This dog is a 4 yr old MN Boxer, dx w/ IBD at age 2. Hs history includes mild seasonal summer allergies and recurrent nausea and diarrhea with symptoms almost always worse in the dead of winter. He also gets a generalized mild alopecia every fall/ winter. Nausea is typically large amounts of undigested food, even 6-8 hours after a meal, and skipping breakfast. And more common in the later afternoon. "Good" stools for him are soft but formed. He came to me in the spring of 2013 on D/d dry , Budesonide and Famotidine, and Metronidazole for diarrhea flare-ups (which helps). Pred had also helped in the past.
So I started him on CSWLT and SMS/DG . Too much SMS (more than 2 tabs) would cause diarrhea. Stools seemed to improve, and no vomiting, but that was expected for summer. Allergies were better than expected last summer. As we got into fall, and had played with his dosages, it seemed that CSWLT gave him the best effect. As we were coming in to winter, I dropped the SMS/DG.
Around that time, he had bloodwork repeated, which showed the mild liver enzyme ^ (ALp and ALT) that he'd had in previous labs. As his pulse was always running thinner and tense, I added in DGSYS (he's prone to mild eye and ear goobers). Two months later he developed his first UTI; treated w/ Ab by the university. Then a moderate flare-up of his IBD in January (bitterly cold here last yr). As CSWLT had not prevented that flare, i switched him to WLT (and still DGSYS). In February, he had another bout of vomiting and diarrhea (typically more the small bowel type).
In March you recc. Wu Mei Wan, which they started. His vomiting increased , so we stopped (but then later he did this on DGSYS alone, so who knows? May have given up too early on that guy.).
This June added LJZT to the DGSYS, and he had bad gas.
The rest of summer, he stayed on DGSYS and had some occasional grass-eating, grumbly stomach noises, skipped AM meals. He had a minor flare -up of symptoms last weekend.
Last weeks' exam :
-skin looks great; best they've seen. Coat is starting to thin, with the cooler weather now.
-pulse: middle, tense, thinner
-tongue; pink, dry
-he is sweet and silly, as all Boxers seem to be!
-no discharges or odors
-no abdominal pain
So I'm thinking that he needs a descending formula for digestion, tonification of his blood supply. Should we be looking at SMS/DG again?He was off these herbs when he had a biggish winter worsening of symptoms. What about Ping wei san? I always think DGSYS will build up these thinner pulses in the blood deficient but damp dogs, but don't; have much success w/ that. Perhaps I'm not using enuf? Or it just won't tonify blood that well? Can this be a Jue yin excess? He is still on the Budesonide, just a somewhat reduced dose from when we started.
Also, we've discussed diet SEVERAL times. Mom is on board, but worried about even cooked raw, dad is not interested. If we can get him stable for some length of time, I think they may be willing, but as they remember him in his "very expensive and almost fead" state form 2 yrs back, they are understandably nervous, I'v e explained about the pro-inflammaotory effects of the processed diet. I thunk we're just going to have to get some obvious improvement on herbs first.
I get a bit lost on these long term cases, lose sight of what they need.
Your guidance is appreciated.
Thanks,
:)Cathy L.