Question Details
Inflammatory Bowel Disease With Diarrhea And Bloat
by Heather1 - March 11, 2010
Hello!

I have a case that I need a bit of help...

Ritz...8 1/2 year old intact male Aussie

History: Diarrhea and flatulence since puppyhood

Primary symptoms now: Severe bloating after eating (Dampness, Stasis)and flatulence with soft stool and diarrhea (Dampness and Spleen Qi Deficiency). The flatulence has moderate odor (Damp Heat), but the odor has become more mild lately.

Has lost over 11 lbs. since November 2009 (Spleen Deficiency). He has a ravenous appetite (Damp Heat).

Had emergency GDV surgery on 12/4/09.

Biopsies taken at time of GDV surgery: Stomach and intestine, revealed helicobacter and lymphoplasmacytic/eosinophilic gastritis and enteritis, no evidence of neoplasia

Fecal cultures: negative (campylobacter and salmonella)
Giardia: negative
Cobalamin and folate: WNL
PLI and TLI: WNL
TP: 4.3 (5.2-8.2)
Albumin: 1.8 (2.3-4.0)

Current meds:

Zantac BID
Cisapride BID
Amoxicillin BID
Metronidazole BID
Budesonide SID
Probiotics and Gas-X

Tongue: mddium pink, no coating, slightly thick

Pulse: good rate and rhythm, medium position, fairly strong, tight and wiry and thin

TCM diagnosis: Dampness with some Heat, Blood Stasis with underlying Spleen Qi Deficiency

At first I was focusing on the Dampness and thinking about San Ren Tang, as I don't think I have enough Heat signs to try Si Miao San.

But, more recently, I was considering Dang Gui Shao Yao San for tonifying, moving and draining Damp. The other formula is more moving but also tonifies with mild dampness properties...Xiao Yao San.

Your thoughts are always appreciated!

Thank you!

Heather
Replies
by naturevet
March 11, 2010
Hi Heather,

Mild odor signifies Qi stagnation more than Dampness. Severe bloating to the point of GDV signifies the location of the stasis is in the Triple Burner, particularly the middle burner. Xiao Chai Hu Tang is usually needed to initially manage these dogs, and will either rectify the problem, or at least allow follow up formulas like Wei Ling Tang, San Ren Tang, Xiao Yao San, or others that regulate digestion and peristalsis to work better.

Chronic mucosal inflammation signifies the need to move blood to the mucosal surface to resolve the inflammatory process. When the pulse is weak, tonics are required to do this. When the pulse is toned and quite strong, then aromatics are required, which Bupleurum contains. The formula is also immune modulating, and helps promote albumin synthesis by heightening mRNA transcription rate in hepatocytes. All in all, it’s where I would start, with the assumption I’d need to roll something else in later.

Let us know how it goes!

Steve
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