This is one of those patients that had a mix of relatively serious signs, seems to have responded over treatment trials and time, and now has what is likely a related less serious condition..and I'm not sure of a "safe " way to turn.. 2.5 year old dog with history of cycling fevers for 1 year-- after receiving multiple vaccinations. Had tests for all kinds of infectious dz's, and a lengthy Hx of meds tried , but fevers, malaise kept coming. Also , groin would develop sterile vesicles, 1cm or so in skin.Occasional seizuring. Dog had a dry red tongue , fear aggression. Pulses thin lifting strong. Low albumin, low bun small liver . LIver U/S found Microvascular dysplasia(mini-shunts).Tried different formulas before getting improvement on SMS and XFZYT. For several months the dog has been active, playful, no fevers, seizures, etc. Now owners brought him for BLACKENING skin. He is a Bichon, normally pink skinned, yet he has pigmented areas that are greatly enlarging and new ones appearing. Tongue is pink to red, somewhat dry with a wet tip Pulses are strong, slightly lifting, fairly full. Coat is soft, silky. Stools are normal on enulose, but tended to be dryish pre- enulose.
I am a bit afraid to make too many changes after his last mix of problems. Any suggestions? Dare to decrease SMS(initially chose due to fevers and vesicles)?. Should also add dog's vitality improved SOME on Yi Guan Jian, but he still had lesser spells of malaise and developed a cough--or already had that , too? The cough and remainder of malaise resolve on XFZYT.
Thanks in advance!!!! Todd