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Chronic High Lipase Levels

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I have a 2yr F/S Australian Shepard. Admitted to hosp with primary complaint of lethargy, vomiting and bloody diarrhea. Lab values were normal except for elevated Lipase 4600. Abdomen tense. Radiographs were normal. The animal was hospitalized with fluid therapy and treated medically for the vomiting and diarrhea with cimetidine, metacloprimide and broad spectrum antibiotics. After 2 days she was discharged feeling much better.

7 weeks later the dog presents to the hospital with 2 bouts of vomiting bile and diarrhea. Normal body temp, BAR and just a little lethargic. The owner was concerned about another flair up of pancreatitis. The lipase levels were higher (5417) than previous testing. Since the animal stresses out in the hospital she was sent home on a strict diet of Purina EN and placed on Biosponge to control the diarrhea. Owner was asked to return in a few weeks to retest lipase.
Lipase levels have gone down but are still elevated (4699). The animal is BAR stools are normal looking with no evidence of blood or diarrhea and there are no episodes of vomiting.

TCVM exam: tongue pink in color with thin body no coating. Pulses: strong deep and even on both sides. Shu points palpate normal as well as the alarms points.

TCVM RX: EN points BL-20/21; ST-36 and GB-34 once a day for 4 days and sent home with RX zymes to add to the EN diet. Are there any herb formulas to consider or other TCVM points to use to bring down the lipase levels which to me are indicating chronic pancreatitis? Diet changes?

by naturevet

February 5, 2010

Hi there,

I would use San Ren Tang for this case. It's a decent anti-inflammatory for the digestive tract and pancreas. The other possibility is SMS plus Dang Gui, but SRT should be a good place to start.

Regarding diet, I would look at a home-cooked grain-free diet.

These two strategies together should accelerate the improvements. If it doesn't work, it might be because there is a Blood deficiency and Liver Qi stagnation.

You can test for that now by needling BL 17 and 18. If the pulse becomes markedly less wiry, then we may be looking at a LV-SP disharmony. Lastly, the only other big possibility is a Triple Burner obstruction. Test for that by needling BL 19 and GB 34, and seeing if the pulse improves. If so, use Xiao Chai Hu Tang.

SRT opens the TB somewhat, so it's a good place to start.

Hope that helps,

Steve

by

February 5, 2010

Great..I'll try this.. Thank you

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