‍Henry’s Condition: Good+  (5 days Good+,  7 days Good) 

‍If BDR dogs Abby and Ziggy had a cousin, that cousin could be Henry!

‍BDR and I discussed his progress to date and expectations for near future. A vet visit for baseline and to schedule a routine is planned. There is no immediate urgency for a visit. 

‍Henry’s supplements (vitamins, minerals, and nutrition) have been well accepted, with no adverse or side effects. 

‍Pregabalin has been stopped to examine possible connection with lethargy. Henry is more alert with no change in rapid respirations with cheek-puffing. His heart still beats loudly. The lung fields are clear to auscultation. No cardiac murmurs.

‍Henry will resume Pregabalin at a half dose schedule to one 75 mg mid-afternoon. 

‍To maximize synergy with Vitamin C and fish oils, Henry will begin taking Vitamin D3. Delaying calcium supplementation for now to avoid leaching calcium from his bones.

‍Henry is not house-trained. Water access will be scheduled and I will take him outside on leash every two hours to his turf spot. Hopefully that time can be extended.

‍Hydrotherapy is very significant for management of Muscular Dystrophy. Henry enjoys swimming to me, for "catch and release; repeat."

‍Persisting Signs/Symptoms of Muscular Dystrophy: 

• Rear limbs remain 0/4
• Rapid respirations with cheek-puffing
• Hard heart beat
• Lack of rear ankle flex/extend 
• One big episode of food regurgitation
• Bunny-hop gait 
• Cannot lift leg to wet, squats

‍Improvements: 

• Shakiness of rear limbs is nearly gone
• Lessened rear haunch hump
• Engagement in life around him, even if to observe rather than participate

‍If Henry had come to me in his condition from five weeks ago, without the diagnosis of Muscular Dystrophy, lab values would still have been assessed in order to augment deficits. Muscle and strength and endurance training along with endurance would have been undertaken. As his physical therapist, this would have been so counterproductive in Muscular Dystrophy! The elevated creatine kinase and biopsy means life to Henry.

‍PLAN

‍Consider red light therapy and Rapamycin. Monitor his response to medications and supplements; pivot as needed.