I am working on an unusual case. Lily is a six year old Yorkshire Terrier. She has experienced periods of anxiety over the past three to four years, but recently they have become much more frequent. During the episodes, she transforms from a "normal" state to an "anxious" state over a matter of minutes. During these episodes, she is very agitated, can't get comfortable, will frantically lick anything and everything (animate and innanimate) and she bleeds into her mouth. The owner describes it as if Lily's skin is crawling (it almost sounds to me like cats that have hyperesthesia).Historically only some of the episodes were associated with bleeding, but recently every time she has an episode, blood is visible in her mouth. I have seen this twice in my office. The episodes last one to two days. When bleeding occurs, it only lasts about ten minutes and then is gone.
Blood work is unremarkable, except that recently her rbc is in the high normal range. Her most recent blood sample was also lipemic. A clotting profile is normal, except an elevated fibrinogen.
I began to see her in early November. Her tongue has a thin white coating and is slightly purple. Her pulses are deep and a bit wiry. She has active points at Liv 8 and GB 33. She responds to acupuncture (points I have treated are BL 17,BL 18 Liv 3, Liv 8, and GB 33). When these points were tonified, her pulses improved and the time between episodes increased. I first prescribed Tian Ma Gou Teng Yin, but there was little response. I then tried Bu Gan Tang. Again there was little response - no real change in the frequency or severity of episodes.
My thinking is that there is internal wind and stagnation. I appreciate any advice you can provide.
Thanks.
Gary Stuer
Bethel, Maine