Question Details
Pneumonia And Combining Formulas
by kkeeney - October 19, 2019
Hi Steve,

I have a dog patient- 13 y/o SF Goldendoodle with a history of what I have thus far interpreted as damp accumulation combined with Kidney Yin deficiency bony bi. She came in for a tune-up treatment yesterday and I ended up sending her to the local ER for rads d/t suspected pneumonia which was confirmed). When I saw her yesterday her pattern seemed mixed. Pulses fast, superficial, thready and wiry, tongue: very deep muddy/lavender pink with white striped. Ocular discharge, crackles on auscult of central ventral lung fields. Super elevated HR and RR, normal temp. In terms of shifts with acupuncture- the wiry aspects of the pulse improved with tonification of BL18, but the pulse became more toneless at that point (still fast and thin). Needling (t) of GB 34 and BL40 resulted in a much more balanced pulse- improved tone and width and depth. Also needled ST36, LI10/11 and LU 1 and did aquapuncture with B12 into GV14.

My question is general in terms of combining damp draining formulas with CHJLGMLT and XCHT formulas. At our previous visit 2 weeks ago with a focus/goal of helping her in terms of energy and arthritic issues, and I was drawn to use CHJLGMLT for her d/t her heat signs, the time of year and given that her pulse at that visit also was improved by needling GB34. She had previously been on SMS alone which I chose not to discontinue (given her historic damp signs- white coating on tongue, slippery pulse, cysts/lipomas, ear infections and ocular discharge). I added the CHJLGMLT in with the SMS, but now I wonder if that combination is counter-productive in terms of energetics. It is so hard for me to grasp the subtleties in prescribing esp when combining formulas! She did develop pneumonia in this recent time frame, but I believe it was an infectious variety since a "friend" dog of hers also was tx for acute pneumonia 7 days ago.

I would love 1) some guidance on what to use herb wise for her at this juncture and 2) any pearls of wisdom you could share in terms of maybe how I can better sort out treating patterns like this with combination formulas.

Hope you can make some sense of all that! Thanks as always for your time and wisdom :)

Kelly
Replies
by kkeeney
October 19, 2019
Oh- I also forgot to mention that the only outward clinical signs so far are slight lethargy and inappetence. No cough at this point. She was started on Clavamox last night.
by naturevet
October 21, 2019
Hi there,

Both SMS and CHJLGMLT internalize Blood. SMS drains downward and inward. CHJLGMLT internalizes without actually draining anything.

The points suggest the Shao Yang formula is appropriate, but the response to tonification of BL 40 and BL 18 suggests that there may be a Wei Qi deficiency going on, which neither formula helps. Wei Qi deficiency is also suggested by current symptoms of lethargy and lack of appetite, since Wei Qi comes from the Spleen.

If you feel the above makes sense, you could add a third formula, Yu Ping Feng San, until the condition is resolved and the pulse is moderate. It can also be continued through the winter months to prevent recurrences

Steve
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