Brigadeer was two years old when it was first noticed in December 1993 that he was sore when getting up. He had been battling a skin problem for a while. The pain in his hind legs progressed and eventually he was holding his left hind leg up. On veterinary examination there was a distinct pain over the hip area; arthritis in the hips was suspected. The dog also had enlarged lymph nodes (especially on the hind legs) and multiple scabs on the skin. He was also thin, had a poor appetite, was lethargic and had intermittent diarhhea. He was initially treated with Chinese herbs for arthritis and antibiotics for the skin. The skin and joint pain improved but the lymph nodes stayed enlarged. A diagnostic blood sample was taken and indicated an immune stimulation.

When the dog started to limp a week later, again an immune mediated origin of the limping was suspected. The owner then revealed that the father of this dog died of Systemic Lupus Erythromatosis. A second blood test showed a positive ANA (antinuclear antibody test) and a negative Rheumatoid factor. No SLE cells were seen at that time. Meanwhile the disease had progressed to a polyarthritis and polymyositis, which affected the joints of the hips and elbows and the masseter muscles, making moving and eating very difficult for this dog.

On the basis of the symptoms, history, and laboratory tests, Systemic Lupus Erythromatosis was suspected. This immune mediated disease can be expressed as an haemolytic anaemia, skin problems (typical on the junction with the lips, eyes, vulva etc), polyarthritis, polymyositis, glomerulo nephritis with protein in the urine, and heart disease. There is a hereditary predisposition as is clear in this case. This dog showed a periodic polyarthritis, myositis and enteritis. During the attacks the dog had a fever, experienced pain, and was lethargic. The Chinese diagnosis was liver wind, spleen and liver Qi stagnation with likely underlying Kidney Qi (Jing?) deficiency, and a wandering Bi syndrome.

The owner was informed of the diagnosis and treatment with Prednisone was suggested to control the disease. The owner was very strongly opposed to the use of cortisone and requested treatment with alternative medicine. On January 25, 1994 treatment was started with acupuncture, Chinese herbs and homeopathy. Brigadeer was my first challenge using complimentary medicine in the immune field and the following treatment has proven to be successful for him and several other dogs and cats. He was put on homeopathic remedies specific for periodic muscle and joint pain. Acupuncture was performed on individual pain syndromes for hips, elbow, shoulders, spine and jaw. Chinese herbal remedies were used according to Chinese diagnostic findings to move the Qi or tonify the liver or spleen.

Brigadeer improved immediately, but had several relapses. These became milder and further apart. Soft swellings around the elbow joints a few months later were seen as a result of inflammation of the joint capsule consistent with Lupus. This did not require any further treatment and resolved within a few days. An infection, caused by a grass seed, and later a skin infection around the mouth did not want to clear up, in spite of soaking and antibiotics. Also his lymph nodes were still enlarged. Two new homeopathic remedies that are used for lymph adenopathy and chronic diseases that don’t want to respond were then used for treatment. The infections cleared up and the lymph node swelling went down. Treatment with the remedies for periodic muscle and joint pain were continued. Over the next year, the attacks became very mild and from January 1995 to June 1995 Brigadeer had no attack at all. He than had another attack of myositis of the masseter muscles. One acupuncture treatment cleared that problem up and a one time treatment with Dulcamara 200 CH was given. This is a homeopathic remedy used for diseases that get worse when the weather changes. This treatment was repeated one month later. For the next 7 months Brigadeer had a pain free and happy life. He was than treated with acupuncture for hip pain, which only started 2 hours prior to presentation. The pain was gone a few hours after treatment and now in October 1996 Brigadeer functions like a normal dog and is pain free. Homeopathic remedies are now discontinued and no further treatment is required.

Conclusion: Systemic Lupus Erythromatoses and other immune mediated diseases are traditionally treated with Prednisone or other corticosteroids. This challenging case was successfully treated using complimentary medicine modalities. The positive outcome in this case has led to using the same modalities in several other cases of immune based arthritis and or myositis. The outcome of all these cases so far looks very promising. The combined use of acupuncture, Chinese medicine and homeopathy in immune mediated diseases warrants more extensive research in pets as well as in human patients. Note: Brigadeer died at 12 years of age from hemangiosarcoma of the spleen.

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