Question Details
Gagging In A Dog
by equinesportsmed - June 13, 2023    View Case Report
Hi Steve--

I saw a 10 year old FS Border Collie almost 2 weeks ago for sudden onset ADR, maybe painful, possibly in spine. Dog has always eaten fresh food only, minimal vaccines, none lately. Owner claimed that up until two weeks previous, had been active/happy like a dog half her age. She'd had a negative snap Lyme test the previous week, pretty normal BW, but I was still suspicious of Lyme. Hx of being "hot", red tongue, pulse seemed weak, lately had been pacing at night, had always had ravenous appetite, unchanged now. Her hind legs were a bit base wide, but no ataxia, sometimes her spine seemed a little roached, and she had been having difficulties rising from lateral recumbency. I treated her with manual therapy and injected a few points on either side of T-L junction with Traumeel and Discus. Her movement and demeanor seemed a lot better from the physical treatments. Sent home on Yi Yi Ren Tang.

A couple of days later, desperate email from owner that dog had been gagging all night-- she sent videos. Lying lateral seemed to trigger it. Owner got on with Dr. Google and decided it was GERD, and began giving 5-6 small meals rather than 2 large ones, and this seemed to resolve the problem. She was still worried about the dog's energy, so I mailed her some high potency Ledum for a Lyme protocol, and arranged for her to come in and pull blood for a Lyme multiplex test. She reported an immediate improvement in energy on the Ledum (Ledum 1M 3x/day for 3 days is the protocol here), but came in for testing yesterday anyway. She lives 3 hours away, and when arriving, reported that the gagging had restarted during the car ride. She did not do it while with me, but I was thinking "plum pit" sensation, and her pulse seemed strong, almost wiry, tongue dark red. Plus she is an anxious high strung herding dog, so I was thinking liver stagnation and sent home on Xiao Yao San.

Another terrible night of gagging ???? Owner losing mind (she is high strung too!) I just saw a case here from 2021 that had some similarities, but complex bulldog with airway issues. It had responded to XYS.

Here is a really weird thing-- her other dog was doing a weird humpy behavior thing out of the blue, and the next day she pulled a garden of plant stems and seed pods out of his urethra!! Now I am wondering if this could be a FB, and am sending her to find an endoscopic exam somewhere. I can't imagine larpar as sudden onset and resolving, even temporarily, with more frequent meals.

Have you ever seen anything that pulls together all these weird signs? I have videos of the gagging-- maybe will post on Ask Dr. Steve.

thanks so much,

Karen
Replies
by naturevet
June 13, 2023
Karen, I can see why you tried YYRT (weak pulse, back pain) but my top suspicion is that this is a Yi Guan Jian case that might have become worsened from drying warming herbs, creating the darkness to the tongue you saw. The Wiry pulse may indicate a worsening of Liver Stomach disharmony (which the formula treats) because of the further declines in Yin. Alternatively, it may signal that this is a Shao Yang disharmony at its core. Don't start with Minor Bupleurum, though, as it too is drying. Start with Yin tonification first.

From a biomedical perspective, GERD and gastritis fit. GERD is often positional in people, too. It's worse when they lie on their left side. It can create referred pain to the costal arch (potentially causing discomfort there that might interfere with the dog's ability to rise easily from recumbency. It can definitely create roaching of the back from referred pain to the Stomach and Liver Association points. Your aquapuncture may have hit those points, causing the temporary improvement. Nausea from gastritis is further hinted at by the worsening with the motion of the car. If the owner has heard any loud gurgling from her dog's stomach at night, that pretty much clinches the diagnosis of Liver Stomach disharmony and Stomach Yin deficiency.

Even wtihout that corroboration, based on all you've said, I would prescribe Yi Guan Jian and see how things go. If they go super well, but there are lingering issues, evaluate the dog for suitability of Xiao Chai Hu Tang next

Hope that helps!
by equinesportsmed
June 13, 2023
Thanks so much! Just got the Lyme results back and she probably has an early infection-- given the info above, I am reluctant to add doxy to the mix. Will try to overnight her some YGJ.
by equinesportsmed
June 23, 2023
Sad end to this story-- dog continued to cough/gag on and off, owner was reluctant to take to ER as I advised for imaging because of her rabies status (unvaccinated). Owner became fixated on the idea that dog had a cardiac presentation of Lyme disease, despite multiple negative tests and no cardiac specific signs. Took to her home town family vet, who did through PE and concluded no cardiovascular issues. Next day she went into respiratory distress, took to ER and found pleural effusion due to probably thoracic mass, and was euthanized.
by naturevet
June 28, 2023
Karen, that's unfortunate news. Thanks for letting us know. If nothing else it reminds us that odd-ball conditions can present with very routine symptoms
by equinesportsmed
July 3, 2023
Yup. Easy to tell a story post-fact, especially about the positional nature of the problem starting out. Her minimal vaccination status is such a two-edged sword! Better for the pet if not over vaccinated but can prevent them from getting more high tech diagnostics in a timely manner.
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