Question Details
Cutaneous Epitheliotropic Lymphosarcoma In A Dog
by sara.baldey - March 25, 2018    View Case Report
Hi,

Here is a little background on my patient (sorry if its a bit lengthy)..

Jackson is an 11 year old, Male, neutered, English Staffy. I am seeing him for supportive care for Cutaneous Eiptheliotrophic Lymphomasarcoma, recently diagnosed by the primary Vet via histopathology. He is currently on 40mg prednisolone sid and 40ml safflower oil, twice a week , as prescribed by the primary Vet. The owner says the prednisolone has helped a lot already. The owner has begun feeding home prepared meals and will start vitamin A supplementation soon. Jackson has been well in himself, eating/drinking, urinating/defaecating normally. He has a history of two previous surgeries, both to remove cutaneous mast cell tumors.

On presentation Jackson had sparse, patchy alopecia over his dorsum and flanks. His skin also felt like there were multiple, small, subcutaneous lumps predominantly over his dorsum. There was erythema extending from his medial thighs, ventral abdomen and thorax to his axillae. There were also occasional small (1cm), dark pink, alopecic plaque-like lesions through his coat. He was hot to touch, all over.
The tongue was pink/purple with a small amount of tacky saliva, but the mouth was not moist. There was a small peeled area close to the central tongue. The pulse was deep, slow, and not toned, though with reasonable amplitude. Back shu points that he responded to were BL16, BL17, BL19, BL26, BL27, and also GB30. (Acupuncture was not performed, due to all the little lumps under his skin).

This is the first cancer patient I am treating. I was planning to give Chai Hu Jia Long Gu Mu Li Tang, or is there a better choice for this patient? I am very grateful for your guidance with this case.

Many thanks, in advance,
Sara
Replies
by naturevet
March 26, 2018
Hi Sara,

We've recently started to use Qing Ying Tang as an anti-cancer formula. I think of it when:

  • The body is hot

  • The dorsum is alopecic

  • There is evidence of Yin deficiency (such as the peeled tongue)

  • There is evidence of stasis, in the form of a darker or purplish discoloration of the tongue and lesions

  • Shao Yang points are active and helpful, such as BL 19 and GB 30, as well as Blood points like BL 17


Given the above, I think you are clear to give Qing Ying Tang a try here. Blood Heat is actually a Shao Yang disharmony condition, say some of the classics, and that is my experience, too. So you could even team it up with Minor Bupleurum or CHJLGMLT. The former would be my first choice, given the depth of the pulse.

I'd start with the QYT first, though, since XCHT can be drying and we have a bit of that already. Let the QYT hydrate the patient, then see which Shao Yang formula might work best. Meanwhile, I'd expect a bit of an improvement in the pulse, the erythema, and some of those lumps.

Hope that helps you out

Steve
by sara.baldey
March 26, 2018
Thank you very much, Steve. Your comments are an incredible help. I will keep let you know how things go,
Kind regards,
Sara.
by sara.baldey
March 29, 2018
Hi again,

I have another question, please. There will be a delay on our order for Qing Ying Tang, due to the 4 day long Easter weekend here in Australia. When I spoke Jackson's owner just a couple of days ago, she said that the predinsolone had almost resolved all the redness in Jackson's skin. I am concerned that the Qing Ying Tang may no longer be metaphorically appropriate and that I need to reassess the patient and consider a new formula. Is this the case?
Thank you, in advance.
Kind regards,
Sara.
by naturevet
March 30, 2018
Hi Sara,

Only if prednisone also corrected the tongue, pulse, alopecia, active Shao Yang points, and body heat signs would it essentially have replaced the need for Qing Ying Tang. Usually you will find this is not the case. So I would plan on introducing it even given the response to pred, which is commonly short-lived when given alone, but which simultaneous use of herbs can help sustain

Steve
by sara.baldey
March 30, 2018
Hi Steve,

Thanks again for your help! I will let you know how things go.

Kind regards,
Sara.
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