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Chronic IBD In A Dog

by mszyrmer - March 6, 2023 View Case Report

Hello Dr. Steve!

I have a chronic IBD dog.. normally I have pretty good luck with fixing these dogs but this one seems to be eluding me.

Snowbee is a 3.5 year old, FS, Wire Fox Terrier

-At 8 months of age began to show symptoms of intermittent vomiting, diarrhea, licking paws and increased anxiety. After multiple months of various diagnostics, endoscopy revealed chronic eosinophilic and lymphocytic enteritis. Was put on Prednisone and HA diet. Symptoms temporarily improved on this but vomiting and diarrhea eventually returned. Appetite very low and weight loss. Improved with prednisone.

-Every year her symptoms are aggravated in April (Shao yang?)

-I saw her the first time in June 2022. She responded well to a combination of rabbit-based kibble, mixed with cooked pork+veggies, Wei ling tang and Xiao Yao San.

Appetite is now normal. No longer on Prednisone. Anxiety improved. Vomiting/ diarrhea episodes much less frequent.

However, as of January 2023, the vomiting and diarrhea episodes came back. The diarrhea now has blood. It seems that even the slightest food change will trigger her. She is now on a very bland diet of Cod and rice, but even a small change in the diet will cause a digestive upset. She is back on Wei Ling Tang only and this seems to help slightly at keeping her stable.

In January, she woke up every night between 3-5am to defecate. This stopped when they stopped giving her kibble.

Recently stool has a bad odor. She is eating soil. So it seems there are some heat signs that are starting to show up.

I was looking at the Gold Standard herbs, and wondering if the Adoptrex might help her?

by naturevet

March 7, 2023

Hi Magda,

The Shao Yang version of Leaky Gut explains most of these findings, so Adoptrex is definitely one idea, since it merges WLT (which has been working) with Minor Bupleurum (which treats the Shao Yang). The latter fits an April onset, an immune mediated issue overall, the paw licking (signaling potentially allergies), vulnerability to and worsening from stress (which is a common feature in Shao Yang dogs), and the eventual worsening of symptoms on pred. Systemic immune mediated disease from Leaky Gut is aggravated by a weakness of local immunity at the gut wall, which prednisone aggravates. So Adoptrex is not a bad idea.

It's always good practice, though, to fully explore aspects of what has been working rather than jump onto a brand new set of tracks. I'm also looking at the fact that you got this dog stable with a basic Zang-Fu Liver-Spleen approach. Even now, you can maintain stability just by focusing on the Spleen. That has me wondering if there is something else you can do from the Liver Spleen angle first.

One possibility is to add a touch of Si Miao San. WLT is warming, so if there is a little Damp Heat in the GI, it could be becoming aggravated even as the Spleen is finding support. Using the two formulas simultaneously may give you continued Spleen support while counteracting any Damp Heat in the colon that is producing colitis.

Another idea, which I like best right now, is to try Bu Zhong Yi Qi Tang. It harmonizes the Liver and Spleen like Xiao Yao San did, but has the added advantage of slowing bowel transit (thus getting rid of the stinky poo) while astringing bleeding. From a biomedical perspective, it strengthens low gut wall immunity, and is especially likely to be needed at the winter solstice, when Wei Qi (a form of Tai Yang energy) is lacking; and when Jue Yin (i.e., tendencies to Liver Qi stagnation) is at its peak.

So BZYQT fits both how the case started and what you're seeing now, as well as what has worked to date. Whenever you have that kind of all round good fit, it's the place to start.

How does BZYQT fit a seeming Shao Yang issue? First, because it takes care of an aspect of immune mediated Shao Yang disease, namely the low mucosal immunity that gets the whole IBD/allergy issue rolling.

It also has a strong lifting action which can be super helpful in Shao Yang cases. Shao Yang disharmonies can result in imbalances in the distribution of Qi and Blood along the vertical axis of the body, since it is the Shao Yang that controls the Dai Mai. If it is failing in good Dai Mai control, uneven distributions of Qi and Blood result. Commonly that creates stool urgency in the lower burner and deficiency from anxiety in the upper burner, both of which are features of this dog.

Sorry for the long explanation. Hopefully there is enough there for you to figure this dog out. I wouldn't be surprised if he wound up doing really well on Adoptrex and Bu Zhong Yi Qi Tang

Steve

by mszyrmer

March 13, 2023

This is amazing! So helpful - Thank you :)

by mnewk

March 20, 2023

I would think fecal transplant and lots of colostrum would help
Margo Roman has the transplant stuff
Mark Newkirk

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