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Beagle With Arthritis

by rmtran - August 3, 2009

Hi Steve,

I have a 11 years old MC Beagle with arthritis

Issues that he has include:

Hx of Liver enzyme elevation
Hx of Seizure (none for the past year)
Blindness due to Progressive retinal atrophy OU
Pica (eats insects)
Probable disk problem on neck and back
Hip Dysplasia

He has been coming for acupuncture every 4-6 weeks for the past 6 months.

The clients think that he got older laterly and his mid-back is sagging more. He had sensitive back shu (BL-18/19) last month.
He came in again with back sagging. No sensitivity on back shu, no heat radiation that I can detect.

Treated with acupuncture that immediately corrects his back to almost normal position.

His tongue is pink and his pulse was almost normal today (maybe sl. wide). His ears were warm, and the clients noticed that he started to prefer cooler place.

Recommended to add organ meat such as beef liver and heart to his diet (currently Solid Gold Holistic blend kibble) in hope of providing protein source he is looking for in insects.

Does ZBDH help him? I cannot think of formula that supports more of his back...

Thanks,

Rieko

by naturevet

August 3, 2009

What points create this dramatic improvement? What kind of stimulation do you provide? How high are the liver enzymes?

S

by rmtran

August 4, 2009

Hi Steve,

The points used were:
GV-14/20, GB-20, BL-18/23/54, SI-9, ST-36, LI-10, Bai Hui, LIV-13.

His recent lab work shows: ALT-75 (12-118), ALP-350 (5-131), high triglycerides-350, low urine SpGr-1.010

Additional info:
PRA x 2 years
Seizure since 1.5 years old
PU/PD
Stormphobia; but it is better due to decreased hearing

Thank you in advance.

Rieko

by naturevet

August 4, 2009

Hi Rieko,

We see the high TG's in Damp or Blood stasis cases, so I'd come at it from that angle. Your acupuncture provides lots of Spleen and Liver support, so the formula should do that as well. Often PRA is a Damp Heat problem, if the animal is not cold. So ZBDHW could be a little rich for him, since it has no Spleen support. I'm wondering about seeing what happens with just general support, like Xiao Yao San or Jia Wei Xiao Yao San. I think that's what I'd do.

The anti-Damp Heat arthritis approaches include SMS (to which you could add Dang Gui) and Xian Fang Huo Ming Yin. But their liver support is not strong.

S

by rmtran

March 22, 2010

Hi Steve,

This patient had a recheck abdominal ultrasound due to increased bile acid level (it was within normal over 1.5 years) recently.

Not much changes since the last visit. Sludge filled gall bladder and some age chenges in pancreas, kidneys, and the splenic nodules appeared stable (hypoechoic nodules). His spleen size was large at that time.

I placed this patient on Xiao Yao San in September '09, but according to the change in pusle and tonge (T-deep and P-pink), I changed the formula to Open the Liver Canal (XCHJYJT) just prior to the abnormal bile acid test and recheck ultrasound. His pulse quality is improved (not deep now) and his back is not sagging as much as it used to. No sensitivities on back shu points. He continues to eat dirt and have loose stool once or twice a week.

The patient is clinically stable, but there was some abnormal findings while internal medicine did work up on him. His urine was very cellurar without the evidence of urinary tract infection. They are concerned about this.

My quesiton for you:

1. Is his cellular urine considered to be "leaking Jing" in TCM term? I read that leukorrhea in human is one of them.

2. For his gall bladder and orthopedic issue, do you recommend changing XCHJYJT ?

3. Are his pica (eating insects and dirt) and consequent loose stool be considered to be SP Qi Deficiency? If so, I do need to add some Spleen support to the formula...

Thank you,

Rieko

by naturevet

March 23, 2010

Hi Rieko,

It sounds like things are going well right now with the recent change, so I wouldn't change too much more yet. One change I would make is to switch to Open the Liver Canals (Xiao Chai Hu Jia Yu Jin Tang). The addition will help increase production of bile that should help clear the sludge and take down the ALP (was it still elevated?).

As for Chronic Lin, I look at that more as the polyuric aging dog with an asymptomatic cystitis where there are lots of bacteria. I wouldn't overinterpret the cellularity of the urine just yet. If there is a renal inflammatory origin to the urine cells, the XCHT should eliminate that. If it's bladder, let's wait for more overt signs of cystitis to develop before we give the dog another formula. But if you did need one, a Rehmannia formula would fit in well with the XCHT if needed.

Lastly, as for pica, I more associate that with Blood or Kidney deficiency, but if you're not seeing other signs of that here, I'd just wait a bit longer for more overt and undeniable symptomatic confirmation that a Kidney formula is needed. Meanwhile, the XCHT with Yu Jin will have the patient's full attention and the best chance of helping mobility and liver sludge.

Continued good luck,

Steve

by rmtran

March 23, 2010

Thanks, Steve.

I will continue Open the Liver Canal for now and wait for the next bile acid level and UA check.

Rieko

by rmtran

August 28, 2010

Hi Steve,

This patient has been stable clinically up until recent.

He is itchy all over the body, and he scratches some lumps on front legs to the point they bleed.

He had loose stool when Actigal was increased to 2 ml BID after the ultrasound in March; it was eventually decreased to 1 ml SID. Stool improved, but he still has occasional loose ones. The client blames it on his pica, eating bugs and digging into soil.

The recent bile acid showed no sign of improvement. Still high (post prandial-32, previoiusly 29, 6 months ago).

His tongue was pink, and pulse was harder to feel, and there were some dandruff on his back.

I changed his formula to Si Wu Xiao Feng Yin (Dry Derma Relief) for now to see if his skin condition imrproves.

Whatelse would you suggest for this patient?

Thank you for your time!!

Rieko

by naturevet

August 28, 2010

Hi Rieko,

The response to Actigal tells us the dog has Spleen deficiency. Elevated post-prandial bile acids tells us Blood deficiency. Putting the two together, there really is only one choice in a liver disease patient, and that is Xiao Yao San.

We talked about it before. I'd give it a try. It can be used with the SWXFY. But if the itch is due to dryness alone (no secondary infections) XYS may suffice to resolve it.

All the best,

Steve

by rmtran

August 28, 2010

Hi Steve,

I have tried XYS for 6 months from September '09 to March '10. It did not help his bile acid level (initially normal then got worse while he was on it). I suppose that adding it to SWXFY or use it in higher dosage will help, won't it?

Thanks for your help as always.

Rieko

by naturevet

August 29, 2010

Hi Rieko,

Have you ever tried Dang Gui Shao Yao San on this dog. It's the other major Spleen Liver harmonizing formula that can correct post-prandial bile acid elevations.

I guess I'd look at that next. Again, no problem continuing the SWXFY with it.

S

by rmtran

August 29, 2010

Hi Steve,

I have not tried DGSYS yet. It seems to be a good idea.

Thank you for all the help; I should study more so that I do not have to bother you so often!

Rieko

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