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Tai Yang/ Shao Yang Pathogen

by marneemadsen - August 7, 2009

Hi All,
13 yr old mini-poodle I have been seeing a couple of years.

HX: Initial consult (2007) for recurrent MCT's and had several small masses recurring post 2 surgeries.
Treated him some of the usuals - modified XFZYT, XYS for some GI things and he has done great overall - no signs of MCT's for past couple of years. He did get a perianal adenoma in Oct '08 that was excised, so clearly still some Liver issues that we continue to work on. Since the sx in Oct "08, he has had bouts of colitis with significant abdominal pain and poor appetite. He has had very consistent GB pts all along, cough, collapsing hocks/elbows - but has not done well with formulas with XCHT or modifications. He did start to have BL 22 consistently and we did SRT and that has helped a lot along with HXZQW and Cham/Wild Yam. We have found DGXYS best for underlying Blood Def. (And Nate thinks he makes things complex!).

So.....in a vain attempt at brevity, I feel like there was a Wind Invasion during that surgery, as he has not been the same since. The SRT and HXZQW have worked best, but still not recovered appetite nor eliminated bouts completely.

Last week he had another bout during our heat wave here. He does not show heat intolerance normally.
T - white coat, lavendar body, red/purple underside.
P - very wiry throughout

Bl 60 S had amazing effect on softening pulse. BL19 S next best.

So, with the heat signs and pts I though Chai Hu Gui Zhi Tang would be perfect and it was not. His appetite got even worse and lethargic. He immediately improved back on the HXZQW.

Can you help me understand why the shao yang formulas make things worse (if that is what is was again), and how to more complete resolution?
Should I try another Tai Yang formula like the Gui Zhi Tang with Bai Shao?

Thanks a lot! Sorry for long post....

Marnee

by naturevet

August 8, 2009

Hi Marnee,

It may have been the warmth of the Gui Zhi (Cinnamon twigs) that aggravated things somehow. In other words, he may need cooling dispersing herbs, not warming dispersing herbs. I think the general direction of an outward push that you've got going is correct, though.

This would be an instance when I would either look at modifying the formulas I've got going, or if I haven't done it already, make sure an appropriate diet is in place.

One other possibility, though, is a formula called Tong Xie Yao Fang, which basically expels Winds which are causing painful diarrhea. It only has four herbs, one of which is Fang Feng to expel Wind. It has a strong antispasmodic effect through Bai Shao (White Peony) and Chen Pi (Citrus Peel) and tonifies the Spleen through Bai Zhu (White Atractylodes). So it should be pretty safe for your patient, but is powerful at expelling Wind that causes GI spasm, pain, and loss of appetite. Think that through as an option as well. It doesn't particularly address the Shao Yang, but perhaps BL 22 is active more on a symptom basis in this case at this time. It has a lot to do with a sense of bloat, which anti-spasmodics obviously address.

If you decide instead to modify SRT, for example, then get clear on what else you need to have happen, then go through the exercise we discussed at Mona's last course. If you have Bensky's books or Pearls from the Golden Cabinet by Fruehauf (ITM), and the single herbs book by Him-Che Yeung then you've got good materials to proceed with.

Hopefully that's a little helpful,

Steve

by marneemadsen

August 28, 2009

Steve,
I just saw this dog again and he may be on his way out.
No appetite for weeks, but doesn't mind syringe-feeding. No vomiting or bloody stools lately.

T = still pale, lavendar
P = incredibly wiry, superficial, can obliterate deeply
Active pts: Still BL22S, BL21S and BL60S have best effect of softening and sinking pulse.
He is azotemic now (no urine submitted unfortunatley), borderline anemic, mild ALT elevation. Very weak. Does not show signs of GI distress or pain now, but is getting Cham/Wild Yam consistently as it was working. Still on HXZQW and SRT.
It's hard to understand the pulse in light of his overall weakness/Qi Deficiency. Appreciate thoughts and ideas for appetite.

Gracias,
Marnee

by marneemadsen

August 28, 2009

Forgot, he has also stayed on the DGSYS.
M

by naturevet

August 29, 2009

I've seen this picture in severe Yang deficient animals. Wei Ling Tang is a good choice to warm the interior and soften up the wiry pulse. If you tonified a GV point, and the pulse softened, you'd have your answer. Rolling it together with your original concern of a GI bleed and a Tai Yang invasion, you could use Huang Qi (Astragalus, which behaves like a hemostatic and Spleen tonic) with Gui Zhi Tang to expel the cold from the Tai Yin interior through the Tai Yang exterior. If it's not so much bleeding but very chronic colitis, again, I'm thinking it's a very deficient colitis associated with abdominal cold, and would switch to Wei Ling Tang.

Hope that helps,

Steve

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