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Growing Multifocal Lipomas In A Dog

by peglaco - February 1, 2021 View Case Report

Hi there,

Bandera is a happy, vocal dog but has recently developed symptoms of lar-par. I do not acupuncture this dog.

She has had lipomas all over her body, mostly along the GB and Liver meridians. I had initially treated her with JTs Max's formula, Stasis Breaker, and Liver Happy for several years and at first they were stable and softening some. But then about a year ago she kept getting more showing up, she was more stiff and sore in the back end and had some dental issues. I switched her to NP TYT and SMS and she seemed to do well despite a fall in 8/20 and had some chiropractic help.

In 10/20 the owner started to describe maybe lar-par type symptoms and she started having drier coat, more muscle atrophy of her hind legs and by 12/20 definitely more lar-par like symptoms. We adjusted herbs by decreasing the TYT from 1 tsp to 1/2 tsp BID, the SMS from 1/2 tsp to 1/4 tsp BID, added in SWT 1/8 tsp BID, and Kan XCHT work up to 4 BID.

I saw her on 1/26/21 and her growths have really enlarged especially in the axillae, thighs and lat chest regions. The owner had only put her on XCHT 1.5 tabs BID. The dog is fidgety when touching her especially her hind legs, does not really want to be palpated and jumps away. She is sensitive GB points on lateral thighs as well as near liv 8. Her tongue is palish and purple, and her pulses this time were very faint, deep, weak bilateral. They have never really been wiry.

I am worried I will be causing a malignancy because I am not addressing the blood deficiency/ blood stasis/shao-yang disharmony I think she is having correctly. Looking at it, I should have started blood tonic sooner and dealt with SY issue. I am just not sure what direction to go now. I appreciate any input! Peg

by peglaco

February 1, 2021

The signalment did not show: she is FS Akita Mix, 12 years old. Fed a combination of Answer's raw and homemade cooked veggies. Peg

by naturevet

February 1, 2021

Hi Peg,

The diet may be playing a role here, depending on what exactly they are using. For example, Answer's Raw Chicken diet is 40% fat, providing 63% of the calories in each serving. That can certainly drive lipoma formation. SMS and TYT have herbs that counteract the metabolic impact of a high fat diet to a point. The reduction of their doses and continued use of the diet could have tipped the balance in this dog in favour of lipoma formation. I have seen lipomas shrink significantly with just diet change alone.

Another possibility is that as you moved toward peripheral circulation enhancing herbs, you helped drive tumor formation, but the feeble pulse makes that less likely. To support peripheral circulation so you can continue using SMS, add 20g of Dang Gui to 100g of SMS. If the muscles are tight and sensitive, you could further add 20g of Mu Gua.

The alternative is that reduced peripheral circulation has impaired peripheral blood flow and immune surveillance, causing tumors to develop. In that case, continued use of SMS would still have driven the circulation deeper. The only way to test that theory would be to stop SMS and introduce an anti-tumor Blood moving formula like Modifed Xue Fu Zhu Yu Tang. If the tumors grew further, then you'd know this was the wrong move and you could more fully explore the ideas for changing diet and metabolism mentioned above. Note that XFZYT could help with the lar par symptoms, though, and can be used with both TYT and XCHT.

If you do decide this is about dietary fat and metabolism, San Ren Tang is a good choice, and can be used with TYT and SMS, but can address respiratory symptoms.

Hopefully this helps you out. Please let us know how it goes!

Steve

by peglaco

February 1, 2021

Thanks for your quick response, Steve! I will give an update when I see her next in early March and after I figure out which approach we will take:) Peg

by peglaco

March 21, 2021

At this recheck, Bandera's growths seemed to have stabilized and no apparent continued growth. Her cough/gag is slightly less, and she did not have any reactive points and was not fidgety with hind limb palpation or seem as painful as last visit. The owner is now feeding Honest Kitchen Turkey and HK Limited ingredient Fish with fewer treats. The owner does report that she is not eating with her usual gusto, is eating, just not as enthusiastically unless treats, and she is still having fluctuating energy levels. One day she is energetic, wanting to play and go for a walk, and the next day she needs to be coaxed to go for a walk and then will only go a short way, and lays around more. We did find a loose upper premolar so maybe that is an issue for her but owner is very reluctant to have her undergo any anesthesia with the suspected lar par issue.

She is currently getting:
NP TYT 3/4 tsp BID and SMS 1/2 tsp BID, Kan Essentials Three Seeds 1 BID, and HTQ 3BID, Evergreen Si Wu Tang 1/8-1/4tsp BID. (I refilled her SMS and added 25gm of the Evergreen Dang Gui to 100gms of the NP SMS to replace the SWT).

Bandera had a purple, slightly pale tongue and her pulses were weak, deep and thin. We ran labs and her Valley Fever was negative, everything normal except mild increase to SDMA 15 (0-14), but this is decreased from 17 in 12/20. Her urine sp gravity was 1.011, no UPC run as rest was normal, inactive sediment no protein. She is on Vit D and we rechecked her level along with the neoplasia index at VDI lab: Vit D sufficient at 114 and neoplasia index was negative as TK1 and CRP were normal (low).

Wondering if maybe I need to cut her SMS down a bit more with the weaker thin pulse, lethargy, and decreasing appetite? Or other suggestions? Thanks, Peg

by naturevet

March 21, 2021

Hi, Peg. Did you discontinue the XCHT? Could that have explained the drop in appetite? It does tonify Qi as it combats the tumor.

If not and it was just accidentally omitted from the list, then the next step is to try reducing the SMS + Dang Gui.

The only other thought I have is that the dog may be Kidney deficient, and could benefit from Rehmannia 8. The pulse and tongue are typical of that. You might want to introduce that formula as you take away the SMS combination.

Hope that helps. Good job on at least stabilizing the dog!

Steve

Ba Wei Di Huang Wan

by peglaco

March 21, 2021

Thanks, Steve!
And yes, sorry, I abbreviated the Kan Essentials Harmonize the Qi (XQHT) as HTQ and she has been getting 3 tabs BID. So I will plan on having her decrease the SMS/DG mixture and see how that goes and may add in the BWDHW. I wondered about Kidney deficiency, too. Will update you at next recheck.
Thanks again! Peg

by peglaco

July 3, 2021

Hello!
This dog with the body full of lipomas and suspected larpar is doing better! She is relatively asymptomatic with the larpar as long as they do not overdo her exercise, she has energy and playful and lays on her Assisi mat frequently:) The big news is that her very large and hard lipomas on her left rear leg (back of whole thigh), and the right axilla, are now much softer and turning into multiple smaller, softer lumps. It still does not appear that she is developing new ones. Her tongue now is more pink in color and a bit plumper, her pulses are still deep, thin, weak and hard to palpate but may be starting to get a little more tone.

She weighs 64# and is currently on:
SRT 1/2 tsp BID
XCHT (Harmonize the Qi) 2 tabs AM, 3 tabs PM
TYT 1/2 tsp BID
SMS 100gm/Dan Gui 25gm: 1/4 tsp mixture BID
Probiotics
Phycox

She is on Honest Kitchen diet currently.

I am continuing on this plan unless something changes or there are other suggestions?
Thank you, Peg

by peglaco

June 12, 2022

Hi Steve,

An update on this very lumpy, stiff girl (63#2oz). She is still getting more lumps, but our concern now is her renal disease (diagnosed Stage 2 IRIS in 12/21) and more recent Yin/Blood Deficient signs: has more dried out hair and skin, with flakiness, has much more weakened left pulses this visit than her last check in March, has brittle dry nails with almost a separation of some as with lupoid onychodystrophy but not as painful, some mild weight loss with terrific appetite, smallish lavender tongue.

Her renal function is stable, slightly improved with UPC that has gone from 0.4 in March to 0.3 now. Her SDMA stays around 23-27, BUN 40s, creatinine started at 2.7 in 12/21 and now 2.4. Her BP is great 115mmHg.

She moves like she has stiff and dry tendons, has muscle atrophy of her hind legs, sore hips and low back, does not like to be touched, massaged other than her head. Still has Lar-Par but has remained stable even now with the hot weather (Phoenix).

Current herbs:
KE Harmonize the Qi 3 tabs TID (for the lar par)
NP BWDHW 3/4 tsp BID (renal)
NP SRT 1/2 tsp BID (lumps, renal?)
NP TYT 1/2 tsp BID (lumps)

My initial thought was I need more Yin/blood tonics for her and thought about switching the BWDHW to Yi Guan Jian but she still seems to fit more overall with the BWDHW (she does not have the GI/liv/pancreas issues or KCS, eye issues). She is more restless and panting at night which I am not sure is Yin defic. or pain related? Is otherwise not anxious or fearful, seems pretty happy. She also needs something more for her arthritis/stiffness, so was thinking maybe the HA granules, but do not think she needs all these formulas (or will take them!)

I am looking for help in herb selection/modification--should I add ophiopogon or something like that to the BWDHW? I think I am just confusing myself going round and round so need some guidance:)

Thanks very much! Peg

by naturevet

June 14, 2022

Hi Peg,

My own dog has similar symptoms: disliking the low back being touched, definite Blood and Yin deficiency, hind end weakness and restlessness at night. Even though her pulse was weak and was not Floating, I put her on Du Huo Ji Sheng Tang. It tonifies the Kidneys, including supporting renal perfusion. She is also on a Liver Blood tonic (YGJ) for gastric ulcer tendencies and elevated liver enzymes, but it was when we added in the DHJST that we saw her back end rally. When she doesn't get the herbs, it shows. She also gets an NSAID, but I'm not sure how much good it's doing her.

An appearance of renal disease in December plus a UPC that is less than one suggest you need a tonifying approach, so you might be able to jettison the XCHT. SRT is good to continue since it syerngistically works with the Kidney tonics to improve renal blood flow. TYT is fine if you saw it help slow lipoma growth. The most beneficial thing I've ever found for lipomas is a lower fat real food diet.

Hope this helps!

Steve

Du Huo Ji Sheng Tang

by peglaco

July 12, 2022

Thank you, Steve. I was using the XCHT for the Lar-par but maybe just tonifying kidneys with the DHJST will be sufficient to keep those symptoms stable. We will give it a try. Peg

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