View Question

Chronic Regenerative Anemia In A Dog

by CorinneC - June 24, 2025 View Case Report

Charlito is a 3yo MN Corgi X Papillon originally rescued from Korea. He was found to have a highly regenerative anemia once brought home to Vancouver. He has been very well tested over the years! Coombs negative, addison's neg, abd xray/US WNL, chest rads WNL, Snap 4Dx negative, Canine tick panel has been negative. They also did stomach biopsies - fibrosing gastritis with spirillaform bacteria and mild lymphocytic inflammation. Mild lympho-plasmocytic enteritis. He was started on injectable iron and Pred with no substantial change in PCV, went from 23 to 28% at best. They were left with a diagnosis from internal medicine of bone marrow fibrosis.

I met Charlito yesterday, very sweet friendly boy. People friendly but anxiety and fear around most big dogs, better off-leash. The Os say he shows no signs of lethargy, but will tire more easily at heavy play, pants and slows down, has to rest. He does well on walks, but needs breaks if running too much and zoomies tire him quickly. On hills he will slow down too. Last year he went to another holistic Vet and was put on Bu Gan Tang, and then Qing Ying Tang (added in April 2025), as well as HepatoVM 1/2 tsp SID, Amino B-Plex 2.0ml BID, Cobalequin SID at night, and probiotics. No real change in PCV or EN. He is mostly fed raw or cooked food. He has a very good appetite, fed BID. BMs generally on the soft side but formed. Prior to TCM he had D+ a lot, stools have improved quite a bit. Got quite boney while Os were away (stayed with friends) over 6 weeks - Spleen Qi deficiency?

His tongue is very pale lavender, moist, sl swollen (Pred?); pulses are fairly well toned, sl wiry. He is o/wise outwardly healthy.

With the regenerative anemia he was sl better with BGT, better EN with QYT. My TCM DDX: Liver Blood deficiency, Spleen Qi deficiency, (Spleen Qi Sinking?? vs Kidney Qi deficiency??); because he loses wt easily I imagine he is def prone to Spleen Qi deficiency; fearful, anxiety around dogs - Liver Blood deficiency? Liver Qi Stagnation?

So my thoughts are that we should look at BZYQT now as neither the meds nor the previous TCM herbs have made a significant improvement. Hoping to hear from the master!!!

Thanks in advance,
Corinne in Victoria

by naturevet

June 26, 2025

Hi Corinne,

I'm wondering about a combination of Yi Guan Jian and Xiao Chai Hu Tang for this guy. XCHT fits the pulse and potentially the reactivity to larger dogs. It addresses Shao Yang disharmony, a common consequence of which is Yang Ming Dryness, which in turn can be associated with the chronic gastritis and the colonization by spirochetes. This latter condition I treat with Yi Guan Jian, which may also have the benefit of boosting RBC counts. Some chronic diarrhea is due to Blood deficiency as well, so it may help there.

These dogs can get very heated with exercise, both because of the Yin deficiency and Dryness; and also the chronic Shao Yang issues which interfere with the venting of Yang to the exterior. You'd think the chronic weight loss might imply Yin deficiency, for which YGJ is appropriate. That's only true for dogs with normal stools and appetites, though.

There's nothing really there to suggest this won't be a good strategy to start with. Even the lymphocytic plasmacytic enteritis might resolve, either because of the immune modulating effects of XCHT or because of the 'active resolution' that comes from YGJ improving the mucosal blood supply. Lastly, the real food diet is one more thing to make you wonder about starting with a Shao Yang approach (though the pulse would be enough).

Hopefully this helps you out. Let us know how things go!

Steve

by CorinneC

June 28, 2025

Ok great Steve. Glad I checked and didn’t go with BZYQT right away. I see the logic. I don’t remember a lot of learning about Yang Ming dryness so that is not fresh in my mind.

Would you say I should reduce or stop the BGT and QYT since they didn’t provide a lot of improvement? Or just keep as is along with the Pred? I think since the HCT didn’t budge much I’d like to wean off Pred too eventually but I want to be super careful too.

Thanks so much for your help,
Corinne

by CorinneC

June 28, 2025

Ok great Steve. Glad I checked and didn’t go with BZYQT right away. I see the logic. I don’t remember a lot of learning about Yang Ming dryness so that is not fresh in my mind.

Would you say I should reduce or stop the BGT and QYT since they didn’t provide a lot of improvement? Or just keep as is along with the Pred? I think since the HCT didn’t budge much I’d like to wean off Pred too eventually but I want to be super careful too.

Thanks so much for your help,
Corinne

by naturevet

June 28, 2025

Well, we don't know if my ideas are right yet, so who knows? Maybe it IS a BZYQT case!

Make changes one at a time. I would suggest adding in the new herbs. If you seen forward movement, you've gone beyond what the drugs and other formulas are doing, and you can probably ease off on their use.

Hopefully we see some good results!

Steve

by CorinneC

June 29, 2025

Thanks so much Steve! I’ve started with the XCHT and YGJ and we’ll see them back in 3 weeks to reassess.
Corinne

by CorinneC

July 26, 2025

Dog's stools now routinely solid, but no other changes. CBC no real improvement, HCT went from 19 to 20%. O is cooking raw. I decided to add Gui Pi Tang as I really feel like this dog is Spleen Qi deficient and the Spleen is not governing Blood well. I am hoping this will help bolster Liver Blood and push the HCT up. I have not seen a case like this in years, since I first saw some of the vaccine-induced IMHA cases. He is so functionally ok, quite remarkable.

by CorinneC

August 28, 2025

I am at a loss for this dog, nothing seems to hit this anemia and now he is losing fur?!?! All else is WNL, appetite and EN great. He is now on XCHY with YGJ, QYT, and GPT. I stopped the BGT so they weren't so overloaded but now wonder if that was a mistake?

Please help when you can!
Corinne

by naturevet

August 31, 2025

Yes, Corinne, I would restart the BGT as it has Mu Gua which promotes hair growth.

If he is now appearing purely Blood deficient and is less reactive with good energy, you can try simplifying and discontinuing some of the drying formulas like XCHT and QYT. Then, maybe double or triple the BGT.

And, of course, if the diet hasn't been changed, now is the time. The hairloss BGT aids is due to endothelial dysfunction, which is induced by processed foods.

Lastly, if the dog hasn't had a work up for endocrine issues in a long time, that's another stone you can turn over

S

by CorinneC

October 2, 2025

Ok, so tripled the BGT, cont'd GPT, added Dextran and B12 injections. He has been off XCHT, YGJ, and QYT for over 1.5 mths. Redid CBC twice in the last 2 mth and RBC, HCT all the same ~ 20-21%. DOg is still reactive but Os cautious not to let him off-leash or around other dogs then his own pack. He has a great appetite and energy. Furloss has stopped but not growing back quite yet. I feel so bad for these folks as they did a huge workup 1 year ago including endocrine, parasitic, etc and no results. Very frustrating as I was so hopeful.
Corinne

by naturevet

October 8, 2025

Okay, another idea. You may be dealing with bone marrow suppression, like you see with hemolytic anemia. Often, QYT is enough to jolt a dog out of that. If not, I would use CHJLGMLT at the same time. It's actually become my favourite hemolysis formula. It might be helpful for the reactivity, as well. Lastly, you can use Yi Guan Jian with the CHJLGMLT for bone marrow stimulation. They go well together. You can actually get them both in the same bottle by using Halscion. So, Halscion and QYT.

Seventeenth time lucky?

S

You must be logged in to reply

CuredCases.com