Question Details
Anxiety With Aggression In A Dog
by LJH - May 14, 2024    View Case Report
Hi Steve,
I was called to see an 8 yr F(S) German Pinscher former show dog, spayed at 4 yrs then adopted by current owners. She has had periodic incontinence since her spay, anxiety she since day one, fly snapping with unpredictable now severe aggression in the last year. Dog is very anxious when owners are even just out of sight and has had lick granulomas in various places in the past, now LH mid metatarsal. She will stop licking if quietly told to " no Licky" but even firm voice would ramp up anxiety. Dog has a genetic predisposition to develop cataract but to date rDVM has found no issues. Owner finds dog in last several months hesitant to go down stairs in dim light, fine in good light. Dog has developed 3 x 3 inch patches where the hair stands up on triceps region and lateral thighs, and a few 1 cm or less flat firm lumps under skin around both elbows. LN's all normal. No skin, ear or anal gland issues otherwise, except haircoat is slightly dry, no dandruff. No vomiting, eructation, borborygmus or flatulence. A good appetite, normal stool. Has a good drink when does but not a thirsty dog. Incontinence is periodic, mostly when lying down but also can when up and walking. No noted relationship of fly snapping to eating. Owner will monitor. Seems more a seizure type occurrence. No time of day,or weather association noted. Dog is heat seeking. When they got a male Boston puppy a couple of years ago she was very maternal/ interested with pup and stopped licking for 6 months. Got a female Boston puppy about 6 weeks ago. Interested and played with pup but never stopped licking her LH this time. Owner reported that dog is very rigid about the other dog and pup's behaviour and corrects them. She is all kissy and playful with them when she wants but they know not to bother her otherwise. Dog is " a bit grumpy". In the last 6 months on 2 occasions this dog unprovoked attacked/ pinned the M(N) Boston though didn't significantly injure him. Dogs never together unless owners are right there. No mobility issues noted. Tongue was slightly pale pink, moist, slight lavender tinge. Pulse was moderate to slightly weak, a bit deep and sl. wiry. Improved with GB points, Sed BL-40 and Ton BL-23. On palpation sensitive +1 BL-18. dip and sensitive +1/2 BL-23. I suggested Bloodwork and investigating the lumps and raised hair patches and chiro assessment. I see Liver Blood def and Liver Qi stagnation, KI def and possibly Shao Yang issue . Considered Tian Ma Gou Teng Yin for the seizure component , or Xiao Yao San/ Xiao Chai Hu Tang but the 2 unwarranted attack episodes made me wonder about Natural path Long Dan Xie Gan Tang being appropriate. Wanted to see bloodwork results. A week later the dog attacked the puppy when she jumped up onto the couch near her. Lighting was dim. Took both owners to get the puppy away from her, fortunately only damage to pup was a gash above her eye. The dog was totally "not there/ zoned out" and sat panting, salivating profusely with jaw chattering. Once she was back to herself she was whining and crying and very worried about the pup, and remorseful.Bloodwork including thyroid all WNL Snap 4 D neg. Scheduled for a CT scan. I would very much appreciate your thoughts on where to go from here if CT scan is normal. Or options if owners want to pursue if CT scan abnormal. This dog was nervous/ anxious for our exam but lovely to deal with. Same at the vet clinic. Owners want to the best they can for her. Many thanks, Llewanda
Replies
by naturevet
May 18, 2024
Hi Llewanda,

Your differential diagnoses seem right to me. I think Shao Yang disharmony with associated Blood deficiency stands out the clearest. Shao Yang disharmony is associated with:
- extreme aggression
- extreme anxiety
- fly snapping (to the degree that in many dogs this is a reflection of a gastric issue - Stomach Heat from our perspective)
- improvement of pulses with GB points
- lavender tongue
- the extreme Metal temperament (anxious, controlling, given to panic), caused by an equally severe constraint of the Wood element
Blood deficiency from Kidney Yin or Essence deficiency is supported by:
- incontinence following spay (due to Essence depletion)
- the vision issues
- dry coat
- chilliness
- the weakness in the pulse
If you're not familiar with how I diagnose Metal excess (when I'm guessing most vets would have said Wood), then see if you can dig up my behaviour webinars for CIVT. One dog in there is a little similar to this one. Meanwhile, my diagram on the Spiritual Axis should make it clear.


The pulse response to BL 40 and BL 23 does make me think that low back fixations causing incontinence through nerve root compression should be ruled out.

Otherwise, a formula that addresses most of this is Chai Hu Si Wu Tang (Xiao Chai Hu Tang plus Si Wu Tang), sold as Cessorex by Gold Standard Herbs should you have that on your shelf. It's the first thing I would try. The surprising weakness in the pulse is probably just due to significant Blood and Essence deficiency, which Si Wu Tang would do a lot to correct.

Some vets have found that Tian Ma Gou Teng Yin helps out anticipatory dread in animals. Long Dan Xie Gan Tang I suspect is too downbearing and depleting to be compatible with the dog, given the pulse. Since she is extremely Metal to overly constrained Wood, using a formula that downbears the Wood element might aggravate the situation further. If you want to try Tian Ma Gou Teng Yin, it's more benign than LDXGT, but I'd have the same concerns as with LDXGT, since it likewise is very downbearing.

Hopefully this helps!

Steve
by LJH
May 18, 2024
Thank you Steve for helping to clarify all the pieces. I've only ever seen such a degree of aggression in Damp Heat dogs and the tongue and pulse on this girl were all wrong.Will see what the CT scan and chiro assessment show and start the Chai Hu Si Wu Tang. I don't have Cessorex on the shelf. Will see too if I can access your CIVT behaviour webinars. Thank you again for all your help! Llewanda
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