I have an interesting case of a dog who has been diagnosed with idiopathic epilepsy. She is 6 years old, black Lab spayed female. Lately, she has been on 750mg KBr q24h and 60mg Phenobarb bid however still has seizures and has side effects from these drugs (lethargy, increased appetite, weight gain). She never defecates during her seizures but sometimes loses bladder control.
This dog was referred to me for TCVM work up/treatments. I examined her 2 weeks ago and she was Hot and Damp and very Yang (hyper!). Her pulses were rapid and full and tongue was red. There was a lot of heat aroung GV14 but no other points were obviously active to me. She had some lipoma-like skin lumps and I started her on Long Dan Xie Gan Tang and hypoallergenic diet (canine z/d because her owners cannot cook for her). I also performed acupuncture to release her excess heat and dampness.
Her blood work was normal except low T4 but the TSH was normal.
A week later I examined her again. Over the past week she had 3 possible seizures (had urinated in the house twice and sometimes when she has seizures she urinates).
On exam she was less hot (pulses were less rapid and full and her tongue was pink) but still Yang. I gave her more acupuncture and renewed Long Dan Xie Gan Tang for 1 more week, and also started her on Ban Xia Bai Zhu Tian Ma Tang.
The owner emailed 2 days ago saying that she had an episode of ‘circling like a caged animal’ and has been urinating inappropriately in the house. He said: “We have noticed 2 different behaviours that have started since we began treatment. One I mentioned was Martie pacing around aimlessly on the deck in circles like a captive animal - she did it friday night for 20 minutes - in a circuit around the deck, down to her dog run and back onto the deck. She also tried to break through a fence in her run and she has never done that before.
The other thing we noticed is this - I told you last treatment I believed Martie had 2 seizures on Tuesday and one on Monday. But, 2 of the suspected seizures (we didn't see any of them) I am questioning. We found 2 spots that Martie had peed in the basement. She never goes down there unless we are down there with her. And the locations aren't in spots where she would sleep. Then tonight(friday) she came upstairs and peed on the carpet in front of my bedroom - no way she could have had a seizure because I literally walked out of my son’s bedroom when she finished. Why would she start peeing in the house all of a sudden? It still makes me suspicious that with a combination of the manic behaviour, peeing in the house (i.e. behaviour changes) and seizures could it be a brain tumor? Just frustrated. I started her on both herbs tonight and maintained her doses of KBr and Phenobarb"
I asked Dr. Marsden’s advice on this dog and his ingenious reply was: “Certainly a urinalysis seems in order. Where there is urinary urgency associated with seizures, Long Dan Xie Gan Tang is a good call. If it now appears maybe that formula worked after all, then I'd stick with it. As for the circling. perhaps what would have been convulsions is now just circling behaviour. Research suggests that adding Gou Qi Zi to this formula will help it potentiate the anticonvulsant effects of phenobarb.
If you are also suspicious of a brain tumor, we've had very good results with Chai Hu Jia Long Gu Mu Li Tang, with Tian Ma Gou Teng Yin added as needed for seizure control.”
I will be examining this dog this week and will let you know how she is doing.