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Previous Wind Stroke Causing Chronic Qi/blood Def?

by medvet - December 17, 2009

I have a 7 year old Australian Shepherd that belongs to a former nurse of mine that was a patient before I moved to Florida one year ago. I previously treated "Sarah" for hip dysplasia/DJD and she had classic signs of qi stagnation at that time and responded very well to acupuncture and PT. After I left my previous job however (and moved away) Sarah experienced an episode of what was diagnosed as systemic inflammatory response sydrome. It affected nearly every organ system and she was hospitalized for some time with vasculitis in her skin, G.I. tract, and even had aspiration pneumonia. A definitive cause was never identified however since that time, she has been diagnosed hypothyroid, with laryngeal paralysis (no history or signs prior to this acute illness) and has had repeated skin infections and swallowing difficulty/mild dysphagia. She is currently taking thyroid hormone, pentoxyphylline, glucosamine/chondroitin/MSM and fish oils.

When I examined her last week while home on vacation she is "frail" looking over all compared to the robust friendly dog I remember. Her haircoat has fine, white dander and she has several lick granulomas on her front legs (LI channel) and her paws feel cold and almost slightly edematous. Her tongue is swollen, light lavendar with a white tongue coat. Pulse is slow, weak, and superficial and slippery.

Her active points included BL40, BL20, BL23, and GV20. Pulse improved the most with needle in BL40.

I am concerned that she had almost a wind-stroke like episode initially (a year ago) when all this "started" and now she has become very qi & blood deficient and dampness? Everywhere I look this poor dog is screaming damp and cold.

Help with herbs for her?
I feel a little bit at a loss since I am not able to monitor her directly or acpuncture her more frequently but my nurse is comfortable with atleast monitoring tongue and pulse and giving me an idea of her repsonse(s). Thank you!

by naturevet

December 19, 2009

Hi there,

It’s unfortunate you’re at such a distance, as this is most likely a multi-layered case that may well need a sequence of formulas over time. I suspect this because of the multiple possible pathologies. Autoimmune problems and immune-mediated concerns such as vasculitis commonly suggest a deeply penetrated pathogen that would potentially benefit from Xiao Chai Hu Tang or perhaps Qing Ying Tang. XCHT may be a more likely candidate, given the problems descending Qi, which it also aids with, and its strong effect on mobilizing Qi to the periphery.

However, the dog currently appears decidedly cold, Damp, and otherwise deficient to you, rendering those formulas inappropriate at least by themselves. The only thing you can do is start where you’re at, which seems to be Kidney and Spleen Yang deficiency, given the points, purplish tongue, poor circulation, and feeble pulse. There may be a Wind, depending on whether you were tonifying or sedating BL 40 when you saw the improvement. If you were tonifying, then BL 40 supports Kidney Yang deficiency.

Probably the best option is to start with Rehmannia Eight (Ba Wei Di Huang Wan) and Xiao Chai Hu Tang together. Chronic problems descending Qi lead to Kidney weakness, so this combination treats both past and present problems, along with the root (TB and GB obstruction) and its branches (Kidney deficiency).

The only other formula that springs to mind for such a mixed-bag case is Yi Yi Ren Tang, but its emphasis is decidedly anti-arthritic, and I don’t know that is your top concern right now.

Finally, please avoid any further immunization of this animal, unless absolutely indicated through appropriate titer testing. With a history like this, vaccines may have been an aggravating factor in the past, and almost certainly would be in the future.

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