Hello. I am needing some help in choosing a remedy for my dog. I am a student of homeopathy but I am totally a rookie and while I can repertorize and prescribe for acute situations, I will not take on chronic major cases without guidance. I was getting help from local homeopaths but there seemed to be a lot of guess-work and palliation involved.

I am an animal health technologist (vet tech) and I have studied dog behavior and training for nearly 10 years so I do have a good undertanding of dogs. Also, he is a German Shepherd and I have had shepherds for 18 years. The reason I say this is because I have been told that one cannot truly know the personality of a dog and so prescribing based on pathology is the best thing to do in animal cases. This is completely ridiculous if you ask me. So I can tell you that I have chosen the most prominent characteristics to repertorize in this case - but my experience and understanding is severly lacking and so some, or a lot of direction is needed.

Here it is. Jackson is 9 1/2 years old. July 02 he began dragging his left hind leg - dragging toes after being confined to a crate for a trip. Got home, paresis improved considerably with no confinement and regular exercise. Still there was weakness of hind legs and sometimes they would give out suddenly and he would sink to the ground. Did some homework and self-diagnosed him (following vet books) with degenerative myelopathy, which holistic vets (Hamilton) believe to be caused by Rabies vaccine (last one spring 98, but yearly til then).

Dog has history of chronic, yearly ear infections and blastomycosis (yeast infection in lungs) at one year of age. No other problems til July 02. He has been fed raw food diet since June 99. He prefers the coolness to heat and stays in the garage/backyard in winter and comes into air conditioned home for a few hours in summer, but still prefers outside in general.

Nov 28-Dec 2/02 I left him at a friend's house while I went away (a member of this board), whereby he was kept indoors, crated the first day and needed to do lots of stairs to go in and out to the bathroom. This caused him to become very painful and curl his back up and tuck head in somewhat. KK thought he was drinking and urinating more also. By the time I got home, he was crying from the pain. She repertorized and thought Nux was indicated and gave it to him (30c) while I drove to get him. It didn't help. The next day I took him in for bloodwork because shepherds (in North America) generally die from cancer at 9-10 years of age. Urinalysis and full blood panel was normal. Herbal pain relief, phos 30c and Rhus tox did not help. After 4 days he was extremely lethargic and literally shivering in the garage under a heat lamp. I brought him inside. He had a real stringy, snotty nose and I gave kali bi 30c over the next 36 hours and he improved but still would not lift his head much and was still very weak and stumbling around like he ingested a bottle of alcohol. He wouldn't even bark at anyone coming in the house!!

Thinking he was in extreme pain somewhere, I gave him an NSAID (non-steroidal anti-inflammatory), and voila, my dog was back - loud and obnoxious as always. But since I do not want to continue with this form of "treatment" I need to find a remedy that will suit him and I desperately need some help!

So, based on the above history and symptoms I have described, and also knowing my dog and what normal behavior for dogs and GSD's is, I have selected the following rubrics. Right now I am using Kent's repertory (I have Boenninghausen's on order). Here are my rubrics:

1. Back, pain, sore, cervical region, motion on
2. Extr., emaciation, shoulder (muscle atrophy here- R. side- but no pain, yet has slight limp on this foot)
3. Extr., weakness, lower limbs, ascending steps
4. Extr., paralysis, toes, turn under while walking
5. Gen., paralysis, painless
6. Gen., heated, becoming
7. Gen., exertion, physical agg.
8. Mind, sadness, mental depression (before anitinflamm)

Are these rubrics okay?? I realize #8 is very general but I am unable to attach any times to narrow it down.

And of course I have no sensations to help either.

What am I missing? Anything???

What is the chief complaint? The neck at this point. BUT, I think that the neck pain and shoulder limp/atrophy are secondary complaints as a result of compensating from the hind end weakness. With my rubrics, the neck and shoulder only come up with 1 & 2 imporatant remedies (asar, nux-v, plb) - in Boericke.

This leaves me totally confused and I do not see a remedy that fits the case here. Can someone please help???

Holly

Hi,

Have you given consideration to what precipitated the episodes? The crating (longer than accustomed inactivity) each time before symptoms appeared, keeping him more immobile, not able to adjust position as frequently as he might normally? The change (maybe) of temperature for this dog who likes and is generally in colder air (warmer house, warmer car ride)? Anxiety from enclosure/confinement (claustrophobic)? Fear of change in his world or that you may not come back? Or curtailment of normal freedom to urinate/defecate at will?

Does he now want comfort or rather be left alone, if this is changed from his norm? Pain not evident descending steps? Difficulty rising but once up, loosens a bit with movement.....or the reverse? Just trying to get this to the top of the list...........! Good luck.

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- weakness of hind legs and sometimes they would give out suddenly and he would sink to the ground

- which holistic vets (Hamilton) believe to be caused by Rabies vaccine

-yearly ear infections and blastomycosis (yeast infection in lungs) at one year of age

-He prefers the coolness to heat
still prefers outside in general.

-very painful and curl his back up and tuck head in somewhat.
(like, pain better in flexed or knee chest posistion?)

Just to help, sorry to be in a hurry, above are some characteristics that you need to use to find the remedy. You could fine rubrics in KEnt or in Boenninghausen.

IF you go the Kent way, it woudl help to add a few more individualizing characteristics about his nature (as GPM suggested), it would confirm the prescription.

The rubrics you've chosen are too general/common sympotms of the disease and not really characteristics that will lead you to a good remedy.
All the best!
doctorleela

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[ 14. December 2002, 06:49: Message edited by: doctorleela ]

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Thanks gpm & Dr. Leela for replying and giving me a new direction to go in. What I did realize from reading your post gpm, is that although Jackson becomes worse from being confined to his crate, he likes it. If given the opportunity, he will curl up in his crate all on his own. (Rare,strange, peculiar). So I will definitely include this in my new set of rubrics.

The one thing I am having trouble with is how exercise and movement both aggravates and ameliorates him... it aggr. his neck and amel. his hind end. I guess I will include both.

Thanks again. I will get to work.

Holly

Thanks gpm and doctorleela for your help. Okay, I did more work on Jackson's case and altered my rubrics. I think they are as detailed about him and his symptoms as I can get them. Here they are:

Mind, fear of being alone (couldn't find fear of abandonment- fear of being alone doesn't seem strong enough as shepherds are very loyal to their family)
Mind, cheerful in company
Back pain, cervical region, motion on
Extr., emaciation, upper limb, right
Extr., emaciation, upper limb, shoulder
Extr., incoordination, lower limb
Extr, paralysis, ll, painless, after vaccination
Extr, weakness, ll, ascending steps
Extr, weakness, ll, descending steps
Gen, change, weather aggr, cold to warm
Extr, motion, ll, toes, restricted
Gen, change of position amel

Remedy choices:
The top remedies that came up were Ars, Plb, Lyc, Phos, Sulph and Thuj.

Ars sort of fits because he definitely has complaints that return annually (ears) and obviously degenerative changes, and the fear of being left alone. He does change places. Stool, evacuation, urine, appetite are all good. But, in extremities, he does not tremble and twitch, but there is weakness, paralysis of LL (no atrophy). Possible peripheral neuritis. In modalities, he is better from cold, not heat.

Plb on the other hand has a lot of paralysis, nerualgic pains and neuritis - but my dog's paralysis is definitely painless (except neck. He was anemic for a few hours last week (I thought there was a tumor bleeding out), but color returned. He has muscular atrophy on the r. shoulder (is it progressive? don't know at this point). Definite locomotor ataxia. Points of attack for plumbum are the neuraxons and the anterior horms. Symptoms of multiple sclerosis, posterior spinal sclerosis. He definitely was depressed. But, he is better with motion (limbs, not neck)not worse and worse with physical exertion not better (but is better with rubbing & touch).

Lyc doesn't have much.

Phos has quite a bit also. He is a tall, slender, deep chested dog. He is reactive to sounds and is very attentive and protective on walks (he's a german shepherd). But, he is not afraid of storms, thunder - he is suspicious of people and animals around me and "his" house. He's had problems with his lungs/resp. tract in past (blastomycosis) and of course he has paralytic symptoms. He is ataxic. And before the anti-infl. drugs, he was depressed. I don;t believe his paralysis is ascending, there is weakness and his joints do suddenly give way. He is better with touch (not worse) and is better with cold, open air.

As far as how he sleeps, I can't say - he sleeps in the garage. It's winter here and there are no thunderstorms now.

Sulph doesn't fit.

Thuja, of course has the ill effects of vaccines which is what deg. myelopathy is caused from (IMHO). But his last vaccine was 5+ years ago. No skin troubles, warts, etc., but possibly neuralgia. He did have green, thick mucus in his nose last week. And extremities, there is weakness.

From the vet manual, deg. myel. : Pathological findings consist of noninflammatory degeneration of myelinated axons in the white matter of the spinal cord, most severe in the thoracic segments. Affected dogs are usually >5 yrs old and develop an insidious onset of nonpainful pelvic limb ataxia and paraparesis.

So what do you think? I am drawn to phos and plb most of all. I did give him thuja 30c in the fall with little response. I only repeated it one time. Can you please give me some more direction here? I don't want to guess because I don't want this palliated. Dr. Hamilton (homeopathic vet) says it is possible to stop and perhaps reverse changes and that is what I am hoping to do.

I look forward to hearing your comments and recommendations.

Holly

Hi Holly,
Plumbum is always a consideration when the pathology is degenerative myelopathy.

You said, "He definitely was depressed. But, he is better with motion (limbs, not neck)not worse and worse with physical exertion not better (but is better with rubbing & touch)."

I think the distinction between physical exertion and motion observed in an animal may be a fine line of dictinction. SO for the moment I'd rather go with Plumbum.

One thing does strike me. Usually degenrative myelopathy is without much pain (correct me if I'm wrong) and you said he has a lot of pain, which was relieved with the NSAID.
This left me to wonder if there was any pressure on his spinal cord right at the cervical level. Some Space occuppying lesion or even some sort of spondylolisthesis or even a disc protrusion at that level. IT has to be high enough to include the atrophy of the upper limbs as well. This could have happened with some strange movement or fall. SO I think this is one major cause that needs to be ruled out.

All the best,
doctorleela

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Thank you doctorleela. I was also drawn to plumbum and I am glad that that is your thought as well. Yes, deg. myelopathy is painless but I think that the pain in his neck is from either arthritis or muscle strain from compensating from a week hind end, and whatever else is going on in his right shoulder. The vet and I discussed that there must be some neuro problem higher up also which is causing the muscular atrophy. So I think that what you are saying about some cervical spine lesion is a very logical possibility. But again, the paralysis is not painful to him. He is actually moving quite well now - minimal toe dragging and can even jump into the back of the truck. He definitely needs to move around, but definitely must stay away from stairs.

As far as ruling out the cause of the atrophy and neck pain, I do not want to do anymore tests right now. An xray means drugs to knock him out because the vet won't xray without them - I don't want to drug my 9 year old dog. So I hope this is an acceptable approach - to give the Plumbum without being 100% sure about the neck/spinal area and what exactly is going on.

I have a couple of potencies, 30c and 200c, of the plumbum on order. I will start with the 30c and wait and see.

Thank you again for your guidance and recommendations. Now can I ask you about my other dog, 10 years old, with the large lipoma on her abdomen that the vet wants to remove?.....oh, I'll leave that for a few days and get this guy organzied!

Holly

Hi Holly,

YEs Lipoma is not something you need to hurry with treatemnt so you could concentrate on your German Shepherd more for the moment.

Dengenrative mylopathis in my experience require a lot fo repetition of remedy.
Even if you start with a 30C, it will help to assess his response - which often may be hardly much in a chronic condition like this. I also sounds like its progressing pretty rapidly.

I would think it best to use a potency that can be repetaed daily if required - so either a 6C (moveing upwards) or an LM would be more ideal.

All the best,
doctorleela

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Again, thatnks doctorleela. You mentioned "experience with DM", have you had success with it? In the vet manual they give a poor prognosis (of course) and give a life span of 6-12 months once diagnosed. So I am at the 6 month point now with him. But like I said, he seems to have bounced back and was trying to run down the street last night while out for a walk - so I am hopeful.

I will try and get an LM of plumbum today.

Holly