I have been charged with the care of a 7 YO MN Rottie with PLE. Biopsy showed lymphangiectasia, and considering negative diagnositics otherwise, we suspect an inflammatory pathogenesis in this dog. TP levels are at 2.6 with an albumin at 1.4 and globulin at 1.2. Platelet count at 500K per uL, hypocholesteremic (78), and a low T4 level. Calcium and magnesium levels are down as well. Otherwise, OK. Clinically the dog looks pretty good; eating well, as to be expected. Having some steatorrhea, gas, pretty loose stool, a little bit of vomiting.
TCM wise, I can see how this dog has Damp Heat - a rosie colored tongue with a white froth. The pulse is slippery, but weak. Active points include BL 17, BL 20, BL 25, SP 6, GB 34.
I sent the dog out of the office without the blood work results in hand. I prescribed Four Marvels, but increased the amount of white and black atractylodes for added Spleen support.
Now I have these protein levels in hand, and the dog has had 3 doses of the herbs. The stool is becoming formed, the dog has good energy, vomited some bile once this AM, and continues to eat a homemade diet with moderate levels of fat.
My question is should I begin prednisone in this situation or hang in there with the current strategy? How pressing is the 1.4 albumin in others experience (I tend not to worry until it hits 1.0, but I don't have a lot of experience treating this disease).
Any thoughts would be appreciated.