I am working up a long term GI case, which may be IBD or IBS, since for most of recent years, episode triggers appeared to be stress. Unfortunately, they live 2 hours away, and traveling is one of the dog's triggers, so I am doing this as a distance consult until a more compelling reason arises for me to drive to Rochester (like performing a fecal transplant). So no good data on pulse or tongue. This dog's pattern is always the same-- stops eating for a few days, then begins vomiting, then has diarrhea. She has been on pred on and off for years and years, to the point of iatrogenic Cushings symptoms. Negative for Addisons, internists say small bowel foci, with accompanying B12/folate insufficiency. Nothing exciting on abdominal U/S. Has tried 5 different hydrolyzed protein diets. Nothing works long term. Previously, travel was main trigger, but in past year, has had episodes with no travel. They bounce between Pred, Cerenia, Metronidazole and diet change all year long, and has since she came to them at 8 weeks.
I am trying to decide whether to start with Wei Ling Tang or Bu Zhong Yi Qi Tang. Can't remember whether response to prednisone is a sign of damp or a sign that damp is not an issue!! I remember reading that pred creates dampness (as in Cushings is a damp condition), so if dog responds positively to pred, the initiating cause is not damp. Does that logic sound right? WLT covers all the GI signs and addresses dampness. But this dog is also super anxious-- has been since pup. Bu Zhong would help that more, but misses the upper GI signs.
Interestingly, when I review her vet visit history, her episodes tend to be in Shao Yang seasons, which I can't make any sense of in terms of the whole picture-- early fall and early spring. Of course the record may be misleading-- she may have been on pred in May-July, and problems only arose when they weaned her down. Any thoughts?