Signalment

• Age: 12 years
• Sex: male neutered
• Breed: Lab Mix
• Species: dog

Disease Notes

• Certainty: confirmed
• Comments: Zeke is a 12 yo MN Lab mix weighing around 55 lbs.
  
  Zeke has been struggling with a chronic hacking non-productive cough (sounds like an old smoker!) for about 9 months. Tracheal sensitivity. Does not sound raspy with panting. The cough is worse at night but he is not restless. Started January 2026?
  He has mild travel anxiety and orthopedic pain that waxes and wanes. He is stiff and recently had left hind limb lameness. Hx of HBC trauma before adoption.
  He has a great appetite, normal thirst and urination. Stool is normal apart from diarrhea from fish oil an occasional dietary indiscretion.
  He is a very happy friendly relaxed dog. Jazzed up by the two new puppies in the house. Energy good for old dog.
  He sleeps good at night with no active excessive dreaming. NO temperature preferences.
  Work up so far includes:
  chest rads- diffuse bronchial pattern with patchy alveolar infiltrates (right cranial and middle, cranial subsegment of left cranial), right sided cardiomegaly
  pelvic rads: hip dysplasia, healed left pelvic fracture, healed left rib 8-10 fracture (previous trauma).
  tracheal wash: eosinophilic, neutrophilic inflammation. no infectious agents; mildly thickened epiglottis and possibly slightly reduced laryngeal function
  labwork: stress leukogram, low thyroid (euthyroid? or steroid effect?), mild elevated ALP >ALT (worsened on prednisone but not severe), , normal CRP, normal proBNP
  AUS: hepatomegaly, no significant findings
  
  Trials of cough tabs, prednisone taper, theophylline all somewhat helpful for short time but never fully resolved. Hydrocodone is helpful to some extent now but again, not resolving the cough.
  
  Medications:
  Prednisone 10mg per day.
  Trazodone 100mg PRN (infrequent)
  hydrocodone pm
  Simparica Trio
  
  Diet: Purina Pro Plan Salmon and rice. No food sensitivities. Adds chicken broth, veggies and milkbones for treats. some cooked proteins.
  
  A:
  Blood Stasis in Upper Jiao
  Possible Triple Heater Obstruction and Blood deficiency
  
  P:
  Recommend pred taper
  Recommend UC-II supplement
  
  Recommend Modified Xue Fu Zhu Yu. Sound like a good start?
  Thanks,
  Jen
• Final Status:

Treatment and Outcome