Question Details
Pemphigus Folliaceous In A Dog
by
kphillips
-
October 3, 2014 View Case Report
Replies
by
naturevet
October 6, 2014
Hi there,
Hopefully this advice will be helpful, as it’s nice to have some initial positive experiences when trying out a new modality like herbal medicine. That’s where we get the confidence and courage to keep going.
Because Long Dan Xie Gan Tang both addresses Damp Heat; and protects Blood and Yin, there are two possible interpretations to the increased ALP:
1. It was too drying, cooling and draining, compromising liver circulation
2. It was too moistening, aggravating liver congestion
Generally, ALP rises when there is increased liver congestion and ALT rises when there is decreased liver circulation, so I assume ‘1’, also known as Liver Blood deficiency is the answer. The thin weak pulse and the lavender tongue are consistent with Liver Blood deficiency as well.
Rather than look at this Blood deficiency as a side effect of LDXGT, look at it as an exposure of the root condition of the pemphigus that no treatments are thus far fully addressing. Introducing a formula to treat this presumed liver hypoperfusion should provide a complete answer to the dog’s condition that will, in turn, allow you to start discontinuing first the drugs and then ultimately the herbs.
To pull that off, I’d suggest Xiao Yao San. It gently increases liver circulation, but helps avoiding aggravating lingering acute Damp Heat conditions by being Dampness Draining at the same time. It also fortifies the Spleen, which produces Liver Blood deficiency and Dampness when compromised. You can get augmented versions, known as Jia Wei Xiao Yao San, that have a bit more of a cooling and Blood moving action. I don’t know you need that, but the rapid pulse suggests some additional Heat clearing might be a good idea. If XYS works, for the dog to come off all meds and be cured of the pemphigus, it needs an unprocessed grain-free meat-based diet (e.g. raw or home-cooked).
The other possibility is ‘2’, that the LDXGT was still too Dampening with its small content of Blood and Yin tonics. This is not as good a fit for the data you presented but is still a possibility. In that case, you would want to try Hoxsey-Like Combination or Four Marvels Combination (Si Miao San), which drain and dry Damp and clear Heat without being tonics. Only resort to this approach if liver enzymes go up further following use of XYS. Check the enzymes a few week after starting XYS to ensure you’re on the right track.
Best of luck! Don’t forget to update this case and let us know how it goes!
Steve
Hopefully this advice will be helpful, as it’s nice to have some initial positive experiences when trying out a new modality like herbal medicine. That’s where we get the confidence and courage to keep going.
Because Long Dan Xie Gan Tang both addresses Damp Heat; and protects Blood and Yin, there are two possible interpretations to the increased ALP:
1. It was too drying, cooling and draining, compromising liver circulation
2. It was too moistening, aggravating liver congestion
Generally, ALP rises when there is increased liver congestion and ALT rises when there is decreased liver circulation, so I assume ‘1’, also known as Liver Blood deficiency is the answer. The thin weak pulse and the lavender tongue are consistent with Liver Blood deficiency as well.
Rather than look at this Blood deficiency as a side effect of LDXGT, look at it as an exposure of the root condition of the pemphigus that no treatments are thus far fully addressing. Introducing a formula to treat this presumed liver hypoperfusion should provide a complete answer to the dog’s condition that will, in turn, allow you to start discontinuing first the drugs and then ultimately the herbs.
To pull that off, I’d suggest Xiao Yao San. It gently increases liver circulation, but helps avoiding aggravating lingering acute Damp Heat conditions by being Dampness Draining at the same time. It also fortifies the Spleen, which produces Liver Blood deficiency and Dampness when compromised. You can get augmented versions, known as Jia Wei Xiao Yao San, that have a bit more of a cooling and Blood moving action. I don’t know you need that, but the rapid pulse suggests some additional Heat clearing might be a good idea. If XYS works, for the dog to come off all meds and be cured of the pemphigus, it needs an unprocessed grain-free meat-based diet (e.g. raw or home-cooked).
The other possibility is ‘2’, that the LDXGT was still too Dampening with its small content of Blood and Yin tonics. This is not as good a fit for the data you presented but is still a possibility. In that case, you would want to try Hoxsey-Like Combination or Four Marvels Combination (Si Miao San), which drain and dry Damp and clear Heat without being tonics. Only resort to this approach if liver enzymes go up further following use of XYS. Check the enzymes a few week after starting XYS to ensure you’re on the right track.
Best of luck! Don’t forget to update this case and let us know how it goes!
Steve
by
kphillips
November 10, 2014
Steve,
Started Allie on Xiao Yao San and after 4 weeks re blood tested- now the ALKP is 1100, and ALT is 430 so major improvement. At the smae time however the steroid dose was dropped a step. The skin is stable apart from the odd yellow pustule appearing and disappearing within 48 hrs, and hair is starting to grow back on the nose ( but not the body). She seems pretty stable and put on a bit of weight ( she had dropped some) except for Diarhoea very runny earlier this week. She maintained well and happy and continued eating- I advised stopping the herbs just in case. The diarrhoea has stopped but not sure if I should continue with the herbs or not.
Thanks,
Kelly
Started Allie on Xiao Yao San and after 4 weeks re blood tested- now the ALKP is 1100, and ALT is 430 so major improvement. At the smae time however the steroid dose was dropped a step. The skin is stable apart from the odd yellow pustule appearing and disappearing within 48 hrs, and hair is starting to grow back on the nose ( but not the body). She seems pretty stable and put on a bit of weight ( she had dropped some) except for Diarhoea very runny earlier this week. She maintained well and happy and continued eating- I advised stopping the herbs just in case. The diarrhoea has stopped but not sure if I should continue with the herbs or not.
Thanks,
Kelly
by
naturevet
November 12, 2014
Hi Kelly,
I'm glad things are proceeding. Please be sure to officially update your case in the database. Here is the link: http://www.curedcases.com/course/edit/100
I would try Xiao Yao San again at a low dose. If the loose stools return, determine if they are large bowel or small bowel. If small bowel, consider Wei Ling Tang, or Chu Shi Wei Ling Tang. If the pulse is slippery and toneless, consider Si Miao San. Start either at a nice low dose
Both should have anti-inflammatory effects on the skin, yet Spleen-supporting benefits that resist diarrhea
Steve
I'm glad things are proceeding. Please be sure to officially update your case in the database. Here is the link: http://www.curedcases.com/course/edit/100
I would try Xiao Yao San again at a low dose. If the loose stools return, determine if they are large bowel or small bowel. If small bowel, consider Wei Ling Tang, or Chu Shi Wei Ling Tang. If the pulse is slippery and toneless, consider Si Miao San. Start either at a nice low dose
Both should have anti-inflammatory effects on the skin, yet Spleen-supporting benefits that resist diarrhea
Steve
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