View Question

ITP In A Dog

by Dreudog - October 31, 2018 View Case Report

Hello Steve and group,

This dog is a 5 yr old Goldendoodle. At 6 months he developed a cyclical fever w/ joint pain, lethargy (fall onset). He was negative on all tick titers thru NCSU, and the owners did not want to pursue further testing for Bartonella. He was treated by his rDVM w/ Doxycycline and Minocycline. These symptoms eventually disappeared.

In Nov. of 2015 (age 2.5), he developed immune thrombocytopenia, and eventually AIHA as well. He was given Azothiaprine + Pred, which stabilized his numbers, and eventually the Pred was omitted. His specialist felt he could stop the Azothiaprine in the fall of 2017, which he did. Then in the spring of 2018, he presented for epistaxis and had a platelet count of zero (!) and PCV of 12% (the latter likely dT his immune dz, since he had not lost that much blood). He was obviously hospitalized for ttrtmnt.

Wilson has a long history of GI symptoms (reflux/nausea on certain foods, gas, occ. inappetence. Also skin allergies, worse in summer.

I met Wilson in April of this year; on exam he was moderately overweight, mm sl. pale w/ a bit of white phlegm. , pulse deeper, thinnish. He is sweet, friendly and has chronic abdominal distension.

I started him on Li jun zi tang for 2 weeks, and then Xiao chai hu tang + gui ahi + bai shao + Yunnan bai yao. He was on Azothiaprine 50mg 1 EOD and Pred 20 mg AM , 10 mg PM from the U.

Since that time, his tongue and pulse have remained about the same, he has a mild anemia, platelet numbers are stable on the same dose of Azothiaprine an Pred 10 mg BID. His GI signs have improved on the LJZT, but I feel he should be able to stabilize on lower doses of meds if the herbs are working well. I've stubbornly kept him on the XCHT, as his numbers were often in normal range (but he has remained on meds also).

Thoughts?

Thank you !!!

Cathy L

PS; I'll fill out his info under Cases also.

by naturevet

November 2, 2018

Hi Cathy,

When ITP and AIHA has been beaten back to the point that active cell destruction has ceased, and all that's left is the need for higher RBCs and platelets, I like to use Yi Guan Jian.

It has a double bone-marrow stimulating effect, since it contains both Dang Gui and Rehmannia, accounting for almost a third of its content. So it's one of our stronger bone marrow stimulants. It also can fit the symptoms of gastric unrest; the pale tongue; the pulse you describe; and the abdominal distention (if due to Qi stagnation).

I'd give it a try, and if the counts finally move up, then he will potentially be able to come off some of the other things you're using.

The seasonality suggests a Shao Yang disharmony at heart, which can in turn be caused by Yin deficiency. In that case, YGJ may keep the dog stable going forward. Otherwise, you can prophylactically start Qing Ying Tang and Chai Hu Jia Long Gu Mu LI Tang (or XCHT) every spring and fall, to try to prevent further relapses, as they are very common

Hope that helps!

Steve

Steve

Yi Guan Jian

by Dreudog

November 2, 2018

Steve,

Fabulous, would not have thought of the YGJ. I'm a little concerned about his tendency towards GI signs and damp in general - I know it should treat some spleen qi def, just have had a few dogs nauseous on it. Maybe the LJZT will help, or maybe he went need it. I do feel that ever since his cyclical fever episodes, and then the onset of his ITP/AIHA several months after he went off meds, he is suspicious for triple burner dz. So maybe using either the QYT or CHJLGMLT also- would it be appropriate to replace the XCHT and friends at full dose, and then wean him down b/t the shoulder seasons + keep up the YGJ if his numbers correct?

Thanks again,

Cathy

by naturevet

November 3, 2018

Hi Cathy,

YGJ is compatible with all TB formulas, so feel free to blend them as you see it. The XCHT may be enough to prevent relapses, but remember QYT and CHJJLGMLT if he starts to look off during the shoulder seasons.

No worries using LJZT at the same time while you're testing the YGJ. You can use the YGJ year-round if the bone marrow needs continued support in bringing counts up.

Steve

by Dreudog

November 5, 2018

Thanks much, Steve!!

You must be logged in to reply

CuredCases.com