Pelvic Limb Paresis in a Dog

Pelvic Limb Paresis in a Dog

By Han Wen Cheng, DVM, MS, CVA, Taiwan

Author: Chi Institute/Tuesday, June 10, 2014/Categories: TCVM Newsletter, 2014 Spring Issue

A two-year-old, 5.2-kg, female dachshund dog was brought in for rear leg weakness. She didn’t have bowel movement and urination for the past two days.

The patient was presented with a chief complaint of pelvic weakness after going out for urinating and climbing stairs two days ago. She had been diagnosed as Grade IV paralysis of inter-vertebral disc disease (IVDD). Laxatives were prescribed and the owner was advised to express her bladder to help urinating. A Decompression surgery for IVDD was recommended, but the owner refused it because of the risks and decided to give TCVM a try.

Physical Examination

The patient had normal appetite and drinking. She could stand for two seconds, but not on the left rear limb. The superficial pain test was positive. She could wag her tail.

The X-ray showed disc calcification at T5-6, T7-8, T9-10, and T12-T13.

Traditional Chinese Medicine Examination

The patient was eager to go out to take a walk every day, but she was sensitive to sound, especially loud noises. Her tongue was purple. The pulse was wiry and rapid. She showed signs of acute pain and stiffness in the thoracolumbar regions, especially between T11 and L2. She had no particular preference to warm or cold places.

Traditional Chinese Medicine Diagnoses

Kidney Jing Deficiency leading to thoracolumbar Bi Syndromes with Qi and Blood Stagnation was diagnosed. X-rays of the lateral thoracic view showed multiple disc calcifications at T5-6, T7-8, T9-10, and T12-13, indicating Kidney Jing Deficiency, which is not uncommon for dogs at this young age. From the Chinese medicine perspective, the purple tongue, wiry/rapid pulses, acute pain and stiffness in the thoracolumbar region all suggested Blood Stagnation. However, the root problem was Qi Stagnation, especially Liver Qi Stagnation, as could be identified from her eagerness for getting out and her sensitivity to loud noises. Liver Qi Stagnation was commonly caused by these factors. If Qi is stagnated, Blood stagnation will follow. In the view of TCVM, Qi is the commander of Blood; Blood is the mother of Qi.

Traditional Chinese Medicine Treatment

According to the TCVM diagnosis, the following points and herbal formulas were selected:

I. Electro-acupuncture: 30 Hz for 15 min, then 80/120 Hz for 15 min.

a. Hua-tou-jia-ji - T11, T13, and L2: Hua-tou-jia-ji (Hua-Tuo’s Paravertebral Points, i.e. HTJJ) are the acupoints on the dorsal lateral region of the back, 0.5 cun right and left lateral to the dorsal spinous process of each of the vertebra from T1 to L7. Since HTJJ may reflect the conditions of Zang-fu syndromes in the trigger points or local sensitive points, the Paravertebral Point near or on it can be used to treat the disorder of the corresponding Zang-fu or the local lesion. In this case, these points were selected to treat local stagnation, i.e. pain and back stiffness.

b. BL-54: Master point for the hind limb; used to treat pelvic weakness, paresis or paralysis.

c. ST-36: Master point for GI tract and abdomen.

d. GB-34: He-sea point (Earth); the key point for tendon and ligaments; used for Liver Qi Stagnation, tendon and ligaments disorder, pelvic limb lameness, weakness and paresis or paralysis, and general pain.

e. BL-67: Jing well point and tonification point; used for relieving pain on the Bladder channel, paralysis or paresis.

II. Dry Needle: 30 min; twisting right and left every 10 min.

a. Bai-hui: Used for Yang Deficiency, pelvic limb paresis or paralysis, lumbosacral pain, and lumbosacral intervertebral disc disease.

b. SP-10: Sea of Blood; used for Blood stagnation, pelvic limb paresis or paralysis.

c. BL-40: Master point for the caudal back and coxofemoral joints; used for dysuria and urinary incontinence, thoracolumbar intervertebral disc disease, and pelvic paresis or paralysis.

d. BL-60: Jing river (Fire) point; used for inter-vertebral disease, and thoracolumbar pain.

e. Rear Liu-feng: used for pelvic limb paresis and paralysis; added at the fourth treatment.

III. Chinese Herbal Formulas:

a. Du Huo Ji Sheng Tang: 0.6g BID, used for relieving the Bi Syndrome (painful obstruction syndrome), nourishing the Liver and Kidney, and tonifying Qi and Blood.

b. Shen Tong Zhu Yu Tang: 0.6 g BID, used for activating Qi and Blood circulation, dispelling Blood Stagnation, opening the channels and collaterals, and relieving the Bi syndrome and pain.

Although the patient had a problem of Kidney Jing Deficiency, she healed very well through the treatment in two months.

First Treatment (Nov 23-25, 2012): After this treatment, the owner reported that the patient could urinate and had a bowel movement at the night of the first visit. On the third day, she could stand and walk stumbling.

Second Treatment (Nov 26-27, 2012): Acupunctured on Nov 26, combined with the herbal prescription. The patient walked better and started to run.

Third Treatment (Nov 28-30, 2012): Acupunctured on Nov 28, combined with the herbal prescription. She tried to jump and ran more.

Fourth Treatment (Dec 1-4, 2012): The pelvic Liu-feng acupoints were added in. She walked and ran pretty well.

Fifth - Seventh Treatment (Dec 5-28, 2012): Acupunctured three times, continuing with the previous prescription. Everything was good.

Eighth Treatment (Dec 29, 2012-Jan 25, 2013): No acupuncture, only prescribed the formulas.

Ninth Treatment (Jan 26-Mar 1, 2013) and Response: Acupunctured on Jan 26 and Mar 1, combined with prescribed herbal formulas for tuning up.

Case Summary: the patient responded well to acupuncture and Chinese herbals. It was quite impressive that, at the night of the first visit, she urinated and had a bowel movement herself, relieving the owner’s main concerns. Only after three days, she could stand and walk stumblingly. By the third treatment, she had already healed 80%. According to the owner, the patient can walk, run, and jump normally, and is enjoying a happy life now.

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