Signalment

• Age: 8 years
• Sex: male neutered
• Breed: Mixed Breed
• Species: dog

Disease Notes

• Certainty: confirmed
• Final Status:

Treatment and Outcome

Problem Notes

• Epistaxis: Trigger is a 9-year-old MN mixed dog that has been dealing with MCT since 2013. He has had multiple lumps removed in 2013 and 2014. At that time, I treated him with Dispel Stasis in the Palace of Blood and XCHT, Fu Zheng Mushrooms and Vit A& D. Tongue has mostly been pale and pulses toned. He has been off the herbs for 2 years.
  However, this has been a bad year for Trigger. In June he was diagnosed with Diabetes Mellitus. He is being managed with NPH Insulin. Last week he presented with 4 new lumps. 3 are MCT. 1 is near an incision where a mass was removed in 2014. 2 are in nonresectable areas. The last is on the bridge of his nose and cytology is nonspecific. He sounds congested and the owner reports he has had small nosebleeds infrequently over the last 6 months.
  Currently his tongue is pink with a lavender center. His pulse does have tone, but I get a slippery quality at times. His active points are sedating BL40 and GB34, and possibly GV14?? BL17/20/22/23 St36 are all negative points.
  So, I need a little guidance as how I should proceed. His tongue does not seem overly hot but the clinical sign of nasal congestion and epistaxis is damp heat. How do I add in the Diabetes? Based on points I would give him XCHT. Also, Xin Yi San and Hoxsey for the epistaxis/congestion? Am I overthinking this?
  I am worried about feeding the mast cell tumors!!
  Any advice would be most helpful. Of course, he is the sweetest dog and this prognosis does not look good….
  Thank you!