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Upper Respiratory Stridor In A Dog

by fdzenitsky - April 5, 2022 View Case Report

Claire is a 4 YO SF Newfoundland w/ chronic upper respiratory stridor and exercise intolerance from intubation-induced laryngeal damage during her spay at 2 years of age. The stridor began 2 weeks post-sx, at that time the arytenoids had minimal movement during inspiration and laryngeal exam revealed laryngeal fibrosis. Surgical resection of the tissue improved improved, but did not resolve respiratory stridor or effort. When she was spayed, radiographs of her hips showed the head of her femurs were not completely in the acetabulum and suspected hip dysplasia.

She has a history of pruritus following rabies vaccine in 2018, hair loss, hot spots. A diet change to raw w/o chicken helped resolve that. She is the Boss, food and dog aggressive, will fight if challenged, but tolerates submissive dogs, fiercely protective of her person. She is very heat intolerant, overheats easily.

On exam, T is normal pink w/ a hint of lavender, wet, drooling; P is deep, toneless, thin for a dog her size. Other than the stridor and continuous panting, the exam was unremarkable. I adjusted her hips (normal gait), but don't do AP, yet. She is stable on no meds, but I'd like to try and help her condition so she can breathe easier and enjoy swims and hunting again. She has a history of Dampness 2' to Spleen deficiency, but I am curious if an iatrogenic laryngeal injury / dysfunction is considered to be SYD like laryngeal paralysis or collapsing trachea in your assessment. Certainly, the hip dysplasia is seen as SYD, but the hips are also believed to be controlled by Kidney Essence (Yin), so Kidney Yin deficiency? I am thinking of starting her on XCHT w/ Qin Jiao and would like your opinion if this is the best approach (main concern is stridor) and if I should add SWT as well. Will adding SWT dilute the effects of XCHT and appropriate w/o overt Blood deficiency signs?

Thanks for all you do, Steve!
Franchesca

by naturevet

April 7, 2022

Hi Franchesca,

The history of trauma to the larynx suggests an upper burner Blood mover like Xue Fu Zhu Yu Tang might help.

The weak pulse is common in Newfoundlands, and is often associated with tendencies to Damp and Wind invasion, so if the airway sounds moist at all, I'd also wonder about using San Ren Tang, either in addition or instead, to address the stridor

The improvement seen with the diet change can support either Shao Yang disharmony or Damp Heat. If raw in general didn't help, but only raw avoiding chicken, then Shao Yang is more supported. If this is a Shao Yang case, the weak pulse suggests adding something in like Si Wu Tang, as you suggested. It's possible the Blood moving effects of Si Wu Tang might help the larynx, or you could try using XFZYT as the Blood tonic to combine with XCHT. Not quite as tonifying

If Blood formulas aggravated the stridor at all, then definitely look at something like San Ren Tang, Si Miao San or Wu Ling San

Hope that helps you sort this one out!

Steve

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