Question Details
Intermittent Seizures In A Dog
by CorinneC - October 17, 2023    View Case Report
Annabelle is a 13 year old spayed female Maltese mix that I have seen for 3 years. Until last summer she was a pretty healthy girl, although she was prone to Liver Blood deficiency and Qi Stagnation - anxious with sep anxiety from owner (will howl if left alone), had dark brown to black stools (but normal CBC and chem), pulses tend to be narrow and taut but weak, tongue lavender-pink, sl swollen, moist with phlegmy stands. She has been fed an excellent diet of cooked venison or bison with veggies, gets D+ on raw food. Did really well on Xiao Yao San and occas Yi Guan Jian. She also had the odd head twitch the O noticed while sitting in her arms, which BGT helped to lessen.

In June 2023 she started having seizure-like events - no true paddling, but would lie on her side, full body trembling/tremors, no actual paddling, no loss of bowel or urinary control, no vocalization. This started to ramp up one night with two in a row so O took to emerg where they found liver congestion on abd U/S and a low BG, started on Keppra TID. She had a bad rxn to Keppra (D+ and breakthrough seizures) and was eventually put on PhB. Sher breakthrough seizures presented with OD: menace absent, dazzle absent, circling to the left
and dull mentation. An MRI showed a lesion which could either be a hemorrhagic vascular accident or 'stroke' or tumour. More recently Zonisamide was started with the hopes of tapering her off PhB as it has made her really loopy and her sep anxiety with O has escalated to the point O has to take her everywhere she goes or she howls. They also want to add on Clopidogrel. The O has been working with a homeopath as well the whole time who I trust. However, the O is leary of drugs and wants another option to a blood thinner and better control of the seizures with TCM. I saw her yesterday, tongue is about the same, more lavender and swollen, pulses are thin, superficial and wiry.

SO the tongue shows Blood deficiency and Dampness - I'm thinking the Dampness is from the PhB?? THe pulses still point toward Blood def and Qi Stagnation? But with this type of lesion (they are leaning more towards hemorrhagic stroke because she's still here), I wondered about CHJLGMLT? but then I panicked because this little dog is on so many meds with such high anxiety, I don't want to make anything worse and it doesn't fit the tongue and pulse. TMGTY seems like a decent fit but may be too Dampening?

Please guide me OH WISE ONE!!!
Corinne
Replies
by naturevet
October 19, 2023
Hi Corinne,

The Wise One is not available as far as I know but I can try to help!

Tian Ma Gou Teng Yin is never going to be problematic,since although it addresses seizures due to Blood deficiency, it actually doesn't contain any Blood tonics. So we don't see Damp as a consequence.

Meanwhile, though, are you reminded of the cat with the stroke that I mentioned in the CNS inflammation lecture I just gave in San Diego? That cat responded well to Chai Hu Jia Long Gu Mu Li Tang. I seem to remember the cat one day getting Yi Guan Jian as a follow up Yin tonic, so you could just start with that combination. Alternatively, you could try Halscion from Gold Standard Herbs if they are on your shelf, as it contains both YGJ and CHJLGMLT.

I'm pretty sure one of the two approaches should help. The only other one I've used in 'stroke' is Bu Yang Huan Wu Tang, but I would look for a very deficient or flaccid pulse before trying that out. If everything is feeling just a little 'excessive' right now, then CHJLGMLT (Halscion) is probably the place to start, but TMGTY should be safe

Hope that helps! Let us know how it goes!!

Steve
by CorinneC
October 23, 2023
So funny Steve! I was reading through your notes from SD AHVMA this weekend and realized that very same thing! I almost felt "learned" lol!! I am going to start this - awaiting Gold Std Halcion as it was on backorder in Canada until this week but Marci says it should be here Thursday!! Yahoo! I also plan to add on Hawthorne (anti-inflammatory, vasodilator, and microvascular clot inhibitor) and CoQ10 (decreases thrombosis, got that from Karen notes!). Hopefully all of this will allow poor little Annabelle to stabilize and not need even more drugs!

Thanks again,
Corinne
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