Exam reveals bilateral partial alopecia of the lateral abdomen with clear demarcation along the dorsal margin. Ventral hair has regrown and is normal. He has a pot-bellied appearence. Tongue was purple in color with thick edges and very moist. Pulse was slippery, not thin or deep. Alk phos moderately elevated (652, remainder of CBC, Chem unremarkable. Borderline results with LDDS test. In 7/08, he had an episode of hepatitis which responded to medical treatment (metronidazole, amoxicillin, denosyl). Owner's biggest concern is resolving the hair loss and would prefer to start with herbal options.
Question Details
Cushing-like Condition In Aust. Shep.
by
CVWDVM
-
June 12, 2009
Exam reveals bilateral partial alopecia of the lateral abdomen with clear demarcation along the dorsal margin. Ventral hair has regrown and is normal. He has a pot-bellied appearence. Tongue was purple in color with thick edges and very moist. Pulse was slippery, not thin or deep. Alk phos moderately elevated (652, remainder of CBC, Chem unremarkable. Borderline results with LDDS test. In 7/08, he had an episode of hepatitis which responded to medical treatment (metronidazole, amoxicillin, denosyl). Owner's biggest concern is resolving the hair loss and would prefer to start with herbal options.
Replies
by
naturevet
June 14, 2009
Hi there,
The first thing I would try is Si Miao San and, ideally, a very minimally processed low carb diet (e.g. raw, if you're comfortable with them). Si Miao San deals with a lot of the adverse effects of insulin resistance and steroid hepatopathy including inflammation, liver enzyme elevations, hair loss, PU/PD, and gas. It addresses Damp Heat, which is characterized by many of the classic signs of Cushing's, including also restlessness, heat intolerance, and exercise intolerance. It works best when the hyperadrenocorticism is pituitary dependent. SMS has even been used successfully in non-functional pituitary tumors.
So that's where I'd start. I do think diet is of crucial importance, though. If the owner can't at least go with a no-grain home-cooked diet, EVO, or Orijen, then results will be limited. If the owner will go raw diet, results will be rapid, with resolution of PDH occurring generally within a year. Initial improvement should be evident within the first few weeks.
Good luck. Cushing's can be a lot of fun to treat using the above protocol. Enjoy yourself,
Steve
The first thing I would try is Si Miao San and, ideally, a very minimally processed low carb diet (e.g. raw, if you're comfortable with them). Si Miao San deals with a lot of the adverse effects of insulin resistance and steroid hepatopathy including inflammation, liver enzyme elevations, hair loss, PU/PD, and gas. It addresses Damp Heat, which is characterized by many of the classic signs of Cushing's, including also restlessness, heat intolerance, and exercise intolerance. It works best when the hyperadrenocorticism is pituitary dependent. SMS has even been used successfully in non-functional pituitary tumors.
So that's where I'd start. I do think diet is of crucial importance, though. If the owner can't at least go with a no-grain home-cooked diet, EVO, or Orijen, then results will be limited. If the owner will go raw diet, results will be rapid, with resolution of PDH occurring generally within a year. Initial improvement should be evident within the first few weeks.
Good luck. Cushing's can be a lot of fun to treat using the above protocol. Enjoy yourself,
Steve
by
CVWDVM
June 14, 2009
Hi Steve,
Thanks for the advise! Out of curiosity, and for the sake of learning, what about Long Dan Xie Gan Tang in this case?
Thanks for the advise! Out of curiosity, and for the sake of learning, what about Long Dan Xie Gan Tang in this case?
by
naturevet
June 15, 2009
Hi Courtney,
LDXGT was the first thing we tried that worked in these Damp Heat cases. It is still well indicated in purely Hot and Excess patients. Where there is involvement of the Spleen (e.g. poor appetite, loose stools, gas, etc.), then SMS is a better choice. The benefits of SMS were discovered after the Manual of Natural Veterinary Medicine was published, so that's why it's not in there. Phellodendron has a lot of current research on it with respect to liver damage - more so than Gentian does. So where there is fatty change, etc., Phellodendron appears right now to have more research behind it as an effective treatment.
But in an extremely hot over the top case with no signs of digestive difficulties, LDXGT appears to work.
All the best,
Steve
LDXGT was the first thing we tried that worked in these Damp Heat cases. It is still well indicated in purely Hot and Excess patients. Where there is involvement of the Spleen (e.g. poor appetite, loose stools, gas, etc.), then SMS is a better choice. The benefits of SMS were discovered after the Manual of Natural Veterinary Medicine was published, so that's why it's not in there. Phellodendron has a lot of current research on it with respect to liver damage - more so than Gentian does. So where there is fatty change, etc., Phellodendron appears right now to have more research behind it as an effective treatment.
But in an extremely hot over the top case with no signs of digestive difficulties, LDXGT appears to work.
All the best,
Steve
by
CVWDVM
June 15, 2009
Steve,
We've started the SMS. Reno's diet was switched to EVO a few weeks ago. I had a chance to follow up with her today. She said Reno developed soft stool and gas with the EVO. More evidence of spleen involvement.
Thanks!
Courtney
We've started the SMS. Reno's diet was switched to EVO a few weeks ago. I had a chance to follow up with her today. She said Reno developed soft stool and gas with the EVO. More evidence of spleen involvement.
Thanks!
Courtney
by
naturevet
June 16, 2009
Sometimes even EVO and Orijen are too rich, given their processed nature. This dog would do best on a less processed diet like raw or home-cooked. A shortened bowel transit time is typical of animals on a highly processed diet. Less processed diets create slower bowel transit times that firm up the stool and eliminate gas by ensuring food is fully absorbed and not passed to the large intestine.
S
S
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