Question Details
EPI With Greasy Fecal Incontinence
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Catchy title, huh?
I have been treating a now almost 4 year Golden/Gt Pyrenes mix FS K9 for EPI. I have been using TCVM for a year, and her stools have gone from essentially undigested food to semi-formed brown feces with some food, larege volumes still but manageable. Which is an improvement from the huge wads of grass and bloody mucous she used to produce! Current meds are BZYQT 2 gm BID, Xiao Yao san 1 gm BID, Probiotic, Pancreazyme, and Prozyme. Home-cooked diet with turkey, yams, spinach, vegetables. I have intermittently added Si Wu Tang or Reh-8 for Bl def 2ndary to Sp Qi/Yang def, and tonify Kidney Yang (fire under the cooking pot). Also have added in Xiang Sha Liu Jun Zi Tang instead of BZYQT sometimes. Last Rx was just BZYQT/XYS as I am trying to simplify and figure one formula for all things.
Currently, 3 week duration, when she passes gas, she oozes large puddles of greasy foul-smelling oil. It is greasy-it coats the perineal hair, and is yellow-green. It stains the floor, so she now has to stay outside (it's very hot here now). Her tongue, instead of pale pink and dry like it usually is, is now a darker (more normal) pink with sl darker pink edges, a little slimy saliva. Pulses are deep, soft. Her right anal gland felt scarred (never been abscessed) with a little bloody d/c. Weight is stable, good appetite, no change in water intake. The only Rx change I made is to take out XSLJZT.
My TCVM dx is Spleen Qi/Yang def with Damp Heat. I think the Damp Heat on top of the Blood def/Spleen def is making the tongue look normal from pale. Yellow/green with odor fits Damp Heat.
Greasy is Damp-but where is this overt greasy d/c coming from? The dog gets no oil supplements, no fish meat.
I prescribed Si Miao San tapering up to 1 gm Natural Path formula BID. My question is-can you explain this excessive greasy d/c from a TCVM perspective, and of course, Rx suggestions, please?
Also, do I need to add a different enzyme for fats, or maybe add fish oil in small amount?
Thanks in advance. Glad you're back safely.

PS. Almost done with the FIP case report for the IVAS course. We'll see what they think!
Replies
by naturevet
July 19, 2009
Hi Jodi,

I agree with your assessment - Damp Heat. From a Chinese medical perspective, this naturally includes any oily secretions from the digestive tract.

The Dampness probably made a stronger appearance once you backed off on the XSLJZT, because it has more Damp draining, Phlegm transforming and Damp drying effects than any of the other formulas you're using. The Dang Gui in BZYQT and even XYS may actually be keeping the stool a little loose, not to mention the Rehmannia in Rehmannia Eight. Both plants are rich in polysaccharides which increase the mucopolysaccharide layer lining the mucosa. In this dog, that will probably translate into more slimy stools.

Hopefully the SMS will work well. If it doesn't, try San Ren Tang (Three Seeds Decoction), as its aromatic nature will help increase absorption across the mucosa. If the dog is chilly, even Wei Ling Tang can be helpful, and lacks even the slight oil content of San Ren Tang.

Some sort of lipase seems in order, or pancreatic enzyme replacer. I'd be cautious with the essential fatty acids until that oily stool has resolved itself.

In general, though, I think you've got this one figured out. Continued good luck,

Steve
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