Question Details
Loss Of Body Condition In A Dog
by Dr. Krisi Erwin - April 6, 2021    View Case Report
Hello again!

So I have this patient, Merlin who is a 12 yo, MN Cardigan Corgie. I have been treating him for the last several years for low back and hip pain. In the last 6 months he has really started to present with mixed clinical signs that I am having a very hard time sorting through. Prior to this, he is prone to fighting with his housemates and the family has to rotate their dogs around so that there is harmony between them. He has a history of Atopy and has had to be on Apoquel for years.

What I am seeing now is:

Intermittent enlarged LN- popliteals most often but sometimes submandibular and right prescapular

PU/PD, flaccid abdominal wall, seeming hot- like a Cushing's dog but cannot confirm on labs and Alk Phos is normal.

Seems hot and dry

Significant muscle wasting on his head and dorsal topline- he looks like he has cancer.

Right sided facial nerve paralysis and sagging.

Hair coat is more dry and losing much of hair- especially from his jaw down to the manubrium.

I don't know why I'm having such a hard time sorting out what to try re: Chinese herbs. RE: AP, I am trying to do points to nourish Yin and Blood. His tongue at my last visit seemed somewhat flabby, purplish lavender in center and redder around the edges. Pulse seems thin and deficient to me. I do not believe it to be wiry.

I've had Yi Guan Jian lurking in the back of my mind for him to try. I guess I keep having additional thoughts of cancer in the back of my mind too. I would love some thoughts and will try to sort out how to post pictures of him as well. I think the rDVM has recommended abdominal U/S, ACTH stim etc but the family is oddly reluctant. I'm not sure if it's because things are so much harder because of COVID and because of curbside service?

Thank you so very much. Please let me know if any additional information would be helpful!!

Sincerely,
Krisi
Replies
by naturevet
April 6, 2021
Hi Krisi,

I agree that Yi Guan Jian springs to mind. It addresses Yin deficiency, which is a top consideration if an animal is losing condition despite eating well and having normal stools. Is that the case? If so, then reach for YGJ. YGJ also cools the Yang Ming, which can help control the high thirst and ventral neck dryness and alopecia.

A Shao Yang disharmony may also be present here. The Shao Yang controls Yang movements, which in turn very much depend on the 'holding power' contributed by Yin. Thus, a latent tendency to disharmony in the Shao Yang is often brought to light or aggravated by a Yin deficiency.

Shao Yang disharmonies interfere with the movement of Yang in both directions, both away from and toward the interior of the body. When Yang is trapped in the interior because of a malfunctioning Shao Yang, it can aggravate Yin deficiency of the interior, by drying out moisture reserves. A loss of moisture in the Yang Ming (Stomach channel) leads to high thirst and ventral neck redness with alopecia, among other symptoms. Normally, we expect a forceful 'full' pulse with simple uncomplicated Shao Yang disharmony, but where Yin and Blood deficiency have become bedfellows with it, the pulse becomes weak.

Other traits suggesting Shao Yang disharmony exists here include:

  • lymphadenopathy

  • systemic immune problems, ameliorated by i mmune suppressant medication

  • aggravations in spring and fall

  • central stasis, showing up as a purple tongue center

  • polyuria and polydipsia (the former from Heat trapped in the upper burner or Stomach, and the latter because of impaired delivery of Yang to the Kidneys to generate Qi)

  • Secondary Qi deficiency, causing symptoms like abdominal flaccidity


For sure, follow your instincts and start Yi Guan Jian, but consider adding in Xiao Chai Hu Tang afterwards to take things to the next level

Hopefully that helps!

Steve
by Dr. Krisi Erwin
April 7, 2021
Thank you so much!! I'll bring the Yi Guan Jian with me next week to his appointment and I will report back. I've prepared them for the potential Xiao Chai Hu Tang as well. I really appreciate it!!

Sincerely,
Krisi
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