A nine year old female spayed Labrador Retriever came to me due to an acute LF lameness two weeks prior, after chasing a squirrel in the yard. The lameness worsened with exercise. She also had a history of chronic bilateral hind limb stiffness and intermittent lameness, worse after resting. She has a chronic intermittently draining wound between the fourth and fifth digits of the right hind limb, which was previously diagnosed as chronic folliculitis. Diet:Grain Free Salmon and Sweet Potato dry kibble, 3 cups daily. She also received a joint supplement (Dasuquin) daily.
Western Physical Examination:
WNL, BCS: 7/9. The patient was moderately lame on the left forelimb at the walk and trot. She was stiff behind, and exhibited mild right hind limb lameness. Bilateral muscle atrophy was evident in both hindquarters. She exhibited a mild reaction to extension of the left shoulder and was moderately painful on extension of both hips, right >left.
Radiographs of the left shoulder revealed mild bony change in the region of the biceps tendon insertion and the caudal aspect of the glenohumeral joint. Radiographs of the hips revealed severe DJD in both hips, right worse than left. Lumbosacral spondylosis was also evident.
TCVM Examination and Diagnosis:
The patient is an earth personality. She prefers soft surfaces, but does not really have a preference to warm or cold regions. Shen was good. Tongue was pale purple and wet. Pulses were deep and weak bilaterally, slightly weaker on the left. Coat was dandruffy, with large flakes. Her back was cool over the lumbosacral region. My diagnosis was Bony Bi Syndrome (Underlying Kidney Qi Deficiency) with local stagnation at left shoulder, hips and lumbosacral region.
1st Treatment, Oct 13, 2010:
Dry Needle:GV 20, GB 21 left side, BL 11 bilateral, TH 14, LI 15 left side, BL 54 bilateral, GB 29, GB 30 bilateral, LIV 3 right; Aqua (AA): 2cc B12 at BL 23 bilateral. Herbal: Body sore 5 grams BID. Loranthus Powder for Kidney Qi/Yang deficiency: 5 grams BID.
2nd Treatment, Oct 22, 2010:
The patient’s forelimb lameness was markedly improved after the first treatment. Her hind limb stiffness was progressively
worse, likely due to the restricted exercise prescribed for her acute forelimb injury. Her tongue was less purple, and wet. Pulse was deep, weaker on the right.
Dry Needle:GV 20, BL 11 bilateral, TH 14 left, SI 9 left, GB 34 left; EA: BL 54 bilateral, BL 23 bilateral, BL 26 bilateral; AA: BL 40 bilateral (2cc Vitamin B12 each site). Herbals were continued.
3rd Treatment, Nov 5, 2010:
The patient’s forelimb lameness was resolved. Her hind limb stiffness was improved. She was less stiff after rising. Tongue was pale and wet. Pulses were weaker on right.
Dry Needle: GV 20, GB 34 left, BL 54 bilateral, BL 20, 29 right, BL 60 right, LIV 3 right; EA:BL 28 bilateral.
4th Treatment, Nov 19, 2010:
The patient was doing well. She had not shown any forelimb lameness. She was noted to be stiff after sleeping, but able to go up and down stairs more comfortably. On this day, the chronic wound that is between her fourth and fifth digit of her right hind was open and draining serosanguinous fluid. Owner reported that it had been draining for two days. It was mildly irritated from licking and the fifth digit was swollen. Tongue was pale pink and wet. Pulses were symmetrical.
Dry needle: GV 20, BL 29, 30, 54 bilateral, LIV 3. Circle the Dragon: four needles were placed in a diamond pattern around the opening of the wound on her right hind foot, approximately 1cm from the wound edges. EA: BL 11 bilateral, BL 23 bilateral, BL 25 bilateral.
Topical Treatment: Golden Yellow Salve was sent home to be used topically on the draining wound twice a day. Discontinued Body Sore, continued Loranthus Power 5G BID.
At the 5th treatment, the patient was doing very well. The owner reported that the wound on the foot was closed 48 hours after treatment. A combination of dry needles, electroacupuncture and aquapuncture was performed. Loranthus Powder 5g SID was continued, Body Sore given as needed. Moxa were used at home over local back and lumbosacral points once a week.
This was a very successful case of a common condition faced by owners of older dogs. While the dog had a chronic history of mild to moderate hind limb lameness, the acute presentation of a LF lameness initiated the visit to a referral veterinarian for further investigation. After the severity of the degenerative joint disease in both hips was realized, treatment was instituted to not only resolve primary complaint of the LF injury, but to also begin to more proactively manage hip pain. The previous chronically draining wound has not since reopened. Her LF lameness responded beautifully to TCVM, and she continues to be managed well with periodic TCVM treatments.