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GS With Stiffness

by rmtran - June 17, 2009

Hi Steve,

I still have one more Shephard with problems, and I need some suggestion.

Kidd is a 14 years old MC GS with Fire personality.
After his younger mate passed away almost 2 weeks ago, he looks somewhat depressed.

He has been very stiff on hind legs as well as front for a while, and herbs he was on before do not seem to be helping (Di Gu Pi and Bu Yang Huang Wu).

His tongue is dark red, his pulse is not wiry but fast, which sinks in (becomes deep) with the draining of BL-40.
His ears are warmer than usual, toes are normal.

Significant muscle atrophy on gluteal and quad, sensitive at LS area, slow CP reflex on both hinds.

He has occasional urinary/fecal incontinence, strong appetite with sl. increased water intake. I noticed that he was extremely anxious when he was kenneled at work; continues to bark towards back wall, panting and almost acts senile. He is an excitable dog and always enjoyed going different places, but this is different.

In order to norish his Yin, clear Heat, calm his mind, I am thinking Chai Hu Jia Long Gu Mu Li Tang. I thought of Zhi Bai Di Huang until I noticed his behavioral changes.

Please tell me what you think.

Thank you always,

Rieko

by rmtran

June 17, 2009

Addendum:

He gets Tramadol but no significant change with it. He is not on NSAID now; it did not make a huge difference in the past.
May be ZBDH is better choice for him. Rieko

by rmtran

August 15, 2009

Hi Steve,

I noticed that Kidd has been dragging his hind limbs more lately.

Tongue-red
Pulse-sl. wiry and fuller at depth.

Pulse improved with sedation of BL-18 and BL-40 (mild) and tonification of BL-23 improved pulse in general, and tonification of BL-18 sunk the pulse.

He has stiff back, often arched; trouble going down stairs (cannot do this by himself for a while), but still manages to come upstairs step by step.

Previous torticolis (?) with front limb lamenss in occasion, that are managed with acupuncture and Tui-na.

His CP is much slower on right hind.

He is on BYHW (EG) and ZBDH (NP). Should I move to another formula that has more Moving action than Tonification?

I can tell that he is a advanced Yin Deficient dog that is very dry and wilted...

Thank you,

Rieko

by rmtran

August 16, 2009

Hi again,

I must add that he acts almost senile when he is in a strange place. Paces around, never gets comfortable. If caged, he will bark towards the wall for good few hours until he gets tired and sleep.

He was very friendly and overly excitable dog for a long time, and I think that HT yin is extremely deficient.

If any formulas address his mobility and mentation, that would be wonderful.

Rieko

by naturevet

August 16, 2009

Hi Rieko,

I'm not sure how I missed replying to this case before - sorry. CHJLGMLT can be very calming. If there are any active GB points at all, it's a good one to try. It doesn't do much for Yin, though.

BYWHT is very warming (if you're using a version with the proper amount of Huang Qi). If you use it in a hot patient, you'll make them hotter. So I'd pull back on it.

Lastly, SMS is calming and is advocated for Wei conditions where the Yin of the lower limbs is badly damaged due to heat. It fits a superficial pulse, but not so much a deep one, except in cases where a moisturizing herb needs to be added.

So those are all options. Hopefully one will pan out.

S

by rmtran

February 26, 2010

Hi Steve,

How are you?

My old one is still hanging on.

He started to have loose stool or diarrhea as soon as he eats slightly different food (I change food to stimulate appetite due to anorexia). His stool contains mucus, odor could be worse at times. I use metronidazole (one or two doses) and started him on Shen Ling Bai Zhu; his appetite is better and stool is normal, but borborigumi continues. I also added Rehmannia Eight combo (Kan)because his feet were cold (especially front). I think it has improved a little.

I have not used SMS on him yet, but it may be too drying for him.

His tongue is dry, reddish pink, and his pulse is superficial and wiry at times (especially with muscle loss, it feels more superficial). He appears to be painful in front legs (arthritic carpal and elbow joints on both) so he cannot even pull himself around any longer. I do carry him mostly, but he is able to stand for a few minutes to do his business.

He will hold urine until he goes outside, but he is somewhat fecal incontinence.

Would you recommend changing the formulas or keep him on the same herbs? I feel that SMS would address his arthritis in front legs, so should I use it instead of Ba Wei Di Huang? May be mixing Dang Gui in SMS will make it less drying and less cold...

Thank you for your imput.

Rieko

by naturevet

February 28, 2010

Hi Rieko,

Nice to hear from you. Glad to hear your little dog is hanging in there. Hopefully you can improve things.

I agree the SMS is too drying, and pulls in the blood supply whereas the dog is responding best to things that push the circulation out.

I also note the wiry pulse, however, which tells us there is a stasis component to the problems. So the question is which formula should we use for dispersal?

For cases with obvious Damp and Spleen problems, Yi Yi Ren Tang (I don't mean the version you were using before, but the NPHC version) is a consideration. If the fore limb problems were emanating from the back, I'd consider Huo Xiang Zheng Qi San. For sure, though, we should try to make the formula choice compatible with the Spleen and Damp concerns.

YYRT would be my favourite choice to start with, I think.

Have a good day,

Steve

by rmtran

February 28, 2010

Thank you, Steve.

I have YYRT (NP) also, so I would start it.

Sorry that I won't be there for advanced course. But I enrolled myself for IVAS Herbal course this year.

I cannot believe that Olimpic is over. Canada was No.1 to get Gold medals! You must be proud!!

Rieko

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