Question Details
Splenectomy, Suspect HSA Vs. Other
by CarolineJ - January 9, 2024
My own dog Fanny (12 year old, SF, border collie) just went through a splenectomy 2 days ago , due to a large bleeding mass.
I don’t have histopathology results yet.

Her bloodwork revealed no significant finding and ct scan didn’t reveal any metastasic disease.

She has a history of being dog aggressive and anxious with new people or places.
Wood dog, very sweet and loyal with her “people”.

I’ve already started YBY and have ordered the HSA formula, along with bilberry extract, Dispel Stasis in the Middle Palace (appropriate for her constitution?) and Coriolus mushroom per your/ Dr Bannick’s protocol.

Is the vitamin A/D recommendation still current? If so, you still recommend the same dosage (500 000 IU) PO? Are the other ingredients in an injectable solution safe PO (I have VetOne product on hand)?

Her pulse is currently strong, superficial/mid level, somewhat wiry.
And her tongue is pink/red, wet
Any thoughts or other herb recommendation?

In your experience, what’s the prognosis with your HSA protocol ? - considering no macroscopic mets at this time (assuming it’s a sarcoma and not hemangioma).
Also, is there an interest in continuing the YBY if the spleen has been removed?

In your opinion, should I be adding an herbal formula to build blood since she lost about 1 L due to the bleeding mass in surgery?

Only medical history is a front end lameness that had responded very nicely to Chai Ge Jie Ji Tang (suspect cervical ivdd, or nerve damage).
Had a recent ear infection, which is very unusual for her.

Had also developed a mild itch over the past few months. In retrospect, she was probably developing a blood deficiency from the blood stasis?…I had put her on Si Wu Xiao Feng Yin with little to no improvement..

Thanks so very much. Forever great full for all the tools and ressources you provide us with.
Instead of being defeated, we are marching on!
by CarolineJ
January 15, 2024
New development - she has developed a UTI which is very unusual.
by naturevet
January 15, 2024
Hi there! Sorry to hear your year is off to a rough start!

You've started managing your dog's case the way I would. The HSA protocol at least doubles the odds of survival to one year. Many dog on the protocol are very long lived.

YBY is fine to use even in the absence of the original tumor (at least until you get histopath back). It is anti-cancer as well as hemostatic. Hemostasis is a good idea even if there were no visible mets at the time of surgery, since even tiny mets that slowly appear can bleed and start compromising your dog. Being able to limit the ability of tiny tumors to create a problem gives the HSA protocol more time to kick in and start debilitating tumor growth and metabolism before you hit some sort of crisis point.

HSA should do a fine job all on its own of stimulating RBC synthesis due to its liberal content of Dang Gui.

I would wonder given the cystitis about adding Bu Zhong Yi Qi Tang. Together, HSA and BZYQT harmonize the ascending and descending actions of Qi, Blood and Yang. That means better peripheral circulation to the skin (to relieve itch) and to the bladder to combat infection. it's also hemostatic due to its content of Huang Qi.

Hopefully things go well for you. Let us know what happens!

by sophiek
January 16, 2024
Hi Steve and Caroline,

I hope you don't mind me jumping in here, but I have a similar case. Is the San Qi in the HSA I formula enough for haemostasis, or best to add the YBY in addition?

by naturevet
January 17, 2024
Hi Sophie,

In theory the San Qi is enough, but particularly when concerns about recurrence and bleeding are still front of mind, adding YBY is advisable. As time goes by without recurrence, then the importance of YBY probably fades, and the importance of San Qi grows

by CarolineJ
January 27, 2024
Hi again Dr Steve, I have an update on the mass they removed and luckily it was a hemangioma (!!). We got lucky!
Is the HSA formula still indicated in this case?
I’m assuming there is still a need to address the underlying imbalances, so I thought I would keep going with it.

I’m trying to address her ongoing patterns and being my own dog, find it quite challenging.

She has always been dog aggressive and nervous with new people (she growls at them when she’s not sure). Also very territorial and is aggressive with delivery folks at the house.. loyal and sweet with the family. Great outdoor girl.

Interestingly, I do find that she is slightly more reactive with triggers post-splenectomy - due to blood loss ?

I currently have her on Dispel Stasis in the Middle Palace to address Liver Qi stagnation and BZYQT due to the new UTI symptoms which are lingering even after a first course of antibiotics.
I was going to see how the BZYQT serves her, but am wondering if I’m missing something herb-wise to help the blood deficiency symptoms.

Lots of blood on the urinalysis - she is on another round of atb while we wait for culture results. I thought about SMS, but was not sure since I just started BZYQT.

Her pulse is strong, I would say wiry, mid level/superficial.
Tongue is flappy on the sides, pink/pale lavender.
Any thoughts are greatly appreciated!
by naturevet
February 2, 2024
That's great news about the biopsy! From a Chinese medical perspective, Shao Yang disharmony is still what needs to be treated. Splenomegaly is almost pathognomonic for it. HSA does that, but with the risk of a bleedout removed, it may not be necessary. Instead, you could maybe switch to Xiao Chai Hu Tang. It will be synergistic with the other two formulas you're using (BZYQT and GXZYT) but may be more likely to help with that extreme reactivity than those two formulas. I'd give it a try and see if it doesn't take the edge off
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