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Stiff Gait In A Dog

by CorinneC - July 13, 2023 View Case Report

Finn is a 12yo MN Welsh terrier who we did a very-needed dental on in Feb 2023. Since then the O has claimed he hasn't been his normal self, very low energy. We saw him a couple of times and noted his gait was quite stiff, he held both forelegs and hindlegs tightly to his frame, and walked with a stiff stilted gait. By June he was refusing to go for walks and slept most of the day. He also was trembling in his hind limbs and has a slight tremor on occasion in his LF limb. The owner was very reluctant to run any tests at this point and just wanted to try medication. He has a history of elevated ALT and ALKP (presently 913 and 1009 g/l) that have slowly trickled up over the last year. Also today I note that his cholesterol is elevated. An abdominal ultrasound was performed in May 2022 with minor abnormalities only.

In June we tried Meloxicam but only very minimal improvement (tail back up, maybe a little better with stairs, but still stiff and reluctant to walk). 2 weeks ago we tried Gabapentin which gave him the best relief yet but still not wanting to go for walks and O concerned about the sedation effects. Convinced them to do xrays and bloodwork - dog had a panic attack and went blue on xray table. Had him return on Trazodone today which helped and we were able to get one right lateral view of most of spine before he panicked again. I see a boney lesion at T6 (irregular shape to entire vertebrae and protrudes into thorax, possibly consolidated T5-6?), T6-T7, T7-T8, T8-T9 all shortened disc spaces, T7-T9 vertebrae all slightly irregular shape as well. His tongue is lavender-purple, narrow, dry but constantly panting. Pulses toned, may be a little taut.

I am thinking this is spondylosis deformans but shocked at the level of pain and discomfort he is in, especially not improving on Meloxicam and barely better on Gabapentin?? He is "bitey" so I did some laser AQ today and then sent him home on a Xiao Chai Hu Tang trial - seemed to fit best with ShaoYang disharmony as ^ALT, ^ALKP, ^chol, IVDD pain, passing out with xray and weak hindend (hot above cool below?). I'm just wondering if modified XCHT will suit him more? Or is this a decent start? We plan to put actual needles in him next week - wish me luck!!

Thanks in advance,
Corinne

by naturevet

July 16, 2023

Hi Corinne,

A Shao Yang disharmony is one of the big differentials. Tai Yang invasion, too. You could address both by adding Gui Zhi and Bai Shao to your XCHT. You could also instead use Voltrex by Gold Standard Herbs, since those herbs are in there along with other additives (Qin Jiao, Tumeric) to address inflammation.

I would probably make that change, since XCHT alone deals with Blood stasis due to constrained Yang. If that were the issue, you'd have seen improvements on NSAIDs. As soon as you don't see an improvement on NSAIDs, you should be thinking Wind invasion or muscle spasm.

Wind invasion fits well, particularly if during the dentistry, he got a vertebral fixation in his neck that has cascaded down his spine. A chiropractic evaluation is pretty crucial to have done. Hopefully you do that, or maybe have someone you refer to? The response to Gabapentin, signaling nerve impingement, is also consistent with a Wind invasion and Tai Yang involvement, as is the holding of the limbs tight to the body wall. If you emulate that in yourself, you'll see you are deliberately tightening your adductors to take pressure and strain off your dorsum and shoulders.

A point to check that would verify the above most of all is BL 40. If you massaged it and felt the pulse lift, then you'll know you have a deeply penetrated Wind pathogen calling for Chai Hu Gui Zhi Tang or perhaps Du Huo Ji Sheng Tang. If you massage GB 34 and the pulse improves, then there is a Shao Yang component.

Hopefully this helps you out!

Steve

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