Signalment

• Species: dog

Disease Notes

• Certainty: confirmed
• Comments: Please highlight, copy, and paste link to view problem information:
  
  Https://drive.google.com/open?id=0B2wrt5ESc5CHa1VJZmo4WmRhRUU
  
  
  thank you
  
  Answer:
  
  Hi Cathy,
  
  A cough that is worse in the wee hours suggests a pathogenic accumulation in the lungs, which is generally either a Wind invasion or Blood stasis
  
  The facial nerve paralysis suggests the dog is prone to Shao Yang disharmony, which can be associated with both of the above-mentioned conditions.
  
  XCHT alone serves as an "ice pack" for the kidneys, meaning we use it when UPCs are high, in acute renal inflammation. When there is no renal inflammation, you'll just see the transient azotemia from attenuation of the blood supply. UPC will remain normal, since there is no inflammation in the kidneys.
  
  I would re-start XCHT, but mix it 2:1 with Si Wu Tang. The Rehmannia and Dang Gui in there will balance out any renal effects, and give XCHT longer to address the condition.
  
  Otherwise, you may have to figure out some Wind invasion or Phlegm herbs to pair it with. If the cough becomes moist on the above strategy, that is what will need to be done next. But the cough will probably resolve with time on the above formula, which will help to move Blood and alleviate the cough
  
  Steve
• Final Status: no change as of day 232 of treatment

Treatment and Outcome