Signalment

• Age: 10 years
• Sex: male neutered
• Breed: Shih Tzu Mix
• Species: dog

Disease Notes

• Certainty: confirmed
• Final Status:

Treatment and Outcome

Problem Notes

• Elevated SAP And Other Issues: Hi Steve,
  Not sure what I did here.... hope this case comes through.
  Oliver had an SAP of 705 in Dec 2020, all else wnl. Cortisol 4.4. USG always well concentrated. He has been on Si Miao San since March 2021, owner can only give 1/4 BID or it upsets his stomach. SAP went to 554 Sept 2021 and back up to 654 last week.
  Has always been somewhat aggressive and bit owner last week, has had 4 BM's / day for several months, prefers warm, big drinker at night, prefers to eat in the afternoon. Whole Hearted dry lamb based, with vegetables.
  He always shakes so pulses are hard for me to determine.
  Any thoughts on the whole package?
  As always, thank you
  Karin