Question Details
Lymphoma In A Dog
by
Lewter
-
July 12, 2018 View Case Report
Replies
by
naturevet
July 13, 2018
Hi Marjorie,
Congratulations on your success thus far. That's great!
In answer to your questions, I never find it's an advantage to pulse the herbs, or otherwise give them more intermittently. When formulas are right for a patient, as they appear to be here, the body never gets de-sensitized to them. Desensitization comes when you are trying to work more pharmaceutically, forcing a reaction that the body is not otherwise inclined to do. Examples include orthomolecular doses of vitamins; pharmaceuticals, etc.
Herbs work more physiologically, however. They remove obstacles to the body doing what it 'wants' to do, so we typically don't see desensitization. In the past, when I've reduced doses of herbs in a case that was doing well, the tumors come roaring back. Sometimes you can reverse that process again and sometimes you can't.
Bottom line, then, at least for me: keep going with full doses as long as they are affordable, or until the animal is in full remission and has been there for such a long time that you're convinced the tumor is gone
Steve
Congratulations on your success thus far. That's great!
In answer to your questions, I never find it's an advantage to pulse the herbs, or otherwise give them more intermittently. When formulas are right for a patient, as they appear to be here, the body never gets de-sensitized to them. Desensitization comes when you are trying to work more pharmaceutically, forcing a reaction that the body is not otherwise inclined to do. Examples include orthomolecular doses of vitamins; pharmaceuticals, etc.
Herbs work more physiologically, however. They remove obstacles to the body doing what it 'wants' to do, so we typically don't see desensitization. In the past, when I've reduced doses of herbs in a case that was doing well, the tumors come roaring back. Sometimes you can reverse that process again and sometimes you can't.
Bottom line, then, at least for me: keep going with full doses as long as they are affordable, or until the animal is in full remission and has been there for such a long time that you're convinced the tumor is gone
Steve
by
Lewter
July 13, 2018
Thanks, Steve,
We will stay where we are. If the lymph nodes start to become reactive and grow, where do we go? Add Four Marvels? Increase dosages? Add the Jing Tang protocol with Wei Qi Booster and Stasis breaker? I am often confused by the difference in herbal formulas between Kan and JT. Since so many people are taking the Chi Institute course they are more familiar with those formulas and reach for them first. I have personally had better success with your formulas in my limited experience. Do you have any experience with artemesia? I have not yet tried adding that for cancer cases. For this patient, it seems the keto diet is really key and the dog"acts like a puppy again". I will keep you posted.
We will stay where we are. If the lymph nodes start to become reactive and grow, where do we go? Add Four Marvels? Increase dosages? Add the Jing Tang protocol with Wei Qi Booster and Stasis breaker? I am often confused by the difference in herbal formulas between Kan and JT. Since so many people are taking the Chi Institute course they are more familiar with those formulas and reach for them first. I have personally had better success with your formulas in my limited experience. Do you have any experience with artemesia? I have not yet tried adding that for cancer cases. For this patient, it seems the keto diet is really key and the dog"acts like a puppy again". I will keep you posted.
by
naturevet
July 14, 2018
This is a great case, Marjorie. Thanks for sharing it. There aren't too many cases yet, where vets have applied both the ketogenic diet and herbs/supplements, so keeping us posted on how it turns out is very important.
Make changes with care, based on physical examination findings, rather than rhetoric. So, only use Si Miao San if the animal develops a very superficial full bounding or slippery pulse, and at that point the other formulas would be contraindicated. Artemisia is likewise more suited to a hot inflammatory clinical presentation (like osteosarcoma), and to Shao Yang or Damp Heat presentations. The design of Wei Qi Booster and Stasis Breaker make no sense to me (from a classical Chinese medical perspective), so I cannot tell you the exact presentation a patient would have that maximally benefits. For Jing Tang formulas, it is harder to know for sure what to do based on the physical examination because most of them are not classical formulas, and fail the 'classical formulas test'.
If a formula is well designed, you can look at the ingredients, and according to their flavours, Qi, organ affinities and symptom reputations (without having to resort to biomedical effects), make a concise list of the symptoms, pulse and tongue (without having to resort to disease names) that a patient should have who is perfectly suited to the formula. In a well designed formula, all the ingredients should be called for in that single patient's picture, and all of the symptoms should be known for being concomitant - you should recognize that patient as someone you have seen in practice.
Most formulas derived in the last century (with notable exceptions like Tian Ma Gou Teng Yin) fail that test. There are modern formulas developed in the past few decades, like Jing Tang and Seven Forest Combinations that use a classical formula as a 'backbone', but then bury it under so many additional herbs that the original classical formula is effectively smothered and unable to act as intended. Even one wrong herb put into a classical formula can effectively kill it. Small wonder, then, that the ancients took centuries to figure out how to turn Three Marvels into Four Marvels. Four Marvels and Minor Bupleurum, have been tweaked, studied and tested over centuries or even millennia, whereas practitioners probably only have a few decades or less experience with the Jing Tang and Seven Forest formulas.
You might assume that old formulas can always be improved upon, now that we have modern medical research behind us, but this is not the case. Chinese medicine is a strange bird, emerging from the egg almost fully fledged thousands of years ago. Ever since then, through the Song and Yuan dynasties to the modern era, it has been the lament of Chinese medical doctors that they could not understand how to use these tools with the same finesse as the ancients that created them.
You might assume this would only apply to a westerner, say you or me, grappling to understand Confucian and Daoist views as applied to nature and the body, but you'd be wrong. Even Liu Lihong, personal physician to the Dalai Lama's closest friends, has voiced the same lament in the Chinese bestseller, Si Kao Zhong Yi - literally, 'Rethinking Chinese Medicine'. His solution? Go back and develop a deep understanding of the philosophies and ingredients of the classical formulas and their associated 'remedy pictures'. Liu Li Hong then devotes the rest of his book to a review of the Shang Han Lun (which almost all TCVM veterinarians have never had instruction in).
CIVT, the alternative to the Chi Institute in Chinese veterinary herbal medicine, devotes a lot of time to the precepts of the Shang Han Lun, and I agree with Shang Han Lun author (Zhang Zhong Jing, probably the most important herbalist in human history), that at least half of patients are better understood according to the Six Phases of Yin and Yang (which forms the basis of the Shang Han Lun), rather than the basic Zang-Fu physiology that TCVM (i.e. the Chi Institute) emphasizes.
In summary, then, when you find the Kan Veterinary Essentials formulas work better (and you are not alone), I suspect it is because they depart as little as possible from classical formulas, whereas Jing Tang formulas show no such historical fidelity.
Sorry for the long post and for getting on my soap box. Some questions are dangerous to ask me. You have to strap in for one of my long-winded replies!
Steve
Make changes with care, based on physical examination findings, rather than rhetoric. So, only use Si Miao San if the animal develops a very superficial full bounding or slippery pulse, and at that point the other formulas would be contraindicated. Artemisia is likewise more suited to a hot inflammatory clinical presentation (like osteosarcoma), and to Shao Yang or Damp Heat presentations. The design of Wei Qi Booster and Stasis Breaker make no sense to me (from a classical Chinese medical perspective), so I cannot tell you the exact presentation a patient would have that maximally benefits. For Jing Tang formulas, it is harder to know for sure what to do based on the physical examination because most of them are not classical formulas, and fail the 'classical formulas test'.
If a formula is well designed, you can look at the ingredients, and according to their flavours, Qi, organ affinities and symptom reputations (without having to resort to biomedical effects), make a concise list of the symptoms, pulse and tongue (without having to resort to disease names) that a patient should have who is perfectly suited to the formula. In a well designed formula, all the ingredients should be called for in that single patient's picture, and all of the symptoms should be known for being concomitant - you should recognize that patient as someone you have seen in practice.
Most formulas derived in the last century (with notable exceptions like Tian Ma Gou Teng Yin) fail that test. There are modern formulas developed in the past few decades, like Jing Tang and Seven Forest Combinations that use a classical formula as a 'backbone', but then bury it under so many additional herbs that the original classical formula is effectively smothered and unable to act as intended. Even one wrong herb put into a classical formula can effectively kill it. Small wonder, then, that the ancients took centuries to figure out how to turn Three Marvels into Four Marvels. Four Marvels and Minor Bupleurum, have been tweaked, studied and tested over centuries or even millennia, whereas practitioners probably only have a few decades or less experience with the Jing Tang and Seven Forest formulas.
You might assume that old formulas can always be improved upon, now that we have modern medical research behind us, but this is not the case. Chinese medicine is a strange bird, emerging from the egg almost fully fledged thousands of years ago. Ever since then, through the Song and Yuan dynasties to the modern era, it has been the lament of Chinese medical doctors that they could not understand how to use these tools with the same finesse as the ancients that created them.
You might assume this would only apply to a westerner, say you or me, grappling to understand Confucian and Daoist views as applied to nature and the body, but you'd be wrong. Even Liu Lihong, personal physician to the Dalai Lama's closest friends, has voiced the same lament in the Chinese bestseller, Si Kao Zhong Yi - literally, 'Rethinking Chinese Medicine'. His solution? Go back and develop a deep understanding of the philosophies and ingredients of the classical formulas and their associated 'remedy pictures'. Liu Li Hong then devotes the rest of his book to a review of the Shang Han Lun (which almost all TCVM veterinarians have never had instruction in).
CIVT, the alternative to the Chi Institute in Chinese veterinary herbal medicine, devotes a lot of time to the precepts of the Shang Han Lun, and I agree with Shang Han Lun author (Zhang Zhong Jing, probably the most important herbalist in human history), that at least half of patients are better understood according to the Six Phases of Yin and Yang (which forms the basis of the Shang Han Lun), rather than the basic Zang-Fu physiology that TCVM (i.e. the Chi Institute) emphasizes.
In summary, then, when you find the Kan Veterinary Essentials formulas work better (and you are not alone), I suspect it is because they depart as little as possible from classical formulas, whereas Jing Tang formulas show no such historical fidelity.
Sorry for the long post and for getting on my soap box. Some questions are dangerous to ask me. You have to strap in for one of my long-winded replies!
Steve
by
Lewter
February 26, 2019
Does anyone have any suggestions to keep this patient lymphoma in a quiescent state? Thanks! Dr B and Dr M
by
Lewter
March 11, 2019
Sommer's submandibular lymph nodes have gotten a little larger. Please see updated case report for last week. Sommer continues to take coriolus extract( Kan) bemer therapy, Ozone PR every 2 weeks, XFZYT, Curcumin 97%,Open the Liver, Vitamin a and d, and strict Ketogenic diet. Any suggestions for keeping her stable with her lymphoma?
Thank You
marge
Thank You
marge
by
naturevet
March 11, 2019
Hi Marjorie,
I can tell you the trio of formulas we're currently exploring to see if they can create improvements in these cases: Hoxsey-Like Combination + Tan Yu Tang + Xiao Chai Hu Tang (which you're using a form of, as Open the Canals of the Liver).
So there are two new formulas to consider layering in
We use the influence of various acupuncture points on the pulse to help us know what type of influence we should be adding. I don't know if you approach cases that way, but if you do, that data would help me help you
Our other secret weapon in lymphoma is very tiny doses of pred - about 0.1 mg/kg SID to BID, sufficient to shrink the lymph nodes, but not at a high enough dose to cause immune suppression or side effects. So that is another option for you to pursue. At those doses, with all the support your herbs are providing, prednisone provides a chemotherapy impact, and cells don't seem to acquire resistance to it.
If lymph nodes have grown just recently, then given we are in the Shao Yang time of year, then bumping up your dose of the Open the Canals of the Liver might be helpful, too.
Hopefully among those ideas is something to help your dog, but you have done very well to date in keeping him stable!
Steve
I can tell you the trio of formulas we're currently exploring to see if they can create improvements in these cases: Hoxsey-Like Combination + Tan Yu Tang + Xiao Chai Hu Tang (which you're using a form of, as Open the Canals of the Liver).
So there are two new formulas to consider layering in
We use the influence of various acupuncture points on the pulse to help us know what type of influence we should be adding. I don't know if you approach cases that way, but if you do, that data would help me help you
Our other secret weapon in lymphoma is very tiny doses of pred - about 0.1 mg/kg SID to BID, sufficient to shrink the lymph nodes, but not at a high enough dose to cause immune suppression or side effects. So that is another option for you to pursue. At those doses, with all the support your herbs are providing, prednisone provides a chemotherapy impact, and cells don't seem to acquire resistance to it.
If lymph nodes have grown just recently, then given we are in the Shao Yang time of year, then bumping up your dose of the Open the Canals of the Liver might be helpful, too.
Hopefully among those ideas is something to help your dog, but you have done very well to date in keeping him stable!
Steve
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