Signalment

• Age: 12 years
• Sex: female spayed
• Breed: Chesapeake Bay Retriever
• Species: dog

Disease Notes

• Certainty: tentative
• Final Status:

Treatment and Outcome

Problem Notes

• Front End Weakness: I have been treating Rosie since January 2020 with weekly EAP treatments for suspected DM by the neurologists, and she had a DM test show up at risk per the owner. (When I first saw her she had been having symptoms of HL ataxia and weakness for the previous 6 months). During this time, she has been on Kan Essentials Open the Liver Canals (XCHJYJT), Spine Lithe (DHJST), and NP Milk Thistle as her primary herbal formulas. She has had quite a few UTIs that are treated based on cysto cultures by rDVM and we have had her on the NP Saw Palmetto to help with bladder emptying. She has progressed now where she cannot stand on her forelegs anymore so os cannot walk her with harness, they are expressing her bladder (she is not incontinent unless has an infection usually) and basically not moving her much at all because she cannot get up and has been quite painful in her neck/shoulder area that is somewhat improved by laser and massage. I tried adding the Bu Gan Tang for spasm but not much improvement. The dog has feeling in her legs and can move them, she wags her tail, she is always full of doggy smiles, has good appetite, BMs, etc. Still chews on her bones, and tries to play with the other dogs. The owner understands that we are progressing but wants to do everything she can for her. I am noticing her tongue changing from reddish to more pink, and gums a bit more pale, her pulses are deep , broad, and seem a bit more weak (I am not a great pulse reader), and her feet are usually cold, but sometimes she has warm back feet and cold front feet (?shao -yang disharmony?)
  
  I am considering Switching her formulas to NP XCHT, BZYQT, and XHLD to see if those are a better fit with her changes. The main issue will be trying to get all the powders into her as she will not take in her meals. The rDVM does have her on amantadine, and gabapentin but the gaba makes her somewhat gorked, she has had some trouble with NSAIDs but doing ok with lower dose Galiprant. I know we cannot stop her disease but wondering if I could be doing something better for her.