Signalment
- Age: 8 years
- Sex: female spayed
- Breed: Australian Terrier
- Species: dog
Disease Notes
- Certainty: confirmed
- Final Status: resolved as of day 150 of treatment
Treatment and Outcome
- Abd. U/S View
Problem Notes
- Nocturia: Wakes at 1:20-2 AM asking to go out. Occasionally incontinent with large amount of urine, sometimes just after returning from outdoors.
- Vomiting And Inappetence: Bad AB reaction
Treatments
- Kan Essentials
- Bu Zhong Yi Qi Tang
- Yi Yi Ren Tang
- Sepia 30C
- Sepia 200C
- Doxycycline
- Nut Vomica 30C
- Six Gentle Pets
- Subdue Internal Wind
- Canine Hepatic Support
- Phos 30C
Notes:
Lilly's health has been off for 2-3 years. She used to be very active agility and frisbee dog with high energy. Starting 2-3 years ago, she became exercise intolerant, would develop muscle fasciculations after work, starting with RF leg, then extending to rest of body over time. Activity slowed down, and fitness declined. No improvement on high quality joint supplements. No change in signs through seasons. Slowest in AM, gets worse with exertion. Does not like to be touched. Most recently, reluctant to jump into car (past 3-4 months). Stretches back a lot in hyperextension. Warm seeking. Tested positive to anaplasmosis earlier in year--referring vet did not treat because judged she was asymptomatic. She acts like an old dog, but she’s only 8 and has been like this for a couple of years. Not joyful. She has always eaten a high quality raw diet.
Hx: Long past history of FS incontinence— was resolved with acupuncture, diet change and herbs.
Lately, waking up to urinate in night (1:30-2 am), occasional large enuresis (2-3x over 6 weeks). Possibly drinking more (3 dogs, hard to tell, but sees her at the bowl).
PE: Stiff all over spine, but no focal point of pain— stoic dog historically. Pulse wiry? Tongue slightly red.
Diet is largely raw
Manipulation or massage was performed
Notes:
12/28/15 Started on Benefit Hips and Knees 2.5 tabs BID. No improvement in 3 weeks.
Dipstick urinalysis: no abnormalities, SG low normal
Gave one dose Sepia 30C and Owner reported that Lilly did not get up in the night to urinate for a day or two.
Diet is largely raw
Notes: My colleague Dr. Dayon saw Lilly today and gave a higher potency of Sepia, since she had positive though temporary response to low potency.
Diet is largely raw
Notes:
No response to YYRT and BZYQT. Dr. Marsden responded to my email query about this case. Have ordered Bu Gan Tang, and will start giving when it arrives 2/13:
I had a case like this that responded well (and quickly) to Bu Gan Tang. Muscle fasciculaton, and stiffness is an important Blood deficiency symptom. As it progresses, it becomes deeper, affecting Kidney Yin and Essence, and thus Kidney function as a whole (from a Chinese perspective). The formula contains Rehmannia, which will boost renal function and urine concentrating ability. Since it tonifies the Liver (that's what BGT means), it addresses the number one cause of Jue Yin excess, which is Liver Blood and Yin deficiency.
So it's the first thing I'd try. You can pair it with BZYQT to get more of an action on incontinence per se. Note that in humans, Sepia works best in Liver Blood deficiency (with associated Qi stagnation)
Notes: No response to Bu Zhong. Decided to try Doxycycline to rule out chronic Lyme.
Diet is largely raw
Notes: Discontinued Doxy due to severe GI reaction: vomiting and diarrhea. No improvement from meds.
Diet is largely raw
Notes: Recommended symptomatic treatment with Nux Vomica 30C. Took blood for chem panel. Results 3/8 showed elevated liver enzymes. File attached. Owner feeding soupy chicken and rice.
Diet is largely raw
Files:
- 3/7 Blood Work View
Notes: Lilly has bounced back from her doxy episode and is back to her baseline: lethargic, irritable, occ urinary incontinence. Abdominal ultrasound did not reveal any major liver issues, like tumors. As per Dr. Marsden's suggestion, started her on Six Gentlemen and Subdue Internal Wind.
Diet is largely raw
Files:
- Abdominal U/S Report View
Notes: Owner reports: Lilly seems to do better. She seems a bit more active even though her legs are still trembling.
Notes:
Email from client:
Unfortunately Lilly is getting worse again. She is trembling more and for the first time she refused to jump in the car after a walk....that has never happened before. :-(
We left it that if she was not more herself in a few day, I would reexamine dog.
Notes: Client's husband was in charge of feeding while she was away, and through a misunderstanding, left out the Subdue Internal Wind herbal treatment-- dog was much better than she had been in a long time. I told her to continue with giving only 6 Gentlemen and see how she did.
Diet is largely raw
Notes:
Client: Seems like I have a new dog.....Lilly is soooo much better! She runs more, has more energy, bugs me again in the evening for more playing (YAY! I missed that!) and trembles less!!!! I'm so happy!!!
Notes: Owner asked for suggestions for thunder phobia for her three dogs, one of whom is sensitive to everything and has a paradoxical reaction. My partner suggested low potency Phos, so she gave it to them all Friday night before storms rolled in. Lilly apparently evacuated her entire bladder in her sleep that night. Dr. Sarah thought perhaps the Phos triggered old reactions, and we hope it was a one time occurrence.