- I realize that we are limited in diagnosis bc I’ve not been able to check tongue and pulse as of yet, nor do a PE, but she has been worked up well by her regular vet
- signalment: SF Border Collie, 8 yrs old, approx 40 lbs bw
- symptoms : chronic episodic diarrhea for 4 months+. used to be every few weeks, for a few days, now seems to be daily with normal stools interspersed. Very watery (or soft) stools, some with mucus, never blood. Stools are often normal 1st thing in the AM, worsening as day goes on. Symptoms often worse “at night” (no exact time given). There is some urgency, and during the episodes she may have 8 stools/day. Mild abdominal tenderness when this happens. Strong smell to stools (owner describes as ‘normal poop smell, just stronger)
- NO vomiting, weight loss or inappetence. No real lethargy- owner says her energy level is high and she is a typical strong-drive BC. Great appetite Good muscle mass acc to owner.
- No responses to multiple diet changes, grain-free or with grain, bland home cooked diets. Nutriscan (recent) showed no food allergies.
- Prior testing includes fecals (negative),basic lab work (sl high creatinine), thyroid (low), TLI negative, cobalamin (low), albumin and globulin (both low), PCR panel for parasites/bacteria negative for all, abdominal ultrasound (normal except possible ectopic ureter??), Urinalysis (normal. SG was 1.007 but IDK if this has ever been repeated and pt is not Pu/Pd) Regular vet has recommended biopsies but not done yet
- Western diagnosis : IBD, protein losing enteropathy. No signs of neoplasia on US, but lymphoma not ruled out
- no response to metronidazole or Tylan
- Other conditions: mild pannus (pet lives at high altitude), possible ectopic ureter but no hx of leaking urine,
- Personality: typical high drive Border Collie, friendly and loves everyone, mild resource guarding with other dog
- Only change since starting some intestinal support products (Ion Biome, Nutrigest) is that now the diarrhea is every day, with normal stools also at least once a day, where before the diarrhea would run for a week about every 4 weeks
Differential TCM patterns?
- I am not seeing Sp Qi deficiency here. Possible Kidney Jing/qi deficiency but I am not really seeing strong symptoms of this (unless the diarrhea qualifies as ‘cock’s crow’?? Doesn’t seem to, since client reports normal AM stools. Not much in the way of Liver involvement exc the pannus, mild abdominal tenderness and mild resource guarding?
- LI Damp Heat?
Formula ideas?
- since it is chronic, not acute, I was hesitant to use Four Marvels.
- Huo Xiang Zheng Qi?
Thank you so much for any insight you can offer