Question Details
Polyphagia In A Dog
by henry - April 26, 2023    View Case Report
Hi, Steve, A few years back I mentioned in a post I was retiring. Couldn't stay away completely so work one afternoon a week.
This case is my own dog. A 14 year old neutered male toy poodle, Mr. Peabody. About 18 months ago, his appetite, which had always been normal, increased dramatically, Lab work at that time was unremarkable.

Also, for several years he has had a dry intermittent cough. It has responded well to XFZYT and became worse when I tried to wean him off so he still gets it twice daily. He has had a workup for the cough in December 2022 with an internist who found normal lungs on radiographs. She did observe hepatomegaly and found slightly elevated ALP with bloodwork.

Over the last few months he has turned into a Cushingoid poster puppy. Thinning hair, polyphagia increased, pot belly, some panting. Although I have not observed PU/PD. Blood work this week revealed ALKP of 1539 and ALT 276. Ultrasound revealed a normal liver but a small mass on the spleen and a greatly enlarged left adrenal gland which she believes is neoplastic.

While I am going to do a surgical consult just to cover all the bases, I am 99% sure that I will not pursue surgery. He is almost 15 and happy and I prefer to keep it that way and use alternative treatments.

So, my questions: Pulse is slightly rapid and weak; tongue is purple. I do find active Shao Yang points with AP but am considering Ge Xiao Zhu You Tang over XCHT as he did respond to XFZYT for the cough and GXZYT seems to be an apt formula for abdominal masses. Thoughts?

In addition, should I address the Damp Heat signs (pot belly, panting, polyphagia) more directly? Should I continue XFZYT as I don't like to muddy the waters with too many formulas. Finally, I have notes from about 10 years ago when you lectured for a CIVT course about neoplasia that reference Vitamin A/D in cancer treatment, but I am a little unsure about doses. Could you give a recommendation?

As always, thanks for your help.Deirdre
by naturevet
April 29, 2023
Hi Deirdre! Welcome back to clinical practice. Naturally the toughest cases are our own!

It's my impression that Shao Yang disharmony is a cause of Cushing's in some dogs, probably especially where there are genuine tumors. Pot bellies indicate Qi stagnation as well as Damp, and strong appetites and poor heat tolerance are a feature of Shao Yang Cushing's as well, especially if there is concomitant Yin deficiency, because of the drying effect of too much Yang being trapped in the Yang Ming by the malfunctioning Shao Yang. The weak rapid pulse suggests Yin deficiency is, indeed, present.Excess Shao Yang also means Blood is trapped in the interior organs like the liver, lungs and spleen, producing organ enlargement and chronic cough.

Based on all of that, I would use Xiao Chai Hu Tang, but team it with Yi Guan Jian to nourish Yin at the same time. There's nothing wrong with using Ge Xia Zhu Yu Tang at the same time if you like, but the root condition of everything appears to be a Shao Yang disharmony.

Hope this helps! Let us know how it goes!

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