Toby is a 15 year old, male neutered DSH who presented for ocular discharge, corneal cloudiness, and squinting OD. A few months earlier, he began squinting and having a yellowish-green discharge OD. At that time, he was being seen at The Ohio State Veterinary Medical Center for a second repair of a non-healing fracture of the right femur (no cancer noted on radiographs). While at OSU, the ophthalmologist examined Toby and diagnosed him with Eosinophilic Keratitis. He was placed on 2% cyclosporine and lysine which appeared to help for a couple months, until the cloudiness started to spread over the entire cornea. The owner was concerned that Toby’s eye was painful and that he was becoming depressed.
Upon examination, it was determined that Toby had a Wood Constitution. There was a pink, opaque material covering 90% of the cornea and clear discharge. His pulses were deep and weak on the right side, with a purple tongue. He preferred to be alone and became aggressive when other cats were near him.
The TCVM diagnosis suggested that the root problem in Toby was Liver Qi Stagnation. The stress of living with many cats plus having multiple trips to the veterinary clinic and two surgeries could lead to this root problem. Toby’s Wood constitution would make an eye problem more likely, due to the eye being the external opening of the liver. The corneal opacity is due to Qi stagnation of the liver. Because Toby has always been aggressive and angry, the liver could have pulled from its parent, the kidney, leading to susceptibility of bone fracture.
The owner was most concerned about Toby’s eye, so treatment was aimed at moving Qi in order to relieve pain and stagnation in the eye. During his first treatment, the points GV20, GV14, GB1 (R), BL67, LI11, LI4, and BL1 (L) were dry needled and left in place for 30 minutes. The next day, Toby’s eye was wide open with no discharge. His 2nd treatment came 4 days after, using points BL67, GB34, and BL1 on the right; GV20 and GV14; LI11 and LI4 on the left with dry needles for 20 minutes. The owner again noted that his eye was wide open, no discharge, and his attitude seemed to improve (walking around the house, climbing on furniture and he was not as aggressive towards the other cats when they came near him).
At his third treatment, his tongue appeared less purple, though his pulses remained the same. He was more agitated this time with having needles placed, so only LI 11 (bilateral), BL 67 (R), LI 4 (R) and GV 14 were used and left for 30 minutes. The herbal formula, Haliotis, was started at this time, ¼ scoop twice a day in canned food. Toby showed great improvement after this treatment, so the owner weaned and discontinued the cyclosporine. His pulses and tongue improved and the corneal opacity was gradually reducing. He did not seem bothered by the other cats anymore.
Toby stayed on the herbal formula for the next month, at which time he was re-evaluated. His pulses and tongue were significantly improved, and the corneal opacity was difficult to detect. A few needles (GV14, LI11 and GB34) were placed due to a slight ocular discharge and he was kept on the herbs for 3 more weeks then gradually weaned off because the eye appeared normal.
This case represented an ocular manifestation of herpes virus called eosinophilic keratitis. Because Toby’s medication was no longer treating the disease, he was likely a good candidate for acupuncture. There was Qi stagnation which led to a painful and cloudy eye, causing the owner to seek another mode of care. The Western medication was weaned off, and only acupuncture and herbs were continued. Though not many constitutional points were implemented, the treatment and herbal formula selected helped to move Qi and resolve the stagnation. Toby continues to do well today.