I need your advise badly on this case:
A 10 years old FS Lab with chronic GI issue
Main issue- belching all day long, occasional bloating of abdomen with pain, some orthopedic issues in front legs
T-red and dry, P-wiry and deep
While I was needling, I noticed that SP-9 made her pulse worse (no tonifying or sedating).
Good appetite, less water intake for the past 8 months; loves soft and warm place; friendly to people, alpha to other dogs (but not aggressive); sleeps well except for the occasional belching/bloating around 3 am, dreams x2/week.
I placed this patient on Bao He Wan (teapills).
The following night, the patient started the acute abdominal discomfort without belching. Then the client gave the first dosage of Bao He Wan, and the patient was taken to rDVM. There was a lot of gas in the intestine, otherwise non remarkable. The patient was placed on Tramadol for pain, then started to vomit mucus with specs of blood in 3 am today. The patient was less painful by 9 am.
The client recalls that pain started before she gave the first dosage of Bao He Wan, then no belching but pain (this is very unusual that this dog did not belch this time per the client). The client also started a new dry kibble the morning she saw me.
One interesting note from the client: This patient was dreaming like crazy for the past 1.5 days.
This is the shared case with internal medicine. This patient was seen 4 weeks ago by our internist and placed on Tylan and probiotics, and prescription diet for watery diarrhea with mucus/odor, no blood. Her stool is almost normal, but belching issue has not resolved; she continues to have an occasional incidence with abdominal distension with pain. At this time UTI was discovered with a routine UA and placed on Clavamox for 3 weeks (her GI did okay with this). The patient did not have any symptom for UTI.
She has been on metoclopramide after she was diagnosed with gastric motility issue at 1 year old; which helped her some. The client has manipulated her diet for years using home cooked diet, just to find that i/d helps her the most.
Her previous hx includes pyometra sx at 1.5 years old; urinary incontinence since spay (on Proin); reaction to Fragyl and most of other abx except for Clavamox (aggravates GI issue); black nose turned pink 2 years ago; no sensitivity to NSAID or Tramadol previously; very driven dog, competed retrieving for years
I am so surprised about the change in this patient so quickly and would like to get your opinion how to pursue this case. My diagnosis was SP and ST disharmony, Food stagnation. Underlying Blood Deficiency might be also a key. Did I miss something here?
Thanks,
Rieko