Page 13 - Autumn 15

Above all do no harm
by Julie Anne Lee, Canada
ARLO: 5 month old Lab/Dane Cross
Chief Complaints on April 27, 2008
Severe Osteomyelitis with a pathological fracture of right hind leg. Specialist advised that options for treatment are a 3-4 months course of Baytril [Enrofloxacin, Ed.], or amputation of the right hind leg. The concern is that a possible side effect of giving Baytril to a dog between the ages of two and eight months old is cartilage defects.
Presenting Symptoms
Arlo presents with a complete lameness right hind leg. He drags the leg, when he walks. Arlo started favouring his right hind leg approximately one month ago. Several days later, the leg became severely swollen and painful. Shortly after that, Arlo became non- weight bearing. X-rays on April 23, 2008 indicate severe osteomyelitis with a pathologic fracture. Arlo had several treatments of antibiotics, predominantly Gentamicin, and he continued to get worse. He was referred to a specialist clinic and taken off Gentamicin as there was no improvement and due to the fact that Gentamicin can be nephrotoxic. Blood cultures showed isolates of Serratia marcescens [often involved in hospital- acquired infections in humans, Ed.].
Past History
Vaccinated and neutered at the Pound. Two weeks later, he had nasal discharge – thick purulent, and a swollen right hind limb.
Case Analysis
There were both chronic and acute aspects of this case.
Chronic aspects
Pound puppy, vaccinated, inability to recover, length of time of disease in the life of this puppy, no lesion, etc.
Acute aspects
Bacterial infection, fracture.
Arlo is a big dog growing at a rapid rate with an intensely destructive pathology. These factors support repetition (see note from Organon below). I made a conscious decision to base my repetition on the x-rays (being taken every 2-4 weeks). We did not have a second chance in this case. If homeopathy did not heal Arlo in 3- 4 month, his leg was going to be amputated. Fortunately the manager of the Pound was unwilling to risk the cartilage in Arlo's limbs by giving him the Baytril prescribed.
Homeopathic differential diagnoses
Phosphorus
• Represented in all the rubrics
• Phosphorus nature – friendly, affectionate,
excitable
Silica
• Well represented in the rubrics
• Necrosis
• Anti-vaccinosis
• Thick, purulent nasal discharge
• Swollen right hind limb (no external lesion)
Phosphoric Acid
• Well represented in the rubrics
• In my experience, well indicated for bone
pathology in fast growing, large breed puppies
However
• Lethargy was missing from this case
• Arlo was rambunctious even when he was
literally dragging his leg behind him
•
Arlo's controlled exercise.
June 28, 2008 - Doing well with new foster owner. Right hind limb palpates normal. Walking normal. Yeast dermatitis. Surgeon recheck went great – said healing amazingly well. Surgeon gave Arlo a clean bill of health and said he can be treated like a normal dog.
Wait. Note If Arlo had been depressed or had the
lassitude one would expect from his symptoms, I would have started with Phosphoric Acid, and then possibly switched to Phosphorus as his vitality started to rise.
Prescriptions
• Silica 1 M single dose, raw food diet • Followed by: Phosphorus 200 C TID
[three times daily, Ed.]
Homeopathic Consultation Follow-Ups
• May 4, 2008 - All is pretty much the same. Arlo is on all raw food diet now. Stool is good. Appetite and energy are good. Very happy. Prescription: Phosphorus 200 C in water TID for at least a week and up to a month. Update weekly.
• May 11, 2008 - Doing well. Walking better. Prescription: Continue with Phosphorus 200 C in water TID for one month. Update weekly.
• May 18, 2008 - Doing well. Increasing the length of walks. Pulls - wants to run and will bunny hop. Limp is diminishing. People can't tell that he limps now. Putting weight on the leg well. Prescription: Continue Phosphorus as directed.
• May 30, 2008 - Increasing walks. Adding hills and stairs. Doing really well. Behaviour issues because of limited exercise. X-rays taken on May 24, 2008 indicate that "there is tremendous remodelling occurring and the pathological fracture appears to be stable and healed. The rest of the bone is looking good." The surgeon, who examined Arlo on May 24, 2008, reported that he is looking very good and is using his leg well on every step. He recommended increasing
Philosophy in Arlo's case
Repetition in Acute cases
Organon of Medicine, 5th Edition – footnote under Aphorism 247:
In acute diseases, the time for repeating the fitly chosen medicine is regulated by the greater or less rapidity of the course of the disease we have to combat, so that, when necessary it should be repeated after twenty-four, sixteen, twelve, eight, four and even fewer hours, if the medicine continues to prove beneficial without interruption – without producing new symptoms...
Prescription
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