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Arthritis, Early Kidney Disease And CHF In A Dog

by Kumiko - April 18, 2021 View Case Report

Hi Steve,

I need help with this case please?

I have a 13 years old Cavoodle who has arthritis, early renal disease, CHF and a 10 cm round mass hanging from her chest, which has been oozing blood. She keeps chewing the mass and making it infected. Due to her CHF, their local vet told the owner that she is not fit enough for the general anaesthetic for the lumpectomy. Her lump is discharging everywhere in the house (she has been wearing Elizabethan colour for 6 weeks, but the owner feels cruel).

She also can't settle down and keep wandering around the living room the whole evening. The owner reported that she sometimes wakes up middle of the night but still sleeps ok (an early sign of Yin and Yan separating?)

Her pulse was superficial and forceful (Excess Yang).
I could not check her tongue as she did not like getting her face touched.
She prefers cool place, and I saw her drinking a fair bit of water during the home visit (Yin Deficiency).
Reactive points were BL 23.
Her previous blood test showed mild azotemia with borderline SDMA and mild elevation of lipase (TB obstruction?).
She had dry biscuit entire life, but now the owner is cooking her food as she did not like renal diet at all.

I have started acupuncture on this dog but have trouble choosing the right herbs as she has so many issues! How would you choose herbs if you have so many conditions to treat? After the first acupuncture session, the owner reported that she gained strength with her back legs, but she coughs more.

My choice of herbs is Chai Hu Jia Long Gu Mu Li Tang to treat TB obstruction and Yin Deficiency then manage arthritis with acupuncture.

I hope I am on the right track. If not, could you please guide me?

by Kumiko

April 18, 2021

Sorry TB obstruction was increased cholesterol. It was within normal limits.
Is it possible to add Rhemannia to the CHJLGMLT to help the kidney? Sorry if it is a silly question.

by naturevet

April 18, 2021

Hi there,

I like your idea of Chai Hu Jia Long Gu Mu Li Tang. It can help with pulmonary edema, the nocturnal restlessness, the thirst, and the heat intolerance.

To support renal blood flow, which I also agree is a good idea, you can try Rehmannia Eight (Ba Wei Di Huang Wan), but you can also accomplish that by further supporting cardiac function. To do that, I would try Modified Xue Fu Zhu Yu Tang. The latter has the advantage, with CHJLGMLT, of being anti-cancer, thereby potentially reducing the growth, inflammation and bleeding of the chest tumor. If the dog gets to a point where the cough disappears, which may happen under the influence of these two herbs, then the murmur might also become quieter, helping the local vet see their way to risking anesthesia and removing the tumor.

In the meantime, I have used topical Xian Fang Huo Ming Yin to help heal, de-inflame, and stop bleeding in tumors. I mix about 10g of the granular extract in a few ounces of a wound healing salve, like something made from paw paw, comfrey, or calendula, then apply it once or twice daily to the mass. I would use a non-stick Telfa pad to do that, then secure it to her chest with a bandage. Even topical application of a granular extract of San Qi (Panax notoginseng) might help to stop the bleeding and slow tumor growth, until the heart has a chance to recover and allow surgery

Hopefully this helps you out. It is a challenging case, but the formulas noted above should address many aspects of it, including even the osteoarthritis. As the pulse becomes deeper, then you can switch from CHJLGMLT to XCHT, which still supports the heart and lungs while being anti-cancer, but also does a better job of addressing limb and joint pain.

Fingers crossed you see some progress!

Steve

by Kumiko

April 18, 2021

Thanks so much Steve for your time and help!

Just to clarify, I start both CHJMLT and modified XFZYT at the same time and wean her off CHJMLT when the pulse become deeper? Or just start with CHJMLT?

Sorry to bother you.

I’m so excited to try the ointment on the lump :)

Thanks again!
Kumiko

by Kumiko

April 18, 2021

Thanks so much Steve for your time and help!

Just to clarify, I start both CHJMLT and modified XFZYT at the same time and wean her off CHJMLT when the pulse become deeper? Or just start with CHJMLT?

Sorry to bother you.

I’m so excited to try the ointment on the lump :)

Thanks again!
Kumiko

by naturevet

April 18, 2021

Hi there,

I would use the XFZYT and CHJLGMLT simultaneously to get on top of the cough and protect the kidneys. Once the pulse becomes deep, if it is also strong and full, then it's time to switch to XCHT

Hope that helps!

Steve

by Kumiko

April 19, 2021

Thanks for clarifying Steve.
Now I need to convince the owner with the plan :)

I will let you know the outcome!

Kumiko

by Kumiko

May 13, 2021

Hello Steve!

I would like to thank you as Miley is now able to relax on her bed (no more pacing around)and her cough seems to be less. Her owner is also applying the herbal ointment to the lumps and the lump seems slightly smaller.

Thanks again for your advice :)

by naturevet

May 14, 2021

That's great news, Kumiko! Congratulations on helping out such a difficult case! Let me know if things shift and you need more advice

Steve

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