Question Details
Autistic Behavior And Seizures In A Dog
by fdzenitsky - October 18, 2021    View Case Report
Hello Steve et al!

Scout is a 16 MO M Min Schnauzer with congenital microphthalmia OS w/ vitreal degeneration of the lens and L7 transitional vertebra partially fused to ilium on R, so L/S stenosis. I first saw him in March, his owner was concerned with odd behaviors that began 1.5 months following a rabies vaccine and the MRI and meds for life approach from her local vet. At that time, we have compulsive tail-chasing spinning, both directions, can last several minutes. He’s restless, strains to defecate w/ right leg up (d/t the stenosis I presume). T is normal, wet; P is deep, wiry, not compressible. I think TBO – subepileptic neuropathic disorder, psychosis w/ a genetic connection (which is reported in terriers) – repetition, OCD, autism. Perhaps vaccine induced, need to internalize Yang. I give him the rabies tautode and start CHJLGMLT and raw diet.

In June, spinning improved substantially, now an occasional slow circle, easily distracted to stop, still lots of nervous energy. T is rosy w/ mild lav center; P is mid, wiry. I switch him to XCHT and CBD oil. The day he runs out of XCHT (early August), he is way overstimulated or terrorized going through a car wash and has his first seizure, grand mal, the next day ~6am, then again 2 days later at same time. Causal or coincidence? His spinning has ramped up again. Bloodwork in August is unremarkable, T3 is low, Mg low normal. He is very unsettled on exam, panting, can’t focus. T is rosy, redder under; P is deep, wiry. I started him on TMGTY on 8/8. He proceeded to have seizures on 8/11, 13, 20, 27, 9/2, 3, all but one between 2:45-6:30am.

I see him September 4th. T is rosy red, P is deep, full, wiry; his torso feels warm. At that time, I transition him to XCHT, adding to it Tian Ma (20g), Gui Zhi (12), and Bai Shao (15), also QYT. His owner thinks this combination is helpful, but still has seizures 9/12, 14, 3 while the owner is out of town for a week (9/17-24), 9/26, 10/4, 6, 7, and 15. They may occur earlier now, as early as 12:30am, always only in the 12:30-6am time period. I let the QYT run out to see how he does on the modified XCHT alone. Honestly, I just don’t know if I am making any headway here! Below is a summary of the signs from his owner. What are your thoughts of this disorder and how to help this guy live a more comfortable life? I watched your recent CIVT talk on behavioral issues and think his Po is strongest, meaning LV is lacking? Liver Yin Def, Empty Heat? Can that account for the autistic behaviors and seizure disorder - along w/ TBO?

-Spinning and trying to bite at rump/tail area
-Scratching his shoulder with his back legs, a lot. Especially if he appears nervous.
-Hard head and full body shakes throughout the day, like shaking off water, almost always when fastened to go outside and as he comes back in and other random times. It appears to me a coping mechanism to shake off excessive energy
-Yapping/snapping during seizures currently (at first, just paddling)
-Restless. Circles, lies down for a few minutes, gets up smells floor and moves then starts over. May repeat 5 or more times before he settles.
-Barks at everything in the yard, dogs, people, nothing.
-Will stand for hours outside just observing. Sometimes he lays but mostly stands. He loves to be outdoors. Loves snow. Not a fan of rain.
-He doesn’t want to be held except in the car. Won’t sit on your lap
-Recently started begging and grabbing for people’s food even if he just finished eating.
-Extremely hyper when people visit home. If you ignore him for a few minutes, he will finally settle.
-He startles at some noises…the vertical blinds rattling really bug him. He gets anxious and will yip and grab something and shake it or try and chew on inappropriate things: shoes, pillows, recliner leg rest, etc. It doesn’t last long but he freaks out. He normally doesn’t chew or bother anything except when noises set him off. But fireworks don’t bother him.
-If his toys are picked up and put in his bed, he will dump them out. if toys are stacked and lined up against the wall he doesn’t touch them.
-if pills are added to his meal he will finish his meal, lick the pill clean, and line up the pills beside his bowl

That’s the skinny, thanks as always for enlightening us!
Franchesca
Replies
by naturevet
October 19, 2021
Hi Franchesca

I don't think we can discount the improvements you saw initially on the CHJLGMLT. If that's true, then this must somehow be a Shao Yang issue. These normally abate in the summer months, but can resume in the fall months. One exception, though, might be if there is an accompanying Yin deficiency.

Yin attracts Yang inwards in the late summer or fall, unless it's lacking. Meanwhile, though, Yin has itself internalized from the upper and outer layer of the body, and begins doing so actually in about June. If Yang is left unopposed in the upper and outer layers, signs of a failure of Yang to internalize can heighten, including seizures.

In terms of which Yin tonic to use, I've been pairing the Shao Yang formulas with Yi Guan Jian, although Zhi Bai Di Huang Wan is an option. ZBDHW is more cooling, but YGJ addresses Yin deficiency in all three burners, so is a more comprehensive solution. Having a Yin tonic on board that targets the Stomach and Heart is advantageous, since Heat accumulating in the Stomach is passed to the Heart to precipitate seizures. Those seizures are more apt to occur in the early morning hours, when the Stomach is at its hottest (and thus driest).

As for why XCHT or TMGTY didn't work, the former is ultimately drying in nature and can eventually be aggravating if there is underlying Yin deficiency. The latter is downbearing, when the patient actually needs release of the Shao Yang layer.

One last thought. Some of the biting behaviours may be due to a sort of Psychogenic Itch. Heart Fire is the main cause of itch, and we know he's likely got that, given the seizures. Suan Zao Ren can be added to YGJ (say 15g per 100g) and helps address that kind of itch biomedically. It also is an astringent, helping to conserve Yin resources. Its sour nature pairs with the sweet of YGJ to make it potentially a more powerful Yin tonic. Something to think about

Hopefully this helps you out!

Steve
by fdzenitsky
October 19, 2021
Extremely helpful, Steve!

So, good plan to go back to CHJLGMLT and add YGJ preferably. This dog runs hot per owner and he does feel warm on exam, but I'm not sure if it is stress-related nervous energy or if the cause matters. I'm happy to give the YGJ a try. I don't have the Suan Zao Ren, but do have Suan Zao Ren Tang (Suan Zao Ren (Semen Ziziphi Spinosae), Fu Ling (Poria), Chuan Xiong (Rhizoma Chuanxiong), Gan Cao (Rx/Rz Glycyrrhizae), Zhi Mu (Rhizoma Anemarrhenae)). Can I add this instead, maybe 30g since SZR is 55.6% of formula? From my CIVT instructor, Jodi, SZRT nourishes the Blood and calms the Shen, clears Heat and relieves irritability. Suan Zao Ren nourishes Liver Blood and calms Heart Shen, Chuan Xiong regulates Liver Blood, Fu Ling sedates the Mind, Zhi Mu nourishes Yin and clears deficiency Heat, and Gan Cao clears Heat and harmonizes. It sounds like the formula would appropriate, but is it too much w/ the other formulas? Worth a try?

Thanks again!
by naturevet
October 20, 2021
Hi Franchesca,

My only concerns are that the other herbs may dilute out the effectiveness of the Suan Zao Ren itself; and that the Chuan Xiong has an upward direction to its action in the body, which could potentially aggravate seizures.

Perhaps let's add one formula at a time here, starting with the CHJLGMLT + YGJ. If that is going okay, with no backwards steps, and maybe some forward progress, then you can add in the SZRT at a half dose. If still improving, you can try bumping it up. I'd use full doses of the CHJLGMLT and YGJ in the interim

Hopefully that makes sense and helps you out!

Steve
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