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Tetraplasia

by rmtran - October 19, 2009

Hi Steve,

I have a 13 years old MC Minipin with multiple issues.

He has heart disease, Cushing's disease, and he is also tetraplesic.

He presented 1.5 months ago with hx of 2.5 months of tetraplasia. He has a history of IVDD at mid back that required laminectomy 1 year ago. He recovered from it fine.

According to the client, the patient fell trying to step up on the porch. Since then, he is paralyzed. His front legs are very weak, and hind limbs are rigid (C6-T2 lesion),
Tongue-red no coating,
Pulse-Full
Ears/limbs cool
Heavy panting with little movement.
On Tramadol, atenerol, amilodopine, theophylline, plavix.
at initial presentation.

Placed on Zhi Bai Di Huang (NP) and Bu Yang Huang Wu (JT), and had diarrhea. He could tolerate ZBDH ok at 1/8 tsp BID.

Some improvement but not much. His halitosis and flaturence went away, and he seems to be slightly stronger, but unalbe to stand up yet.

Last appt: tongue was less reddish with paler rim, pulse was fast but not full. She seems to have some more stength on front, but knuckles.

Do you have any suggestion for this patient? Her appetite is good, has a good Shen. She shakes a lot and very nervous.

Does Xue Fu Zhu Yu may do some good for front limb condition such as this? I think that this patient has underlying blood deficiency that is not so obvious, and can be helped from some moving herbal formula.

Thank you for your time.

Rieko

by naturevet

October 21, 2009

Hi Rieko,

I was disappointed and a little surprised to read you haven't had any stellar success yet with herbal medicine. Maybe it's your tough cases. Sooner or later, though, one is bound to do well. Maybe this one?

I think of Chai Ge Jie Ji Tang (Bupleurum and Kudzu) for severe neck lesion with red tongue (or other Heat signs like aggravation by Astragalus in BYHWT) and a toned rapid pulse. It expels Wind Cold that is turning to a Heat pathogen as it penetrates through to the Yang Ming and even Shao Yang layers. From a western perspective, it is a good disc or spinal tumor formula, and is a strong pain-reliever and anti-inflammatory especially designed for cervical or upper thoracic complaints. So it's my first thought in this case.

Hope that helps for a change!

Steve

by rmtran

October 23, 2009

Thanks, Steve.

I am seeing this patient today, and I will try this!

Rieko

by rmtran

November 7, 2009

Hi Steve,

This patient had blow out diarrhea after taking small amount (a pinch) of Chai Ge Jie Ji Tang.
She was treated by rDVM for diarrhea, and placed on Metronidazole.

Ten days later, today, she visited me for follow up acupuncture. She was not panting any longer for the past week or so, and her drinking has decreased to normal, and she actually stood up by herself a couple of times.

Her tongue was pale lavender, and her pulse was thin. Her ears and toes were normal. She does not like the Winter weather in VA.

I am thinking that Gymsum containing formula might have been too strong for her. Since she will be off of the Abx after today, I dispensed Xian Fang Fan Huo Ming Yin. I did not mention this on the previous post, but she is very lumpy (weak SP?).
She has been Zhi Bai Di Huang in the past, but I think that it was not strong enough to clear her Heat signs. It seems that an antibiotics therapy did its job.
That is the reason I chose XFHMY despite of her tongue/pulse today.

Now it seems that her hind limbs are more of the issue. They are much weaker than front. Do you think it is reasonable to mix other formula such as Zhi Bai Di Huang (or even Liu Wei Di Huang) to XFHMY if she is able to tolerate?

Thanks for your input!

Rieko

P.S. I got a responce from the program: Thank you for your reference. R-

by rmtran

November 7, 2009

FYI-this patient is a female, not male. My mistake! Rieko

by naturevet

November 8, 2009

Hi Rieko,

The diarrhea clearly tells us the Spleen and Stomach Qi are weak. So I would make them the center of your next approach. So in addition to XFHMY, you should be ready to try SMS. Now that the dog has told us that digestion is a key issue, and now that hind limb weakness is the main symptom, SMS could work well. It matches the former strong heat presentation, was originally developed (in the form of Er Miao San) to deal with leg weakness, yet protects the Spleen and Stomach.

I don't think you need to stop XFHMY, but would start SMS as well, if the results aren't what you hoped.

Good luck!

Steve

by rmtran

December 31, 2009

Hi Steve,

This patient got better for the past month, and all of the sudden, worse again.

I did not add SMS since the client was pretty happy with the improvement, and she was actually walking.

2 days ago, the client noticed that she cannot even stand up with the assistance. She has increased its water intake at the same time.

Her tongue is pink, and her pulse is wide and fast. The sedation of BL-40 slightly improved its pulse, so I thought of Wind invasion.

Her fore limbs were cold, so I dispensed Du Huo Ji Sheng Tang (NP): Yours have extras to help her neck, I remember.

I might use SMS on top of it, since the pulse was more superficial (I did not dispense it today). I am hoping she will get better...

Thanks for your help and Happy New Year to you, too!!

Rieko

by rmtran

January 11, 2010

Hi Steve,

I saw this patient today.
She is better with DHJST and able to keep herself on sternal position (she was not at the last visit).
Her rear limbs are still weak, so I added SMS today.

Her pulse was wiry and more superficial (she gets excited with any movment, so it might not be so wiry at rest).
Her tongue was pink.

I will continue to update her condition.

Thanks,

Rieko

by naturevet

January 11, 2010

Hi Rieko,

I'm glad to hear you're seeing progress. If the owner doesn't feel the SMS is helping, feel free to discontinue it, as it is most indicated when there is no vessel wall tone (i.e. the Blood is maximally peripheral). Xian Fang Huo Ming Yin might be a better option if you see:
heat, damp/phlegm, and a response to a Wind expeller like DHJST. But give the SMS a chance first and see what happens.

Your little parcel on how to make miso came today. Thank you so much! I'll try it out as soon as I get back from Florida's NAVC.

Have a great January,

Steve

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