Signalment
- Species: dog
Disease Notes
- Certainty: confirmed
- Comments: A 4YO NM Mini Dachshund presented in October 2020 w/ Hx of seizures q 2-4 wks. On exam, he is anxious, panting, injected mucous membranes, bright red tongue, esp. underside, pulse is surprisingly deep. Bloodwork reveals erythrocytosis (HCT 64.8, RBC 9.2 M/uL, HGB 23 g/dL) and reticulocytosis (136 K/uL), Cortisol 6.36 ug/dL with a cortisol insufficiency leukogram, and mildly elevated AST, ALT and low ALP. It was a rough stick, lots of hemolysis, so we repeated the panel 2 weeks later w/ similar results. I started him on Answer's raw and QYT, suspecting polycythemia and processed foods as main culprits for the seizures and wanted to address that before moving on to endocrine imbalances. TCM Dx: Blood stasis, Yin def. w/ Blood heat.
On recheck in January, seizures are much less frequent, 1 in Dec., then 1 early Jan., that's it. He appears less anxious, T is lavender, dry; P is deep, slippery. Really no shift in blood tests and I am so surprised. erythrocytosis (HCT 61.2, RBC 9 M/uL, HGB 22.2 g/dL) and reticulocytosis (126 K/uL), cortisol insufficiency leukogram, and mildly more elevated AST, ALT, low ALP. Since no benefit of QYT, I'm not inclined to increase dosage or even continue and he appears to be more Blood deficient from T&P. - Final Status: slightly better as of day 90
Treatment and Outcome
Treatments
Notes:
Patient is on TMGYT and Wu Mei Wan + Dan Shen Since then, increased panting in evenings, if not panting, breathing deeper, still rapid, and it resolves in 1-2 hrs. Owner feels he is generally "hot". He had been w/o seizures since 4/22, but they began again this month w/ a time of day shift, now in the evenings. The first was 6/7 at 8:30-9pm, in and out of seizures for an hour that only resolved w/ diazepam and CBD oil. Then 6/9, 11:45pm and 6/11, 10:30pm, both short typical seizures.
I checked him on 6/18. T is muddy lavender, P is mid-depth, slippery. His mucous membranes on right side only are inflamed brick red (new) w/ heavy calculus. Persistent erythrocytosis (HCT 69, RBC 8.8 M/uL, HGB 23 g/dL) so worse except for RBC, TP high at 7.5, cortisol insufficiency leukogram, and normal liver enzymes. For the first time T4 is low at 0.8 ug/dL,
D/c the herbs and started QYT and XCHT with 20g of Tian Ma (Gastrodia), 12g of Gui Zhi and 15g of Bai Shao to handle those seizures.
Diet is largely raw
Notes: I started this guy on YGJ and TMGTY in January and d/c the QYT. In March, his person reported he was doing well, only 2 seizures (1/31 & 2/7). On recheck 4/30, she tells me of seizures on 4/3, 10, & 22. Timing tends to be 3-4pm, one 3:30am, and the last one at 9pm. No GI or other issues. Persistent erythrocytosis (HCT 60, RBC 9.1 M/uL, HGB 22.2 g/dL) no worse but no better, cortisol insufficiency leukogram, and normal AST and ALT, still low ALP. But now, ALB is high at 4.4 g/dL. T is pale w/ a redder tip and quivering; P is deep, slippery.
Diet is largely raw