I have a 10 yr old mixed FS dog that presented with vomiting and foul odor from mouth. She maintained a decent appetite and energy levels, no pu/pd.
My colleague evaluated her, normal PE, dental disease, all else wnl.
The next day when labs returned, BUN was >130, Creatine 5 and Phosphorus elevated, high SDMA, normal Cholesterol, HCT at 45%, normal platelets. Dilute urine with 3+ protein.
The patient had started to not eat as much and was admitted he following day.
After 2 days of fluids the patient developed forelimb, trunk and hindlimb peripheral edema and the numbers were the same essentially.
I was asked to intervene, confirmation of peripheral edema, pulses were superficial, toned, moderate finger lift, resists compression and normal rhythm and slightly elevated rate (normal temp). Tongue was pink/pale with lavender hue. Tips of the ears were cold, feet were warm.
Warm on GB25, BL23, BL24, BL25, BL40, seemed warm on the pericardium channel (PC 1 area).
It was not until I needles BL40 that the pulse modulated and became less superficial.
So I d/c fluids, added Xiao Chai Hu Tang and Ba Wei Di Huang Wan.
I did not have Fang Ji Huang Qi tang, but I did add it at a low dose when I received it a few days ago.
So, I was thinking that the patient had a triple burner obstruction that needed to be cleared evidenced by the peripheral edema and no improvement with diuresis.
A week has passed and the BUN and phosphorus have improved but the creatinine continues to rise and is now 8.
The patient is eating, no vomiting, soft stools and energy levels are ok.
I reevaluated her yesterday, her tongue is still pink/lavender and still warm at BL40 especially as well as the edema on ventral chest and withers, peripheral edema is better.
Is my treatment plan appropriate? I don't understand why the creatinine continues to rise?
Thank you so much!