View Question

Proteinlosing Enteropathy

by swaneysue - July 4, 2009

Hi, I need help with any suggestions for a diet plan and herbal changes for a 7 year old male neutered golden retreiver with a Dx of Protein losing enteropathy :

6-7 month history of diarrhea , abdominal effusion ,weight loss and muscle atrophy.

Presented on
Pepcid, carafate, Pred , Imuran, lasix, spirolactone, mertazapine,
Slippery elm, k-9 enteric,hepatic and adrenal support,
Chelidonium majos 30 c
Tylan powder
Had been on baytril but off now for fever

Albumin 1.1, Alt 198
Increase drinking and appetite
Palpate warm all over, seek cool
Stool between soft formed and liquid diarrhea smelly, no vomit
Very thin and severe muscle loss all over
Very low energy
Very sweet-Earth constituion
History of seperation anxiety, storm and noise anxiety

Diet-Boiled chicken oats few veg
Had been on Royal canine low fat diet-not eating now

T= pale laveneder
P=thin wiry middle deep positions

Placed on 4 marvels , XiaoYao San , acupunctureGV 14, ear tips, LI 10, St 36, GB 34, BL20 , BL22
Stopped the oats and changed to rice/potatos add gizzards every few days , sweet potatos of pumpkin

Improved , after several treatments blood better ALT normal, albumin 2.4, fluid in abdomin significantly down, energy up, some weight gain
Stool fluctuates between normal for 3-5 days then goes to liquid- owner gives flagy and Gi fast Balance( b vit and fiber supplment with probiotics) for a few days and he improves again..

He is off the spirolactone lasix , pepcid, carafate tylan, and down on the pred to 10 mg daily from 40 mg.

Energy is up but we have stalled on progress now he is good for a few days the has an episode, He is not as warm.I tried owering the pred to every other day but he didn’t do as well,
Last visit T=pale pink with fine cracks P= middle deep to upper(felt in all three)rolling, but tight soften with sedate BL 40 and GB34
Increased energy and weight, still weekly episode of liquid diarrhea 3 am , smell, gas and rumbling.

I replaced xiao yao san with Tong Xie Yao fang and fast baalnce replaced with Nutrigest

Appeteite is up and down.

Any diet, herbal suggestions would be appreciated. Thanks sue

by naturevet

July 4, 2009

Hi Sue,

Interesting case. Congratulations on getting him re-stabilized and off all those drugs. Indeed, if it were me, I might have continued the Xiao Yao San while I rolled in my plan B.

There are several options for Plan B, including Wei Ling Tang (except the animal prefers cool), Shen Ling Bai Zhu San (which we're learning is most indicated where there are substantial Damp Heat signs, but the need to stop fluid losses), and Huo Xiang Zheng Qi San. The latter, known also as Agastache Combination, expels pathogens from the interior where they are causing diarrhea. It seems to be cooling, and is one of my top choice in animals with diarrhea and a pulse that improves with sedation of BL 40. The other possibility is San Ren Tang (Three Seeds Decoction), which has a nice normalizing effect on the stool. The fact that you achieved some benefit with Xiao Yao San implies there was a Liver - Spleen disharmony perpetuating the Spleen imbalance. So continuing with a Spleen formula is a good idea. Tong Xie Yao Fang is a LV - SP harmonizer, but especially where there is painful intestinal spasm. If spasms are overt, it is a good choice. Otherwise, I'd try either San Ren Tang or HXZQS. Probably SRT would be where I would start. If he responds well, then continuing in the low or no carb unprocessed vein is indicated.

Good luck and congratulations thus far!

Steve

by naturevet

July 4, 2009

If not SRT, then Shen Ling Bai Zhu San. It has the advantage of a having a reputation for being astringing, which would seem to be of particular benefit in PLE. Lastly, for some Damp Heat dogs, we've stopped their diarrhea with the single herb Wu Wei Zi, also an astringent.

Hopefully one of these options will strike a cord with you!

Steve

You must be logged in to reply

CuredCases.com