Signalment

• Age: 5 years
• Sex: male neutered
• Breed: Labrador Retriever
• Species: dog

Disease Notes

• Certainty: confirmed
• Comments: 5 yr presented with 8 month hx of acute onset ventral andomen and axillary swellings.
  Progressed to diffuse transudate due to significant lymhedema
  Hx of Anaplasmosis since last 6 months: Significance not clear
  Also mild non regenerative anemia noted (HCT30-32)
  Modifed translate aspirated
  Initally responsive to prednisone, not responsive at this time
  Has been treated with several rounds of abx which initially help but do not completely resolve.
  
  Personality:
  Earth but very suspicious. Lives in house with wood dog who randomly bullies him.
  Diet: Kibble eukaneuba
  Very large Lab (110 lbs): about 20 lbs overweight.
  Tongue: Pale and dry
  Pulses: very weak and deep and thin, best palpated close to body wall.
  BL20 sensitive
  NO GI signs, PU/pD (on pred)
  Pulses improved with BL40 and LIV3, did not improve with BL22, GB34
  
  TCM:
  Spleen qi def with damp
  Liver qi stagnation with blood def
  
  TX today:
  Acup: BL222, 20, 17, BL40, GV14, LIV3 (thats all he would allow today although definitely relaxed with tx)
  Herbal:
  Started Qing Ying (NP) 3/4 tsp BID to help expel potential pathogen: trying not to drive any pathogen deeper.
  Diet: switch to fresh diet
  Other herbal to consider for the ventral lymphedema that may also address the blood def and support immune
  Considering Xian Fang Huo Ming Yin and maybe Xiao Yao San or Gui Pi Tang
  Thanks for any help
  Hannah
  
  
• Final Status:

Treatment and Outcome

Problem Notes

• Anemia: Non regenerative
  
• Transudate: Lymphedema is causing transudate
  This is quite significant as dog is constantly dripping fluid from entire ventral abdomen (mostly caudal prei pretuial and inguinal) but does have some swelling axillary.