Signalment
- Age: 12 years
- Breed: Min Schnauzer
- Species: dog
Disease Notes
- Certainty: confirmed
- Final Status: better as of day 21
Treatment and Outcome
Notes:
Bella is here for a recheck to assess the herbal medicine. She is doing well!
appetite is back to normal and she is eating great in the mornings too. No vomiting.
Stools are normal. Thirst is her usual- increased from normal but not guzzling and hanging out at the water bowl.
urination- they take her out every 4 hours during the day to pee, she can hold it overnight. They don't let her go longer than 4 hours so not sure if she would have accident if they pushed it but hasn't had any accidents.
No UI. She restarted incurin 2 tabs per day for a week because she started leaking again at 1 tab every third day. She is back to 1 tab per day with no leaking.
temperament is her usual. Energy level is good for her.
Hind limbs still seem a bit weaker- slower on the stairs but she is going up to bed at night again.
She gets overheated easily but doesn't seek cool or heat
Pertinent medical history:
tried tapering zonisamide to 100mg and 50mg and she had some weird tremoring/ataxia episodes so went back to 100mg BID
LE improved but not completely back to normal
cholesterol and triglycerides and cPL normalized
slight elevation in BUN but Cr normal
slight elevated Phos and Potassium- N/K ratio slightly low
resting cortisol 1.5
Tongue: light pink with thin white coating, full with some wavy edges, not overly wet
Pulse: bradyarrhythmia; deep, toned, pulse slapping at finger and then falling away. relatively full with upward pulse wave and thin with downward pulse wave
Some heat on top of head, mid back, lateral thighs and lateral tibia; ears and paws cool; no obvious reactivity to GB25
NEW major concern: while much of her symptoms have improved, since the heat of summer has arrived (late April/early May) she has been having short episodes of falling over/collapsing on walks. She recovers quickly but I had the owner check her HR when this happens and it is around 40 bpm. Owner says her HR is consistently 56 to 58 bpm in the house at rest. I have been worried about her bradyarrhythmia for a while now but it hasn't seemed to cause a problem until now. She doesn't seem to be able to compensate for the heat and I think these are syncopal episodes. There is a cardio eval scheduled for August.
Her dosing of XCHT Evergreen granules is 1/4 tsp BID and Bu Zhong Yi Qi (Lift the Qi Kan Essentials) 1 tab BID.
Diet is largely canned or kibble