View Question

Vestibular Disease

by amymatthews - September 17, 2009

Hello! And Thanks for this forum. I have a very vital 15 year old MN shiba inu who presented for vestibular disease. Acupuncture and chiropractic help him temporarily, and he had gradually improved in coordination but is still compromised and has a significant head tilt. HIs tongue is repeatedly red-pink or bright pink with a thin clear coat; his pulse is weak. He has a dominant streak and will bite, though has never tried while under the watchful eye of his owner who has excellent control. He had an ocular disease of unknown nature which resulted in a fully scarred cornea of one eye. I tried him on Ban Xia Bai Zhu Tian Ma, but it made him so restless he couldn't sleep at night. After talking his case over with Mona, we started him on Tian Ma Gou Teng Yin, but this caused rapid exacerbation of his clinical signs (as did a few homeopathic remedies the owner tried on her own). We discussed trying San Ren Tang, but weren't sure it really fit his presentation (though he does have food allergies) and wondered if Xue Fu Zhu Yu Tang might be appropriate.

At his last appointment 3 weeks ago he had started showing signs of severe atopy (seasonal, has happened before); he has chewed most of the fur off his feet (forefeet slightly more severely affected) and has scratched abrasions into his face - he is very pruritic! When I saw him at that time, the skin looked fairly calm despite the pruritis and chewing - he may look different by now.

I would love your thoughts on this case.

Amy Matthews

by naturevet

September 18, 2009

Hi Amy,

Tough case. The vital clue might lie in the wholly unexpected response to the BXBZTMT and TMGTY. Both descend, the former is drying. So the dog might have a cryptic need for increased cerebral blood flow, not decreased.

Using such a formula would increase cutaneous blood flow as well. That's okay, but it would need to be anti-itch. Probably the formula that best matches this criteria is Qing Ying Tang (Clear the Nutritive Decoction).

I guess the only other thing to be sure of is that GB points don't correct the pulse. If you know where GB 34 is on the hind leg, you could try massaging it or needling it. If it markedly improved the pulse, then we need to be looking at formulas related to Minor Bupleurum. In this case, the TMGTY would have been aggravating by 'pressurizing' the system through its descending action, when actually what was needed was a mixed raising and descending action that opens the Triple Burner, allows Qi to be formed, and Yang to descend. So get the dog back in and check that out. If GB 34 or any other GB point help, then a formula to address both the neurological complaints and the itch might be Chai Hu Jia Long Gu Mu Li Tang.

Hopefully you have some success here.

Good luck,

Steve

by amymatthews

September 18, 2009

Thanks! I saw him today, he has more signs of internal heat (tongue brick red, still moist; pulse more forceful), but his skin is still incredibly calm despite extensive hairloss. Turns out the original corneal scarring was due to previous allergy seasons and scratching around his face; now his good cornea is getting edematous from the trauma. GB34 had minimal effect on his system.

Will look into Qing ying Tang and let you know how it goes.

Amy

You must be logged in to reply

CuredCases.com