This case is a 9 year old SF Boxer w/ IBD (biopsied). Also in her history; IVDD cervical, recent sl. ^ SDMA, chronic ^ ALP (400-800's) for several years and glucose (150- 200, not glycosuric, fructosamine normal). Liver biopsy showed "reactive hepatopathy". I'm assuming she'd had a Cushing's workup; not finding in my notes. Also a 1X indolent ulcer in the fall.
First exam; June 2017:
-QAR, sweet
- T: pink, dry
- P: deeper, sl. thin, toned
- gingival hylerpasia
- alopecia medial legs, venture.
- gassy (and odor!)
She was on Budesonide, Omeprazole, Thyroxine. Off Budesonide her symptoms had worsened. Her typical GI symptoms were gurgle stomach noises, lack of appetite and lethargy during flareups. The owner did not appreciate any seasonality to Blade's symptoms
I sent her with Si Miao San and dang gui and had the owner start Balance IT pork and sweet potato diet.
At recheck, stools had been the "first normal stools in years" on herb and previous diet, slightly softer once she started the home cooked Balance IT diet. Her P: was a bit more middle position, otherwise PE same.
BY 10/19 we tried to wean her Omeprazole, a couple days later she had dark, tarry stools w/ a bit of fresh blood on stool. She had not had digested blood before, usually fresh. We restarted Omeprazole.
By 10/29 the owner reports that she is stable; stools softer but formed, burps some, energy and appetite are good. Glucose 195, ALP 220.
So, I feel the SMS/DG is justified and she had quite a good response to the herb start (+ probiotics, enzymes, slippery elm, etc) even before the (hypoallergenic) diet chang., chronic ^ ALP and Glucose, steroids help. As we are moving into (cold MN) winter, I'm wondering whether I should be looking at a less cooling herb to add in SID and keep the SMS/DG PM. She had been on the SMS for 3 months before we tried to wean the Omeprazole.
Thanks !
Cathy L.