Question Details
ITP In A Dog
by marneemadsen - January 18, 2015    View Case Report
Hi Steve,
10 yr old std poodle with severe ITP last December/January. She was put on high doses of prednisone and azothioprine. She had significant side effects from the prednisone - to the point of poor quality of life.

I saw her 2/28/14 and she was weak, PU/PD, lethargic, distended abdomen, anemic and wide, slippery with a little bit of tone that responded to typical damp heat points. We started Si Miao San and immediately started tapering off prednisone. She did great and platelets back up to 300,000 by April.

Her T4 was consistently low and based on a panel sent to Hemopet, thyroid supplementation was started late fall. Her platelet count late October was 68,000 with clumps. HCT 46. She stayed on DGSYS over summer and pulse moved deeper and became thinner and slightly toned. We added SMS since she had responded well to it in the past.

Typical points are BL 17 S, BL 20 T, BL 21 S, BL 23 T. She often can have active GB points, too, but not last visit 1/29/14. She developed diarrhea shortly after taking CHJLGMLT but not sure if related so I am a little gun shy on the XCHT or mods.

Last blood panel 12/29/14 shows platelet count still at 69 with giant platelets and some clumps but now they estimate she is low. HCT still 46%.
It looks like I should probably go with QYT but curious about BL 23 T, which is consistent - do you have other thoughts for this consistent late fall/winter pattern? I checked SP 4 with no improvement.

Thanks!
Marnee
Replies
by naturevet
January 20, 2015
Hi Marnee,

Because QYT has Rehmannia in it, it does support the kidneys and can be used when BL 23 is active.

A worsening on CHJLGMLT suggests a dryness issue, however, so a purely moistening formula is a consideration. For dogs with persistently low platelets, but who are not in crisis, Yi Guan Jian is one of my favorites. I'm not sure why it works so well as a bone marrow stimulant compared to other tonics, but it does. So I'd think about introducing it here. The assumption would be that long term Damp Heat has damaged the Yin, which now needs direct tonification.

QYT may have a similar benefit in this dog to YGJ, though, since the dog has mid-winter aggravations. Mid-winter is one of the times Yang and Yin separate, which that formula helps address. But a lack of response to GB points suggests YGJ may be a better bet than QYT for this dog

Steve
by marneemadsen
January 20, 2015
Thanks, Steve. What about the consistent BL 17 sedation? Does YGJ have enough blood cooling effects to consider when gettting this point?
Thanks!
by naturevet
January 20, 2015
It may mean a need to move Blood. YGJ may be sufficient, but if not, QYT might

Steve
Reply to this question.
You must be logged in to reply