13 yr M(N) lab with a history of laryngeal paralysis, osteoarthritis, spondylosis, multiple lipomas and an interdigital cyst. Last year tested positive for Lyme and treated with doxy, still weak positive when rechecked Oct/23.Was on Metacam then in May/23 started Librela injections. Despite heat and humidity this summer causing a lot of breathing difficulty and a couple of hot spots, he had good attitude,appetite and energy, normal water consumption and urination, normal stools no vomiting. Bloodwork in July only abnormality was ALP 239. FNA done on large mass RH thigh Dx as lipoma, but started proprioceptive deficits with rDVM thinking mass maybe exerting pressure on sciatic nerve.
In Sept dog began getting very picky about eating, had a couple of overnight episodes of fecal incontinence, and began losing weight. Mass RH thigh enlarging and developing a soft area which on FNA revealed blood. Bloodwork same, X-ray showed spleen displaced caudally so referred for ultrasound which identified splenomegaly, especially splenic head. Follow up splenic FNA no evidence of neoplasia. Started on Pred and Cerenia as Appetite was worsening, continued weight loss, never eats in the morning. ALT now 167, ALP 829. I was called in to try acupuncture after he started having shaking episodes a couple of times a day and they wondered if back pain was contributing to inappetance.
He is generally deficient and heat seeking, thin body condition with generalized muscle atrophy, dry bleached haircoat, mass RH is warm, occasional knuckling both hind limbs R>L.Prefers to lay with R side down. Mild fecal incontinence. Looks interested when owners preparing food but not wanting it when presented. Sensitive BL17,18, 19, 22, 25,27, 54 and GB30. Prominent dips BL18,20,23, ST 36, 37, GB-34. Tongue pale, moist, swollen edge, very slight lavender tinge, flabby. Pulse sl. weak, deep, a bit thin but toned/ wiry. It improved with GB points and ton BL 20/and BL-23. After 2 acupuncture treatments the shaking has reduced to about twice weekly, and pulse a bit stronger, sl deep and sl wiry but minimal improvement in appetite and owners struggling to find anything he will eat, ex right now cucumber, cooked chicken breast and canned cat food in small amounts. Stool a bit soft since he stopped eating his kibble. He gets up to greet me at the door when I arrive, tail wagging so owners want to do what they can and are willing to try herbs. rDVM has just started a trial of sulcrate. Time of year , laryngeal paralysis, Lyme, splenomegaly and response to GB points speak to Shao Yang issue but general Qi and Blood def, esp Sp. Qi. Damp/ Phlegm is lurking as well. Not sure the pulse is strong enough for Xiao Chai Hu Tang without something to address the Qi/ Sp Qi def . Wondered about WLT or BWDHW as he is now heat seeking. And even LJZT, although nothing has been noted on U/S I have a gastric adenocarcinoma patient that presented initially in a very similar manner. Any thoughts or suggestions you might have would be greatly appreciated. Many thanks, Llewanda