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Hepatocutaneous Syndrome

by petvetlb - March 9, 2010

I have a 10 yo sf maltese that has just been diagnosed with hepatocutaneous syndrome and a bladder stone. She has severe pododermatitis that is yellow in color and painful. She has comedones on her dorsum by her tail base. She has been dribbling urine intermittently and has been diagnosed with a urinary tract infection.

I am interested in finding out your experience with amino acid supplementation and if there are any herbs that may help her with her problems. I will be evaluating her tongue and pulse on my next visit and will post this information as I have it.

Thank you in advance for your help.

by petvetlb

March 9, 2010

She is currently on denamarin and egg as an amino acid supplementation.

Her ALT level is currently 205
alk phos is 570
albumin is sl low at 2.3
CBC mildly weak regenerative anemia
She is thought to be early on in the disease process.

She has some arthritis in both stifles with patellar luxation - bi syndrome?

I am thinking that she has dampness - stones in bladder and kidneys

Heat and blood deficiency

Sorry I left this information out in my prior posting.

Lisa Beagan, DVM

by naturevet

March 9, 2010

Hi there,

Pulse and tongue can be important here. Did you get that data?

Also, can you describe more fully what the pododermatitis lesions look like?

Thanks!

Steve

by petvetlb

March 12, 2010

The pulse and tongue for this case are as follows:

pulse - wirey, sl deep and fast
tongue - pale to moderate lavendar and sl moist especially on the tip, middle is more dry

The pododermatitis is now cracked on the edges of the foot pads and dry. There is some pink in the center of the pads now (previously the pads were yellowish). There is no discharge or smell at this time. The pads are thick especially on the edges.

I am interested in herbs for this dog and your experience with specific diets with this disease. The owner is willing to change her diet as well.

Thank you again for your thoughts.

by naturevet

March 16, 2010

Hi there,

There are a lot of possibilities here, but in general:
stones signifies Damp, as does UTIs. You didn't mention stones at first, but I take it they have been visualized? If so, we need to prescribe on that basis.
anemia signifies Blood deficiency. The liver enzyme elevations are consistent with that, but the ALP is bordering on being a little excessive, so we'll need to watch it and make sure it responds well to the herbs we use.
The current foot lesions seem to have an aspect of deficiency about them. Any skin lesion on the foot should have us thinking about poor peripheral circulation. If we use a formula that invigorates that, we would want the animals paws and ears feeling coolish to start with. Do they?
The pulse also suggests a degree of stasis.

So we need a blood tonifying, moving, and Damp draining formula. The formula that fits that bill is Dang Gui Shao Yao San and is how I'd start. I'd follow up in 3 to 4 weeks to make sure you're seeing improvements in symptoms (eg. dribbling, foot lesions) and in liver enzyme elevations. Please let us know what you find.

All the best,

Steve

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