Biscuit is a almost 16 yo MN shih tzu mix who presented to me for a QOL evaluation.
He seems constantly hungry but also losing weight. Can't seem to settle, sometimes doesn't sleep through the night. Stares off into space and sometimes startles himself.
Drinking a little more than usual but nothing crazy. Starting to pee and poop in the house now which he never did
Was vomiting bile but pepcid has helped that.
No coughing. No diarrhea
now is eating his own poop as well
vision is poor/cataracts
Pertinent medical history:
perianal carcinoma removed about a year ago- no visual evidence of recurrence
oozing cyst on his neck- doesn't bother him
tried rimadyl previously and he was panting excessively
Medications:
pepcid BID
gabapentin - 50mg BID
omega benefits cognitive, just started
Diet: wellness core senior small bites. wet food on top for meds and enticing
Tongue: pink to light pink with fine cracks
Pulse: deep, vessel tone but soft pulse, somewhat narrow
neutral to warm all over
greasy coat
Diagnostics:
slightly elevated BUN, SDMA, platelets, cholesterol, potassium
Assessment
The owners main concerns are the behavioral changes. To me he has signs of Kidney/Liver Yin deficiency and Blood deficiency and also some Damp Heat and Blood stagnation.
If I try to not overthink it, it seems like there is a lack of Yin so Yang is not achored. Lack of Blood is leading to stasis and Heat.
When I look up cognitive dysfunction, two formulas that could fit are San Piao Xiao San or Ban Xia Bai Zhu Tian Ma
I look forward to your guidance!
jen