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Resolving Meningitis In A Dog

by Tracey - May 24, 2018 View Case Report

Hi Steve, I've got a 9 month old dog who had acute onset of presumed meningitis/meningoencephalitis in March. He was put on prednisone after declining diagnostics and had a slow but positive response.

I saw him about 6 weeks into treatment, he was still on high doses steroid, had a pale dry tongue, ropey superficial pulse that improved with sedation of BL 40, GV pts and BL 17 and tonification of GB pts. I put him on Qing Ying Tang and Chai Ge Jie Jeng Tang assuming he had a Shao Yang problem with Tai Yang Excess.
I've been bringing his steroid dose down gradually (but faster than recommended) and at last check he is doing great. He is totally assymptomatic after 5 weeks of herbs. He is still on a low dose pred SID but pulse is now a bit thin, wiry and superficial, and tongue is slightly pale lavender. I still found tonifying GB pts and sedation BL 40 and GV points helped his pulse. I'm feeling like the need for QYT is diminishing but am frustrated that pulse response is still telling me I have shao yang/tai yang issues. Was thinking I might half the QYT dose and perhaps try XCHT? or Gui Zhi CHai Hu Tang? instead of CGJJT . Any suggestions or thoughts?
thanks,
Tracey

by naturevet

May 25, 2018

Hi Tracey,

Consider 35g Si Wu Tang in tandem with 65g XCHT. The reason you may not be getting control of the Shao Yang disharmony is potentially because of an underlying Blood or Yin deficiency, which QYT may not be quite strong enough to address. The Yin deficiency causes a chronic tendency for Yang to rebel upwards, which a weak Shao Yang may struggle to counteract.

I have one case (the most severe one I've ever seen) that appeared to start as a Tai Yang issue which progressed to the Shao Yang. It was sedation of the GB points that improved her, so my treatment may not be applicable to your situation, but I used Xiao Chai Hu Tang plus Gui Zhi and Bai Shao (i.e. what you referred to for your case) to get her off pred and back on her feet. I'm now using You Gui Wan to restore continence and strength, as she appears to have an underlying Kidney Qi deficiency. Next time you see her, double check that sedating the GB points isn't now giving the best response to the pulse, and if it is, consider using this herbal approach.

If the points truly do need tonification, you can still use Chai Hu Si Wu Tang. The combination of XCHT with Yin tonics gives the latter formula the 'downward and inward' drag that you're looking for to control the rising of Yang. You can use it in tandem with the CGJJT for now, and if you find you're finally getting the active points resolved, you can slowly wean off the CGJJT, and then ultimately off the CHSWT if you wish

Steve

by Tracey

May 25, 2018

Thanks Steve
I'll give that a try and let you know how it goes.
Tracey

by Tracey

June 20, 2018

Hi there,

Just rechecked this dog and, she continues to do great. She has been on CHSWT and CGJJT for a little less than 3 weeks. Her tongue is better although still a bit pale and pulse is a less 'ropey', good strengh but still a bit superficial and wiry. She still has active point at thoraco-lumbar junction, but not her GB points. This time, I found tonifying BL 40, BL 17 and GB 30 all helped.
So still feeling like I need more blood tonification (maybe just more time on CHSWT as has only been 2 1/2 weeks) and don't want to take Bupleurum away. I was thinking of weaning her off the CGJJT and keep going on CHSWT. i have also taken her off pred as of this week.

Interestingly, she has developed a voracious appetite for dandelions to the point where she eats enough, if allowed, that she has to get up in the night to pee (dandelion is a diuretic). What do you think? Is this her trying to eliminate damp (but absolutely no damp signs in history of this dog other than her meningitis of course), or is it the liver trying to tonify blood and/or decongest...or is it just that she likes dandelions and wants to keep her yard weed free.

Tracey

by naturevet

June 21, 2018

I need that dog in my yard! I'm inclined to view this as a bit of 'nutritional wisdom', where the dog has a sense that her liver needs bucking up, which of course is what you have been doing for her, too. It's not much of a Blood tonic. More of a Heat Clearing Yang internalizing herb, so it jibes with what you've been trying to do.

I like your idea of slowly weaning her off the CGJJT, once she's been off the pred for a while with no untoward effects

Bu Yang Huan Wu Tang can make sense in a dog that benefits from tonification of the Tai Yang (which includes Wei Qi) and I have seen the formula help animals with 'stroke' (per their CT scans) achieve full recovery, in tandem with XCHT. So you could always go that route if you felt you were hitting a wall with the CHSWT. Just a thought

Steve

Bu Yang Huan Wu Tang

by Tracey

June 21, 2018

Thanks Steve.

I'll keep you posted but won't see this dog again until late August. Fingers crossed she stays stable.

Tracey

by Tracey

November 8, 2018

This dog did really well. Weaned her off her CGJJT and maintained her on just Chai Hu Si Wu Tang until the owners ran out while travelling this summer. She has done so well they haven't brought her back.

Thanks for your help on this one.
Tracey

by naturevet

November 8, 2018

Excellent! Thanks for the update!

Steve

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