I've been seeing a 5yr M(N) Dachshund who had surgery for a Grade IV disc herniation at L3-4 8 weeks ago. No deep pain pre or post surgery. With very rapid progression they were worried it was going to prove a Grade V .At his recheck with the surgeon he now has deep pain both hind feet, reflexes present but muted. He is able to wag his tail some of the time. There was difficulty expressing his bladder at the hospital post surgery but at this point owner can give a light squeeze and he will empty his bladder on his own. No evidence of incomplete emptying and no infection. Usually no feces in his kennel overnight and though occasional accidents when picked up he seems to have some control over defecation. Pecking at BL-67, GB-44 or St-45 you can feel his foot trying to pull back and sometimes will give a kick.He has however in the last couple of weeks started to show a lot of muscle atrophy over hind quarters especially gluteal muscles. Owners have followed the range of motion exercises they were given and will be starting with physio , now that he is off cage rest. Besides acupuncture ( twice weekly to start, now weekly)I have him on Xiao Chai Hu Tang and used Traumeel, Galium Heel and Discus Compositum. Arnica 30 C seems to help. When we gave Hypericum 30C owner thought he seemed a bit worse. Definitely were more issues again with him not keeping his penis in his prepuce. His tongue is slightly pale pink, moist. Pulse usually moderate to deep, slightly thin, slightly wiry. His incision healed very well and hair grew in well but haircoat is feeling a bit dry especially over back of neck and shoulders. He doesn't drink much even though gets dry food. They are adding water. Stool a bit dry.Owners not interested in going to home cooked or raw diet. He is the rare dachshund that has never been overweight and he has a good appetite.I wondered if there would be any advantage to using Benefit Hips and Knees instead of XCHT and if we should look at adding DHJST. I also wondered about XHLD though he seems a bit Blood deficient. Any suggestions regarding the best acupuncture approach to take from here ( miracles always appreciated) and anything that may help regarding the muscle atrophy ( Bu Gan Tang?) would be appreciated. I've approached him as Bi above, Wei below with general Qi deficiency esp Ki Qi def.Using various points including SI-3, BL-18,23,25,27,35,40, GV-14,4,2,tail tip, Gb 29,30 43, St 36, SP-6,KI-3.The surgeon didn't hold out a lot of hope for him, and he was terribly weak and Qi deficient when I first saw him, but he has bounced back with a great deal of determination and while owners will get him a cart we all still hope for more. Once again many thanks for all of your help.
Question Details
Herniated Disc In A Dog
by
LJH
-
June 25, 2018 View Case Report
I've been seeing a 5yr M(N) Dachshund who had surgery for a Grade IV disc herniation at L3-4 8 weeks ago. No deep pain pre or post surgery. With very rapid progression they were worried it was going to prove a Grade V .At his recheck with the surgeon he now has deep pain both hind feet, reflexes present but muted. He is able to wag his tail some of the time. There was difficulty expressing his bladder at the hospital post surgery but at this point owner can give a light squeeze and he will empty his bladder on his own. No evidence of incomplete emptying and no infection. Usually no feces in his kennel overnight and though occasional accidents when picked up he seems to have some control over defecation. Pecking at BL-67, GB-44 or St-45 you can feel his foot trying to pull back and sometimes will give a kick.He has however in the last couple of weeks started to show a lot of muscle atrophy over hind quarters especially gluteal muscles. Owners have followed the range of motion exercises they were given and will be starting with physio , now that he is off cage rest. Besides acupuncture ( twice weekly to start, now weekly)I have him on Xiao Chai Hu Tang and used Traumeel, Galium Heel and Discus Compositum. Arnica 30 C seems to help. When we gave Hypericum 30C owner thought he seemed a bit worse. Definitely were more issues again with him not keeping his penis in his prepuce. His tongue is slightly pale pink, moist. Pulse usually moderate to deep, slightly thin, slightly wiry. His incision healed very well and hair grew in well but haircoat is feeling a bit dry especially over back of neck and shoulders. He doesn't drink much even though gets dry food. They are adding water. Stool a bit dry.Owners not interested in going to home cooked or raw diet. He is the rare dachshund that has never been overweight and he has a good appetite.I wondered if there would be any advantage to using Benefit Hips and Knees instead of XCHT and if we should look at adding DHJST. I also wondered about XHLD though he seems a bit Blood deficient. Any suggestions regarding the best acupuncture approach to take from here ( miracles always appreciated) and anything that may help regarding the muscle atrophy ( Bu Gan Tang?) would be appreciated. I've approached him as Bi above, Wei below with general Qi deficiency esp Ki Qi def.Using various points including SI-3, BL-18,23,25,27,35,40, GV-14,4,2,tail tip, Gb 29,30 43, St 36, SP-6,KI-3.The surgeon didn't hold out a lot of hope for him, and he was terribly weak and Qi deficient when I first saw him, but he has bounced back with a great deal of determination and while owners will get him a cart we all still hope for more. Once again many thanks for all of your help.
Replies
by
naturevet
July 6, 2018
Hi Llewanda,
Generally disc disease is a pathogen affecting some combination of the Shao Yang or Tai Yang. To determine which, I assess the response of the pulse to some key points. For example, Tai Yang involvement would be signaled by the pulse responding to sedation of BL 40. Shao Yang involvement would be signaled by the pulse responding to sedation of GB 25 or BL 19. Sometimes both points help, in which case both layers are affected. This is commonly the case in animals worse after surgery, and correlates to deep spinal cord trauma, likely due to the dog not being able to actively resolve inflammation.
Deep does not mean irreversible, however. If both layers are affected, which is common in post-surgical cases, I use Xiao Chai Hu Tang (100g) mixed with 12g Gui Zhi (Cinnamon twig) and 15g Bai Shao (White peony). After several weeks of treatment, the pulse usually becomes buoyant and toned, signaling just a Tai Yang pathogen, at which point a Tai Yang formula like Du Huo Ji Sheng Tang will usually carry the day, especially with the haircoat issues.
A deeper Shao Yang issue is also likely given the spring onset; the gluteal wasting, which is caused by blockage of the GB channel; a deeper toned pulse; and the apparent Qi deficiency (which results from chronic Shao Yang obstruction).
As to points that I would expect likely to help, I would suggest sedating: GB 30, GB 25, BL 19, GB 34 and BL 40. I haven't found Benefit Hips and Knees to help these dogs very much.
Bottom line: I'd test those points and the response of his pulse, one by one. If it seems he's responding like I said, then I'd try the Chai Hu Gui Zhi Tang recipe above. Generally, after a few weeks, the pulse will signal a Tai Yang issue, and the dog will at that point likely benefit from DHJST. But if there are active GB points that help the pulse, it won't help the dog tNo introduce the formula early. If, instead, you find points that address Dampness (e.g. SP 9, BL 22) to be helpful instead, then I'd try San Ren Tang.
Hope that helps you out. Let us know how it goes
Steve
Generally disc disease is a pathogen affecting some combination of the Shao Yang or Tai Yang. To determine which, I assess the response of the pulse to some key points. For example, Tai Yang involvement would be signaled by the pulse responding to sedation of BL 40. Shao Yang involvement would be signaled by the pulse responding to sedation of GB 25 or BL 19. Sometimes both points help, in which case both layers are affected. This is commonly the case in animals worse after surgery, and correlates to deep spinal cord trauma, likely due to the dog not being able to actively resolve inflammation.
Deep does not mean irreversible, however. If both layers are affected, which is common in post-surgical cases, I use Xiao Chai Hu Tang (100g) mixed with 12g Gui Zhi (Cinnamon twig) and 15g Bai Shao (White peony). After several weeks of treatment, the pulse usually becomes buoyant and toned, signaling just a Tai Yang pathogen, at which point a Tai Yang formula like Du Huo Ji Sheng Tang will usually carry the day, especially with the haircoat issues.
A deeper Shao Yang issue is also likely given the spring onset; the gluteal wasting, which is caused by blockage of the GB channel; a deeper toned pulse; and the apparent Qi deficiency (which results from chronic Shao Yang obstruction).
As to points that I would expect likely to help, I would suggest sedating: GB 30, GB 25, BL 19, GB 34 and BL 40. I haven't found Benefit Hips and Knees to help these dogs very much.
Bottom line: I'd test those points and the response of his pulse, one by one. If it seems he's responding like I said, then I'd try the Chai Hu Gui Zhi Tang recipe above. Generally, after a few weeks, the pulse will signal a Tai Yang issue, and the dog will at that point likely benefit from DHJST. But if there are active GB points that help the pulse, it won't help the dog tNo introduce the formula early. If, instead, you find points that address Dampness (e.g. SP 9, BL 22) to be helpful instead, then I'd try San Ren Tang.
Hope that helps you out. Let us know how it goes
Steve
by
LJH
July 6, 2018
Thanks so much. His pulse responds to sedation of both BL-19 and BL-40 so I’ll order the Gui Zhi and Bai Shao to add to his XCHT and hold off on DHJST until we see that pulse change. Llewanda
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