Signalment
- Species: dog
Disease Notes
- Certainty: tentative
- Final Status: slightly better as of day 97 of treatment
Treatment and Outcome
Problem Notes
- Tremors: Hi Steve. Not sure if this is the place to add this, but I also wanted to mention that Daisy has developed rear limb tremors over the past few months as well. I have been treating her with acupuncture which seems to help. At any rate, I feel this is a stagnation or deficiency sign. Thanks!
sam
Treatments
Notes:
Hi Steve. I'm hoping this is a way to not just add an update, but to also get your help on this ongoing case, as Daisy is having a tough time with some worsening symptoms. After your last reply, I put Daisy back on Si Miao San (Blue Dragon Herbs). In addition, I spoke with Dr. Jean Dodds and she recommended flax seed lignans (1mg/#/day) and melatonin (6mg BID) as these treatments have dramatically helped her own dog with cushings. Well, I have no doubt the SMS is continuing to help, but the addition of lignans/melatonin were amazing. PU/PD down, less stress and appetite much more regulated. I also cut out all starches as you recommended. For those interested, I got the lignans from "Lignans for Life" on-line. Great place, very reasonable. That's the update until now. Damp skin issues still doing great. Of other import, I moved from Portland, OR to Asheville, NC in December. No doubt getting away from the rain has helped dampness as well. Hold on for bloodwork...
Middle of last week, Daisy woke up with a really high fever and was very sick. She ate her breakfast, but extremely lethargic. She seemed to get a bit better throughout the day, but I ran bloodwork that afternoon and gave her SQ fluids. By that evening, the fever broke and she was definitely feeling better and has stayed that way, but she still doesn't seem quite 100%. The CBC was normal, but unfortunately it got spun down so not sure if normal is really normal or not. But it set my mind at ease from infection standpoint. The blood chemistry however showed ALT up to 414, AST up to 79 and GGTP up to 37. These were slightly elevated in 10/14. One bright spot is that ALP was down to 1108 which is 500 U/L LESS than it was in 10/14. Urine SG still 1.010, telling me cushings is still there, but the ALP tells me it is more under control.
My instincts tell me that the dampness is being cleared up and perhaps liver issues are rising to the surface. But this is getting complicated and and ultrasound is seeming like a good idea to look for what I don't want to find. I have added Vitamin E (400 IU BID), Zinc Picolinate (30mg BID), SAMe (400mg SID) and milk thistle seed glycerin extract (500mg BID). I would like your opinion on dosing for milk thistle. There seems plenty of "volume/# of liquid extract", but a mg/kg would be very helpful. The glycerin product I purchased is from Gaia Herbs and is 500mg/ml. Their straight alcohol formula is 1000mg/ml but the alcohol content is very high so I thought this not best for an acute liver case. I imagine Daisy is entering Chai Hu territory. I still have plenty of SMS and an unopened bottle of Natural Path Xiao Chai Hu Tang I'd like to use, but can certainly get whatever you recommend. Lastly, her pulses seem a bit more wiry, but are easy to find and not easily compressible. GB34 makes a noticeable difference, as always. Tongue is pale pink and dry. Thanks as always, Steve. She is 13 this month; so tuff seeing them get older.
Diet is largely raw
Acupuncture points were stimulated