Question Details
Gastritis In A Dog
by CorinneC - December 21, 2024    View Case Report
***Before I begin I apologize for this LONG post but it's been a doozer of a case and I want to make sure you get the details:)

Murphy is a 40 French bulldog I started seeing in May 2024. He had just been to emerg for V+ and blood in stool, told IBD through U/S, was on raw, told to switch to hydrolyzed protein diet, and give Sucralfate and Omeprazole. Did what they were told but Murphy wouldn't eat it, became desperate to eat grass and gagging. He alsohad cervical disc surgery in Dec 2023 and has had incredible anxiety ever since, esp with car travel and needs to be drugged with Trazadone to go anywhere. She then tried Hills z/d canned and dry but has to handfeed for him to eat it. Skin and coat generally dry on z/d. No V+ since Feb incident. Stools never became D+, usually hard, occas softer by end of day, having at least 3 BMs/day. Some BMs look like baby D+ - green-brown meconium. Seems to not have the EN to go on full walks anymore, no wincing, just sits down and refuses to go further, O has to carry him. Used to go for long hikes, easily 4km. not very social with other dogs. Went to daycare for 6 mth ~2 yrs ago (2022), but eventually became reclusive, would just sit and watch so O stopped. Likes other Frenchies. Will become a bit reactive, tries to lunge at little dogs, Border Collies, serious dogs. Used to get along really well with daughter's Dogos (in California) in 2022 but no longer socializes with them on visits. Friendly with people, jumps and nips. Breath horrid , licks everything - stairs, blanket, feet. In the morning his tongue looks almost white its so pale.

PE was hard to really discern much as he was on Trazadone - tongue pale lavender, dry, normal size; pulses toned.

DDX: Prone to pancreatitis & gastritis, recently V+ blood flecks with bile, loss of appetite, bad breath & acid reflux, excessive licking, pale tongue, anxiety --> GIT inflammation, leaky gut, dysbiosis, with subsequent brain dysbiosis/inflammation = TCM: ShaoYang disharmony, Liver Blood deficiency, Qi Stagnation

Rx 30g Yi Guan Jian and 100g Chai Hu Ji Long Gu Mu Li Tang (essentially Halscion but we were out of it). Ultimately I want to get Murphy on a homecooked diet but I didn't want to stress O out more than she already was.

Seemed to do really well! No further borborygmi or tummy episodes but still not eating well first thing in the am so O handfeeding. Will eat all if handfed. Still BMs TID, poop colour improving (more tan, not so yellow), semi-formed, first poop firmed but by third poop pretty soft. Spirits have improved. Still occas puts breaks on on walks.

So I cont'd with Halscion and started him on a homecooked diet - 50/50 cooked chicken and veggies, slow transition off z/d.

Juen 27 recheck: Started V+ bile, usually first thing in am, one day entire meal in 3 diff piles, gulping, licking, ate grass and V+ grass, being picky with chicken or turkey, still handfeeding at least one meal/day, sometimes super low EN, but stools have been pretty well formed. Seemed to all point more to gastritis-focused GIT issue so I increased YGJ, lowered XCHT component, cont'd with diet as is.

July 25 recheck: bad mth, since last visit lots of V+, nausea, eating lots of grass, licking and gulping, so O gave Cerenia. Took 4 days before he would eat better. V+ yellow foamy bile again, needing to be handfed. I thought now more Damp than initially thought, Rx Adoptrex and switch to beef and veggies.

Aug 27 email: solid 4 weeks he was eating well but increase of Adoptrex from 1/8 to 1/4 tsp vomited overnight, so O kept at 1/8 tsp BID. Still not eating on his own in am, no V/D.

Oct 22 recheck: started V+ mid am a X days (thick bile with a small amount of blood specks), borborygmy, stools WNL, BUT now terribly itchy! He is getting out of bed in the night to scratch and lick his paws, axilla and inguinal areas all red, shaking his head and scratching his ears, army crawl to scratch his belly, now a real struggle to get him to eat even his supper now nevermind breakfast. Rec'd O stop O stop sweet potato and Adoptrex (just in case too drying) and pruritus did ease up a bit, started eating his am meal, eating on his own.

I rec'd SID feeding to fast him a bit and allow mitochondrial clean-up. O now seeming a bit of a hypochondriac??? REc Smack freeze dried pork, restarted Adoptrex.

Nov 26 email: diarrhea since starting Smack, although only pooping 1x day, drinks lots of water, but walking everyday 2km, and itching getting really bad again :( His chest, muzzle, eyes and feet all red again, goopy eyes!!! O decided to switch to Herring Smack before bringing him to me as she hates that he gets so stressed.

Dec 10 recheck: Stool became loose oh Herring Smack and wouldn't eat fish by 3rd day. Went back to eating Smack pork but D+ or loose stools. EN levels are great, no V+ since Nov, but so itchy! Stopped herbs Friday and very sl better for itch today, not as pink and not so itchy. Had been scratching his skin to raw, patches of hairloss, esp in armpits, goopy eyes. On PE, pulses weak, hard to find; tongue lavender, sl dry, a little swollen. Now I am thinking Spleen Qi deficiency, Dampness, Liver Qi Stagnation? So I started him on XYS and that backfired BIGTIME - itch X 10! His right eyebrow is now puffy/swollen and red, under carriage and penis bright red, inner ears are bright pink, and he just can’t stop itching.

So now I beg you to make sense of all this jumbo PLEASE!!!!

Happy holidays,
Corinne
Replies
by CorinneC
December 21, 2024
Addendum: geez Corinne, like this wasn’t a long enough question!!

1) Murphy has always come in on Trazadone. He is a very shy, sweet, quiet dog. I’m not sure how this drug affects tongue and pulse?

2) I think that the XYS drove peripheral circulation and intensified the itch ?
by naturevet
December 26, 2024
Hi Corinne,

I suppose with a reaction like that to XYS, you have to explore whether Si Miao San helps the dog and gets rid of the vomiting and itch. Maybe they are the exception that proves the rule that raw fed dogs don't get Damp Heat.

Otherwise, the Blood deficiency, prior response to Adoptrex, and progressively loose stools suggest a combination Shao Yang/Jue Yin excess/Wei Qi deficiency case. If the dog is that uncomfortable, then Qing Ying Tang seems the place to start. It can be used with SMS if you see some GI benefits with that formula (if you give it a try first). Then, as inflammation subsides, I'd wonder if Cessorex (Si Wu Tang + Xiao Chai Hu Tang) would keep the dog stable, possibly combined with BZYQT if the stool frequency and consistency is still a problem. If the skin issues dropped right off the map, then Adoptrex and Qing Ying Tang could be used together. Maybe this time you'd get by with a higher dose.

As for Trazadone changing the pulse, that doesn't tend to happen, unless the drug also happens to be curative for the dog. Doesn't sound like that is the case!

Hopefully the above helps you navigate things! Let us know how it goes!

Steve
by CorinneC
December 30, 2024
Thanks so much Steve! I will start with SMS with QYT in the wings - O took both just in case. I truly appreciate your help. O emailed me today and he is scratching really badly.
Corinne
by CorinneC
March 5, 2025
In January, skin on ventral belly became really red and itchy on both SMS and QYT. By February not improving, so stopped herbs. O restarted Adoptrex though because his gut was acting up again, V+ X2 straight bile, not wanting to go for walks again. Once on Adoptrex 4 days, really itchy again, so stopped. On no herbs right now. Just eating his Smack pork. Tried Rockfish but refused. Stools still runny/cow-patty, 90% straight D+, and super gassy (smell so bad). Still not wanting to go for walks. Skin all BTN. Occas still gets up in middle of the night to scratch, but no longer belly rolling/rubbing. Only able to get herbs in SID as only feeding SID. Occas wants to eat in am, so O gives small meal, but mostly eats ~4-6pm.

tongue lavender, dry, normal size; pulses not well toned, easy to clamp down

With the timing I wondered about Wei Qi deficiency, Spleen Qi deficiency, Spleen Qi Sinking? Blood deficiency from Spleen not tranforming/working? Liver Qi Stagnation? Rx Bu Zhong Yi Qi Tang trial to improve EN, tonify Spleen, boost Wei Qi production to skin and aid general immunity, nourish Liver Blood compromised by flagging Spleen Qi, move Liver Qi.

This week update: "He is itching again, getting off the bed during the night to itch. Scratching during the day. His skin hasn't gotten to red just really keeping a close eye on it. On the Bu Zhong Yi Qi Tang at 1/8 will start to increase to ÂĽ tsp today. Still very runny poops."

This really doesn't sound good and I think I've once again "trapped the thief in the house" with Huang Qi! Not sure if this is a QYT or YGJ addition and I'm feeling really badly that I've let the O down again.



by CorinneC
May 12, 2025
I am at my wits end with this case! I don't know if I'm doing this right either as the last recheck wasn't acknowledged? Is there a better way to get your attention? I am SO SORRY to pester but I can't see this dog often, hence the email stories. He is fed Smack pork.
by naturevet
May 14, 2025
Hi Corinne,

If Adoptrex helped the GI in the short time it was used, then it may be close to the right answer. You could try instead Xiao Chai Hu Tang with Yi Guan Jian. XCHT is half of Adoptrex. Wei Ling Tang is the other half. If his lower abdomen (Stomach channel) is getting red on it, then it may be the Wei Ling Tang half that is bothering him.

If that is the case, I'd try XCHT plus YGJ, with the latter targeting Stomach dryness and Heat. It may be Stomach Dryness and Heat that is wrecking his appetite in the am, too, and a very small number of dogs may have diarrhea when they are Yi Guan Jian deficient, because Stomach (Yang Ming) Heat can lead to 'colitis'. Y

ou could even just try Yi Guan Jian alone to see what happens, then add the XCHT in later. Adding the XCHT is likely important, since it is usually a Shao Yang disharmony that is trapping Yang in the Stomach to produce all that Heat.

The pulse seems to echo the Blood deficiency and secondary Stasis that YGJ also treats.

Based on all that, this is what I would try next. Hopefully this helps you out!

Steve
by CorinneC
May 14, 2025
On it Steve! Thank you again as always! I will start with YGJ alone, see how he does to be safe, then add the XCHT if all goes well. It all makes sense!
Corinne
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