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Di Gu Pi in a Hip Displasya Case

Di Gu Pi in a Hip Displasya Case

By Cindy Wallis, DVM, CVA

Author: Chi Institute/Saturday, November 1, 2008/Categories: Student Case Reports, TCVM Newsletter, 2008 Winter Issue

Sandy, aka 'Girlfriend', a spayed 12 year old Golden Retriever, first presented to me as a 'last resort' on 5/11/2007. Her owner was considering euthanasia due to her declining quality of life from progressive degenerative joint disease, ie. 'hip dysplasia'.
All conventional Western medicine options had been exhausted and Sandy could no longer stand on her own or walk much further than needed to urinate and defecate. She also suffered from severe thunderstorm phobia which was being marginally controlled with acepromazine.

She had had an FHO on the left hip 2/7/1996. Recent radiographs showed severe degenerative joint disease in both hips and mild lumbar spondylosis.

Her conventional therapy consisted of Glycoflex and Deramaxx 100 mg 1/2 to 1 tablet daily but no longer seemed to be helping. Her owner had begun to give her melatonin for the thunderstorm phobia. She was overweight, BCS 7.5/10, at 88 pounds but had lost 30 pounds by dieting over the last several months yet her arthritis symptoms continued to worsen.
Her neurologic examination was unremarkable. She had severe crepitus in both hips and moderate crepitus in both stifles. 
She initially presented as an 'Earth' type personality with occasional Liver Yang Rising (biting when in pain or needled in a sensitive area). As her treatment progressed and she began to improve she clearly showed her true 'Fire' personality with a constant tail wag, persistent face licks on greeting and never snapping. 

On her initial TCVM exam her tongue was pink with a slight purple tinge. Her pulses were deep and slightly thready with the left pulse weaker than the right.

Chemistry profile, CBC, urinalysis and thyroid tests were all normal. She had no other medical symptoms or problems at the time.

Her TCVM diagnosis was Boney Bi Syndrome secondary to Kidney Yin Deficiency, Qi stagnation, Shen Disturbance (Thunderstorm phobia) and excess phlegm accumulation (overweight).

Dry needle acupuncture was begun addressing the Bi syndrome and Shen disturbance.

Sandy stumbled out of the car and was groomed immediately following her first treatment and her discomfort worsened for the first 2 to 3 days. However by her second treatment her owner reported that she had recovered well, was more comfortable than prior to the treatment and was wanting to walk farther. Dasuquin was begun at the second acupuncture treatment.
On week 3 her owner reported that Sandy seemed worse the first day after her second treatment but then significantly improved. She was walking more in the mornings and was going up and down a flight of stairs with no hesitation or obvious discomfort. She was able to stand throughout most of the needle placement at her third treatment and seemed much more comfortable and relaxed.

At week 4 aquapuncture with 50% B12 at An Shen and Da Feng Men was added. Shen Calmer for the thunderstorm phobia and Di Gu Pi for the Bi Syndrome were begun.

By week 5 Sandy was very happy to go for her morning walk and was able to get up easily on her own even on tile floors. In spite of her owner's attempt to restrict her from the stairs, Sandy went up and down easily with no hesitation or crying. She was very happy during her treatment with no complaints about needling.

By week 6 her Bi Syndrome has shown continued and marked improvement. Her thunderstorm phobia was still pronounced therefore her Shen Calmer was increased from 3 0.5 Gm capsules BID to 5 BID. One week later she presented for aquapuncture to help with the thunderstorm phobia and firework fear. Aquapuncture was performed with 50% B12 at An shen, Da Feng Men, Ht7 and PC6. Her Shen Calmer was increased to 7 capsules BID.

On Week 7 her thunderstorm phobia had significantly improved by about 75 to 80% according to the owner but she was 'hesitating' on the stairs the last 2 to 3 days.  Dry needle, aqua and electro acupuncture were employed primarily directed at the Bi Syndrome but for control of the Shen Disurbance as well.

By week 9 Sandy had lost 4# on her diet. She was much more energetic and eager to go on her walks and her thunderstorm phobia was almost totally resolved. During her ninth treatment a severe thunderstorm occured. Sandy calmed within 10 minutes of aquapuncture at An Shen and Da Feng Men and her treatment proceeded as usual with her sleeping throughout the electro acupuncture.

The time between treatments was increased to every 3 weeks. By the third month of treatment Sandy was a typical very happy and friendly 'Fire' dog. She was pulling her owner to extend her walks and displaying almost no signs of thunderstorm phobia. Her owner had begun to decrease the Shen Calmer to 5 capsules twice a day. Her tongue at each visit was almost consistently normal. Her pulses were normal except a slight decreased Kidney Yang pulse and we began watching for signs of QI deficiency.  We began to wean her off of Deramaxx.

Sandy's treatment has continued to progress well over the next 6 months. She has been completely weaned off of all NSAIDS and Western 'anxiety' medications. She is 13 1/2 years old now and is doing very well on dry, aqua, and electro acupuncture treatments every 3 weeks. She declines slightly if we try to extend the treatments to every 4 weeks and her owner prefers to maintain the every 3 week schedule.

She is also maintained on DI Gu Pi twice a day and very occasional Body sore if she is overly active or jumps out of the car too quickly.

No obvious signs of Qi deficiency have been observed yet though we continue to monitor for them as her right pulses are slightly weaker than her left.        

                                       
In the winter Dok's Formula was added for Cold Bi as Sandy had begun to hesitate on the stairs. She resolved within 2 weeks and was weaned off the Dok's Formula after 4 months with the onset of Spring and warmer weather.

At her most recent visit, 8/07/08, her serum chemistries, CBC, T4 and urinalysis remain normal. Her nuclear sclerosis has not progressed at all. Her weight is normal and maintained at 65#. She continues to do well enjoying her usual walks, getting up on her own even on slippery surfaces and navigating stairs with no problems. She is on Di Gu Pi twice a day for maintenance and occasional Body sore as needed. We just restarted Shen Calmer after having discontinued it for several months due to recent thunderstorm anxiety. In addition we have added Wind Toxin and some appropriate acupuncture for some front leg licking.

We will continue to adjust her acupuncture treatments and herbal medicines as needed. We will incorporate Western medicine as indicated in order to continue to provide the best possible quality of life for Sandy and her owner.

Sandy is a wonderful example of the benefits of TCVM. After over 20 years of practicing Western medicine it is a privilege to have learned these new tools from Dr. Xie and all of those at Chi. I am so grateful to be able to help so many patients and their owners enjoy more QUALITY time together. I believe the greatest benefit to my patients and to my enjoyment of the art of medicine is to be able to learn the effective use of as many tools as possible. We can then apply those, or a combination of those, that are most appropriate for each patient. Our reward is to watch them enjoy an active, comfortable and healthy life.

 

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