Physical exam abnormalities that were noted include difficulty and reluctance to use pelvic limbs, urinary incontinence, and mild obesity. Pain was elicited on palpation at thoracolumbar region. The gait was normal when walking, but he had difficulty rising. Conscious proprioception was normal. The range of motion was normal in the coxofemoral and stifle joints, and no pain was noted. As the owner refused to pursue further diagnostic procedures, a tentative diagnosis of intervertebral disc disease (IVDD) at T10-L1 was made based on the findings along with his signalment, history and physical exam.
Cooper was always quiet and aloof which makes him a Metal personality. His Shen was normal and his tongue was red and slightly purple with thin coating and normal moist. Pulse was deep weak and fast (weaker on the left). Body was slightly warm with slightly dry hair coat and small dandruff. His stool was usually soft with mucus. He was sensitive along BL-19 to BL-23 on palpation. He was always panting and sought out cool places.
Kidney Qi and Yin deficiency with Qi/Blood Stagnation, Spleen Qi deficiency.
TCVM Treatment Goals and Plan:
Tonify Qi and Yin, strengthen Kidney and Spleen, and clear Stagnation to improve hind limbs strength for mobility and resolve incontinence.
- Dry needles: GV-20, GV-14, Bai-hui, GV-1, ST-36, Liu-feng, BL-39 alternately.
- Electroacupuncture: Hua-tuo-jia-ji (HTJJ) (at T10) bilateral, HTJJ (at T12) to Shen-shu, BL-54 to KID-1, Bai-hui to GV-14, HTJJ (at T10) to BL-23, Liu-feng bilateral, BL-39 bilateral alternately (20 Hz/10 mins; then 80-120 Hz/10 mins).
Aquapuncture: 0.3 ml of diluted Vitamin B12 at BL-39, KID-1, ST-36, HTJJ (at T10-L1), Liu-feng alternately.
Chinese Herbal Therapy:
0.5g Jin Suo Gu Jing, 0.5g Bu Zhong Yi Qi Tang, and 1g Hindquarter Weakness, orally twice daily for 4 weeks
Days after receiving initial treatment, Cooper could stand up and walk on wood floor more frequently and did not have any urinary/fecal incontinence in the house for 3 days after treatment. As no fecal accident was noted in the house for 2 weeks, Bu Zhong Yi Qi Tang was discontinued and 1g Double P II, orally twice daily for 2 months was added. Two months after the first treatment, his ambulation and energy level are much improved and he is able to walk and play for longer periods. Cooper has no longer been having any accidents in the house. Currently the dog has been doing well over the past six months, and is now maintained by acupuncture every 4 months and daily herbal therapy with 0.5g Hindquarter Weakness orally twice daily. In conclusion, this case report illustrates the value of TCVM approach for a dog with paraparesis and fecal and urinary incontinence.
1. Kidney/Urinary/Reproductive/Geriatric Herbal Module Notes 2010, Chi Institute of Chinese Medicine, Reddick, FL.
2. Xie H, Preast V. Xie’s Veterinary Acupuncture. Ames, IA: Blackwell Publishing 2007:276-279.
3. Xie H, Preast V. Xie’s Chinese Veterinary Herbology. Ames, IA: Blackwell Publishing 2010:310, 465, 493.