Notes:  Krueger is much brighter, appetite has improved and groaning / abdominal pain has resolved. Urine (free catch sample) is clear dark yellow, there is no obvious blood, however urine dipstick still shows 4+ blood.

Acupuncture points were stimulated

Notes:  Hi Steve,

An update on Krueger, and a couple more questions about how this case progressed;

He did great on XCHT and SFZYT/SMS for suspected prostatitis for approx 3 weeks. Abdominal pain and dysuria resolved, and normal appetite and energy levels returned. He then started having some blood loss from mouth overnight, with no appreciable cause of this. Previous blood test a couple of months ago showed slightly low platelet count, so bloods were repeated - platelet count normal, BUN slightly low, but everything else within normal limits. I asked her to stop the SFZYT and continue with the XCHT and bleeding from mouth/throat resolved. She then stopped the XCHT a week later as she noticed he was losing fur in patches over his dorsal shoulders. Clinically he is now really well, blood in saliva/from mouth stopped, fur regrew, but still has a small amount of blood in urine on dispstix.

Thinking about the herbal formulas here
- I thought Blood movers (SFZYT) were generally safe and shouldn’t cause bleeding, but are there any situations this doesn’t hold true? I think this dog is Liver Blood Deficient, would that affect the way Blood moving formulas work?
- why the XCHT caused fur loss over dorsal shoulders – so if XCHT is drying and could worsen Yin deficiency, could it also exacerbate Liver Blood Deficiency and maybe leading to fur loss? There were no other signs of Yin Deficiency Empty Heat, but maybe if we had continued they may have surfaced?

I’m going to go to your recommendation next of adding in BZYQT. I’m wondering if using this with the XCHT would be enough of a Blood tonic to mitigate the possible Yin drying effects of XCHT, plus address the blood loss from mouth/throat and in urine. My other thought was to add YGJ as more of a specific Liver Blood tonic.

Thank you!
Sophie