Question Details
Hindend Weakness In A Dog
by CorinneC - December 3, 2022    View Case Report
Buddy is an 11yo MN Pomeranian. He came to me in April 2022 after a series of ailments. He was being fed a raw diet (surprisingly!). He had a history of chronic URTIs and UTIs, as well as the usual suspects for Cushings: pu/pd, couldn't lose wt, crepe paper skin, thin fur with much reduced undercoat and a naked tail tip, hepatomegaly, elevated ALKP and cholesterol, and heavy fat pads over his hips. He also had horribly luxated patellas that literally slid and stayed medial. He also had nasal congestion that sounded quite wet with a clear nasal exudate. His tongue was dark purple-pink, sl swollen, moist and pulses were slippery. Seemed a straightforward case and I put him on SMS. I later added Bu Gan Tang for his coat but he progressed very well until this Fall when the owner stopped the herbs "because he was doing so well!!!"

He returned to me in the same mess as April and I restarted him on SMS and BGT. I just rechecked him and his knees and nasal congestion have not improved like they did before. His pulse and tongue are the same (tongue less swollen). I decided to add some San Ren Tang (nasal Damp Heat) and a titch of Xiao Chai Hu Tang (knees, GB issue). And then I second guessed myself! Am I on the right track?!?! I don't want to send this boy on the wrong course! His pulses are really hard to decipher due to his bad knees and he is so wiggly and trembly on exam. Please guide me!!!

Thanks as ever!
Corinne
Replies
by naturevet
December 7, 2022
Great job on this little guy, Corinne. You figured out the problem behind most of his ailments, so there is actually only one left to solve.

Both patellar luxation and the nasal congestion are commonly associated with a tendency Wind invasion. Wind invasion of the dorsum causes spinal stiffness and fixations that then interfere with his own ability to keep his patellas inline using his glutes. A chiropractic evaluation might help a lot to restore that ability.

To help preserve any benefits of a chiropractic treatment (or to improve him slowly if those services aren't available), we need to probably choose a Wind expelling formula, which means choosing the type of Wind that is invading him. You can't be invaded by something unless you're prone to it already. In his case, that is Dampness. So we are looking for a Wind Damp formula that helps with the nose and back.

San Ren Tang actually fits that bill, so you could just start there. I don't think BH&K is a bad idea either.

If his nasal congestion improves, but nothing else, then I would look at Yi Yi Ren Tang next. It's one of my go-tos for patellar luxation

Hopefully this helps you out! I think you're right on track. If not, then we can both be wrong together!

Steve
by CorinneC
March 10, 2023
SRT helped resolve URT congestion and he is now able to stretch out his back legs, but the skin is an ongoing battle. Ran a thyroid panel and he is confirmed hypothyroid as well so may start him on DGSYS to tonify and support a bit (?) but waiting until meds kick in.
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