Signalment
- Age: 4 years
- Sex: female spayed
- Breed: Bichon Frise
- Species: dog
Disease Notes
- Certainty: confirmed
- Final Status: slightly better as of day 158 of treatment
Treatment and Outcome
Problem Notes
- Polyuria and Polydipsia: Started as a significant polydipsia ( approx. 3 litres / day ) - measured carefully by owner. Now is inappetant and depressed - no vomiting or diarrhoea.
TCM DDX : kidney Yin deficiency? Triple burner obstruction caused by a chronic active hepatitis? ( excess yang in upper burner causing thirst and dryness to other organs like the bladder causing nephritis and dysuria ).
Have started on Xiao Yao San but maybe CHJLGMLT is a better option? - Thrombocytopaenia: Just realised on today's blood tests the platelet count returned a level of 67 ! A marked thrombocytopaenia! Immune - mediated disease?
Notes:
Correction from last post - polydipsia has improved but Sophie is still drinking well in excess of 1 litre per day ( 6.8 kg BW ). Today she revisited after a short visit yesterday when she was administered an injection of dexamethasone to stimulate her appetite - Owner reports she made a sensational recovery after the injection but then deteriorated through the night. Today she has begun showing vestibular symptoms of imbalance, incoordination and weakness - difficult to measure CP deficits due to weakness / knuckling. No back pain, no cranial nerve deficits and no nystagmus / anisocoria present. She is also licking quite a lot - can identify a fluidy, cystic - type swelling just under her tongue on the L side. She walked over to the consult room door and leaned against it with her head, as if for support and was quite wobbly on her legs with her front legs crossing over. She is still ambulatory but prefers to be recumbent. Temp is normal but she is still having intermittent episodes of shortness of breath.
DDX : seems to be a possible meningitis - immune-mediated? Will be running full bloods today.
Pathology : haematology - leucocytosis with a neutrophilia
biochem - ALT 314, all other parameters WNL, except a slightly low BUN, CREAT and AMY. Electrolytes and glucose normal.
DDX : infection somewhere? Liver? Infectious meningitis?
Tx Plan - start antibiotics. Consider Bup, dragon bone & oyster shell for TBO
Diet is largely raw