Question Details
Chronic Renal Failure--end Stage
by ericahawker - August 12, 2009
Hi--

I have a 18 mth old MN Bull Terrier that I have been treating successfully with Ba Wei Di Huang Wan for 6 mths along with famotidine, enalapril, fish oil, tumil k, aluminun hydroxide, metoclopramide, SQ fluids EOD, and k/d diet. I tried to switch him over to a moderate protein home-cooked diet a few mths ago but he vomited on it.

He is a very energetic dog with a pale pink, dry tongue and superficial, strong, slippery pulse. He is having more bad days and it AMAZES me he is not worse considering his bloodwork results. Shows the power of TCM! No UA available that day.

BUN 119, creat 13.2, phos 9.7, calcium 13.2, and hematocrit 19%. Owner not interested in erythropoietin injections for anemia. I have asked them to try homecooking again and gave them Susan Wynn's mod protein renal diet recipe from AHVMA and started probiotics (per Susan's suggestion for toxins) and increased fluids to daily.

He seeks heat, is PU/PD, vomits, has chills, becoming more anorexic and lethargic.

I am considering changing him to Liu Wei Di Huang Wan but am not sure if it will be warming enough for him. I know with the pulse that I need to bring more blood to the core of his body and was surprised with his pulse considering his CRF and that BWDHW improves renal blood flow.

Thanks for the help and any suggestions!
Erica
Replies
by naturevet
August 12, 2009
With high levels like that, I think of using formulas that treat 'excess' conditions like Damp accumulation or Triple Burner obstruction. If BWDHW isn't halting the pathology, I'd try rolling in something like Xiao Chai Hu Tang (Minor Bupleurum) with added Qin Jiao (large-leafed gentian root), ideally. There'd be no harm in using San Ren Tang (Three Seeds Decoction) simultaneously.

If the dog is definitely better on the BWDHW than he was before you started, then continue it. If you've seen no symptom benefits, then just try the XCHT and SRT.

If the dog improves on the XCHT and/or SRT, daily fluids may complicate things, since they'll act contrary to the formulas, which are all about renal decongestion.

I'm not sure Liu Wei Di Huang Wan is different enough from BWDHW to expect it to work well where BWDHW isn't.

Hope that helps!

Steve
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