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GSP With Multiple Problem

by rmtran - June 10, 2009

Hi Steve,

I have a 13 years old MC German Shorthair Pointer with several issues.

He presented for coprophagia/polyphagea, eosinophillia, loose stool, weight loss (better with increased food intake), spondylosis, occasional bleeding from nose that responds to deworming.

I was placed on Anypril by rDVM which helped some to reduce food begging in the middle of the night.

His initial examination revealed slow CP reflex on both hind limbs, warm ears with normal toe in touch. His tongue was thick and pale in the back, and the rest was pink. His pulse was irregularand various quality. No murmur audible.
The client thinks that his hearing has deminished but he is able to see ok.

I started to treat him with Zhi Bai Di Huang since April off and on (the client failed to get refill) and his eosinophilia resolved and coprophagea improved.

He developed VPC's lately and was placed on Sotalol, that seems to help his ECG reading, but not his pulse quality.

I am thinking of using ZBDH for a long term since his pulse quality has improved while he was on it. Would it be more appropriate to consider another formula for this patient?

Thanks for your help.

Rieko

by naturevet

June 9, 2009

Hi Rieko,

An irregular pulse like that suggests Blood stasis. Meanwhile, I'm wondering if the ZBDHW helped the coprophagy and eosinophilia by clearing some Damp Heat. Certainly the other problems are all consistent with Damp Heat, including spondylosis, nasal bleeding, soft stools, eosinophilia, and polyphagia. Damp Heat can also lead to Yin deficiency, for which ZBDHW is often prescribed. At the same time, the Heat arises because Damp obstructs the flow of Blood, creating a potentially choppy pulse. From a western point of view, the berberine in ZBDHW is anti-arryhthmic, as well as anti-inflammatory, so it's a good idea to continue it. In ZBDHW, it's carried by Phellodendron, which is also in Si Miao San.

So putting all that together, I can see how SMS would address the common origin of both the Yin deficiency and the Blood stasis, while having the same biomedical impact as the ZBDHW. You could use the two together, or just try SMS alone. If SMS is helpful, but you want more Blood moving influence, then you can try pairing it with Xian Fang Huo Ming Yin instead.

Hopefully that makes sense to you as an approach. I guess the other thing you can do is first make sure that the ZBDHW isn't still appropriate all on its own. That's a fine approach to take. If he really is Damp Heat, continued use of the ZBDHW should eventually bring that out more clearly.

Good luck and hope I didn't muddy your waters too much!

Steve

by rmtran

June 11, 2009

Thanks, Steve.

If his condition is worse with the warm weather, and his breathing is heavy (he sounds like a dog with laryngeal paralysis), would it change your approach?
As a history, he had GDV surgery 1 year ago.

Thanks!

Rieko

by naturevet

June 11, 2009

Hi again,

If his breathing rattles, then I'd go with Si Miao San +/- Xian Fang Huo Ming Yin. A Yin tonic in this instance would be possibly too congesting.

S

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