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Painful Arthritis And Low Grade Anemia

by ericahawker - August 15, 2009

I have a 11 yr old FS lab that is quite painful from what I presume is arthritis (no films ever taken) on her rear limbs and right front limb. She eats a home-cooked diet, but I recommended cutting out the potatoes and oatmeal recently.

She has had significant thrombocytosis (1.2 million)for about 18 mths noted on routine bloodwork. She is on flax oil, fish oil, glucosamine and tramadol. She had been on Deramaxx but had started vomiting intermittently in Nov 08, then 1-2 times daily in July. We did an extensive workup and only found an increased WBCs (28,000) and mild anemia (31%). Fecal occult blood was negative. 14 day course of amoxi resolved wbcs, but still mildly anemic. Deramaxx was stopped 3 wks ago also and no vomiting since. However, the lameness is getting much worse on the tramadol alone. I had previously tried homeopathy and SMS with no response. Owner called today and said she is really painful today even on the tramadol.

Kizzy is overweight, (was a breeding dog for 4-5 yrs), great appetite, normal thirst, lameness worse with movement, and clingy with owner. Dislikes the heat, but does sleep on dog bed. Pulse is deep. Tongue is dark pink/red.

I think she is hot and has a blood stasis that is contributing to the blood deficiency and heat/inflammation in her joints.

My proposed formula is Xue Yu Tang to move the blood and clear the heat. Any other suggestions?

Thanks-
Erica

by naturevet

August 15, 2009

Hi Erica,

Any chance of an autoimmune arthritis here? That might explain the extreme pain and elevated WBC count. Any fever? Just a thought.

For tricky cases, it's always helpful to ask Hot or Cold, Excess or Deficient?

I'd say Excess here, given the severity of signs. A high platelet count makes me think, in particular, of a pathogen in the Shao Yang. This can be associated with immune mediated problems, as well as conditions like Lyme's. Any chance of that?

If anything, she seems hot. Certainly she has stasis. So, we need a cooling, moving, anti-excess formula. I can certainly see how you got SMS out of that, but the pulse is the one thing that doesn't fit SMS, at least right now. SMS is anti-inflammatory, but by itself pulls Blood in. We need a formula that disperses.

I guess with all that, my first thought is Xiao Chai Hu Tang, or even Qing Ying Tang, given the anemia aspect of things. You can use both together. And I'm definitely thinking either Lyme's or immune-mediated disease. If the two formulas work, then the likelihood of that goes up, since that kind of pathology is their forte.

Qing Ying Tang is normally used for skin problems, but it fits the bill of tonifying Blood, clearing Heat, moving Blood and dispersing outwards.

That's what I'd try. Hope that helps. Let us know how it goes!

Steve

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