Notes:  First visit.
Presented with history of back end weakness of 3 week duration following jumping off furniture.

EXAM: tongue pink with white coating Pulse: weak slightly toned
Back pain at the level of L 3
Marked hind end weakness with proprioceptive deficits in LH leg (knuckling).

DX: IVDD at the level of T13 - L3
TCVM DX: global blood defficiency with wind invasion

Treatments:
VOM adjustments at T11 - T12 and L2 - L4

Acupuncture: BL 23, BL40, GB 27

Chinese herbs: Du Huo Ji Sheng Tang

Advised to change food to home cooked.

Diet is largely canned or kibble

Acupuncture points were stimulated

Manipulation or massage was performed

Notes:  Owner noted much improvement in Coco's mobility a day after the first visit.
On July 15/14 Coco rand down 5 stairs and became acutely painful and developed hind end paresis.

EXAM:
TONGUE pale PULSE weak, soft
unable to stand on hind legs, marked back pain at T11 - L3
Severe proprioceptive deficits in both hind legs.

Treatment:
Acupuncture: BL 23, GB 20, BL 40, BL 62, HUA TUO JIA JI at T10 - L1, LUI FENG on both hind legs

Continue with Du Huo Ji Sheng Tang at 1/8 tsp BID.

Acupuncture points were stimulated

Notes:  Unable to use hind legs. Owner noted increase in pain since the last recheck. Urinating OK, has trouble with bowel movements. Owner noted good response to meloxicam.

EXAM: Able to stand when propped up. Good withdrawal RH leg, weak withdrawal LH leg, severe knuckling on both hind legs.
TONGUE: pale slightly lavender, PULSE: wiry (thin, toned)

DX: IVDD
TCVM DX: local blood/ QI stagnation in the spinal cord.

TREATMENT: Acupuncture BL 19, BL 18 BL 40 BL 62, LI 4, LUI FENG hind legs bilaterally

Benefit hips and knees 1ml bid.

Acupuncture points were stimulated

Notes:  Owner has difficulties administering the tincture of benefit hips and knees.
poor appetite since the last visit, one episode of vomiting, several incidents of urinating in the crate. Able to drag herself energetically around the house. Still painful. Responds well to metacam. Owner gives metacam PRN.

EXAM: able to support her weight on hind legs when stood up. Good withdrawals on both hind legs, severe knuckling bilaterally.
TONGUE red-purple PULSE: full, decreased tone.

TREATMENT:
Electro acupuncture BL 21, LUI FENG (bilaterally) at 4 - 6 Hz, BL 40 at 40 - 60 Hz

Decreased dose of Benefit Hips and Knees to a maximum tolerated dose. Owner will start at 2 drops BID and will increase.

Acupuncture points were stimulated

Notes:  Improved pain, appetite, energy level. Owner stopped using metacam.

EXAM: standing with little support. Good withdrawal on both hind legs. Knuckling on both hind legs.
TONGUE: dark-pink-purple PULSE: superficial toneless.

TREATMENT:
Acupuncture: BL 23, BL 40 HUA TUO JIA JI (T10 - T12), BL 62.

Continue with benefit hips and knees increase dose to 3 drops bid. Dispensed homeopathic preparation of Benefit Hips and Knees (0.5ml in 50ml distilled or spring water succussed 200 times) 1 dropper full BID.

Owner is doing a great job with passive-range-of-motion exercises.

Acupuncture points were stimulated

Notes:  Increased energy, good appetite, much improved back pain.

EXAM: TONGUE: pink with purple centre, PULSE: weak toneless.
minimal discomfort on back palpation.

Fixations at T9 - T11, adjusted with VOM.

Treatments:
acupuncture: BL 21, BL23, BAI HUI ( at LS junction), SHEN SHU, BL 40, LUI FENG, BL 62 (left).

Continue Benefit hips and knees (full strength tincture) 5 drops bid + 1 dropper of homeoppathic preparation BID.
Du Huo Ji Sheng Tang 1/16 - 1/8 tsp bid.

Acupuncture points were stimulated

Manipulation or massage was performed

Notes:  Owner noted increased mobility in hind legs (Coco trying to use her legs for to scratch), able to stand on her own with little support.

EXAM: stands on her own once positioned still severe knuckling both hind legs.
TONGUE: pink PULSE: slightly weak

ASSESSMENT: steady slow improvement.

TREATMENTS:
Acupuncture: GB 20, BL 23, BAI HUI (at LS junction), SHEN SHU, BL 40, BL 62, LUI FENG both hinds.

Du Huo Ji Sheng Tang 1/8tsp bid + Benefit Hips and Knees 5 drops of tincture + 1 dropper of Benefit Hips and Knees homeopathic preparation.
Owner to continue passive-range of motion exercises.

Acupuncture points were stimulated

Notes:  Increase in mobility of hind legs, trying to walk. Much improved strength when standing.

EXAM: tongue - pink, pulse - slightly weak
increased strength in hind legs when standing.

TREATMENT:
Acupuncture: BL 23, BL 40, BAI HUI (at LS junction), SHEN SHU, BL 62, LUI FENG (hind legs).

Du Huo Ji Sheng Tang 1/8tsp, Benefit Hips and Knees 10 drops BID.

Acupuncture points were stimulated

Notes:  Walking with moderate ataxia, very active.

EXAM: delayed placement of LH leg, knuckling RH leg
Tongue: pink/red, Pulse:thin

Treatment:
Acupuncture:Bl 23, BL 24, BL 40, BL 62

Du Huo Ji Sheng Tang 1/8 tsp reduce Benefit hips and knees to SID dosing and stop in 7 days.

Acupuncture points were stimulated

Notes:  Walking almost 100% normal

EXAM: walking with mild ataxia in the examination room. RH leg seems to be weak.
Normal placement, strength and withdrawal on LH leg.
Knuckling and slightly decreased strength on LH leg.
Treatment:
Acupuncture: BL 23, BL 40, BAI HUI (at LS junction), SHEN SHU

Du Huo Ji Sheng Tang 1/8tsp bid long term (at least 3 months).

Owner moved to British Columbia at the beginning of October.

Acupuncture points were stimulated