He is raw fed
Few years ago started a chronic hacking cough, comes and goes but when bad is off colour, hacking cough, dry sticky mucus, some putrid smell from face at times, sticky nasal discharge, reverse sneezing++, will be like that for several days and then settle
Contacted me re sudden onset polydipsia
urine: normal sg, hematuria, proteinuria
Bloods raised urea 29.4 mmol/l, creatinine 268 mmol/l, phosphate fine, no anemia, raised amylase+++ but normal lipase, calcium normal, alt 81 u/l, slight e0soniphilia but rest of blood count fine. urine protein/ creat ratio: 1.78
prostate fine on exam, no pyrexia, feels hot for a dog of this breed, not clammy but definitely warmer than I expect, dry red tongue, pulse toned
chest auscultation: no lowerairway issue or cardiac so cough seems upperairway, no masses felt near larynx
Owner says variable appetite on some days really severe borborygmen, abdomen slightly tender, prayer position when has a bad day, is supplemented with mercola probiotics, variable protein source diet. Noise sensitivity
Firts line vet had recommended renal ultrasound
Funds are limited
I am inclined to treat San Ren Tang although prot creat ratio is less than 3.5 because of GI signs/ airway signs match or should I go for Rehmania 8?
I have started on food diary to see if certain proteins trigger GI signs
wormcount to eliminate lungworm, kefir and bone broth to support GI health. Interesting that this entire dog does have no upper airway signs for weeks when friends dog next door is on heat, I wondered if sniffing and increased sens stimulation increases lubrication of larynx/pharynx...