-DCM currently managed with Sotalol
-Severely elevated liver enzymes (in the thousands) since 2018.
-Most current labs (February) showed ALT 1234 and Alk Phos 2819; Recent ultrasound (February) showed cirrhosis and "The liver is irregular in appearance with no normal hepatic parenchyma and diffuse hypoechoic nodules."
-Since early February, she has been lethargic, has a low appetite and is showing signs of pain. This is why the owner took her to the specialist for the ultrasound and labwork.
On exam, she has severe kyphosis, mild CP deficits on back legs with evidence of scuffed nails on back legs. Her neck is very tight. Has yelped a few times and has a very stiff gait with short-strided front and back legs. Has a history of torn CCL and TPLO surgery.
What we can't figure out is - is the pain coming from the liver issue (I think less likely because these elevations have been the same for a long time) or is it a musculoskeletal issue (neck pain/ wobblers, etc.).
Due to the high liver enzymes, I wanted to put her on XCHT+Qin Jiao to also support her lower back. I don't know how much this formula will support her neck, however. But, before I did this, the owner wanted to start Prednisone (Specialist's recommendation for the liver and I figured would help her pain too)
We wanted to start one thing at a time so I thought that was fine.
She did well initially after acupuncture last week and starting the Prednisone, however, on Saturday night (during the cold spell in Los Angeles), she had a major neck pain flare up even while on the prednisone. Now she is in a lot of pain per the owner and not eating well.
I will check her pulses and give a better pulse diagnosis when I see her tomorrow... but if pulse is superficial and responds to BL 40, I will consider Du Huo Ji Shen Tang for her.
My question is: Is it ok to give Du Huo with the severe liver elevations and the cirrhosis? Is there another herb that would be better for both of these conditions?