Paresis / Paralysis

Intervertebral Disc Disease — Paresis / Paralysis

Definition and cause

Intervertrebal (IV) disc disease is a degeneration of the intervertebral disc, which is characterized by leakage of the disc material, leading to spinal cord compression and neurological deficits. While no proven genetic link has been determined, certain breeds such as dachshunds, beagles, and corgis are more predisposed to the condition. The literature links the cause to aging and degeneration of the disc tissue. The neurological deficits are secondary to compression.

Medical therapy rationale, drug(s) of choice, and nutritional recommendations

The medical or surgical approach to IV disc disease, pain, paresis, and paralysis depends upon the severity of the inflammation and the compression of the cord. Restricted activity or cage rest is recommended in most cases. Corticosteroids are often recommended for their anti-inflammatory effects. Surgical intervention (hemilaminectomy or fenestration) is often necessary because pain or neurological deficits are common. The dietary recommendation focuses on weight reduction in obese animals. Vitamin E is beneficial for cats but has no proven indications for dogs.

Anticipated prognosis

The prognosis depends upon the damage to the cord. Patients with painful episodes generally carry a better prognosis than animals with neurological deficits, paralysis, paresis, and incontinence. The prognosis with surgery is good if the surgery occurs within 48 hours of the rupture.

Integrative veterinary therapies

Paresis refers to weakness of motor function without total paralysis. Paralysis is a lack of motor function. Anything that negatively impacts function of the motor unit can result in signs of paresis or paralysis. Damage to the upper motor neuron or central nervous system can result in paresis due to loss of conscious proprioceptive functions. Nervous tissue is extremely susceptible to a wide variety of injurious processes, and determining the cause of paresis can be challenging. Paresis in this section of text refers to neurological deficits, but the reader should remember that musculoskeletal problems can also lead to gait weaknesses, and that all paresis is not necessarily neurological in origin.

An integrative approach to IV disc-related paresis focuses upon the integrity of the disc itself as well as the secondary compression, inflammation, and resultant cell death. The addition of nutrients, nutraceuticals, medicinal herbs, and combination homeopathics that have anti-inflammatory and potentially regenerative effects on the nerves and IV disc cells can often help improve the clinical signs and the day-to-day level of comfort, and can enhance the healing process. In addition, complementary and alternative veterinary modalities (CAVM) can also strengthen surrounding discs and help prevent recurrences in adjacent locations.

Nutrition

General considerations / rationale

While surgery can help relieve the compression and improve clinical function, nutritional therapies can help improve nerve regeneration and return of function.

Appropriate nutrients

Nutritional / gland therapy: Glandular brain and cartilage supply intrinsic nutrients that help to improve nervous and organ function, reduce cellular inflammation, and strengthen connective tissue (see Gland Therapy in site for a more detailed explanation).

Phospholipids found in glandular brain are a source of unsaturated omega-3 fatty acids, which are now thought to play a vital role in the development and maintenance of the central nervous system. High concentrations of phosphatidyl choline and serine are found in brain tissue. Horrocks (1986) reported on the potential clinical use of these nutrients in chronic neurological conditions.

Lecithin / phosphatidyl choline: Phosphatidyl choline is a phospholipid that is integral to cellular membranes, particularly those of nerve and brain cells. It helps to move fats into the cells and is involved in acetylcholine uptake, neurotransmission, and cellular integrity. As part of the cell membranes, lecithin is an essential nutrient that is required by cells for general health and wellness.

Coenzyme Q10: Coenzyme Q10 (ubiquinone) is found in the mitochondria and is involved in the cells’ energy production that is required for the daily functioning of the body. It is essential in the manufacture of ATP, the energy source for all of the body’s cells and tissues. CoQ10 is also a potent antioxidant that helps to neutralize free radicals and protect cells.

Chinese herbal medicine / acupuncture

General considerations / rationale

Intervertebral disc disease may be a result of trauma, as in Western theory. It may also result from Wind, Damp, and Cold invading the Kidneys, which leads to Qi and Yang deficiency.

Trauma is self-explanatory. It was also thought that Wind could blow Cold into the body, where it could attack the Joints. Application of Heat often relieves the signs in these patients. Damp tends to make things tight and sticky, which explains the stiffness many patients feel in damaged Joints. The Kidneys control the Bones, so Kidney pathology can cause Osseous and Joint lesions. When there is Qi and Yang deficiency, the patient has little energy to move and too little warmth to warm his body and Joints.

Treatment is aimed at decreasing the inflammation associated with injuries, increasing mobility, and decreasing pain.

Appropriate Chinese herbs

Atractylodes (Cang zu): Increases the pain threshold. In addition, it can counteract xylene-induced ear swelling and carrageenin-induced foot swelling. This indicates that it may be useful in decreasing inflammation at the site of disc disease.

Aconite root (Fu zi): Reduces swelling and inflammation in joints. It has been shown to have analgesic properties.

Angelica (Bai zhi): Has been shown to have anti-inflammatory and analgesic effects in mice.

Angelica root (Dang gui): Is as strong as aspirin at decreasing inflammation and is 1.7 times as strong as aspirin for pain relief.

Astragalus (Huang qi): Has demonstrated mild analgesic effects in mice.

Cinnamon twig (Gui zhi): Has analgesic properties. It was part of a formula used in 30 patients with arthritis; 50% recovered completely, 20% showed marked improvement, 17% showed some improvement, and 13% did not respond.

Coix (Yi yi ren): Has analgesic and anti-inflammatory effects. It suppresses dimethylbenzene-induced auricular swelling and carrageenin-induced foot swelling in mice. It was shown to help women with severe menstrual cramps, which may indicate that it would be useful in treating the pain associated with intervertebral disc disease.

Earthworm (Di long): Has a significant analgesic effect.

Jujube fruit (Da zao): Decreases inflammation. Jujube fruit was shown to reduce dimethylbenzene-induced auricular inflammation in mice and egg-white-induced toe swelling in rats, which implies that it may be useful for decreasing the inflammation involved with intervertebral disc disease.

Licorice (Gan cao): Contains glycyrrhizin and glycyrrhetinic acid, which have anti-inflammatory effects. They have approximately 10% of the corticosteroid activity of cortisone. They decrease edema and have anti-arthritic effects. Licorice has demonstrated analgesic effects in mice, especially when combined with white peony (Bai shao).

Notopterygium root (Qiang huo): Has anti-inflammatory and analgesic effects. In mice, it was shown to decrease xylol-induced ear lobe swelling and carragenin-induced foot pad edema, and increase the thermal pain threshold.

Sichuan aconite (Chuan wu): Seems to have a centrally mediated analgesic effect. In mice, it was shown to be effective for decreasing inflammation and pain. It is stronger than aspirin at reducing inflammation. It controlled the signs in 92% of 150 human patients with arthritis when given in combination with Cao wu, Qiang huo, Du hua, Fu zi, Mo yao, Ru xiang, Dang gui, Chuan niu xi, Ma huang, Gui zhi, Wu gong, Chuan xiong, and Ma qian zi.

White peony (Bai shao): Contains paeoniflorin, which is a strong anti-inflammatory. It has demonstrated specific effects on pain in the lower back.

Acupuncture

The World Health Organization lists lower back pain as one of the indications for acupuncture (World Health Organization 2006). One study looked at the use of abdominal acupuncture and electroacupuncture for treatment of prolapsed lumber intervertebral discs. In this study there was complete relief from symptoms in 35% of the patients, significant improvement in 45% of the participants, slight improvement in 16%, and no response in 4%.

Homotoxicology

General considerations / rationale

It is beyond the scope of this text to fully deal with all causes of paralysis and paresis. This section primarily addresses fibrocartilagenous embolic and intervertebral disease, which represents Impregnation or Degeneration phase homotoxicoses.

Appropriate homotoxicology formulas

Aesculus compositum: Treats post-embolic circulatory disorders such as infarct and stroke. It is worthy of evaluation in fibrocartilagenous embolic disease, but no studies exist. Supportive of circulation (Aesculus hippocastanum, Secale cornutum, Tabacum, Solanum nigrum, Arnica Montana, Barium iodatum, Hamamelis virginiana, Arteria suis, and Rhuta graveolens). Cuprum assists with spasm. Aesculus has specific antiCOX-1 and COX-2 inhibitory effects; other agents also affect vascular structures. It is supportive of joints and muscles and is useful for sharp pains and counteracting the effects of cold, wet weather (Solanum dulcamara). Apis helps reduce swelling and pain.

Atropinum compositum: The oral and injectable vials are currently off the market in the United States, but oral tablets are available. This agent is highly effective for spasm and pain associated with diseases of the spine and back. If this remedy is not available consider Spascupreel in its place.

Barijodeel: Treats paresis post stroke.

BHI-Inflammation: Rhus toxicodendron assists in cases of paresis. Cases may be aggravated after lying in wet grass. Patients may have pustular, pruritic skin conditions, joint pain, myelitis, vertigo / dizziness, intercostal pain, and other types of neuralgia. Commonly used in combination with other antihomotoxic agents.

Cerebrum compositum: Used in the recovery phase. Placenta suis assists in peripheral circulation while improving vitality and awareness, particularly in aged patients.

Cimcifuga homaccord: Has regional affinity for cervical spine neuralgia and pain originating in the sacral area and passing cranially. Treats cervical spine spasm.

Coenzytne compositum: Supports energy production through enzyme induction and repair. Useful in repairing damage to enzyme systems of metabolism and following administration of drugs injurious to metabolism. Phase remedy in the Degeneration and Dedifferentiation phases.

Colocynthis homaccord: Regional remedy for pain in the sacral and lumbar region. Useful in colitis cases and for sciatica.

Discus compositum: The principal antihomotoxic medication for intervertebral disc disease. Discus compositum contains 37 ingredients, making it a balanced agent that helps a wide variety of spinal and matrix-clearing issues. Signs of homotoxin off-load is common following use of Discus compositum.

This compositae class agent combines animal, mineral, and plant agents to assist in healing, drainage, and detoxification. Tissue receives direct support through Discus intervertebralis suis (intervertebral disc), Funiculus umbilicus suis (umbilical cord, which supports vascular and stem cell tissues), Cartilago suis (cartilage), Medulla ossis suis (bone marrow), Embryo suis (embryo), and Glandula suprarenalis suis (adrenal gland). It is useful in all cases of intervertebral or degenerative spinal disease. This remedy treats sciatica and sciatic neuralgia (Citrullus colocynthis, Cimcifiga racemosa, Picric acid, Ammonium chloride). It also supports energy metabolism and tissue repair (vitamin C, vitamin Bl5 vitamin B2, vitamin B6, Nicotinamide, Coenzyme A, Nicotinamide Adenine Dinu-cleatide, Sodium osalacetate, Thioctic acid, Calcium phosphate, Silicic acid, and Sulphur). Zincum metallicum is a strong nerve remedy that is included for peripheral symptoms in the nervous system, with numbness of the soles of the feet and cutting pains in the heel, which may proceed to the point of complete paralysis or hemiparesis with twitching, tremors and weakness.

Engystol N: Creates a “channeling effect” in the mesenchymal tissues and lymphatic system.

Galium-Heel: This phase remedy in matrix and cellular phases provides powerful support of the immune system (Echinacea augustifolia). Assists in drainage of cell and matrix, supports renal tubular function, and decreases swelling and edema (Apis mellifica, Galium aparine, and Galium mollugo). It is a critical component in the deep detoxification formula. Dosing should be done with regard to clinical condition and response, with the dose reduced if strong reactions are noted.

Gastricumeel: Useful in supporting gastric and duodenal function following spinal pathology.

Gelsemium homaccord: Used for headache, depression, posterior weakness, and fear of open spaces. Main formula for paresis. Gelsemium semperervi-rens has long been used in herbal medicine because it has an affinity for nervous tissues. Strong neuroprotection results from low-dose use of Gelsemium.

Glyoxal compositum: Used to unblock cellular receptors and provides mitochondrial repair of damaged enzyme systems in Degeneration and Dedifferentiation phase disorders.

Lymphomyosot: Used after cortisone therapy and mesenchymal purging in chronic disease states. Reduces swelling and pressure. Contains Aranea diadema for periodic neuralgia, spinal nerve irritation, paralgesia, and painful articular disease. Calcium phosphoricum is indicated for calcium deficiency and spinal affections. Fumaria officinalis has indications for tightness in the back over the right kidney. Treats back pain and cutting pain on the right side, along with lumbar pain or sudden weakness in the lumbar region and cervical tension on the right side. Myosotis arvensis is used for conditions that include left-sided cervical pain or constriction in the cervical region. This also treats pressing pain in the lumbar region and right-side scapular pain that is stabbing.

Nux vomica homaccord: Provides enteric protection following spinal injury.

Ovarium compositum: Supports gonadal tissue in geriatric patients.

Placenta compositum: Supports hypophysis after cortisone therapy. Contains sulfur to support enzyme and metabolic repair. Regenerative of hypophyseal-adrenal axis and vascular stem cells. Repairs vascular structures and is used intermittently in endocrine disorders.

Khododendroneel S: Treats paresis of the radial nerve.

Solidago compositum: Deposition Phase remedy needed to remove debris from the matrix after regressive vicariation begins.

Spascupreel: Treats stabbing pains, muscle spasm, and neuralgia. Very useful in managing spasmodic pain. It is an alternative for Atropinum compositum.

Testes compositum: Supports connective tissue.

Thalamus compositum: Supports thalamus, pineal gland, adrenal gland, and cellular regulation through glandular content and homeopathically diluted cyclic adenonsine monophosphate (cAMP). Assists in establishing autoregulation of pyschoneuroendocrine-immune functions. Assists in resetting pain thresholds.

Thyroidea compositum: Used for matrix drainage and repair of autoregulation. Contains low levels of thyroid, pineal, spleen, bone marrow, umbilical cord, and liver to support glandular function and repair. Galium aparine drains matrix and cellular components. Cortisonum aceticum in low potency assists in repairing damage from excess levels of cortisone. Precursors and Krebs cycle constituents promote energy metabolism through the Michaelis-Menten law of enzyme activity. Pulsatilla and Sulfur assist in regulation rigidity-type situations. Part of the deep detoxification formula.

Traumeel S: Has nonsteroidal anti-inflammatory effects. Useful in acute intervertebral disc herniation to reduce swelling (Apis) and pain, and activates blocked enzymes. Listed in the Physician’s Desk Reference.

Ubichinon compositum: Provides mitochondrial repair of energy production mechanisms. Used in chronic diseases, iatrogenic injury to mitochondria from antibiotic therapy, and is part of the deep detoxification formula.

Zeel : Useful for its anti-inflammatory effects and supportive qualities for chronic arthritis.

Authors’ suggested protocols

Nutrition

Brain / nerve and cartilage / ligament / muscle / skeletal support formulas: 1 tablet for each 25 pounds of body weight BID.

Coenzyme Q10: 25 mgs for every 10 pounds of body weight daily.

Lecithin / phosphatidyl choline: One-fourth teaspoon for each 25 pounds of body weight BID.

Chinese herbal medicine / acupuncture

Formula H39 BackRelief: 1 capsule per 10 to 20 pounds twice daily. If necessary it can be combined with steroids, nonsteroidal anti-inflammatory drugs, and nutraceuticals. (NOTE: it is never recommended to combine NSAIDS and steroids). In addition to the herbs listed above, Back-Relief also contains aconite / cao (Cao wu), allium (Cong bai), carthamus (Hong hua), papaya (Mu gua), poria (Fu ling), and siler (Fang feng). These herbs increase the efficacy of the formula.

Recommended acupuncture points are “AShi” points, BL23,BL25, BL57, BL40, Baihui, ST36, and GB30 (Handbook of traditional Chinese medicine Practitioner 1987).

Homotoxicology (dose: 10 drops PO for 50-pound dog; 5 drops PO for small dog or cat)

Symptom formula: Traumeel S and Discus compositum given initially by injection, preferably into applicable acupoints. Traumeel Gel and Lymphomyosot Gel mixed together and massaged into the affected areas BID to TID. Spascupreel, Aesculus compositum, Lymphomyosot, and Traumeel S combined and given orally BID to TID. Add Cimicifuga homaccord (cervical disc or pain), Gelsemium homaccord (posterior weakness), Colocynthis homaccord (lumbosacral disease or sciatica). Zeel and Discus compositum orally twice per week and Cerebrum compositum weekly.

Deep detoxification formula: Galium-Heel, Hepar compositum, Solidago compositum, Thyroidea compositum, Coenzyme compositum, Ubichinon compositum mixed together and given orally twice weekly to every other day.

Product sources

Nutrition

Brain / nerve and cartilage / ligament / muscle / skeletal formulas: Animal Nutrition Technologies. Alternatives: Cosequin — Nutramax Labs; Glycoflex — Vetri Science; Musculoskeletal Support — Standard Process Veterinary Formulas; Nutriflex — Vet Rx Vitamins for Pets; Arthra-gen — Thorne Veterinary Products.

Coenzyme Q10: Vetri Science, Thorne Veterinary Products.

Lecithin / phosphatidyl choline: Designs for Health.

Chinese herbal medicine

Formula H39 BackRelief: Natural Solutions, Inc.

Homotoxicology

BHI / Heel Corporation