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Weight Loss/chronic Hepatopathy

by Michelle1 - September 1, 2009

Hi Steve,
Am seeing a Cocker S/F 16 years old with a 2 year history of PU/PD and elevated SAP (from 1179 to 708 and then ALT was started to rise slightly to 105 from 36). Tested for Cushing's- inconclusive. Stated her on Standard Process Hepatic and Whole Body Support in addition to adding trace mineral and acupuncture and her liver enzymes are back to normal. Also have her on the homecooked diet. She is feeling much better, no longer PU/PD, but continues to lose weight! Her body condition score now is about 3/9, no palapble masses. Would you add Bu Gan Tang or something else for this situation? Her muscles are very tight and she is a little irritable, too (what Cocker isn't, though) :)

Thanks!
Michelle

by naturevet

September 1, 2009

Does the owner have an explanation for the weight loss at all? Is the dog's appetite at all low? Any loose stool?

Assuming appetite and stools are normal, chronic weight loss often signals Yin deficiency. You'd want to make sure, however, that the amount of home-cooked food being fed is sufficient for the dog to maintain its weight. Assuming it's a reasonable quantity, and you do think the dog might be Yin deficient, one nutritional way of dealing with that is to allow a modest return of carbs to the diet. In particular, I prefer rolled oats or barley. For some dogs, a small amount of carbs is essential to maintain weight.

If the diet still has a lot of starch (e.g. rice) in it, then I would wonder if the pre-Cushing's is not yet under adequate control. In this case, removal of the grain component of the diet would be the next step, at least in my book.

How are the labs looking? If you haven't seen a drop in liver enzymes, then some added herbs are in order. For Damp Heat cases, we use Si Miao San; for Blood stasis, we use Ge Xia Zhu Yu Tang; for Triple Burner obstruction, we use Xiao Chai Hu Tang.

Hope that is somewhat useful and not too confusing.

Steve

by Michelle1

October 8, 2009

Hi Steve,
Her labs are all fine, including a TLI test, ultrasound today shows thickened bowel loops only- lymphnodes are all fine. She is ravenous despite adding rice, tapioca and sweet potato. Are adding rolled oats now as you suggested- she is also "hot" loves the cool weather- Si Miao San?
Michelle

by naturevet

October 8, 2009

If there are no loose stools, and appetite is strong, the dog may be Yin deficient. I'd look at Zhi Bai Di Huang Wan, Liu Wei Di Huang Wan, or even Yi Guan Jian as good options. If the dog has loose stools, then San Ren Tang or Si Miao San are better options.

Good luck!

Steve

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