Francis is a 15.5yo MN Coton de Tulear who presented 1 week ago for acute onset swelling of his LH limb along with fever and inappetence. He has a history of IVDD, which had flared up recently, but seemed to improve with acupuncture and gabapentin. He also has a history of chronic intermittent GI upset (vomiting, inappetence, and diarrhea) that has recently worsened. He also has a history of frequent dermatitis that may be related to food allergies.
He was admitted to the ER and a left femoral artery aneurysm was identified, though the underlying cause is unknown. Rads and AUS were unremarkable aside from mild hepatomegaly. He has mildly elevated liver values, borderline anemia, and all else was normal. He began to have severe bruising from the perineum to toes on the LH. He was sent home with yunnan bayao and aminocaproic acid. He was unable to urinate on his own or stand, at time of discharge, but has since regained the ability to do both. He has had gabapentin for pain control as codeine seemed to cause too much lethargy.
Unfortunately after discharge he continued to be inappetent, so Entyce was started and he had another acupuncture session, which seemed to help his attitude. He has been drinking very well, but is still quite lethargic and has not defecated in 3 days. The stool was soft at his last BM.
On exam today the swelling and bruising LH is profoundly improved, though he remains minimal weight bearing lame and prefers not to walk much. His spine was non painful on palpation, abdomen soft and non painful, MMs pale pk and mst, with CRT <2s. His heart and lungs are normal, and he was QAR but brighter after treatment.
His TCVM exam revealed a pink, slightly dry tongue and rapid wiry pulses. He had heat over GV 14 and depressions at BL 20 and 23. Feet were normal (LH was warm), ear tips were normal. The owner reports he is always cold.
I treated him with An Shen, GV 14, Bai Hui, BL 18/20/23, ST 36, SP 10, and PC 6. He was eating treats, drinking, and will to stand briefly during treatment. His pulses were less forceful after.
I'd say he has spleen qi deficiency (and global qi deficiency), blood deficiency, liver blood deficiency/qi stagnation, and blood stasis along with a history of blood heat.
I started him on cerenia, tramadol, and switched from entyce to mirtazapine, but am curious about what herbal options might be possible. He didn't have a fever today, but I am concerned there may be some cyclical fever going on. Any advice would be appreciated! Thank you!