View Question

Chronic Mixed Bowel Diarrhea And Vomiting In A Dog

by ajerger - May 23, 2024 View Case Report

Hi there!

So Spurs is owned by a trainer and wanted the Beauceron breed for agility. Spurs had diarrhea and vomiting the first 1.5yrs of life and the owner finally realized kibble was the cause.

Originally she was a great eater, but after the chronic diarrhea and vomiting she became picky even with fresh foods.

She has a heat cycle every 15 or so months, very heavy mix of light and dark blood.

She has severe noise phobias to leaf blowers/ice maker/fire works outdoors noises etc..., she shakes every morning for hours and paces until she is ready to eat. She walks around with her ears down and frightened about everything.

Currently her stools are formed, vomiting is most mornings between 9-11am. After she eats she gets a sudden burst of energy and runs around, tries to hump people, the other dog etc..
No pu/pd.
Labs are completely normal, ACTH was normal but on the low end, bile acids were normal.
I first started with Xiao Yao San and Chai hu gia long gu ma li tang. This actually helped from last April 2023 to when she had her heat cycle this past February 2024. She was able to do agility, appetite was great and no gi signs. After the heat cycle she reverted back to the same signs/behavior but now much worse.
I added Xiao Chai Hu Tang and Zhi bai di huang wan for added yin support, with no significant change.

TCM-
Damp empty heat?
Spleen Qi deficiency/Rebellious stomach Qi- hx of vomiting/diarrhea with kibble
Blood Deficiency- fear/phobias/ delayed heat cycle
Tongue- mostly red
Not sure where to go from here.
Thank you in advance!!
I will try to send videos over....

by naturevet

May 25, 2024

Hi there!

I think I would look at Bu Zhong Yi Qi Tang here, along with your continued use of Chai Hu Jia Long Gu Mu Li Tang. It is a spin on worked well before, since BZYQT contains many of the same herbs as Xiao Yao San. Additionally, though, it addresses Spleen Qi sinking and Stasis in the lower burner, which can be responsible for:
- alternately watery or very dark bloody vaginal discharge
- pathology worse during cycling
- rapid gut transit times causing diarrhea, which is remedied in part by feeding more whole foods
- anxiety (i.e., deficiency in the Upper Burner) because of all the Stasis in the Lower Burner
- adrenal insufficiency, signaled by the marginal ACTH stimulation test result
- possible hypoglycemia, signaled by the dysphoria before meals and the 'caloric rush' behaviour after eating
My suspicion is the dog should do pretty well on it. Note that BZYQT treats what is essentially Jue Yin excess, which peaks in incidence from December to February, so a need for the formula is consistent with everything coming off the rails in February.

Hopefully this helps you out. It's a very interesting case! Let us know what happens!

Steve

by ajerger

October 30, 2024

Hi there,
This patient is doing much better on BZYQT. We are planning on spaying soon. Do any of the herbs need to be adjusted for anesthesia?

by naturevet

November 3, 2024

That's great news! The formula is safe to continue up to, through and after surgery. Thanks so much for circling back and letting us know!

Steve

by ajerger

December 23, 2024

Hi! So surgery happened at another veterinary hospital and there have been major complications. She developed a hemoabdomen a few days later. She was admitted to an emergency facility, transfused and recovered. There was a point they thought they had to go back in, they thought the stump was bleeding, but have since not had to go back in, (her vonwillebrands was 47%, low incidence of risk of bleeding) from what I can gather they think it may be surgical technique.
She is home now, on w/d food and now vomiting and having diarrhea! So I am back in the picture of care for this patient.
I advised a home cooked diet, she is not on any herbs at the moment. she is low energy, and back to where she was before the herbs were instituted, unfortunately.
Should I put her back on one by one?
Thanks so much!

by naturevet

December 26, 2024

Well, that's a bummer! I'm glad she made it through, anyway!

Once the vomiting has stopped, then BZYQT might help her rally more quickly. It's good for stress-induced crises and also, come to think of it, dogs prone to passive bleeding (almost like a diapedesis). So it would be the first thing I would introduce as it may be enough for her

Steve

by ajerger

March 10, 2025

Hi there!
So, Spurs did well on the BZYQT addition and the owner said she was essentially back to the Beauceron that she could do agility with in the ring. She was maintained on Chai Hu Jia Long Gu Mu Li Tang, Happy Wanderer and BZYQT.
What happened next was very bizarre.. This owner trains this dog at a large facility, almost like a warehouse. On 2/28/25 they were training with the building doors locked, and someone wanted to enter so there was banding on the door and Spurs began to bark excessively and the owner notes she went crazy over the banging.

Spurs was placed in her crate, the person was let in, barking stopped. The owner went over to the crate to restart the training and Spurs would not look at her, head down like she was sniffing and would not come out of the crate. ( This was similar to the behavior prior to her being on herbs and the reason we met initially).

I evaluated her a week later, and indeed she was back to the original presentation of panicked state, pacing, head down, to herself. She also was vomiting everyday after she would hear sounds and get spooked. She sleeps through the night, but pants and paces all day on and off. Drinking is normal, but she is drinking her urine and if allowed she would eat her stools.

The only thing that had improved when we added back the BZYQT was there was no mounting behavior and excessive scratching after eating. She still had a burst of energy post prandial but not as bad. She is still also experiencing borborygmi intermittently throughout the day. Vomiting has subsided and stools are great.

Her pulses were also very new for me, they felt strong, rapid but almost like an electric tiny shock as the blood flowed. My staff, unfortunately, did not write down where the pulse was felt, so from my memory I think it was mostly superficial.

So, the only herb that I had her on before that was not reinstated, was SMS. I thought to add that back since she is hot, possibly yang trapped in the upper burner but without any seizure episodes, but agitated and fearful? Would Si Miao San help?
Thank you so much..

by naturevet

March 11, 2025

Hi Corinne,

That is truly a bizarre development.

Did anyone take the dog's temperature when it saw you? Was it's head up and the dog walking normally? Or was it still in the head down posture? The pulse you found and the head-down posture can also fit with an acute meningeal irritation, calling for something like Chai Ge Jie Ji Tang (Bupleurum and Kudzu). Perhaps it's mild enough to just be manifesting with a headache and noise sensitivity.

At the very least, if you witnessed the head-down posture, the dog should be evaluated chiropractically. If something is found, then herbs to address Tai Yang invasions like Du Huo Ji Sheng Tang could be considered.

If you saw no fever, no abnormal posture and no neck issues, then yes - either Si Miao San or even Ban Xia Bai Zhu Tian Ma Tang seems a good call in case there is a Dampness situation going on.

If you add one of them and there is a partial improvement, then taking away the BZYQT seems wise and will likely allow further improvements to accrue. Remove the BZYQT if CGJJT helps, too.

Hopefully the dog feels better soon!

Steve

by ajerger

May 9, 2025

Hi there,
So Spurs is still the same, actually getting a little worse with the fear and pacing. I evaluated her a few weeks ago and here are my findings:
PE:
1. Very nervous, but friendly. Temp 100.5 F
2. Flakey Coat
3. Tongue: Brick Red
4. Pulse: Toned, somewhat wired, superficial, moderate. finger lift and increased rate.
5. Warm on GV14 and BL40
5. Cool Limbs
6. Ears are normal temperature, maybe a little warm
7. Pulses are felt stronger on the right side vs the left

Owner cannot afford much more as far as labs go, I was only able to do a CBC which were all within normal limits
Per the owner she is pacing all day long and in between pacing she is lethargic from exhaustion, severe noise phobia, vomiting multiple times per week, eating raw food ok but not ravenous, not really drinking much, she is still drinking her urine and still experiencing a rush of energy after eating.
I told her to stop Happy Wanderer and Settle the Yang for now, as I feel I need to start over and see what her body does. She is only on Four Marvels tabs for now.
My TCM dx:
1. Liver blood deficiency
2. Rebellious Stomach Qi
3. Qi Deficiency

Would you classify her as Hot/deficient/internal/more Yang?

Not sure where to go from here..
Thank you so much!

by naturevet

May 11, 2025

Hi there!

Can you do acupuncture one more time? If you massage or needle GB 34 and/or GB 20 and the pulse improves, then you're dealing with a Shao Yang disharmony. Xiao Chai Hu Tang would be called for, but I would add Yi Guan Jian given the dryness and Stomach symptoms. If you see improvements, probiotics (Lactobacillus, Bifidobacterium) are called for (along with ensuring ample plant material in the diet). The microbiome is more and more considered important for normal brain function.

If she improves instead with tonification of BL 23, KI 3 or SP 6, then you may be looking at Empty Fire, calling for Zhi Bai Di Huang Wan.

Even better than ZBDHW, given the cool limbs, might be Qing Ying Tang. It actually would be useful in a Shao Yang case as well. Given the itch, I would probably use it regardless.

I suspect the former scenario will prove to be the case. QYT and ZBDHW are certainly compatible with SMS, if you feel you've made some headway with it. SMS addresses Damp Heat, but not so much the severe Yin desiccation that comes after. The use of real food suggests it's not DH, but if you saw improvements, then Yin deficiency or Empty Fire becomes that much more likely.

Hopefully this helps you out!

Steve

You must be logged in to reply

CuredCases.com