I recently saw Moby, 11y, MN, Beagle X Cavalier King Charles Spaniel. In 2014 he had a cervical hemi-laminectomy for IVDD, which did not significantly improve his symptoms of neck pain. Since this time he has been managed with NSAIDs, tramadol and gabapentin when he experiences acute neck pain. This has only happened 3-4 times since 2014, and usually occurs during changeable weather. The most recent incidence of neck pain was a month ago when the weather was alternating between warm and cold.
On presentation, Moby was bright and happy. Moving fine, with no obvious sign of neck pain. On palpation, he had mild to moderate discomfort in his neck when moved in all directions. He also had bilateral hip pain. There was a nice sheen to the coat, but a very small amount of dry dander. He has good appetite, and is drinking, urinating, defaecating normally. However..., I am concerned that I can feel a firm, left sided, cranial abdominal mass (possibly spleen or liver).
Both pulses were moderately toned and weak.
The tongue was pale, lavender, dry, with no coat.
Back shu points that were responsive: BL17, BL18 (inconsistent), BL20, BL24
Alarm points that were responsive: CV12 (mild), LIV13, GB24
reactive GB points: GB25, GB30
When BL40 was sedated, the pulse did not improve.
I suspect a TBO in this patient, but the pulse is not strong or wiry (from what I can feel). It seems to me there are also hints of blood/SP deficiency. Obviously, I am concerned about a possible abdominal mass too. I am in the midst of convincing the owner to investigate this further.
Is is ok to start Xiao Chai Hu Tang? Can this do any harm? Or is there a better formula to choose for this patient?
Many thanks, and kind regards,
Sara.