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Coughing Cardiac Case

by flaviaz - March 1, 2010

Hi Steve
My first cardiac TCVM case. Shih-Tzu mix 17y NM, 3-4/6 holysystolic murmur, owner declines w/u. Cough much better on furosemide, no difference with weather or time of day. Has coughing spasms. Balanced heat and cool preference. No energy, Earth and imbalanced Wood personality. Deaf, arthritic, does very well on a baby aspirin once a day, no vomiting except once on the aspirin, no diarrhea
Deficiency at Shen Shu, all of dorsum is hot, weight loss at spine. Pulse slippery, Tongue: dry purple body, small notch.
"Where there is cough there is Phlegm" so says Dr Xie, but I am not sure if Tan Yu Tang is right. What would you recommend?
thanks
flavia

by naturevet

March 1, 2010

Actually, where there is cough, there is disruption of the flow of Lung Qi. Sometimes that is by Phlegm, but many times not. Sometimes there is just Qi and Blood stasis; sometimes Wind invasion; sometimes Kidney deficiency failing to pull Lung Qi down; sometimes it's a Triple Burner obstruction; etc. etc.

In this case, I'd start with Xue Fu Zhu Yu Tang, only because it helps to reduce pulmonary congestion and secondary edema. It's a Blood mover, and any response to ASA suggests Blood stasis, as does a purple tongue.

As for the pulse, I see it often in cardiac cases and look at it as the body trying to compensate by having full and complete peripheral circulation, but still ending up being ineffective. We can support those efforts with XFZYT, and maybe even something like enalapril if you're so inclined.

That's what I'd try first.

Let us know how it goes,

Steve

by flaviaz

April 3, 2010

Hi there
No change in cough, and he has been on the herbs close to a month. Owner declines (actually her huband) cardiac w/u, so I am a bit reluctant to rx enalapril since she is a nurse. I have not seen the dog to reassess P and T. Should I do that first, or would you recommend trying something different?
thanks
flavia

by naturevet

April 3, 2010

Hi Flavia,

Particularly when an animal has been on something obvious, and the owner says there has been no benefit, I like to have the dog come back so I can personally reassess. Sometimes (especially with a cough, or any other symptom that an owner fixates on), they can be oblivious to other changes. Repeating the history-taking and another exam should confirm whether the dog is truly not better.

If the pulse was really wiry, then enalapril, or something else that did a better job of enhancing peripheral circulation should help. If it's slippery, then added diuresis using herbs or a higher furosemide dose should help.

One other easy thing you can have owners do if they insist on one other treatment to try at home, first, would be homeopathic Spongia. It's a harmless antitussive that can often benefit cardiac cases. I'd use it BID. It should be easy to source.

Let me know what you find,

Steve

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