14 year F/S lab
Current complaint: severe bilateral stifle arthritis with deformed, bowlegged posture. Actual quite mobile given the severity but she is stiff and weak by the end of the day (she lives at a preschool and walks around all day).
Hx skin allergies which improved with diet change to turkey Honest Kitchen (dehydrated diet) and added cooked veggies. Ears worsen after the switch and she has a resistant Staph in her right ear that recurs whenever she comes off meds.
HX extremely elevated ALP (>2200), mild elevation ALT. Normal ultrasound.
Has mucus on top of stool, loose at the end for 1 BM every other week.
Tongue thin, cracked. Color ok, if anything tiny bit pale. Pulse deep, wiry.
Very happy, friendly, mentally alert. Slightly overweight.
So she she seems to have Damp Heat (ear, stool), Blood Stasis. I am concerned about TBO given the pulse and ALP elevation. I wanted to use SMS and Xiao Chai Hu Jia Qin Jiao Tang. I had the SMS but had to order the other so I started SMS alone. Within 3 days she was weaker and stiffer. I suspect I either cooled her too much or pulled the blood away from the chronically inflammed joints and wish I'd used SRT. I told her to stop the SMS of course. Should I just start with the XCHJT and see how it goes? I started a diet trial and new med (mupirocin) for her ear and its looking better.
This is a long post for just a question. Am I putting this in the right place? Thank you