10 yo MN german shepherd. history of hit by car many years ago - RF leg fracture repaired but owners said not quite right since. 18 months ago has two surgeries for hind limb paresis in short succession due to disk herniation around TL and LS. Did great after TL surgery, not so well after LS surgery. Has been somewhat weak in the rear end since then and dragging back feet but was able to ambulate and go on long walks. About 3-4 weeks ago he developed acute worsening with hind limb paresis followed shortly by hind limb paralysis and fron linb paresis. Neurologist diagnosed cervical disk herniation based on PE. No improvement on low dose of pred - owner won't do high doses due to severe incontinence which develops. He has had no pain associated with this recent episode. He dribbles urine but is able to consciously void. He is fecal incontinent. He cannot ambulate on his own, although he has some mild motor function in the front legs which are hypertonic. Has deep pain in the rear but no motor.
Tongue: dark pink and wet. Pulse: superficial, bounding and wide - not wiry and is what I would call "soft". Anxiety/restlessness. Has always tended to anxiety with change in environment. Prefers cold sleeping places. Good appetite and very alert and would be active if he could be. GI normal other than fecal incontinence. No other significant med hx. Sedation of BL 40 did make the pulse less superficial and bounding after which it was on the weak side but wide and still moderate to superficial in depth. Sedation of BL 28 and tonification of LV 3 improved pulse the most. BL20 was active. Also had a lot of heat radiating from BL11 and intrascapular area and was having a hard time localizing. No improvement with GB 34. Has some heat around GB 30 and 29 but he is generally sort of "hot on the surface" so hard to tell what is real.
My initial thought was Gui Zhi Tang because of the cervical lesion, but not sure if this is best because he has no pain. San Ren Tang is the only formula I can find that is specifically for nonpainful paresis but this is really more for hind limb.
Wondering if you think Du Hou Ji Sheng Tang would be appropriate for this patient (given your formula which has Qiang Huo for upper back and neck wind dispersion)or if you have another suggestion. It doesn't seem quite right to me because he does not scream overall deficient right now, although I suspect he will be once we get this initial level cleared (probably has underlying Blood deficiency and stasis issues). Will this be too warming? What is throwing me is the complete lack of pain here with the sudden onset of symptoms. The dog seems overall quiet "excess".
Thanks for your suggestions!
Erin