Question Details
Hindlimb Edema With Prostatitis In A Dog
by drwells - July 25, 2022    View Case Report
Help with pattern diagnosis and herbal suggestions:
Teak, 7 yr M Leonberger with acute onset in Fall 2021RHL swelling, mild fever ,slight increase in cholesterol (Very mild) , wbc and low T4. Abx non responsive, Progressed to severe RHL edema. AUS showed prostatitis, cystitis with abdominal effusion. CT confirmed prostatitis, cystitis, periotoneal effusion and deep vein thrombosis. RHL then had open draining wounds with staph Pseudointermedius. Hypercoagulation as well.
On many meds to include pentoxyflyline, Xarelto, Plavix, Meloxicam.
Constitution: wood
TCM DX; damp heat with Shao Yang invasion ???
Previous vet has him on Shao Fu Zhu Yu Tang.
Any thoughts?
Replies
by naturevet
July 26, 2022
Hi Hannah,

That is a strange and challenging case. Prostate conditions are associated with systemic tendencies to thrombosis in people, so it's reasonable to assume the same may be occurring here, implying that the secret to resolving the leg complaint is to resolve the prostate complaint (unless that has already been accomplished). if the prostate issues are still present, I would use a combination of Minor Bupleurum and Ge Xia Zhu Yu Tang to address it. The latter is more anti-inflammatory than SFZYT, which is more suited to a very low grade smouldering inflammatory process, not one that is so fulminant.

If the prostatitis and abdominal effusion issues are 100% resolved, then we just have the DVT to resolve. The infection is just an opportunist. Once we normalize circulation, then the body will resolve it.

We can use severe stasis dermatitis in humans as a model for how to approach this dog, since human patients with that condition have profound lower limb swelling, pitting edema, and non-healing wounds. The best thing I have found for that is Hoxsey-Like Combination, along with a real food diet.

The drugs in use inhibit platelet aggregation, but don't do much for endothelial dysfunction causing exposure of sub-intimal tissues that initiate clotting. Blood movers are called for in that instance, like Modified Xue Fu Zhu Yu Tang. If the infection is nasty-looking and inflamed, consider additionally or instead Xian Fang Huo Ming Yin. These can be used with Hoxsey if you want to hedge your bets.

Hopefully this helps you out. Please let us know how it goes!

Steve
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