By late spring he stabilized and I did not hear from owner until mid August. At that point he was getting weak and more ataxic, poor appetite, knocking over in front. I did a house call and he responded brilliantly to manual therapy and acupuncture. Sept 1, I got a call that he had crashed again-- very painful and ataxic. When I went to see him, his back was very roached, neck low and was much worse after I adjusted him-- could barely support himself on forelimbs. Laid him down for acupuncture and treated KI and GB points. Pulse was toned, tongue fairly normal looking. Owner said he had been having episodes of getting "hot" in the evenings, almost like a fever, could not stop panting. Also told me (which I had not known previously) that he took 20 mg pred daily, and that she was only giving BGT once a day-- had mistook the instructions long ago. That's about 0.6 mg/kg on the pred. I encouraged her to go BID on the BGT, get some blood work to retest for infectious disease, and also a thyroid panel because his skin was dry and he was losing hair on his haunches. By that night he was much better in balance and reduced pain.
Later that week, it occurred to me that he might benefit from Chai Ge Jie Ji Tang, but it was our Labor Day holiday by then and ATTH was closed, so it wasn't until Friday just past that he got the herbs.
Today I got an email from the client that he has suddenly declined a lot in the past few days-- can barely keep his legs under him, knuckles under badly, is miserable. When I spoke to her later in the day, he had improved a bit and was resting.
Here's the thing-- I had noted in the spring, that he was worse in the cold wind, and his downturns always seem to come with changes in weather. The last few days have been awesome sailing-- a front came through on Thursday and the wind has been wild since then. Finally calmed down this afternoon. Bode was diagnosed by the neurologist last winter with cervical myelopathy, and indeed, is primarily affected in forelimbs. When I first saw him, he was classic Liver Yin Def, and responded really well to Bu Gan Tang, even at half dose. But now I'm wondering if his destabilization is strictly Wind related-- literally he crashes when there are high winds. Can that be treated prophylactically with herbs or AP? I never tried him on Du Huo because he seems to suffer a lot with the heat. Not sure where to turn next. He's only been on Chai Ge Jie Ji Tang for a few days, and I was unsure whether to keep him on Bu Gan Tang at the same time. His tongue is no longer lavender and his pulse was toned but not wiry last week.
Help! (I think the client, though devoted, may be reaching the point of thinking his QOL is too diminished.)