Question Details
Lethargy And Anorexia After Librela Injection In A Dog
by
LJH
-
November 15, 2024 View Case Report
Replies
by
naturevet
November 26, 2024
Hi Llewanda, it's been my impression that dogs prone to Shao Yang disharmony are prone to Librela issues. Too bad that the leading cause of joint issues in dogs is Shao Yang disharmony, for which the Librela is prescribed! It doesn't bode well for the future!
I would support this dog as thought it had HGE. For me, that means Xiao Chai Hu Tang at first (which helps heal IBD, and drives deeper pathogens to the surface. Then I usually follow up with Huo Xiang Zheng Qi San to oust the 'pathogen' and help reduce the risk of relapse. Taking this last step does seem to help a lot, making these dogs much less prone to HGE like symptoms in the future.
I would guess the Blood deficiency will correct once the Middle Burner is functioning normally again, while the Ginseng in XCHT will help target the current Qi deficiency. If the dog is on real food already and is not Damp, then you can mix 1 part Si Wu Tang with 2 parts XCHT to correct the Blood deficiency more quickly.
Going forward, some prophylactic XCHT each spring and fall seems to be a good idea. Hopefully this dog does well for you again. Please let us know the outcome, as you are not the only one asking questions about Librela.
Steve
I would support this dog as thought it had HGE. For me, that means Xiao Chai Hu Tang at first (which helps heal IBD, and drives deeper pathogens to the surface. Then I usually follow up with Huo Xiang Zheng Qi San to oust the 'pathogen' and help reduce the risk of relapse. Taking this last step does seem to help a lot, making these dogs much less prone to HGE like symptoms in the future.
I would guess the Blood deficiency will correct once the Middle Burner is functioning normally again, while the Ginseng in XCHT will help target the current Qi deficiency. If the dog is on real food already and is not Damp, then you can mix 1 part Si Wu Tang with 2 parts XCHT to correct the Blood deficiency more quickly.
Going forward, some prophylactic XCHT each spring and fall seems to be a good idea. Hopefully this dog does well for you again. Please let us know the outcome, as you are not the only one asking questions about Librela.
Steve
by
LJH
December 23, 2024
Hi Steve, I was able to get to laser her acupuncture points after my initial posting. Did BL-40, GB-30, BL-19, BL-23, KI-3, ST-36, BL-20, BL-17 GB-34 and, as she was flat on the floor and at one point in her history had neck issues, I threw mud at the wall and also included GV-14 GB-20,21 BL-10,11. Started her on Homotoxicology drops I mixed up including Traumeel, Gastricumheel, Engystol, GaliumHeel and Nux Vomica 30C. She surprised us all by having a more comfortable night and the next morning drank a bit of water and ate a bit of chicken and egg. Temp was back to normal. Owners wanted to see specialist before trying herbs. I have lasered her a couple of times and continued the homotox. She steadily improved with her energy, got back to drinking water, though sometimes needed to have a bit of food mixed in it to get her to drink it. Appetite and stools were good. Real food diet, won't touch kibble. Respiration has been clear but a bit rapid. Tongue sl pale pink, moist, sl lavender tinge. Pulse moderate to sl weak, sl deep, sl wiry.t She saw the specialist and had essentially a head to toe CT scan. Results not what they expected. No tooth issue noted. Bilateral pleural effusion, some lung lobe consolidation. Changes to the sternum that seem like an infectious process/ small abcesses/ cellulitis and misalignment maybe from a trauma/wound/ no FB. Owners are super vigilant and they feel she has never had a wound. Ill defined thickening of pylorus, maybe normal variation but can't rule out early stage neoplasia. A few small gallstones as well. Specialist started Clindamycin, (on 2 weeks) until culture and sensitivity of effusion identified staph pseudintermedius and changed to minocycline last week. No growth observed on original plates, organism isolated from thioglycolate broth. I had started her on 1/8 tsp XCHT SID as intro just before specialist changed over the antibiotics. She has now been anorexic, not drinking for the past 2 days. They stopped the herbs 3 days ago. Antibiotics ( needs another week on them ) likely issue with stomach irritation. At some point I would like to retry the XCHT if they will go for it. Would including XFZYT as well be a consideration? Thoughts on options if she doesn't tolerate XCHT? If the stomach upset ( vomited bile twice on Friday before going totally off food) and anorexia continues they suggest a biopsy of the pylorus. I think the owners would decline to do so at this point. Try Liu Jun Zhi Tang , or maybe Yi Guan Jian for gastritis. vs HXZQS as there has been no diarrhea, or still go with it? I have seen pleural effusion listed assoc with Librela adverse reaction. Thoughts? Many thanks, and apologies for the length, and hope you have a good holiday, Llewanda
by
naturevet
December 26, 2024
Hi Llewanda,
Though their default seems to be suspicious of herbs, any adverse effects of herbs tends to disappear within 24 hours, suggesting the antibiotics are the more likely cause of appetite suppression.
As for whether Xue Fu Zhu Yu Tang could help here, for sure you can give it a try. Given the deficiency, Damp and stasis suggested by the tongue, one thing I would suggest using in addition is Dang Gui Shao Yao San.
Pyloric ulcers frequently respond to Yi Guan Jian and tumors to Liu Jun Zi Tang. The latter fits the low appetite and collapse state well. If the ulcerative tendency is confirmed and chronic, then using XCHT along with YGJ is a good idea.
If the HGE symptoms are not really present, you can skip the HXZQS.
It seems right now that DGSYS + XFZYT might be the best first things to try, if the owners will let you know. If the lungs don't clear up on the antibiotics, you're going to need something else. If not herbs, then the proverbial steroids?
Steve
Though their default seems to be suspicious of herbs, any adverse effects of herbs tends to disappear within 24 hours, suggesting the antibiotics are the more likely cause of appetite suppression.
As for whether Xue Fu Zhu Yu Tang could help here, for sure you can give it a try. Given the deficiency, Damp and stasis suggested by the tongue, one thing I would suggest using in addition is Dang Gui Shao Yao San.
Pyloric ulcers frequently respond to Yi Guan Jian and tumors to Liu Jun Zi Tang. The latter fits the low appetite and collapse state well. If the ulcerative tendency is confirmed and chronic, then using XCHT along with YGJ is a good idea.
If the HGE symptoms are not really present, you can skip the HXZQS.
It seems right now that DGSYS + XFZYT might be the best first things to try, if the owners will let you know. If the lungs don't clear up on the antibiotics, you're going to need something else. If not herbs, then the proverbial steroids?
Steve
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