Another interesting and therefore challenging case. Thanks in advance for your help!
“Boston†is a 11 yo male German Shepherd Dog. Recently, he was diagnosed with a sertoli cell tumor and had one testicle removed so that he could continue breeding. After anesthesia (12/1/09), he was weak in his hind legs for about 36 hours and then spontaneously recovered, ambulating, urinating and defecating normally. About 24 hours later, however, Boston was unable to use his hind legs and his regular vet referred him to Tufts for an MRI and further workup. At Tufts (12/4), he had significant decreased CPs hind and severely decreased anal tone and absent perineal reflex. The MRI showed spinal cord edema from L4-S3, and the final diagnosis was presumptive FCE. Also noted was an enlarged prostate gland. He was sent home on Clavamox and Rimadyl. A week later “Boston†was able to walk again but had urinary and fecal incontinence. His owner came to see me (as a last resort!) on 12/22, her major complaint was constant dribbling of urine.
When I met Boston he seemed “depressed†for lack of better description. The owner said he had not been himself since the FCE. He really didn’t move much in the exam room and was wearing a diaper to catch urine. His pulses were deep and slippery, his tongue lavender with a thin white coating. I DN’d GV 20, 14, 4, 1; BL 11, 21, 23, 26; CV 1, ST 36 and SP6 for 15 minutes and had a decent pulse when done. I also sent her home with some Vetri-Science Bladder Strength (Pumpkin Seed Powder, Rehmannia, Wild Yam, Soy Protein, Corn Silk, Saw Palmetto, Olive Leaf and Vit B6).
One week later I saw “Boston†again and – no kidding – he was a different dog. The owner reported that she took the diaper off the day after his acupuncture and no dribbling! She also reported that he had increased mobility starting the same day. What was most striking to me was the personality difference. He was downright bouncy: a mildly neurotic (read: normal), sweet, gentle, but energetic GSD. His tongue was pink, no coating, but slightly swollen. His pulses were still deep and slippery but slightly improved from the previous week. He was off Rimadyl. I DN’d the same points.
Week 3, “Boston’s†mobility continues to improve, however he began dribbling urine while walking. He does not leak while lying down. Again, the change in his affect was profound. Even more energetic, and slightly more neurotic – his owner reports he is back to his “old self.†Pulses still deep and slippery, tongue still pink, no coat, slightly swollen. I DN’d same points and added Baihui, BL 40, 54, 60; GB 29, 30, LU 1, and LI 15.
I would like to start “Boston†on some herbs, but he’s tough for me to figure out. I’d like to pull some of his Qi up (heat up the lower burner or strengthen the upper?) to stop the leaking urine but am concerned about taking away from his hind legs. Or should I be addressing the TH? Any advice on herbal formulae to try and/or points to add would be MUCH appreciated. Sorry for the lengthy post.
Sincerely,
Carol Gifford