Pain Case Report

Dr. Shana Buchanan, MBA, Certified in Veterinary Acupuncture, Certified in Veterinary Chiropractic, Veterinary Food Therapist, Certified in Chinese Veterinary Herbs

Pet "P" is a 14 yr old FS Jack Russell Terrier weighing a lean 15 lbs.  The patient has a history of a partial RACL of the right rear limb that occurred when the pet was three years old.  As the pet ages, the pain during cold weather worsens and is almost nonexistent during warm weather.  NSAIDs occasionally alleviate the pain but not consistently.  The pet is known to sleep deeply and dream excessively to the point of waking up self and seeks cool places after lying next to the owner after marked panting.  The tongue is red and dry and the pulses are very deep and wiry.  Previous radiographs do not reveal any bone cancer but does reveal effusion and arthritis in the stifle joint.  Recent blood work abnormalities reveal a slightly elevated ALKP 330 (3-131 Normal) and microabluminuria > 30 (< 2.5 Normal).  Active points are located at BL 20, 21, 23 and GB 34. 

A Western diagnosis is arthritis due to a partial RACL at the age of three.  An Eastern Diagnosis is a Triple Heater (TH) obstruction and Cold Bi.  The TH obstruction is evident by the mixed hot and cold symptoms of a red tongue, cool seeker and cold aggravating the pain in the rear limb.  Additionally, blood deficiency is evident by the deep sleep and dreaming which can be caused by continual heat and a TH obstruction.  The appropriate formula for this patient is Xiao Chai Hu Tang (Minor Bupleurum Combination) twice daily.  This herb will harmonize the patient with the mixed hot and cold symptoms and will relieve the obstruction of the TH.  Bupleurum expels pathogens from the GB and TH channels by forcing upward and outward.  Scutellaria descends Yang from the upper burner to reintegrate with the lower burner to generate Qi to give more limb strength and stamina.  Ginseng, Jujube and Licourice relieves Qi deficiency from the failure of Yang and Yin to merge as a result of the TH obstruction.  Pinellia removes Phlegm from the GB channel.  Ginger harmonzies the middle burner.   After the patient was on the herb for two weeks, the pet no longer needed NSAIDs for the Cold Bi symptoms, even during a severe cold front.  Additionally, the pet no longer has excessive dreaming.  The pulses are becoming stonger but still have a wiry feel to them, and the tongue is still red.  These symptoms indicate that the formula is appropriate, but the 9 year deep seated TH obstruction followed by Cold Bi will take more than two weeks to completely resolve.