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Preventing Lumps

by LJH - February 13, 2010

Hi Steve,
I saw this 7 yr M(N) Rhodesian Ridgeback for atopy a few years ago and he responded well to Zhi Bai Di Huang Wan then Qing Ying Tang and diet changes and quercetin.6 months ago,however, his owners had him to his regular vet to remove several small lumps that he had developed.3 were follicular cysts (parafollicular variant), 1 was a trichoepithelioma, but 1 was a malignant melanoma removed from outside lower rt eyelid.Good margins were obtained.Owner wants to know if there are any herbal formulas to help reduce development of new masses as he is already developing 2 small(4mm),fatty feeling masses on his shoulder and flank. His tongue is a bit pale and pulse a bit thin and a bit wiry. Hair was slow to regrow after surgery and is generlly a bit bleached in color and a bit dry.He has also in the last few days been itchy around his muzzle and eyes, with lips slightly puffy. He has always seemed primarily blood deficient to me so I was thinking Xue Fu Zhu Yu Tang might be appropriate. He doesn't really have any Damp signs,but I wondered where the follicular cysts fit in the picture.If the itching really flared up I would consider Qing Ying Tang again but for the lumps thought XFZYT might be better.Any thoughts you might have would be appreciated. Thanks,
Llewanda

by naturevet

February 14, 2010

Hi Llewanda,

Lipomas are essentially a Damp symptom, while the dry coat with reduced hair growth and pale tongue suggest Blood deficiency.

So you need an anti-Damp Blood tonifier. I'd think of Dang Gui Shao Yao San.

Diet is probably really important here, too. In many species, the tendency to benign growths is associated with insulin resistance and the use of processed diets. By switching to a home-cooked or raw diet, the owner can probably halt the growth of future lumps, or make sure they are limited in size.

Lastly, we look at Blood tonics for the inhibition of malignancies anywhere on the periphery. So if you feel the dog is dry, not Damp, then I'd use Xue Fu Zhu Yu Tang to limit any melanoma re-growth.

Hope that helps you out!

Steve

by LJH

April 22, 2010

Hi Steve,
Since this dog seemed dry and blood deficient and I didn't see any Dampness I put him on Xue Fu Zhu Yu Tang 1/2 tsp BID. He seemed to be doing very well. 3 days ago however,he suddenly developed generalized lymph node enlargement (egg sized in case of submandibular) Regular vet assumed Lymphoma but fine needle aspirates were not conclusive.We stopped the herbs and she put him on meloxicam. Bloodwork came back today increased. WBC 16.7(N4-15) neutrophils 12.8(N2.8-10.56)monocytes 1.837(N0-0.98) no circulating neoplastic cells identified.Liver enzymes were mildly increased ALP 360. ALT 115 and there was mild hypoalbuminemia 22(N25-36).Inflamation source ? can't rule out lymphoma and will be going for ultrasound to assess abdomen.In mean time he has also been started on antibiotics.Today for the first time in the 5 years I've known him his pulse wasn't his typical weak, thin slightly wiry. Was84bpm still sl. wiry but less weak and a bit fuller.Tongue still pale with a very slight lavendar tinge.His appetite and stools are good and while still active and playful seems a bit down in energy .Lymphoma if diagnosed is more Damp Heat and I see you've been using Si Miao San, Xiao Chai Hu Tang, Hoxsey + low dose pred. though XFZYT +/-XCHT has been used where blood def and stasis only.I still see blood def. and stasis some with him but the pulse is starting to show Damp too. Is Dang Gui Shao Yao San still an option to address both Blood def and Damp, or not going to be enough Damp Heat clearing. Owner not sure Chemo an option if dx as lymphoma.Willing to work on the diet.Any thoughts would be appreciated. Thanks,
Llewanda

by LJH

April 26, 2010

Hi again Steve,
Just to update as the owner emailed me from the regular vet's office. Xrays showed both liver and spleen enlarged but no observed masses. Thorax "full of fluid" that they are trying to drain and will send for cytology if they can get a sample. Last 2 days he has started getting really itchy again(had been much improved on the XFZYT) and now is getting swelling of the head and neck. Regular vet now going to start on Prednisone to try to reduce. He had difficulty eating yesterday a.m. with the swelling but otherwise appetite has been good.Lymphoma remains the primary TDx but hasn't been able to confirm to this point.Still has Blood def/stasis but seems to be getting more Damp/Damp Heat. Any thoughts or suggestions appreciated.Thanks, Llewanda

by naturevet

April 26, 2010

The classic formula for that 'trapping of fluid in the upper burner' you're seeing is Fang Ji Huang Qi Tang (Stephania and Astragalus Combination). We can easily make that for you. It contains Astragalus (as you may have guessed), which can have significant anti-neoplastic activity. That's where I'd start. You'll know it's working if you see the fluid in the face and thorax resolving.

Steve

by LJH

May 3, 2010

Hi Steve,
Sorry to ask yet further questions on this case. The fluid in the chest and swelling of head seemed to resolve quickly once the regular vet started him on prednisone. Unfortunately the pred hasn't fully brought down all the LN's yet and he is now dribbling urine along with the typical PU/PD.In light of this would you still go with the FJHQT or try another formula(s) for the lymphoma.Can the FJHQT be used with other formulas if the effusion and head swelling was to return later, or only alone?If we went with something like SMS that drains Damp Heat +/-XCHT is it likley to worsen the incontinence, (although I've heard it can reduce pred side effects generally)? Also is DGSYS ever something used in lymphoma where the typical Damp/ Heat is mixed with Blood def/stasis? Sorry once again for the further questions regarding a case you've already commented on. Thanks,
Llewanda

by naturevet

May 3, 2010

Sorry to ask yet further questions on this case. The fluid in the chest and swelling of head seemed to resolve quickly once the regular vet started him on prednisone. Unfortunately the pred hasn't fully brought down all the LN's yet and he is now dribbling urine along with the typical PU/PD. In light of this would you still go with the FJHQT or try another formula(s) for the lymphoma?

It’s still potentially helpful.

Can the FJHQT be used with other formulas if the effusion and head swelling was to return later, or only alone?

It depends on what the other formula was.

If we went with something like SMS that drains Damp Heat +/-XCHT is it likley to worsen the incontinence, (although I've heard it can reduce pred side effects generally)?

Not necessarily. But we’d like the cat to look hot to warrant SMS. FJHQT may bring down LN, too.

Also is DGSYS ever something used in lymphoma where the typical Damp/ Heat is mixed with Blood def/stasis?

Yes, it’s a possibility

by LJH

May 22, 2010

Hi Steve,
We are starting to see more heat in this dog, and pulses getting more rapid and wiry. Can Si Miao San be used with FJHQT or is another formula preferable. He has started losing weight and energy down last couple of days. Thanks,
Llewanda

by naturevet

May 22, 2010

Hi Llewanda,

If you haven't seen any appreciable improvements on the FJHQT, then I'd go ahead and just switch to SMS. If there have been improvements, then SRT might be a better fit for use concomitantly with FJHQT.

S

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