hard boiled eggs, and accupressure points
Acupuncture points were stimulated
Notes:
Re ck Exam: Doing much better. Appetite much improved, and stools normal. Less water drinking. Wants to go for walks, but tires out after a while. Not drinking as much water. Still giving Chinese herbs rectally.
Exam: Looks good. Appears to be putting weight back on. T-pink; P- toned, stronger
* UA strip in house: Blood 4+; pH 6.5; Prot 2+; SG 1.015
A) Doing very well; Urine clear now, but still has signif hematuria and proteinuria, low SG
P) Acp Tx: BL17,20,23; ST36 R; KI3,KI6, SP6 L *15 min
* UA strip in house: Blood 4+; pH 6.5; Prot 2+; SG 1.015
Lab Results:
Bun 89 ; Was 102 on 10/2/14
Creat. 5.1 ; 6.4
Phos 10.3 ; 10.4
HCT 33 ; 31
Glob 4.1 ; 4.2
Alb 2.7 ; 2.5
Acupuncture points were stimulated
Notes:
Re-ck: Cont to do very well. Appetite still improving, and good energy on walks. Not drinking as much water now. Stools normal. Feeding Pitcarn Kidney Diet: Ground beef, white rice, eggs, parsley , garlic, yams. Still giving herbs rectally, and Phos Bind 1 scoop after meals.
Exam: Looks great. T-lavender; P- toned, strong, but not excessively taught or choppy now.
P) Acp Tx: Bl 20,22,23; KI3, KI6, SP6 R; LU7, ST36 L *15 min
* Submit Vet Screen / no CBC
* Cont herbs rectally
Acupuncture points were stimulated
Notes:
Still doing very well. Appetite usually good. Stools good. Putting 1 tsp bid in food and tincture. Normal water drinking, urination. Some stiffness in front legs last week. Energy and endurance good.
Exam: Looks great. 64.6 lbs. T-pink, lavender; P- strong, taught
A) Still cont to do well. Gaining Wt. TCM: Qi Stag / Kidney Def
P Acp Tx: BL17,BL22 ( Pulse smoothed), BL23; ST36 L; KI3, SP10 R * 20 min
P) Submit Vet Screen / CBC
Lab Results: ?BUN 67; ?Creat 3.8; Phos high N 6.0; Glob 3.9: HCT? 31%
A) BUN and Creat about the same, but phos, and globulin slightly higher again; Mild anemia. LDH and T4 N.
Pos return of inflammatory state?
P) Rx: Ba wei di huang wan 60g
Xiao chai hu tang 40g
* Rounded tsp bid
Acupuncture points were stimulated
Notes:
Daisy is not doing as well. She won't eat her food if I put any herbs or supplements in it. She started leaking at night, despite taking her out to void at 9:00 p.m. She lags on walks on the last hill home. Started giving herbs rectally again. Water drinking same.
Exam: 62.5 lbs. Looks a little the. Shy and and a bit anxious as usual. T-pink; P- full, toned, but weaker on compression. Pulse may be a bit better townifying ST36, SP6
*PCV in house: 25%
*UA: SG 1.015; Blood 4+; pH 6.0; Prot 1-2+; Gluc Neg
Sediment: Neg
Vet Screen results: BUN 78, Creat 4.5 ( was 67/ 3.8 Nov 20th) ; Phos 5.9, glob 3.4, Alb 2.7 ( 6/ 3.9 / 2.9 Nov 20th)
A) Doing a bit worse: Appetite not as good, losing wt, lower stamina. Anemia worse, and ongoing occult hematuria, proteinuria
TCM: SP Qi Def; Kid Qi Def
P) Acp Tx: Bl 17,20,23; ST36, GB40 L; KI3, KI6, SP6 R *15 min
Rx: You gui wan 65g
Liu wei di huang wan 35g
Dang gui 10g
* 2 tsp rectally bid
Acupuncture points were stimulated