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GI Issues Persistent

by LaurieJohnson - March 7, 2010

Hi Steve,

This is a follow up about our dog Timber. My husband, Sam wrote you about him previously and you recommended starting him on Bu Zhong Yi Qi Tang for spleen Qi sinking. He's been on the herbs now for 3 weeks and his colitis has improved significantly. There is no more mucous or blood and he is only occasionally having soft stool. Unfortunately, he is having more frequent bouts of "plum-pit" swallowing and anorexia/depression/ sick dog in the morning. Not hearing the borborygmus as before, but he will eat grass. This has happened 5 times in the last week and he's also had 3 episodes of regurgitation (small amounts of fluid) at random times. Each time he's anorexic, we give him pepcid and he's able to eat within a few hours except that he's eating less each time. By dinner, he's ok. We just started transitioning him to some raw food at dinner, so we can phase out the kibble.
Wanted to get your input about the next step. Put him back on the Ban Xia Hou Po San (seemed to make a big difference with the plum pit) or add in Bao He Wan? We'd like to stop using the pepcid, but we're a little desperate. Considering another scoping procedure...

Tongue lately is pale lavender, wet. Pulses seem slippery, weaker on left. No heat signs.

thanks for the help,
Laurie and Sam

by naturevet

March 8, 2010

Hi Laurie,

Glad to hear one end is clearing up. I think we can fix the other end as well.

Digestion in Chinese medicine is a balance between two forces - descending Stomach Qi (peristalsis); and the ascent of 'Clear' Qi by the Spleen (assimilation). BZYQT, through its antispasmodic effects, is 'raising the Clear' and thus lessening diarrhea. But we need a formula paired with it that will 'descend rebellious Stomach Qi' to stop vomiting.

From a less metaphoric perspective, BZYQT may be slowing aboral peristalsis, but having a mucosal immune-stimulating effect. If there is an inflammatory process going on in there, BZYQT is waking it up. So using an antispasmodic formula drying anti-inflammatory formula is the next step. I would even wonder if Si Miao San would work here, but otherwise you could try changing BZYQT out for San Ren Tang (Three Seeds Decoction). It has the antispasmodic effect, but is anti-inflammatory and doesn't produce quite the mucosal blood flow that BZYQT would. It also fits the lavender moist tongue. If SRT works, you can treat the whole problem potentially with one formula.

Otherwise, your two ideas of Bao He Wan and BXHPT both descend Stomach Qi and would counteract and complement the effects of BZYQT to at least some extent. If you just used them, you'd wind up back with diarrhea, though, since they don't raise the clear, but heighten Stomach Qi descent.

Hope that helps you out.

Steve

by sam

March 8, 2010

Hi Steve. Thanks, as always, for your help. A couple more bits of info with questions. Yesterday, after Laurie posted that Timber's stools were finally normal, he had a bout of large-bowel diarrhea with mucous and blood. Honestly, you never really know what you are going to get from this guy. The initial stools from that very walk were picture perfect. At any rate, we are wondering if the raw food may be contributing. He has only been getting raw at night for the past few days. But how do you know whether to blame the food or the herb mixture? We certainly want to continue the raw if it's helping from an antiinflammatory effect, but are wondering if we should go back to cooking turkey and sweet potatoes until we get the herbs right. To complicate it further, this morning he vomited up a piece of a toy with scant blood that has been missing for 2 weeks. Most will try to blame the toy for most, but it's more of a bump in an already bumpy road. We will switch over to 100% San Ren Tang tonight. To summarize the questions: One, should we continue raw or cook? Two, should we continue western supportive care such as pepcid, sucralfate etc. Thanks again.
sam and laurie

by naturevet

March 11, 2010

Sorry, I had replied to this, but I see it vanished in the ether.

If you'd like to use home-cooked, that should not be a problem. Also, no problem to continue the western meds that you feel are helpful. Anything that seems superfluous should (and can) probably be discontinued.

Any changes on the SRT?

S

by sam

March 12, 2010

Hi Steve. Here is this week's run down: Tuesday, the day after he vomited the FB, was a good day. Started cooked turkey and veggies and SRT. Wednesday morning, back to usual with lethargy. No breakfast, ate dinner/SRT and pepcid. Thursday, good day, ate breakfast and dinner, had 2/3 BZYQT and 1/3 SRT. This morning, terrible. Vomited all his food at some point overnight, super red tongue, wanting to go out and eat grass. Gave metoclopramide. Unfortunately, unless a change in herbs can be noticed after a day or so, it's almost impossible to really give any one thing a chance. I gave him coptis this moring in hopes of cooling things down. Not sure if it matters what he eats since when he's sick it never makes it past the stomach. That being said, we'll continue cooking and stick with the SRT alone. Not sure if the 2/3 BZYQT was the reason for this mornings misery, but it's all we have right now.

by naturevet

March 12, 2010

Let's stick with SRT and a home-cooked diet. He may be too hot for BZYQT right now.

If he fails to thrive on SRT, then our next stop is probably the Yin tonics that clear Heat like ZBDHW or maybe even Yi Guan Jian.

Good luck

Steve

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