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Seizures In A Dog

by kkeeney - September 23, 2019 View Case Report

Hello and thank you! I have entered this as a case, but I cannot seem figure out how to get a question on the forum once I do so. Sorry for the hassle.

Tucker is a 5 year old M Golden Ret.

First visit: 7/13/19
History: Had 2 grand mal seizures a week apart at the end of June/beginning of July. Totally healthy otherwise. Had labwork run and all looked normal. Anticonvulsant meds recommended after the second one, but family prefers to try herbal tx first. No behavior issues or medical history. Eats a blend of freeze dried food and Canidae.
Current Medications/Supplements:
1. Vitamin E and Fish oil
Brief Physical Examination:
Wt/TPR: HR 72 bpm, RR pant/min
Subjective: Bright, alert, responsive, hydrated
Objective: DENT- n/e EENT-mm pink, CRT < 2 seconds, eyes/ears/nose clean, visual o.u..H,L-No cardiac murmurs or arrhythmias, lungs clear, eupneic. ABD-soft non painful. RECTAL-not performed. MS-ambulatory x 4 BCS . NEURO-apparently WNL INTEG- NSF PERIPH LNs-normal PULSES- wiry slightly thin, superficial- med depth, toned TONGUE- dark red with lavender hue.

Assessment:
1. Seizures r/o epilepsy, toxin, other IM, neoplasia, open
2, TCVM: Mild liver blood def and internal wind heat
Treatment Plan and Recommendations:
GB20, BL18, GB34 (strengthened pulse), Liv 3, BL40
Rec change to an unprocessed diet.
RX: CHJLGMLT 100g plus 10 g Tian ma added

Follow up visit:
8/10/19
History: Has been doing well. No seizures- taking herbs with no problem. PULSES-deep wiry and slighlty thin, fast, weaker on the left TONGUE- deep red-lavender, no significant coating.

TCVM: Heat pattern (yin def?) with underlying blood def and h/o internal wind
Treatment Plan and Recommendations:
GV14, BL17/18, SP10, LI4, LIV 3, BL40
Rec re-fill herbs (CHJLGMLT, Tian ma)
Can add in 10 g DG when they return for additional blood support. Will send with them now. Also rec probiotic addition as well.
Re-check in Oct unless things shift significantly or there is any worsening of signs before.

DG addition seemed find. Refilled blend 100g CHJLGMLT/10g Tian ma/10g Dang gui on 9/18.

Update: Had a seizure 9/22/19 6am lasted just a couple minutes at most. It took around 5 minutes for his vision to return and probably 40 minutes for him to completely recover. He paced for most of the 40 minutes.

Recent changes: Gave treats with grains (just a few), switched to chicken based food vs. pork which he had been on since first visit. The dang gui addition in late August- maybe exacerbated a damp issue that I missed?

Your thoughts and wisdom on this case would be greatly appreciated! This is a very committed family!

Thanks so much,
Kelly

by naturevet

October 4, 2019

Hi Kelly,

Sorry for the delayed reply. Somehow I didn't get notified that you had logged a question.

I have a few ideas. First off, if the dog still had a pulse that was responding to Shao Yang acupuncture treatments (which you didn't mention as being the case in that most recent visit), then we are trying a new formula called Chai Hu Gui Zhi Gan Jiang Tang, to which we add Tian Ma. It seems to be working better than the CHJLGMLT

Next, we do notice that some dogs can become more overtly Blood deficient after treatment for Shao Yang issues - or, more accurately, that they are the underlying cause of the Shao Yang issues and are revealed when the Shao Yang layer is peeled away. In that case, we've had to move to Tian Ma Gou Teng Yin to manage them. Fall seizures are more likely to be Blood deficient in cause if there is now no evidence of a Shao Yang disharmony, making it more likely the TMGTY will work. You don't mention what kind of pulse response you saw to the last treatment but if it was a good one, that is probably where you need to go next.

Otherwise, if the dog is Damp, you'd see slippery pulses responding to anti-Damp points. As a rule, seizures from Dampness and Phlegm accumulation are generally worse in the morning hours and spring

Hopefully these ideas help you out. Please let us know how it goes!!

Steve

by kkeeney

October 22, 2019

Hi Steve,

So, I have had this guy on TMGTY most recently since he seemed to be primarily blood def (aslo has increased itching), but better in terms of heat and shao yang. He did have a couple of reverse sneezing events and the increased itching that has persisted. Unfortunately, he had another seizure this morning 10/21 at 4:30 am. seems to be recovering quickly. No changes outwardly that the family aware of other than cold front came in. It is about a month after his last one but increased frequency compared to prev when he went several months with no seizure. I am not sure what to change, He still seems to have the predominant patters blood def and wind invasion. His pulse was moderated best by tonifying BL40 at the last treatment. Also BL18 cleared the wiry aspects of the pulse. GB34- no shift either way.

Any ideas for an herb shift or addition? I think we may have to consider conventional anti-seizure meds if he continues with the increased seizure frequency.

Maybe I need to add in an anti-damp approach given the early morning trend?

Thanks so much!
Kelly

by naturevet

October 22, 2019

Hmm. Try tonifying GV 20. If his pulse improves/moderates a lot, then he may be a Bu Zhong Yi Qi Tang case?

Check that out? Yes, though, seizures after 3 am in the morning are more likely to be Damp cases, calling for something like Ban Xia Bai Zhu Tian Ma Tang

Steve

by kkeeney

October 22, 2019

Great- thank you!
The family says that his itching, anxiety, energy and dandruff have all worsened on the TMGTY vs CHJLGMLT +TM+ DG he was on previously (and had a seizure on that formula as well). So odd. I am having them stop it until I can get him on something different

Just for my clarification and since I trained in acupuncture at Chi and checking the pulse quality in response to needling specific points is something I have been picking up remotely from you vs. formally in my training, I was hoping to get a quick crash course on that.

I think I know that if pulse moderated by GB34 = shao yang disorder/TB obstruction, BL40= wind invasion?, SP4= damp issue?, BL17= blood def? What does GV20 indicate? Anything I am mistaken on or any others that are important to know? Qi/Yin/Yang deficiency indicators?

I worry that I mis-interpret the pulse often and want to get better at that in regards to herbal prescribing especially. I hope I can get it right for this dog! In your experience are you often able to maintain seizure patients just on herbs and unprocessed food? I recommended they try homeopathic Ignatia as well until I can re-check him. For dosing that, do you keep them on it indefinitely at 2-3 times a day? Any opinion on CBD or other side supplements?

Sorry for the barrage of other questions- I am so grateful for your help and any guidance you have time to share!

Kelly

by naturevet

October 22, 2019

Hi Kelly,

The weird response to TMGTY makes sense if the seizures are caused by Qi collapse instead of Yang rising. The pulse fits that. If it responds as per my previous post, that is likely what is wrong. In that case you could start BZYQT and possibly add in a bit of Tian Ma to achieve the perfect balance between raising Qi and descending Yang.

Regarding point effect interpretation, if the pulse improves with:

Tonification of BL 40, think Tai Yang deficiency, manifesting as Wei Qi deficiency, renal failure or, potentially, collapse

Sedation of SP 4, think Chong Mai - Yin Wei Mai disharmony (leaving Qi trapped in lower burner and unable to properly nourish the Heart and sense organs)

Sedation of BL 17, think Blood stasis
Tonification of BL 17, think Blood deficiency

Tonification of GV 20, then Qi and Yang should be raised

Sedation of GV 20, then Yang should be internalized (which is normally the case for seizure animals, but perhaps not this one?)

Regarding other treatments, I'm fine with CBD. Ignatia BID to TID is also fine if it seems appropriate, maybe once or twice a day if you have to go long term. If no reduction in seizures then it isn't helping so you would discontinue it.

I always strive for control of seizures using herbs and food. It is not always possible but often it is, allowing me to keep drugs in reserve for use later if things destabilize and become refractory.

Assuming you achieve at least a partial improvement or resolution, the herbs minimize the required dose of drugs going forward, lessening the chances of adverse events or toxicity

Steve

by kkeeney

October 22, 2019

Thank you so much- that is super helpful!

by kkeeney

November 24, 2019

Update and question on this guy. He seemed improved clinically (less itching, less reverse sneezing, better energy and just seemed to feel better) after we shifted herbs 10/22 to WMW 50g, QYT 50g and 5 g TM 1/2 tsp po BID plus a low dose 1/4 tsp BID of LDXGT. (I didn't get your response before I saw him, so went on my own creative herb prescribing path).

As a recap of the history, Tucker is a 5 y old MI golden ret, had grand mal/cluster seizure event in late June this year after which they came to seek alternatives to anti-seizure pharmaceuticals. I placed him on CHJLGMLT + TM and he did well until end of Sept when he had another single seizure event. He has mostly blood def signs (thin pulse, anxiety, response to blood tonic points) and TB obstruction signs, so I added in DG in (in the interval between first seizure event and second seizure event after a recheck visit in which the blood def signs were persisting) in hopes of better addressing blood def safely, but then he had his second seizure and I felt like I needed to change things. In above posts there is more info on pattern details at his visits.

After the 2nd seizure, I put him on TMGTY since the blood def seemed to dominate the pattern, but he then started having a seizure close to monthly and was seeming worse in terms of his itching, anxiety and dandruff. So last month Oct 22, I changed gears and tried WMW/QYT with a little TM plus a low dose of the LDXGT. He improved a lot clinically on that strategy (less itching, less reverse sneezing, better energy and just seemed to feel better) but had another seizure at the 4ish week mark (after my treatment with him yesterday of course- augh).

Yesterday: TONGUE- lavender, dark pink, slightly moist, no coating PULSES- toned, very slighlty thin, wiry, med depth and fast. Treated GV20 (t) no big shift, GV14 (t), BL17 (t) slight improvement in pulse- more even/broader, BL17 (s) did not seem to improve pulse, BL18 (t) strengthened pulse notably, GB34 (moderated/evened pulse), ST36 (t)
The seizure that occurred this morning was different. It was at 3:15am vs the usual 6ish am time. He did (and always does) vomit prior to the seizure, but the seizure itself was much shorter in duration and he didn't lose his vision which he typically does. I recommended that they stop the LDXGT since his damp signs have seemingly resolved and maybe it is exacerbating the blood def. Given that they live 2 hours away and were just here yesterday, I can't easily re-check him soon, Also, given how much GB34 improved his pulse and that his seizure interval seemed to be longer on the CHJLGMLT blend, I was going to have them 1) Continue the WMW/QYT/TM blend they have since it really has seemed to help him but 2) Take out the LDXGT and add in the CHJLGMLT + DG+TM blend they have on hand at 1/4 tsp po BID. I wish they had CHJLGMLT alone- not sure if the other 2 herb additions will make a big difference negatively (the ratio was 100g CHJLGMLT + 10g TM + 10 g DG). Am I totally off base here? Do you think I could have sparked that seizure with my treatment yesterday?

As always, I send my endless gratitude for this forum, your advice and support!
Kelly

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