Clinical history: Chaos is a 12 year old female spayed medium sized mixed breed dog with a history of pheochromocytoma, a type of cancerous tumor affecting her adrenal gland. Chaos had surgery to remove the tumor in February 2018. Due to the location and nature of the tumor, the surgeon had to remove Chaos’ adrenal gland and kidney as well. Chaos also suffers from stiffness and pain primarily in her hips and lower spine. Her discomfort has become progressively worse of the past 12 months.
At home, Chaos is a friendly, happy dog. She is prone to anxiety, and tends to pant excessively. She prefers cool temperatures and has recently stopped sleeping in the bed with her owner. Chaos has a good appetite with normal stools. She drinks a large amount of water. She is up to date on core vaccines and is current on heartworm and flea / tick prevention.
X-rays show osteoarthritic changes to her hips and lower back. Routine bloodwork showed mildly elevated kidney values (BUN 45, creatinine 1.8).
Chaos’ owners main concerns is her hip and back pain. Because Chaos only has one kidney, she is not a good candidate for traditional Western drugs to control her arthritis.
Western Diagnosis: Osteoarthritis of the hips / spine; chronic renal insufficiency
TCVM Diagnosis: Kidney Yin Deficiency leading to Bony Bi Syndrome; Qi Stagnation of hips / lower back
Treatment Principles: Tonify Kidney Yin and clear local Stagnation
- GV-20 – permission point
- ST-36 – Qi tonic
- LIV-3 – clear Stagnation
- BL-23 – association point for Kidney
- KID-6 – tonify Yin
- Shen-shu/Shen-peng/Shen-jiao – local points for hips/lower back and support Kidney function
Electroacupunture (80 Hz / 120 Hz):
- GV-14 connected to Bai-hui – clear stagnation along spinal cord, support immune function
- BL-54 connected to BL-40 – Master points for the rear limbs and caudal back / hips, respectively
- An-shen -calming
- SP-9 – tonify Yin
- LI-11 – boost immunity
Outcome: Chaos did very well with treatment. During this time, she did not receive any other therapy for her arthritis or kidneys other than acupuncture. She did not relax during the actual acupuncture sessions, but she tolerated the needles and permitted the electroacupuncture therapy if she was fed during her appointments. Initially, she was treated once weekly. Immediately after her sessions, she was significantly more uncomfortable, but would improve within 24 hours. After significant improvement in her stiffness and comfort level, we were able to spread treatments out to once every 3-4 weeks. Chaos was able to play with her younger housemates again, jump on the bed, and seemed to have much more energy overall. Several months after treatment, Chaos’ kidney values were back within normal range (BUN 20, creatinine 1.1). Chaos’ owner plans to continue treatment monthly.
Discussion: In Chinese medicine, the Kidney System rules the bones and rear limbs in particular. In Chaos’ case, the Kidney is directly affected by the surgical removal of one kidney and elevated kidney values. Because of her age and the chronicity of disease, Chaos has a Deficiency. Chaos’ restlessness at night, cool-seeking behavior, and heat signs on TCVM examination represent signs of a Yin deficiency- her body’s cooling system is insufficient. A Kidney Yin Deficiency led to Bony Bi syndrome. Pain associated with arthritis is known as Bony Bi syndrome in TCVM. Any pain is is considered a Stagnation of either Blood or Qi. Dull, aching pain associated with arthritis is usually Qi Stagnation, while sharp more severe pain is considered Blood Stagnation. Treatment principles focus on first treating the excess (pain condition), then supporting the underlying deficiency.
Emily Falk, DVM