Notes:  Hi Steve,

I wanted to update this case and get an updated opinion on where to go next. Frankie had been doing fairly well, but his owners got super busy and haven't been in August of this year. On the CHJLGMLT he was able to get down to a lower dose of prednisone and his hair coat even seemed to be growing back some. I tried adding YGJ, but his stomach could not tolerate it. So we pushed forward.

The owners ran out of CHJLGMLT in early October and he actually seemed to improve much more after stopping it. No GI upset, thicker and less dry hair coat, plenty of energy overall. Then in early November he had a full clonic-tonic seizure with a second follow up seizure a few days later. In the past, the neurologic episodes only progressed to ataxia and weakness; not full seizures. He is now back on a higher dose of prednisone and levetiracetam again. No seizures or episodes since then. He isn't nearly as polyphagic on the prednisone this time and he's having a lot of belching and reflux type GI distress at the higher dose.

I saw him today and his tongue was pale pink/lavender and his pulse was hard to find and easily pushed through. It wasn't overly thin, but I was concerned with just how feeble it was for a dog his size and age. It became stronger and improved with SP 10 stimulation. It was hard to check the other points as he was more resistant of handling and his needles today. Typically he would fall asleep after the first or second placement. Today he was agitated and restless. He also belched several times and seemed quite nauseous.

Could this be a fall thing and blood flow issue? I didn't start anything until consulting with you first.

Thanks so much!

Acupuncture points were stimulated