Question Details
Elbow Dysplasia In A Dog
by bfellis - May 1, 2023    View Case Report
Nymue is a 1 yr old (dob 4/11/2022) Female GSD. She presented to rDVM at 6 months of age with shifting forelimb lameness, L>R. She was diagnosed with UAC on L and on R. Panosteitis was diagnosed in L radius and ulna and mild patchy atlectasis in lungs with CT. UAP was corrected with a screw and proximal ulnar Oseotomy on 2/1/2023. An ulnar osteotomy was done on the R on 3/29/2023.
Patient has recovered well and came to me for TCVM/VSMT evaluation and treatment on 5/1/2023. Patient is BAR mild RF lameness but bearing full weight.
Tongue is pale body with dark pink edges, fine cracks in center with thin white coat. Dry body and wet tip. Pulse is broad full and toned, the pulse hits your finger tips superficially (Wind) but with light to moderate pressure a full Shao Yang pulse is evident that moderates with pressure at GB34. However, I did not find active GB points., though I adjusted T9PR prior to scanning-so May have missed a BL 19 Ah shi pt. Patient is not fearful, pretty friendly for GSD, not a vivid dreamer and no phobias. Coat is shiny soft and healthy with no dandruff. Nails are healthy. No history of allergies though she did have a severe rash on her abdomen in March -first Sx was 2/1, came into heat on 2/3 so had diapers and a cone for 2 weeks. The rash was in caudal abdomen and was very red with welts/hives. rDVM treated with Apoquel and there are no lesions present today. Though still on 16 mg once daily. She is fed kibble and on Cosequin and Salmon oil.
So, I’m getting a Shao Yang vibe but pulse is biggest clinical sign for that. She’s not clinically Blood deficient, though is on kibble and will likely be sooner than later. Cold does not aggravate her pain-she really loves cold weather. I was thinking about Shen Tong Xue Yu Tang but owner would like tablets. Does your Canadian herb company have that formula in tablets? I’m sorry I forgot the name of that company. Or would Xiao Chai Hu be appropriate? Could I add any herbs to help with elbows?
Thank you!!

by naturevet
May 6, 2023
Hey, Brett! It does sound like a Shao Yang case. Remember that Zhang Zhong Jing would prescribe Minor Bupleurum on the basis of pulse alone, because it was such a reliable sign. Having the pulse moderate with pressure at GB 34 is enough to clinch it, although a belly rash responsive to immune suppressants is likewise suggestive.

If the owner must use pills, that means Benefit Hips and Knees. I'd also add Quick River from Kan for its Blood moving effects, since it also has a Wind expelling effect.

A couple of things you can add:
1. Homeopathic Symphytum officinale. I use 30C strength and would give it twice daily. it appears to heal subchondral bone deficits (i.e., essentially micro-fractures) to resolve lameness in OCD related disorders like UAP. I'd use it for a month or so
2. If the panosteitis is not yet resolved, then I'd also use Boneset (which you can buy as a tincture online) and homeopathic Mercurius solubilis 30C. I'd go with twice daily dosing for that, too

Let us know how it goes!

by bfellis
May 9, 2023
Excellent. Thank you !!

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