Daisy, a six year old rough-coated collie dog was brought to me with a history of chronic diarrhea, a moist cough, hind end weakness, and vomiting of phlegm almost every night for nearly two years. The vomit contained thick, clear, stringy liquid. Her care giver reported that all these problems started shortly after vaccinations were given. She had developed too numerous to count hard skin nodules as well that resolved after a number of months. Biopsy of the nodules was attempted but the previous veterinarian found them to be rock hard.
The care giver then took Daisy to a second animal hospital. A complete blood count and serum chemistry panel showed normal values. The thyroid (T4) value was borderline low at 1.0 ug/dL and a cTSH value was high at 0.82 ng/ml. Thyroid supplement was dispensed by the second veterinary hospital however she vomited each time the medication was given so the caregiver discontinued it.
The diet was a fish and sweet potato kibble supplemented with brown rice and organic salmon. The care giver emphasized that this was the only diet that did not give Daisy diarrhea.
On TCVM examination the tongue color was very pale purple with a thick coat of phlegm. Femoral pulses were floating, forceful, choppy, fast, and wiry. The skin had dandruff and the nose was cold and moist. Daisy drank a lot of water and often vomited foamy liquid immediately after drinking. Her appetite was poor and she struggled to stand from a sitting position. Dark spots were present on the skin of the abdomen. She reacted to pressure at BL-18, BL-19, BL-20 and BL-21. Daisy had an easy going, mellow, Earth constitution.
The TCVM diagnosis was Five Stagnations: Food, Phlegm, Heat, Qi and Blood Stagnation. The complex pulse pattern told the story—floating and fast pulses indicated an Excess Heat; wiry and choppy pulses indicated Stagnation of Qi, Blood and Phlegm. The Phlegm on the tongue was remarkable; and the color was also consistent with Stagnation. Vomiting after drinking suggested Food Stagnation. Although Daisy appeared weak her pulses were forceful indicating an Excess pattern. In addition, the dry coat and thirst were a result of a Liver Yin and Blood deficiency. Treatment of a deficiency pattern first would exacerbate the Excess condition.
The Excess pattern had to be treated first. Acupoints chosen were: An-shen to calm the mind; LI-11 and GV-14 to dispel Damp Heat; BL-18, BL-19, and GB-34 to move Blood and Qi; BL-20 and BL-21 to benefit the digestion; ST-40 to transform Phlegm; and SP-6 to move and nourish Blood, move Liver Qi, resolve Damp, Cool Blood, and tonify Yin.
In the first week after acupuncture Daisy had only one episode of vomiting. The acupuncture was repeated and the Chinese herbal formula Escape Stagnation was dispensed at a dose of 0.5 grams for every 10 pounds of body weight every 12 hours.
Escape Stagnation contains five herbs to treat each of the five stagnations: Cyperus Xiang Fu Zi moves Liver Qi; Atractylodes Cang Zhu transforms Phlegm; Ligusticum Chuan Xiong moves Blood; Massa Fermentata Shen Qu resolves Food Stagnation; and Gardenia Zhi Zi clears Heat.
Nine days later the care giver reported that the dog had no digestive problems at all and no cough. She was running around and playing more and her appetite had improved. She readily ate the herbal powder. No phlegm was visible on the tongue. Ten days later, the dark spots had disappeared from the abdominal skin and the tongue color was brighter (changed from Rose’ to Red Clover on the Sherwin-Williams paint chip chart).
Acupuncture was repeated every two weeks for two more treatments and then monthly while the herbal formula was continued. After three months from the onset of acupuncture the tongue color continued to brighten (Cyclamen on the Sherwin-Williams paint chip chart). Hind end weakness was still an intermittent problem and the caregiver was encouraged to have the thyroid values retested.
Four months after the initial visit the T4 value was within normal limits at 1.7 ug/dL with normal values ranging from 1.6-5.0 ug/dL and borderline low values ranging from 0.8-1.5 ug/dL.
This case emphasizes the importance of a TCVM diagnosis when standard medical diagnostics fail. The thyroid was never the problem but was the result of a sick dog and a euthyroid condition. The herbal formula was gradually decreased and the dog continued to have normal digestion.