Question Details
Lymphoma Dog
by landauvet - May 11, 2009
Hi Steve,

This is the lymphoma case that I mentioned to you over the last herbal course.
Ruffy 10 year old MC Pomeranian weighing 7.3 lbs.
Presenting problem: Lymphoma diagnosed in Dec., 2008. Peripheral lymph nodes as well as liver, spleen, and small intestine affected. Ruffy was anorectic and lethargic which led to the diagnostic workup prior to my seeing him.
Tufts University started Ruffy on chemotherapeutic levels of prednisone (1.5 mg/kg sid). Ruffy developed a lot of anxiety, pu/pd, polyphagia, etc. The owners sought me out for an alternative which would let Ruffy have a quality of life while being treated.
1st appointment 1/2009
Exam: hot dog with excess energy, deep red tongue, yin def pulses. BL-20 /21 reactivity. Abdomen full and round. Was on high pred dose at this appointment.
Plan: Started tapering pred to 0.5 mg/kg bid doses.
Si Miao San, Alfalfa drops, Milk thistle drops, XCHT, Vit a/d3
My initial dosing may have been a little hard for Ruffy, because he developed diarrhea and a rectal prolapse in the first week after our appointment. After stopping and restarting the herbs he was fine. Submandibular lymphadenopathy started to develop as soon as pred dose was decreased. Pred dose 2.5 mg sid for 2 weeks, then 1.25 mg sid for two weeks, then 0.65 mg bid. At this point, I got scared, because Ruffy's energy was dropping off, respiratory stridor worsenning, and lymph nodes enlarging quickly. I increased the pred to 1.25 mg bid, then to 1.5 mg in am and 3 mg in pm. He is having pu/pd at this dose, some decrease in energy, but stable for the moment.
Presently his submandibular lymph nodes are walnut sized and a bother to him. His energy is only a little decreased. Appetite excellent.
Last Appointment findings (5/7/2009):
Pulse: thin, fast and superfial.
Tongue: slightly red, lavender sides.
active points: Bl-13, 17, 18. I treated these plus under chin phlegm point(?), BL-40
Lymphnodes under jaw were big and hot.
Supplementation:
Si Miao San 6 drops qid
XCHT 1/4 tsp bid
Milk Thistle 1 drop tid
Vit A/D3 1 drop eod
Calcium lactate 1 pill sid
Alfalfa 3 drops in pm
Tan Yu Tang 1/4 tsp bid

Help if you can!
Kevin
Replies
by naturevet
May 11, 2009
Hi Kevin,

Interesting case. You're doing all the right things, it would seem, but not getting far. Those points are definitely Blood and Liver points. You didn't mention whether you were tonifying or sedating them. I'm assuming sedating. With Blood Stasis such a major aspect of the picture, I would wonder about shifting focus to the internal organs using a Blood mover, and seeing if we see the cervical lymph nodes start to shrink secondarily. If we do that, we should keep XCHT, vitamin A, Milk Thistle, and probably Tan Yu Tang. We can choose what we want to roll in with this protocol - Xue Yu Tang, Qing Ying Tang, Xue Fu Zhu Yu Tang or Ge Xia Zhu Yu Tang. I'm actually thinking of XFZYT as a good first guess. You can use the version that has San Leng and E Zhu in it for added anti-neoplastic activity.

Watch for loose stools on it - maybe work your way to a full dose; the same dose you're using for SMS may be fine. Essentially, we're going out on a limb here and saying the lymphadenopathy in the neck is not Phlegm, as it usually is, but Blood stasis instead. I hope we're right. Let us know how it goes,

Steve
by landauvet
May 12, 2009
Steve,
I just put Ruffy back on Si Miao San one week ago after getting back from confernce, because of heat and inflammatory signs. I do like your blood stasis theory and will order the XFZY plus the San Leng and E Zhu. Can I just add this formula to the mix or would you recommend stopping TYT or SMS when I add the new formula?
Best, Kevin
P.S. This is so awesome to get to discuss cases with you! Thanks.
by naturevet
May 12, 2009
Hi Kevin,

Glad you like the new forum. Many more cool features to come for this site. Meanwhile, yes, continue the SMS if there have been no adverse effects of it, and just roll in the XFZYT. If you see some positive changes, we can see how few formulas the dog really needs.

All the best!

Steve
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