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Acu in Practice: Koko balances pancreatitis and renal insufficiency

Welcome to acu in practice! Meet Koko, a 14 ½ year old, female toy poodle who has been diagnosed with IRIS Stage 2 renal insufficiency and intermittent pancreatitis. Koko has always been particular about food, but after developing the renal insufficiency, Koko became even more picky. She vomited a couple of times after consuming goat’s milk, but her pancreatitis was subclinical for the most part, manifesting as reduced appetite and intermittent soft stool. Her energy level is great. She has become more heat seeking with time, but also drinks more water than she used to. She is happy, content and her owner says she often still plays like a puppy. In the exam room, you can see that Koko is interactive and will do anything for a lick of manuka honey!


TCM diagnosis: Kidney Yang Deficiency with secondary Spleen Yang Deficiency leading to Damp accumulation and Damp Heat in the Small Intestine, secondary Yin deficiency (dehydration do to renal insufficiency/Kidney Yang deficiency), intermittent Liver Qi stagnation.


Like most senior pets, this patient is a mixed pattern patient. She has both Yang and Yin signs.


Without the Kidney Yang to fire up the Spleen, the Spleen will become deficient and less effective at its job of transformation and transportation. This leads to Damp accumulation which will eventually generate Heat in both the Spleen/Pancreas and the Small Intestines.


This patient is a Fire constitution which predisposes her to Yin deficiency over time. The failure of the Kidney Yang to sufficiently recycle water back into the body also causes a general Yin Deficiency.


TCM treatment principle:

Tonify Kidney Yang, Tonify Spleen and resolve Damp/Damp Heat, Nourish Yin, Move Liver Qi





GV 20, BL 18, BL 20, BL lumbar BH, LIV 13, KID 3, ST 36


Koko is very picky so our options for herbs and supplements have been limited, but we have come up with a plan that is supporting her.

Additional components of treatment plan:

Manuka honey for positive reinforcement (she loves it and hardly notices the needles!) and positive effects on the gut flora.

Subcutaneous fluids 75 ml once to twice per week (depends on patient tolerance)

Spleen Support Formula Tincture by Kan Herb

Rehmannia 8 formula by Kan Herb

Canine Renal Support by Standard Process

Azodyl by Vetoquinol USA

Milk Thistle tincture

Food Therapy plan focusing on Kidney and Spleen nourishing foods.

Manuka honey for positive reinforcement (she loves it!) and positive effects on the gut flora.


This post was created by Nell Ostermeier, DVM, CVA, FAAVA and is intended for informational use, not to replace medical advice.