Question Details
Spinal Tumor Or Meningioencephalitis Of Unknown Origin In A Dog
by LJH - May 8, 2023    View Case Report
Hi Steve, I'm seeing a 7 yr F(S) Mixed Breed weighing 10kg. She was initially presented to me for acupuncture after she started having difficulty going down stairs a couple of weeks before, then progressed to ataxia, knuckling and crossing over in all 4 limbs shortly before I saw her. At her rDVM bloodwork had been normal. She had significant cervical muscle spasm but moderate sensitivity on palpation of GB20,21, BL-10,11 GV-14, BL-22,BL-27, GB-30. She had normal mentation and cranial nerve exam. Withdrawl reflexes normal all 4 limbs, patellar reflexes normal to increased bilaterally, good anal tone. She had a bit of small flake white dandruff and was mild to moderately pruritic. Dreams a fair bit, no snoring, not really heat avoiding or seeking. She didn't have a fever. Her tongue was slightly pale pink, moist, slight lavender tinge. Pulse was moderate strength, somewhat deep and a bit wiry. Her pulse improved with massage of GB points and Sed BL-40. She wasn't able to stand on her own without falling over, and was uncomfortable lying on her right side. I treated BL-40, GB-20,21, BL-10,11, GV-14, GB-30,34 TH-5, BL-22,27. I wasn't sure if we were dealing with cervical IVDD(degree of pain didn't seem to match the spasm), Lyme,aseptic/ septic meningitis ( no fever, ) or even neoplasia so sent her back to her rDVM for more diagnostics. Snap 4D was neg and x-rays normal. To me it seemed Tai Yang and Shao Yang involved, so I started her on Xiao Chai Hu Tang with Gui Zhi and Bai Shao added as her pulse didn't seem to fit Bupleurum and Kudzu or Chai Hu Jia Long Gu Mu Li Tang. I gave her a dose of Heel's Belladonna Homaccord and dispensed homotoxicology mixture including Traumeel, Spascupreel, Gelsemium Homaccord, and Arnica 30C.After her acupuncture treatment the knuckling improved except RF, no crossing over front or back but still ataxic. She remained that way for about 4 days before worsening again, and was referred to the Vet College where MRI showed diffuse cervical spinal cord changes, fusiform elongated region of contrast enhancement C3-C5 with patchy meningial enhancement and mildly dilated central canal. CSF tap had pleiocytosis and elevated proteins with nucleated call population predominantly lymphocytes. Suspected spinal neoplasia or MUO. She has been started on high dose Pred with a guarded prognosis. Her tongue and pulse remain about the same. Would Xiao Chai Hu Tang +/- Qin Jiao be indicated or would you recommend a different Bupleurum formula /Qing Ying Tang? Medicinal mushrooms? These are very devoted owners and a lovely little dog so any thought or suggestions you might have would be most appreciated. Many thanks, Llewanda
by naturevet
May 18, 2023
Hi Llewanda!

Sorry for this delayed reply. I like how you handled the case and would have done the same. I would at the very least continue your treatments and take the opportunity to see how her pulse evolves. If it turns into a more Bupleurum and Kudzu pulse, then you could switch over to it, but I've used the approach you're using in even pretty severe spinal cord inflammation. I certainly wouldn't subscribe to the guarded prognosis given the changes you were able to affect with your acupuncture.

If you were going to ramp up the anti-inflammatory effects of the current formula somehow, then you could order and add Ge Gen at least, maybe 15g per 100g of XCHT base. I'd expect that to help more than Qin Jiao. You could also get some Qiang Huo and add it in there and add it in there for the same reasons.

Bottom line: I'm optimistic you can greatly help this dog, and if they continue seeing you, it will give you a chance to monitor the pulse and see how it is evolving

I guess let us know how it goes!

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