I have a question for a patient of mine. Zola is a 16 year old FS Poodle who was diagnosed with pancreatitis 2 weeks ago. Her normally ravenous appetite started to decrease since the beginning of December until she stopped eating and drinking two weeks ago. She had a mildly elevated ALT, BUN and cholesterol (Blood def, stasis) and her PLI was over 1000. They placed her on Cerenia, Methadone and SQ fluids SID. Her previous meds that she is still on are: Pepsid, Gabapentin and Melatonin for restlessness at night. Diet is now Royal Canin GI low fat cans.
Her appetite is back to being ravenous (heat) but she is not drinking at all for two weeks. Her thirst was historically normal except in late June when owner noticed an increase in her drinking (heat). This lasted through beginning of December. Owner reports she perks up after fluids but appears dehydrated and dry before receiving them (yin def). Her nighttime restlessness (heat) has worsened and she is up pacing from 12am to 8am. She sought out an electric blanket (SP Qi deficiency)to lay on twice this week although historically she runs hot.
Owner notices Zola burping a lot and hears gas in throat (Blood, Yin def, stasis). Abdominal radiographs show distended bowel loops (stasis). Soft stool recently but no diarrhea now or historically. No vomiting.
No coughing or sneezing.
Owner notices twitching and tremors for awhile (yang pushed to exterior).
Zola has a pronounced arch/hump at her T-L spine (Stasis) and has ataxia to her hind legs (KID Qi def, Shao Yang). She is lethargic on her walks and doesn't go far (KID Qi def).
Past history: for years, owner feeds 6 times a day and started on Pepsid to prevent vomiting. I switched Zola to a grain-free diet years ago which helped with her vomiting (SP Qi def). She also used to defecate every two hours which decreased with a grain-free diet and the gabapentin.
She has had UTIs (Damp Heat) in the past. Currently skin with mild pruritis (Blood Def), has decreased hearing (KID def) and normal vision.
Her tongue is dry (heat, yin def) with a pale center (blood, qi def) and purple edges. Pulse was thin, slightly wiry, not superficial.(stasis)
I thought of a Shao Yang pathology (hot up top/cold on bottom, stasis issues, initial complaint started in summer) although the pulse didn't fit (I was expecting a more superficial bounding pulse). I tonified BL19 and the pulse improved immediately so I went under the presumption of a Shao Yang pathology.
Acupuncture; BL19, GV3, BL23 (tonify)
GV 20, BL15, BL 20 (sedate)
I was planning on starting her on Chai Hu Jia Long Gu Mu Li Tang
My questions are: 1. Am I on the right track? 2. Would you add in a Qi tonic for her since she is so depleted like Six Gentlemen or Rehmannia 8?
3. I don't understand why she is not drinking. She seems Yin deficient (dry, responds to fluids, false heat at night, ravenous appetite) so I would expect an increased thirst.
Thanks for your help and sorry for the long history
Talk soon
Steve