Question Details
Weight Loss In A Dog
by lpshiner - January 24, 2020    View Case Report
Saw another complicated case yesterday I could use some help formulating an herbal plan for. Owners drove 3 hours to see me, and only live in Tx for the winters, so I cannot do frequent acup or rechecks.
Signalment: 5 yr old Chesapeake (?) Retriever mix, SF, adopted as a rescue at 4 months of age. Lives in Minnesota part time, in Texas for the winter. normal wt=57# (o says has always been thin)
lowest wt due to recent illness= 47#
wt today= 54# (still waay too thin/emaciated)
History: Bout of cystitis (DampHeat) with oxalate crystals tx in MN with antibiotics but didn't resolve until treated with Red Front Door and Crystal Stone Formulas. Was fine until around December in TX- no recurrence of UTI symptoms patient continued to be PU/PD. Around Nov or Dec pt developed inappetence, weight loss, lethargy, which alarmed o and regular vet. Referral to internist recommended, and o sought TCM advice first since her regular vet in MN is TCM Owner did stress that pt symptoms are all improving since recent diet change, although this dog is *definitely* not healthy.
Previous Diet: Wellness Kibble, Blue Diamond canned.
Current Diet: Pure Vita Holistic Pet, probiotics, Stella&Chewy; freeze dried
Previous workup: fecal (neg) numerous UA's (only abnormality is consistent hyposthenuria or isosthenuria ranging from 1.000-1.010, mild increase in ALT, albumin low normal, resting cortisol 1.0, thyroid "abnormal" according to lab, neg for HW and tick panel
On exam in my office:
Walking textbook screaming "DEFICIENCY"......with some very mild DampHeat and probably bony bi of hips/lower back. BUT.. just enough other confusing symptoms/patterns to make me think twice about the Patterns, and how to approach peeling the onion. She is obviously deficient, but am I categorizing the deficiencies correctly? Am I missing another pertinent pattern that needs to be addressed so I don't tonify an excess somewhere... or miss that Shao Yang obstruction that might be hiding in there??
- Pulse: SLOW, thin, weak, deep. responded well to needling with some increase in tone and pace.
- Alarm points sensitive: GB24 and 25, Liv 13 and 14. Disappeared with needling.
- very thin almost emaciated dog, borderline lethargic and dull, but did perk up towards the end of the session and ate a liver treat. Quiet and good for needling
- only occasional soft stool, never vomiting. inappetence better with new diet. some intestinal gas according to owner
- occasional urinary accidents but rare. Still PU/PD
- wakes up at 1:00 AM often, but sleeps ok other than that Best energy acc to o at 7-9 PM ( I'm trying to make sense of this- LV/GB? SI? seem weird that her best energy time is at the nadir for SP/ST)
- gait stiff behind, tight pectineus suspect some hip arthritis (GB connection here, KID?)
- wet, swollen pale tongue (Yang def? )
- one lipoma, ears sl Damp and warm, head warm but not hot.
- extremities not hot nor cold
- I needled the following with good response in pulse and attitude:
tonified LI10, BL20,BL23,ST36, GB34, LIV3 (all on one side only) and sedated LI11, BL54, GB29 and 30 on the side with the most stiff hips.

Owner may still take this dog to the specialist, but I want to get her started on some support while they make arrangements to do that (another out of town appt for them)

I'd like to prescribe herbs. HELP. ;-))
SP qi tonics? Rehmannia8? What else?
Thank you for your patience in reading this admittedly scattered case report....
Lynn Shiner
Replies
by naturevet
January 30, 2020
Hi Lynn

I think starting by tonifying is okay. The response to the formulas for the bladder issue indicates Blood deficiency and Dampness, the common source of which is Spleen deficiency. Dogs that have Dampness accumulation can feel better in the evening, since the Tai Yin (and thus its pathogen, Damp) is at a low ebb.

In terms of the appropriate tonic to try, I guess I would go with Liu Jun Zi Tang, since it drains Damp and tonifies the Spleen as well as the Source Qi. Source Qi deficiency (which can also accrue from chronic Spleen deficiency) is indicated by the low resting cortisol (and presumed adrenal insufficiency). I'm assuming the worsening at Christmas reflects Kidney Qi (and in particular Source Qi) deficiency.

At the very least, building the Qi of the dog will build the Qi of any disease process, making it more clear what we should be doing, if the formula is not itself the right one for the dog. Still, I suspect it will probably work for you

Steve
by lpshiner
February 1, 2020
Thank you so much, as always! LJXT was one of the formulas I was considering, so I will go with that and keep you posted.
Lynn
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