It's been awhile but I've got a new case:
Marty is a 12 yo MN Bulldog.
He had a severe bout of aspiration pneumonia that landed him at Penn Vet. He was oxygen dependent at Penn Vet and a thorough work up was done.
Findings were:
aspiration pneumonia, pulmonary edema heart based mass that is presumed to be a chemodectoma
thickened and nodular right arytenoid (likely to be his primary breathing issue)
laryngeal dysfunction
large linear mass in the retropharyngeal region likely to be a slow growing carotid body paraganglioma.
otitis externa bilateral with mineralization and stenosis
splenic nodules
left renal cortical cyst
possible sliding hiatal hernia
Bloodwork: neutrophilic, monocytic leukocytosis, very slight ALP elevation
He has responded very well to antibiotics and steroids. He is feeling better than he has in a long time. Snoring used to be severe and now it is very minor. He is eating great. No vomiting or diarrhea. No coughing or breathing issues. He is having no side effects to the steroids and has normal thirst and urination.
Also no side effects from antibiotic use
Medications currently: cisapride, clindamycin, prednisone (1mg/kg/day)
Diet: RC HP veg kibble (started this diet as a puppy due to "stomach issues")
TCVM: Not able to assess tongue and pulse today (telemedicine)
Personality: happy go lucky dog and tolerant of anything with family members except is they try to apply medication to his face/head. He is not good with other dogs. This is attributed to him being attacked twice when he was a puppy. But he loves people and kids.
LOVES the cold weather. Very intolerant of heat
Sleeps great- all day! Does do some excessive dreaming
TCVM Dx:
Blood Stasis (All three Jiao)- chemodectoma, paraganglioma, renal cysts, splenic nodules
Excess Damp/Heat- otitis (chronic), snoring, hx of skin infections
Blood/Yin deficiency- excess dreaming, long standing Damp Heat damaging the Blood and Yin; responding great to Steroid with no side effects (Hot and Deficient)
Plan:
We will need to change the diet!
Herbal medicine: Modified Xue Fu Zhu Yu and San Ren Tang or Six Gentlemen?
Given the tumor type, herbs with anti-angiogenic properties would be useful. MZFZY would fit the bill. I see a note in The Essential Guide to Chinese Herbal Formulas to not use XFZY in peripheral tumors that are overly inflamed. Given this dog's response to steroids and abx, I would assume he has significant inflammation. Should I use Xian Fang Huo Ming Yin first?
As always, thanks for your guidance!
Jen