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Rottie Cross With Hindlimb Issue And More

by rmtran - June 30, 2009

Hi Steve,

I am treating a 8 years old MC Rottie Cross with himd limb weakness for the past 2 months.

He has a quite history; had a TPLO surgery 1.5 years ago that failed, he got two more surgery. Eventually the right hind limb was amputated. During that time, he was hypoalbuminemic and anemic, so he had to have a blood tranfusion to recover from the third surgery. He was finally worked up by an internist, who discovered that he was atypical Addison's. He is currently on low dose of pred.

His pulse used to be very deep, and his tongue was sl. pale. He responded well with acupuncture at first, but he is not doing so well lately. His tongue is nice pink but dry, and his pulse is thin on surface and normal at deep area. The pulse improves with draining of BL-40.

He never grew hair back completely on the area shaved for surgery and ultrasound from a year ago, but he started to loose hair around neck for the past 1 week. He is drinking more water (just a little more per the client), and he needs to be helped to get up all the time. His condition changed all of the sudden 1 week ago. He does not do well in hot weather (it is hot and humid in VA now).

I think that he has False Heat from Yin Deficiency, Kidney Qi Deficiency, and underlying Blood Deficiency.

I thought of Xiao Chai Hu Tang first for him being Addison's, but I wanted to treat his deficient Heat first.

Then thought of Chai Hu Jia Long Gu Mu Li Tang, and dispensed small amount to see how he does.

Do you think of this selection appropriate?

Thank you,

Rieko

by naturevet

July 1, 2009

Given the pulse that is stronger at depth, and the improvement of that pulse when BL 40 is drained, I'd say we have a pathogen in the Tai Yang layer - i.e. a Wind invasion.

The dryness, heat and Yin deficiency must also be addressed. Putting this altogether, the formula I would think of trying is Du Huo Ji Sheng Tang. There is some Ginseng in there to help with the Addison's. That's what I'd try first.

Good luck with him, whatever you do!

Steve

by rmtran

July 1, 2009

Thanks, Steve.

What should I try if DHJST makes this patient feel more warm?

Rieko

by naturevet

July 2, 2009

Hi Rieko,

I'd definitely be sure I tried it for a few weeks, even if it meant having to drop the dose a little.

Good luck!

Steve

by rmtran

July 4, 2009

Hi Steve,

This patient had an episode while he was on CHJLGMLT.

His leg started to quiver; discontinued the herb. The evening, the patient vomited multiple times, then eventually diarrhea started. Not lethargic, but weak on hind (he is missing one hind leg). He responded to supportive tx well (pepcid, cerenia, SC fluid). The client thinks that the patient ate some wood chips in the back yard (he has pica) and that was the cause.

I thought that it might be the herb, although he only had three doses and 2/3 of regular dosage.

This patient previously had a reaction to thyroid supplement (T4/fT4 are low, but TSH is normal) where he got very aggitated and he started to eat everything and anything (yes, he has pica but got extremely worse). He is off of supplement now, and he is back to where he was before.

Would this additional info changes the approach?

Thanks,

Rieko

by naturevet

July 4, 2009

Hi Rieko,

If the herbs really ramped up his pica, I assume it was by their strong cooling properties. I generally associate that kind of pica with deficiency. So if this truly is the case, then a tonic like Du Huo Ji Sheng Tang if anything is even more indicated. It has tonics that can bolster the Spleen and also nourish the Blood, deficiencies of which seem to be involved with pica.

So I'd continue with the plan, if you still feel comfortable with it.

Good luck,

Steve

by rmtran

July 4, 2009

Thanks, Steve.

I feel comfortable with DHJST.
The patient is here at ER, and I appreciate your timely reply!!

Just FYI, he had very strong reaction from needling GB-34 (he actually tried to snap). His hair is thinning at ventrum, and his tongue appeared to be slightly paler than before. His tremor on hind limb is more consistent today. I agree, that he is VERY Blood Deficient.
I also recommended blood tonifying food. This patient gets raw food (chicken and beef) with veggies, and some kibbles as filler (about 2 oz).

Thank you again, and see you in a few weeks!

Rieko

by rmtran

August 20, 2009

Hi Steve,

This dog is doing well except the hairloss. He's got a custum made brace that helps his remaining of the leg.

He is on DHJST (NP) 1 tsp BID. His tongue is pink and more normal size (used to be small), and his pulse is much improved.

His hairloss around neck has stopped, and we see some hair growing back. However, his tail base is bald now. The client thinks that he is much hangrier, and inhaling food lately (this dog also has hx of pica).

I am reluctant to re-start this dog on thyroid supplement since he goes crazy about eating everything.

Could this hairloss and increased appetite be a sign of Yin Deficiency?

Any idea?

Thanks,

Rieko

by naturevet

August 20, 2009

Hi Rieko,

Yes, hairloss and increased appetite can signal Yin deficiency. DHJST should be helping treat that, but you can try rolling something else in, especially Qi Bao Mei Ran Dan (Seven Treasures Combination), since it is specific for hair loss from Yin deficiency, but is not too cloying (at least not the way we make it!).

If the dog hasn't been evaluated for hypothyroidism, it probably should be.

Steve

by rmtran

August 20, 2009

Hi Steve,

IMED has checked him several times using Michigan profile, and the endocrinologist has commented 'diagnostic dilenma' about the result.

When he had thyroid supplement earlier this Spring, he developed severe polyphagia and behavioral change, and the client do not want to try it again.

QBMRD sounds good idea, and I will try it for him.

Thanks for your help!!

Rieko

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