Question Details
Cervical Ivdd In A Dog
by mszyrmer - March 1, 2023    View Case Report
Roxy is a 9 year old FS Doberman Pinscher.

Previous history:
-DCM currently managed with Sotalol
-Severely elevated liver enzymes (in the thousands) since 2018.
-Most current labs (February) showed ALT 1234 and Alk Phos 2819; Recent ultrasound (February) showed cirrhosis and "The liver is irregular in appearance with no normal hepatic parenchyma and diffuse hypoechoic nodules."

-Since early February, she has been lethargic, has a low appetite and is showing signs of pain. This is why the owner took her to the specialist for the ultrasound and labwork.

On exam, she has severe kyphosis, mild CP deficits on back legs with evidence of scuffed nails on back legs. Her neck is very tight. Has yelped a few times and has a very stiff gait with short-strided front and back legs. Has a history of torn CCL and TPLO surgery.

What we can't figure out is - is the pain coming from the liver issue (I think less likely because these elevations have been the same for a long time) or is it a musculoskeletal issue (neck pain/ wobblers, etc.).

Due to the high liver enzymes, I wanted to put her on XCHT+Qin Jiao to also support her lower back. I don't know how much this formula will support her neck, however. But, before I did this, the owner wanted to start Prednisone (Specialist's recommendation for the liver and I figured would help her pain too)
We wanted to start one thing at a time so I thought that was fine.

She did well initially after acupuncture last week and starting the Prednisone, however, on Saturday night (during the cold spell in Los Angeles), she had a major neck pain flare up even while on the prednisone. Now she is in a lot of pain per the owner and not eating well.

I will check her pulses and give a better pulse diagnosis when I see her tomorrow... but if pulse is superficial and responds to BL 40, I will consider Du Huo Ji Shen Tang for her.

My question is: Is it ok to give Du Huo with the severe liver elevations and the cirrhosis? Is there another herb that would be better for both of these conditions?


Magda :)
by mszyrmer
March 2, 2023
Quick update: Her pulse today was very superficial and forceful. It was hard to say if it softened or not with BL 40... possibly slightly but not dramatically. But she seemed to relax a little with other wind points: GB 20, GV 14.

She is not eating well and vomited one time. I began to wonder about Agastache formula instead. Would that also be safe for the high liver values and fit the pattern?

I forgot to mention that she has a chronic UTI that we recently treated with Clavamox (and responded well) but had bloody urine again today.
by naturevet
March 5, 2023
Hi Magda,

I'm thinking this is a dog that has a pathogen invasion of both the Tai Yang and the Shao Yang. So your sense of some sort of Wind Cold Damp expulsion is likely correct, but that to completely oust the pathogen, the Shao Yang (beneath the Tai Yang) will also likely need to be treated and released. You can get both actions in one product by using Gold Standard Herbs Voltrex. You can buy wholesale from them, then just drop ship to your client. Or they can buy it themselves. Or you can buy it wholesale then sell it to them. To set up a veterinary wholesale account, just email them at

Consistent with Shao Yang involvement are the pulse you describe as well as:
- the cruciate tear and need for a TPLO
- very high liver enzymes
- UTIs (since the Shao Yang controls the Dai Mai)
- digestive unrest and lack of appetite (since the Shao Yang mediates the production of Source Qi and since all digestive organs are controlled by the Triple Burner, a Shao Yang structure)

You can see the Tai Yang involvement in the more superficial nature of the pulse, even if it didn't feel Floating or Drumskin; and also in the involvement of back and neck pain and stiffness; and the worsening of those symptoms in inclement weather.

My guess is that her pulse would respond really well to GB points. I'd check for that if your still unsure what to try, but Voltrex should be safe if you're not seeing the dog soon. If GI signs worsen on Voltrex, then the dog likely has a Stomach Yin deficiency and you'd want to add Yi Guan Jian as well.

Hopefully this helps you out!

by mszyrmer
March 6, 2023
Thank you! I remember this formula from the lectures but haven't used it yet... will send the client the link and in the meantime read up on my notes about it. Thank you for the help!!!
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