Question Details
Herb Choice For Multiple DJD And FR Lameness Lab Mix
by CarolineJ - May 17, 2023
Ella, 12-year-old, spayed female, Labrador Mix, Canine

P had TPLO sx on both stifles in the last year and has documented hip dysplasia and hip arthritis. Otherwise she has been overall historically healthy (no GI concern, great energy, normal recent labwork, drinking/eating normally, no temperature preference but likes to lay on cozy surfaces). She does have a tendency to get anxious and likes to be with her owner – O’s presence is likely comforting to her.
She is currently on Adequan, Carprofen, Gabapentin, Myos, MovoFlex Advanced as well.

She recently saw an orthopaedic specialist for her FR lameness (pronounced head bob) and unless the client does an MRI, the only dx on the table for now is multifocal spondylomyelopathy. No improvement with a prednisone trial.

Western and TCM exam findings:

BCS 3/5
Pd dz grade 1/4 - had a dental
Osteoarthritis in both hips (hip dysplasia and previous ACL sx in both stifles) and in R elbow
Severe muscle atrophy in both hind end and shoulder areas
Trigger points caudal to scapula in the Fei-Pan area – muscle spasms when massaged
She tends to be more lame as the day goes on and with more exertion.

Tongue is wet, pink/lavender
Pulses were recently very deep, normal width, but weak
Body temperature: hind feet feel cool
Typically sensitive over Bl23, Bl18/19, Bl17 and when palpating upper thoracic vertebrae
Minor CP deficits in the hind end. Does not like putting weight on the FR (pain? vs. neuro deficit?)

Working TCM patterns or diagnosis(es):

Constitution: Earth and Fire
Kidney Qi Deficiency (osteoarthritis/ hip dysplasia, older patient, although energy level is quite good- she’s a Lab !)
Liver Blood Deficiency – ACL injuries, dandruff, mild nervousness/anxiety
Spleen Qi Deficiency – Muscle atrophy (general)
Bone Bi (Stagnation in both hips, stifles (Excess) and R elbow (Excess)
What herbal would you choose to help her lameness/overall issues? I was thinking CGJJT or XCHT with Qin Jiao or Xiao Huo Luo Dan?

Thanks !!!
by naturevet
May 18, 2023
Hi there!

I like your idea of Xiao Chai Hu Tang with Qin Jiao. Any chance you could have a chiropractor check the neck? I find vertebral fixations there to be an exceedingly common cause of lameness.

To get extra Blood moving effects, you could add Xiao Huo Luo Dan. If things are going well, but you want more tonification back there, you could add in You Gui Wan or Bu Gan Tang.

I think this case might go pretty well for you. Please let us know what happens!
by CarolineJ
May 19, 2023
Great, I’ll keep you posted once I add in those herbals! Thank you!
by CarolineJ
May 19, 2023
Great, I’ll keep you posted once I add in those herbals! Thank you!
by CarolineJ
July 20, 2023
Update on Ella :
She has started seeing a chiropractor and her mobility has somewhat improved. Her FR lamaness is still going on and she will not take any tablets.. Do you still think XCHT w/QJ would be beneficial here? I would have to try a liquid form!

The reason I haven't started her on the suggested herbals is that she has had a serious episode of GI issues (I'm suspecting triggered by a course of Pred - which was suggested a few months ago for the FR lameness). She did not respond to the Pred and as mentioned, developed bloody diarrhea, vomiting, inappetence and became VERY picky with food. We got her back on track using WLT (liquid) and added some fresh foods to her diet (Medicus prescription fresh food).

Pulse: Soft, good tone, middle level and deep level.
Tongue: Pink/Lavender, wet and flaccid edges

Thank you for letting me know your thoughts.
by naturevet
July 26, 2023
Hi Corinne,

One idea given the prior benefits of Wei Ling Tang and also with chiropractic is to try Yi Yi Ren Tang first. I've seen it help with some forelimb osteoarthritis, and it is a Tai Yang releasing formula in case the neck is still causing some nerve impingement. It should be safe at least

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