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Hind End Weakness 11 Year Old Weimeraner

by jk176 - January 30, 2021

Hello,

I have been treating an 11 year old FS Weimaraner with progressive hind end weakness. She weighs 62 lbs. The owner's reported this started after she was attacked by 2 German Shepherd dogs. Both hind limbs are weak, she has trouble jumping in the car and she drags her right hind limb intermittently - I haven't observed this. She is going deaf, but startles easily if something is dropped. She has a good appetite and a good energy level.
No v/d, normal thirst/urination
sometimes she sounds like she has phlegm in her throat/hacks
no temperature preference
she likes to be massaged
she is very nervous in the clinic
She had no improvement on NSAIDs
signs worse when she gets up in the morning or from lying down

Another veterinarian had her on Jing Tang Hindquarter Weakness - the classical antecedent of this formula is Bu Qi Zi Yin Tang - she did not improve on this

I treated her with Du Huo Ji Sheng Tang for about 1.5-2 months - her gait improved but she still intermittently dragged her right hind leg.

I switched her to Xiao Huo Luo Dan. She was on this alone for about 1.5 months with no improvement. I added Xiao Chai Hu Tang. She was on both formulas for about 3 weeks, when her owner's reported she was getting more lame - this was around 1/8/21. So I had them finish out their current supply of both formulas then discontinue. I started her on prednisone 15 mg PO SID x 5 days, then 10 mg PO SID x 5 days, then 5 mg EOD. They report her right hind leg is a bit more functional after starting prednisone.

I am also treating her with acupuncture which the owners report helps her gait and energy.

CBC/chem 7/17/20 wnl

PE - on pred 5 mg EOD
Tongue pink, big/moist, pulse - toned/weakish
tense lumbar spine, tense flanks, sl. delayed cp reflex rhl
prefers to sit in the exam room
nervous
2 lipomas - left axilla, left pre-femoral

Assessment - kidney qi deficiency, qi stagnation, +/-blood or yin deficiency or triple burner obstruction - anxiety, damp - phlegm in throat/lipomas

I am not sure where to go next with Chinese medicine. Maybe I should have kept her on the formulas longer before switching?

Thank you for your help,

Jennifer Katz, DVM, CVA
Veterinary Clinic of East Hampton

by naturevet

February 1, 2021

Hi there,

Given the stiff back and taut flanks, along with the partial response to DHJST, it looks like the lesion is in the mid-back, affecting dermatomes to the back legs. A gentle chiropractic treatment, such as using an Activator, may do wonders for this dog and help you get a complete response with your herbs.

As to which herbs to use, the response of the pulse to different acupuncture points can provide clues. For example, if it really rallied and moderated with sedation of BL 40 and tonification of BL 23, then you'd know DHJST is absolutely the right formula, and that some mobilization of the spine is probably what is called for next.

Conversely, a response to GB points would suggest a Shao Yang issue is present, despite the lack of response to XCHT. If that is the case, then given the improvements on DHJST, you probably need to treat both the Shao Yang and the Tai Yang with your herbs. You could try combining XCHT with DHJST or you could use just one formula by adding 12g Gui Zhi and 15g of Bai Shao to 100g XCHT.

A response to GB points implies the bruising extends deeper into the spinal cord than when just BL 40 improves the situation. In that case, you have to treat both superficial and deep levels of the cord to get those dogs better. Probably, though, this is just a superficial cord injury, and what is needed is chiropractic.

Besides a Tai Yang invasion, the other thing that appears worse on rising after lying down a while is Blood stasis. These cases respond to XHLD and/or NSAIDs. So we know Blood stasis is not present given the lack of impact of those herbs/drugs in this dog.

As to the Jing Tang formula, it is almost purely a tonic and not a mover or Wind dispeller at all, so dogs that are very stiff on rising don't really respond that well to it. It would be indicated more for a dog at their strongest early in the day, but then much more compromised by the end of the day.

Hopefully the above ideas help you out!

Steve

by jk176

February 3, 2021

Good evening Steve,

This information is very helpful! I will stimulate the points as you recommended and monitor the pulse. Thank you for the detailed answers and recommendations. I am learning - slowly:)

Jennifer

by jk176

February 4, 2021

Do you have a recommendation for a comprehensive human or veterinary acupuncture textbook?

by naturevet

February 4, 2021

Hi Jennifer

Although a human text, my favourite is Peter Deadman's 'A Manual of Acupuncture'. It helps you get a complete understanding of what the points do. The point locations are pretty much anatomically transposable directly to small animals. You'll find some points 'active' (and thus swollen and/or radiating heat) on your small animal patiens that veterinary texts don't mention, but which Deadman does, allowing you to interpret them. So, all in all, it's my favourite

Steve

by jk176

February 4, 2021

Hi Steve,

Great. Thank you for the recommendation.

Have a good evening.

Jennifer

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