He had to have an enucleation as the shavings caused irreversible damage to one eye (ectropion).
After rescue: he had a pexy done.
Upon adoption: he came with prednisone for presumptive IBD.
Past 8 months:
Ectropion sx for remaining eye, 3 foreign body surgeries which have resulted in ressection and anastamosis of at least 6-8 inches small intestine, adhesions.
Current complaint:
Chronic intermittent (one day ok, next day terrible) explosive, urgent small bowel diarrhea with foul smelling gas. Urgency, no straining or blood, some mucus is present.
Significant belching constantly
He bloats significantly if he drinks a lot of water at one time, which he often does if not monitored.
Gi tract is loud
He regurgitates food and foamy water if drinks water too fast or in excess.
Can be a little cranky if asked to get off couch.
Irregular appetite
relatively good energy for a Dane when not having an episode
Sleeps deeply with snoring, no vivid dreams
Territorial on a leas, sucks stuffed animals
Does not have a particular temperature preference
Pulses: Superficial and wiry (not really slippery)
Tongue: lavender with a lot of white coating, very drooly
Pulses did improve with dry needling BL22
Current diet: Natures's Balance sweet pot and salmon, red meat seems to make it worse per o.
Diarrhea Does respond to metro and tylosin initially, but clinical signs recur even when still on metro and Tylosin
TCVM DX: Spleen qi def with stomach stagnation, rebellious qi, possible shao yang disharmony.
Conventional: Suspected IBD/IBS (no biopsies done at 3 surgeries even with ressection...why), possible anatomical issue due to pexy although we don't know if bloat situation was prior to pexy as well.
Treated with Wei Ling tang (NP) 2 tsp twice daily (a higher dose due to severity)
Conc. Sheng Ling Bai Zhu (JT) 3 capsules twice daily
XCHYT (NP) 2 tsp twice daily
Entero pro by vetri science
2 weeks: Still wax and wane diarrhea. no significant improvement although diarrhea seems to be a little less severe. Belching has reduced but still bloats. Appetite improved.
So now I am stuck
Is my TCM diagnosis correct. Do we just need more time?
Should I start with a hypoallergenic commercial diet or might we fare better with a fresh diet. We can start with either one. Owner initially reluctant to change diet due to expense, but now willing to start with one of the above options.
Do we add in low dose pred.
There is still a lot of stagnation in middle jiao wiht phlegm and I do think there is a TBOB (Shao Yang Disharmony as pulses improved with BL22).
Any help would be greatly appreciated.
Thanks so much as always
Dr. Hannah Wells