Hi Rieko,
I knew if you were desperate enough, you’d break down and use the forum. I hope your dog has been feeling a little better. Regarding this patient:
• Leukemia is often a heat complaint. This may be an explanation, then, of why BL 40 was helpful. When sedated, it will pull pathogens out of the Tai Yang, to be sure. It will also, however, vent extremely hot energy (aka pathological levels of Tai Yang). But the rest of the case tells us if there is Heat there, it is masquerading as deficiency, which does sometimes happen. Read on to see one mechanism…..
• Anemia can indicate Blood deficiency and/or Blood stasis, as well as Qi deficiency
• Internal lymph nodes behave more like Blood stasis. External lymph nodes behave more as accumulations of Phlegm that have congealed in the outer Yang layers of the body due either to an abundance of Heat or to inadequate Yin mixing into those Yang layers
• The rapid progression and high malignant potential smacks of Heat as well.
• The tongue and pulse suggest both Blood deficiency and Blood stasis
• Itch can indicate Heat. Cool extremities can accompany Heat if we essentially have a Blood Heat pathogen. The Heat dries and congeals the Blood, thus inhibiting its circulation. Blood stasis leads to cool extremities; Heat accumulation due to Blood accumulating in the interior; and Blood deficiency. From this perspective, the ideal formula so far might be Qing Ying Tang, which moves, moistens and cools.
• The belching at first doesn’t make a lot of sense. But it does if the problem is inadequate mixing of Yin and Yang. If Yin does not mix with Yang, we get peripheral lymphadenopathy. Since the Shao Yang (TB and GB) fill this mixing role, we can also get TB and GB symptoms and signs like decreased peripheral circulation and impaired descent through the TB. If this is what is going on, Xiao Chai Hu Tang is the ideal formula to start with.
• The low appetite, soft stool, and aversion to raw suggest Qi deficiency, which can accompany the failure of Yang and Yin to integrate.
• It’s worth noting that we see a lot of Blood Heat pathology in animals with TB and GB problems, so we don’t have to pick one of these two diagnoses. There may be both going on.
So that’s the direction I’d come at it. I’d probably at least start with Xiao Chai Hu Tang and see what transpired. I have used a version of it to reverse leukemia in people. In addition, after a few days, if the formula is well tolerated, I’d add to the regimen Qing Ying Tang. I’d then use the two formulas together and see how it went. Another recent case of mine that appeared very fatigued responded surprisingly well to Hoxsey, so that’s another option for you to try. But given all the convoluted logic above, I’d go with QYT and XCHT first, starting with XCHT.
Hope that helps. Tough case!
Steve