Signalment
- Species: dog
Disease Notes
- Certainty: confirmed
- Final Status: Deceased from this disease on day 379
Treatment and Outcome
Problem Notes
- Gallbladder Disease: On 12/20, Noodles presented for vomiting, lethargy, and abdominal tenderness. Bloodwork revealed sudden elevations in his liver enzymes and an increase in his total bili. Ultrasound revealed a thickened gallbladder wall, mineralization of the biliary tree, and a few gallbladder calculi and sludge. He was started on antibiotics, ursidiol, and a low fat diet.
4 weeks later, liver enzymes are improved, his total bili is normal, and he seems to feel much more comfortable. There is reduced sludge in his gallbladder. - Tricep Spasms: Noodles developed extremely tight right triceps about 3 months ago. The right side is visibly thickened and knotted compared to the left. His limp on the right side persisted, and no evidence of any OA or neoplasia was identified on x-ray. An ultrasound was performed and no evidence of tumor in the muscle was identified.
On Feb 7, Noodles was started on Bu Gan Tang to address the following: tricep spasms, a history of failure to regrow hair after clipping (even years prior to development of his cushing's disease), and hypothyroidism. He has been on two tabs PO BID and thus far there has been some mild improvement in his muscle tightness and in his coat.
Treatments
Notes:
Noodles tricep spasms are improved on Bu Gan Tang, though he continues to "paddle" his right leg when he walks and to drag the toes when he tires. He has more a of a desire to walk farther with each walk.
His Cushing's disease is still well-controlled on 40mg of trilostane BID, though since starting trilostane, he has had overall reduced energy and is much stiffer. There is no evidence of OA or other bony disease on x-ray.
Diet is largely canned or kibble
Manipulation or massage was performed
Notes:
After 6 weeks on XCHT, Noodles' requirement for trilostane dropped dramatically and he is currently only taking 10mg (reduced from 90mg) per day with a possible complete discontinuation of trilostane in the near future.
He now is showing signs of kidney qi deficiency (a new finding).
He refused to eat a homemade diet and is now eating solely kibble
Diet is largely canned or kibble
Acupuncture points were stimulated
Manipulation or massage was performed
Notes: Patient is losing muscle mass and seems weaker in the hindend. He has a sawhorse gate in both front and hindlimbs. Eating and drinking are normal, though he continues not to grow hair normally. He is currently eating a combination of homecooked and kibble diet. He has pain in his neck and sacrum. He receives chiropractic adjustments twice monthly and acupuncture weekly.
Acupuncture points were stimulated
Manipulation or massage was performed
Notes: Unfortunately despite attempts at herbal therapy, the cushing's pseudomyontonia worsened profoundly and I ultimately chose to euthanize my dog due to pain and dysfunction associated with it. Chiropractic did help get him relief when done once weekly. Thanks for your help with this one! Sorry I failed to update it!