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Possible Eosinophilic Gastroenteritis In A GSD

by rcooper - June 11, 2017

I am an acupuncturist /herbalist in the USA, in practice for 25 years.
My vet and I are in the diagnostic stage of Ben's problem.

He's a working line GSD with good blood lines, was cryptorchid as a pup, otherwise healthy but w a sensitive digestive system. Highly sensitive nervous system, hair trigger responses to any movement I make, it took him all of his 6 years to get some calmness. Friendly and happy otherwise. He is on grain free salmon and potato kibble.

He had very bloody vomit in early March which occurred 1 day after reingesting his vomit through a pile of birch branches. ( he has always been a random vomiter)...That resolved but has since had some malaise, no appetite on random mornings, and some raspberry jam blood in stool.

Stool sample, xrays normal. Very high eosinophils and low albumin.
I'm getting a urine sample tomarro and we are de worming with a probable change in food first.

In my practice I use and value the incredible beauty of XCHT as a go to formula for many applications. Harmonizes ascending, descending, internal, and external.

I have started him on 1 550 mg pill once a day. A baby dose, but I don't want any surprises.

The problem is that I don't want to have to be the treating herbalist here (my vet acu skills are nonexistent) , and need a vet trained in this for accurate pulse, tongue point location etc.

Are there any suggestions of how to find someone in my area?

I hope the post is aporopriate. I am not asking the board for veterinary diagnosis, but herbal medicine input perhaps.

Thanks so much!

by naturevet

June 12, 2017

Hi there,

Even a homemade meat-and-vegetable-based diet might help. That's really job one. Your existing vet can do a food allergy test to determine the likely offending food allergens. You'd then find a grain-free low starch meat and vegetable diet that avoids that allergen

Minor Bupleurum can be very helpful in these cases. It's fine to try it, and it may help. The diet change is more important, though

To find a Chinese medically trained veterinarian near you, consult www.ivas.org and use the 'find a practitioner' feature on the right hand margin of the home page

Hope this helps. You should be able to find help for your dog and get him healthy again

Steve Marsden

by rcooper

June 12, 2017

Thank you, I will check it out.
I was fortunate to study with Ted Kaptchuk before he stopped teaching and about Minor Bupleurum he used to say, " The patient will tell you, "I remember the exact day this started", or, " I got sick and never really got over it." What it meant was that the pathogen got stuck, half inside/ half outside.

Ben has always been a Liver/Spleen dynamic and high strung. My being away for the first time from for 2 wk vacation affected his nervous system. His babysitter never noticed vomit, or blood in stool. But this dog never takes his eyes off me--he missed me.

Here is my working hypothesis:

A stomach/ spleen qi disharmony ( long term emotional upset, vomit) plus the introduced ' pathogen' of pointy sticks/tissue injury, I believe was the instigator of a shaoyang level issue and concomitant immune system dysregulation.

After 3 doses of the formula, the tongue color went from dusky grey pink wth red edges and tip to a healthy uniform pink. The shen, which was muddy, returned. His appetite was ravenous, and he wanted to play a lot.

We will continue to deworm. Will see how he does. I will check the stool more frequently. But as the Chinese doctors would say, " when the appetite returns, the prognosis is good for recovery."
I think he is going to be ok.

by rcooper

July 18, 2017

Update on Ben:

He has returned to his normal happy, playful self except for one issue which is recurring : occasional a.m. appetite loss. On those mornings he is quiet. I notice it often happens on damp misty, cloudy mornings, but not always. This is accompanied by audible squeaky borborygmus.

His appetite picks up at 2 or 3 pm which is the usual time for his second feeding. And he acts like nothing is wrong. The next day he is back to his ravenous self.

Followup prot/creat ratio urinalysis after a positive albumin dipstick was normal. Eosinophils have not been rechecked yet. His stool has at times been dark, almost tar like after the deworming protocol.

I ran out of probiotics in the last 2 months which he was getting daily. Kefir, which he loves, gives him v. Smelly gas. I have been giving XCHT @550 mg ×3 once a day.

Wondering if he needs LJZT to get back on track and back on probiotics? I use Klaire labs human formulas - Vital ImmuneBiotic. Any suggestions of a good vet. probiotic would be welcome.

I hesitated changing his food to Raw/veg since he is so sensitive to any changes in diet. Vet has suggested Royal Canin hydrolyzed if problems persist.

Thank you for any input you may have.
Rose

by naturevet

July 18, 2017

Hi Rose,

Low appetite in the morning (when Tai Yin is high) can signify Damp; but it can also signify Stomach Heat (since Yang Ming is also strong at this time of day). XCHT addresses both. The other observations make me think, however, you should assume there is a Yang Ming excess. This can be associated with Liver Qi stagnation - that is, from a Liver Stomach Disharmony. The cause of that, in turn, is Yin deficiency, so my guess is that you need a Yin tonic (observations about Damp weather notwithstanding).

Use of a Stomach and Liver Harmonizing approach is further supported by:

improvement in the afternoon (at Liver 'low tide')

borborygmi

Assuming this approach is correct, I'd recommend adding Yi Guan Jian into the protocol. Try a lower dose while you ascertain that it is well tolerated. I'm guessing it will help.

Steve

by rcooper

July 18, 2017

I will get some. His tongue in the central portion is light lavender with red edges and tip, tho not too red. The T is sl. Pale

by naturevet

July 18, 2017

Sounds like a classic YGJ presentation to me!

Steve

by rcooper

July 20, 2017

I will be ordering the linking decoction tomarro. Thought I should mention that this morning was a no appetite morning, and while I was in the garden had a second bowel movement, half of which looked normal, the other half had some raspberry jam, dull purplish matter in it.

This is the type of stool that brought us back to the vet for xrays and bloodwork. That stool had a streak of blood in it, this one didnt. The first stool happened on a no appetite morning as well.

I have also seen normal stools. Ben was very hungry this pm, and I fed cooked chicken and rice.
I will watch every stool from now on and see how things progress.

Just wondering if YGJ and XCHT are still a good combo.

Thanks for your input

Rose

by naturevet

July 20, 2017

I think so. I'd proceed with it

S

by rcooper

July 20, 2017

Will do!

by rcooper

August 6, 2017

So...Linking Decoction had no effect, unfortunately. Ben still had periodic morning anorexia accompanied with some red berry jam in an otherwise normal stool and low mood. Other days he seemed fine.

I researched bloody diarrhea and vomiting in Bensky, and Fischer & Wu. I had one bottle of Kan's Irriitease that seemed to fit the bill.

The formula is made up of 2 formulas: Important formula for Painful Diarrhea and Agastache Powder to Rectify the Qi.

Rice with his grain free fish/potato kibble after a few days of boiled chicken (which had been tried before without effect), there was one morning w vomiting two hrs after breakfast. After that w 3 small meals instead of 2 he seems back to normal now.
Tongue is a uniform pink w a redder front. Shen is clear and full of yang qi

Hopefully this is the end of the travail!!

Rose

by naturevet

August 6, 2017

Thank you for the update!

Steve

by rcooper

August 21, 2017

Blood test results revealed Lowe eosinophils (3000 down from 4000) but Lower albumin.
This test taken on 8/15/17. On that morning he had morning anorexia, borborygmus,low mood and a 2nd stool w alot of raspberry jam blood in it.

Doc said flagyl,and a hydrolyzed diet was next, then pred. If no response, then scoping both ends.

He is respectful of my herbal interventions and agreed to a watch and wait time period.

After consulting with my 85 yr old Chinese doctor (who was confused about making recommendations for a dog) I got the sense that he thought XCHT was the best idea w the addition of magnolia, Chen pi atract. Etc.

So since 8/14 I have given in cresting amounts of grain free kibble with bland rice/meat mixture. Herbs gave been 2 XCHT , 1 Ping Wei San .

All fine till 8/19 which was a low mood, borb. No appetite morning. Switched to 2 XCHT and 1 Irritease which brought him back on line.

On that herbal regimen he has been great.
All stools since 8/14 have progressed from soft and a little sloppy to perfect, w/o any blood.

The 8/14 downside was due to having stopped the XCHT for 2 weeks prior and just using the irritease.
Seems there are 2 components to the problem: one being constitutional spleen stomach disharmony and an attack of a Shaoyang disorder. Both must be adressed.

Will get another blood test in a month if things keep going as they are.

by rcooper

August 21, 2017

Meant 8/15 downslide.

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