I found Trekker to be sociable and highly energetic, with the ability to settle. The owner reported dreaming once daily, a preference for warmth, normal thirst, firm long stools, and good with people but occasionally growly with other dogs. Trekker loves to track and is focussed when doing so. The owner reported that Trekker fears wind and spends the winters with her in Mexico. His heart rate was 90/minute, he was in lean condition, tongue dark purplish, pulses wiry. He was warm over BL18, LIV 13 and GB 24. I needled those points and some other empirical points for liver disease, but noted little difference in the pulse. I discussed the benefits of whole food rather than a processed prescription diet.
I saw Trekker again in April 2014 when he returned from Mexico. He had good energy, heart rate was 90/minute, tongue lavender and pulses wiry; he had lost weight. Repeat blood work showed ALP 2246 (21-122), ALT 571 (10-113) and GGT 73 (1-18), Pre-bile acids were 27.7 (0-15) and post 123.4 (0-22). The owner proceeded with a liver biopsy late in the summer that indicated 40% hepatic fibrosis.
In August I saw Trekker; he had remarkable ascites, was thin, eating poorly and had decreased energy. He was panting and restless and seeking cool. His regular veterinarian had prescribed prednisone, spironolactone, milk thistle, vitamin E, ursodiol, omeprazole, sucralate and a prescription hepatic diet (that Trekker would not eat). Tongue was pale lavender, pulses slippery and wiry, and there was warmth over BL 18. He had collarettes and some active areas of moist superficial dermatitis on his left ventrolateral abdomen that he was licking obsessively. I needled BL 18, 20, 22 (pulse worse with 22 so removed), ST 36, SP 6, 9, CV 4, 5, 6, LIv 3 and LI 4. I asked a human TCM doctor for some herb advice and he prepared a formula of Ci wu jia, Huang qi, Yu Jin, Chai hu, Dan Shen, Zhi mu, Huang bai that was begun August 27. The first week of September, Trekker's enzymes had improved except for the ALT which had worsened. He was beginning to eat well (whole food, including liver) and was feeling better. September 5 he had most of the abdominal fluid removed and it has not returned. His albumen is normal.
On September 30 I started him on Xiao Yao San, and saw him again on October 17. The skin lesions on his side had healed and left numerous scars, and a new area had become bothersome at the costochondral junction of his 10th left rib. No other areas of his skin were affected. He was eating well, had normal energy and had gained weight.
He is currently on prednisone 5 mg daily, ursodiol, sAme, milk thistle, vitamin E and Rambling Ease. I appreciate any further advice.
Thank you in advance.