Which Practitioner Dispensed formula is right for my animal?

• chronic back pain
• lumbar stiffness
• reluctance to jump
• slow to rise
• older dogs
• long-backed breeds commonly affected
• improves once warmed up

Think: age-related degeneration and poor circulation are affecting the back and hindquarters.

→ Lumbrex

• cruciate disease
• hip dysplasia
• sacroiliac dysfunction
• recurrent hindlimb lameness
• symptoms tend to flare and settle
• inflammation never seems fully resolved

Think: mobility problems affecting structures along the Gall Bladder meridian which can fluctuate and struggle to stabilise.

→ Voltrex

• overweight or easy keeper
• inflammatory arthritis
• recurrent inflammatory flare-ups
• hot, inflamed presentations
• symptoms tend to flare rather than remain constant

Think: excess inflammation and metabolic dysfunction are contributing to the mobility problem.

→ Si Miao San or Kan Essentials Four Marvels (Si Miao San)

• swollen joints may be present
• chronic inflammation
• recurring stiffness
• poor circulation
• elbow or shoulder disease
• chronic back pain
• large breed dogs commonly affected

Think: chronic inflammation and Dampness are preventing complete recovery.

→ Yi Yi Ren Tang and Kan Essentials Free the Sinews (Yi Yi Ren Tang)

• chronic lameness
• hind limb weakness
• worse in cold weather
• stiffness improves with movement
• worsens again if overworked
• little obvious swelling
• poor peripheral circulation

Think: chronic stagnation and poor circulation are limiting mobility.

→ Xiao Huo Luo Dan

• lower back pain
• urinary incontinence
• bladder weakness
• urinary and mobility signs occurring together

Think: lower burner dysfunction is contributing to the mobility problem.

→ San Ren Tang and Kan Essentials Three Seeds Combination (San Ren Tang)

• poor stamina
• muscle loss
• slow recovery
• weakness limiting rehabilitation
• chronic disease reducing resilience

Think: the body may lack the resources needed to fully recover and adapt.

→ Add Galvanex to the primary mobility formula to help support strength, resilience and recovery.

For dogs with a veterinary diagnosis of Degenerative Myelopathy.

• progressive hind limb weakness
• toe dragging
• knuckling
• muscle loss
• progressive neurological deterioration

Think: neurological support may be beneficial alongside conventional management.

→ DM Formula

Many mobility conditions benefit from a combination of nutritional, weight management and herbal support. Depending on the individual patient, the following resources and products may also be helpful.

Whole Food Diet Resources

Many chronic inflammatory and mobility conditions improve when nutrition is optimised.

• Learn more about whole food diets in Integrative Veterinary Medicine
• Balanced canine recipes

Essential Fatty Acids

Particularly useful for:

• arthritis
• chronic inflammation
• joint stiffness
• ageing patients
• long-term mobility support

→ NAS Omega Oils

Mushroom Elixir & Longevity Mushrooms

May provide additional support for healthy ageing, recovery, resilience and long-term wellbeing.

→ NAS Mushroom Elixir and NAS Longevity Mushrooms

Weight Management Support

Maintaining a healthy body condition can significantly improve comfort, mobility and quality of life in dogs with arthritis and chronic musculoskeletal disease.

Many behavioural and cognitive presentations overlap. If the patient is showing anxiety, pacing, panting, night-time restlessness or cognitive decline, Halscion is often a useful starting point.

Halscion

• pacing
• panting
• unable to settle
• night-time restlessness
• cognitive decline
• hypervigilance
• hind limb weakness or tremors associated with cognitive decline
• excessive vigilance or reactivity

Think: the nervous system is overly active and struggling to switch off. These patients often show a combination of chronic overstimulation alongside underlying depletion.

→ Halscion

• trembling
• insecurity
• emotionally fragile
• stress-sensitive digestion
• anxious but not hyperactive
• symptoms worsen during stressful events
• may have mild skin, ear or yeast-related problems

Think: stress, emotional sensitivity and poor regulation are driving the presentation.

→ Xiao Yao San and KAN Essentials Happy Wanderer (Xiao Yao San)

• poor resilience
• chronic illness
• low stamina
• recovering from illness
• anxiety associated with weakness or depletion
• appears unable to cope with normal stressors

Think: deficiency is limiting the patient's ability to adapt and recover from stress.

→ Galvanex

(Halscion may be combined where anxiety, pacing or restlessness are also present.)

• cognitive decline
• confusion
• disorientation
• hearing loss
• hind limb weakness
• tremors
• age-related behavioural changes
• urinary or kidney-related ageing signs

Think: declining reserves associated with ageing are contributing to the presentation.

→ Rehmannia 8

• chronic tension
• anxiety with muscle tightness
• dry constitutions
• poor nourishment
• depleted patients who remain reactive
• signs of dryness outweigh signs of inflammation

Think: the nervous system and tissues require nourishment and restoration rather than stronger regulation or anti-inflammatory support.

→ Yi Guan Jian and Kan Essentials Glehnia and Rehmannia Combination (Yi Guan Jian)

Many behavioural and cognitive conditions benefit from a combination of environmental, nutritional and herbal support. Depending on the individual patient, the following resources and products may also be helpful.

Mushroom Elixir & Longevity Mushrooms

May provide additional support for cognitive function, healthy ageing, resilience and overall wellbeing in older animals.

Particularly relevant for:

• cognitive decline
• ageing patients
• reduced resilience
• long-term health support

→NAS Mushroom ElixirandNAS Longevity Mushrooms

Whole Food Diet Resources

Many behavioural and cognitive presentations are influenced by overall health, inflammation and metabolic function.

• Learn more about whole food diets in Integrative Veterinary Medicine
• Balanced canine recipes

Pure Colostrum

May provide additional support for immune regulation, gut-brain health and overall resilience.

Particularly relevant where stress, chronic illness or reduced vitality are contributing factors.

→NAS Pure Colostrum

Essential Fatty Acids

Support nervous system function, healthy ageing and cognitive health.

Particularly relevant for:

• senior animals
• cognitive decline
• dry or depleted constitutions
• long-term behavioural support

→NAS Omega Oils

For many chronic cough, congestive heart failure and circulatory conditions, Xue Fu Zhu Yu Tang is often a useful starting point.

• chronic cough
• congestive heart failure
• exercise intolerance
• pulmonary congestion
• chronic respiratory disease
• ageing patients

Think: impaired circulation, congestion and reduced tissue oxygenation may be contributing to the problem.

→ Xue Fu Zhu Yu Tang

• collapsing trachea
• waxing and waning respiratory disease
• chronic inflammatory airway disease
• recurring cough
• symptoms that improve then relapse

Think: these conditions often reflect a Shao Yang-type dysregulation, where inflammation and healing never fully resolve.

→ Consider Voltrex and/or Cessorex

Voltrex may be preferred where inflammation, irritation and active symptoms predominate.

Cessorex may be preferred where the same pattern occurs in a more chronic or depleted patient.

• fatigue
• weakness
• reduced stamina
• poor recovery
• pale patients

Think: depleted patients often benefit from additional support and resilience.

→ Consider adding Galvanex

• reverse sneezing
• recurrent nasal congestion
• chronic sinus irritation
• upper airway inflammation

Think: congestion and fluid regulation problems affecting the upper airways may be contributing to the presentation.

→ San Ren Tang and San Ren Tang

Many heart and respiratory conditions benefit from a combination of nutritional, herbal and circulatory support.

Whole Food Diet Resources

Many chronic cardiac and respiratory conditions are influenced by nutrition, inflammation and vascular health.

• Learn more about whole food diets in Integrative Veterinary Medicine
• Balanced canine recipes

Dandelion Whole Extract

Particularly useful for:

• fluid retention
• congestive heart failure
• pulmonary congestion
• ascites
• long-term cardiovascular support

May provide gentle diuretic support while also supporting liver and kidney function.

→ Dandelion Whole Extract

Hawthorn

Traditionally used to support:

• cardiac function
• circulation
• healthy blood flow
• ageing cardiovascular systems

Often used alongside herbal formulas in patients with chronic heart disease.

→ Hawthorn

Mushroom Elixir & Longevity Mushrooms

May provide additional support for:

• healthy ageing
• resilience
• chronic inflammatory disease
• long-term cardiovascular and respiratory wellbeing.

→ NAS Mushroom Elixir and NAS Longevity Mushrooms

Chronic digestive disease often has multiple contributing factors and many patients do not fit neatly into a single category. If unsure, Adoptrex is often a good starting point.

Adoptrex

The modern chronic gut patient.

• intermittent digestive upset
• recurrent vomiting or diarrhoea
• bloating
• digestive dysfunction that does not fit neatly elsewhere
• patients consuming processed diets
• suspected microbiome or digestive dysregulation

Think: chronic digestive dysfunction and poor gut regulation.

→ Adoptrex

• symptoms worsen during stress
• anxiety affects appetite
• vomiting or diarrhoea occurs during stressful events
• emotionally sensitive patients
• digestive signs fluctuate with environment or routine

Think: stress is influencing digestive function.

→ Xiao Yao San and Kan Essentials Happy Wanderer (Xiao Yao San)

• poor appetite
• chronic illness
• chemotherapy patients
• elderly or debilitated animals
• struggling to maintain condition
• weakness is more obvious than inflammation

Think: the patient lacks the resources to digest and recover effectively.

→ Liu Jun Zi Tang and Kan Essentials Six Gentle Pets (Liu Jun Zi Tang)

• improves but never becomes normal
• recurrent relapses
• persistent soft stools
• chronic inflammatory bowel disease
• long-standing digestive disease
• partial improvement followed by plateau

Think: healing has stalled and the gut never quite recovers.

→ Chu Shi Wei Ling Tang and Kan Essentials Dispel Dampness and Nourish the Skin (Chu Shi Wei Ling Tang)

• recurrent stomach discomfort 
• nausea, lip licking or grass eating 
• empty stomach vomiting 
• animals receiving long-term NSAIDs 
• chronic pancreatitis 
• dry, depleted patients 
• digestive disease associated with deficiency rather than excess 

Think: the upper digestive tract requires nourishment and restoration rather than stronger Damp-clearing or anti-inflammatory support.

→ Yi Guan Jian and Kan Essentials Glehnia and Rehmannia Combination (Yi Guan Jian)

• chronic constipation
• alternating stool quality
• poor gut tone
• weak or older patients
• gut motility appears poorly regulated

Think: the gut is not moving and coordinating normally.

→ Bu Zhong Yi Qi Tang and Kan Essentials Lift the Qi (Bu Zhong Yi Qi Tang)

• overweight or easy keeper
• recurrent digestive upset
• recurrent skin, ear or inflammatory problems
• symptoms tend to flare rather than remain constant
• tendency toward hot, inflammatory presentations

Think: excess inflammation and metabolic dysfunction are contributing to the digestive problem.

→ Si Miao San and Kan Essentials Four Marvels Si Miao San

• digestive disease with urinary involvement
• lower back involvement
• Damp accumulation affecting the lower body
• bladder and bowel signs occurring together

Think: Damp accumulation affecting the lower burner.

→ San Ren Tang and Kan Essentials Three Seeds Combination (San Ren Tang)

• recurrent vomiting
• bloating
• bloat or GDV tendencies
• fluctuating appetite
• large breed dogs
• digestive disease occurring alongside cruciate disease or hip dysplasia
• suspected microbiome dysregulation

Think: the digestive signs are part of a broader Shao Yang pattern rather than an isolated gastrointestinal disorder.

→ Xiao Chai Hu Tang

Many digestive problems benefit from a combination of nutritional, microbiome and herbal support. Depending on the individual patient, the following resources and products may also be helpful.

Whole Food Diet Resources

Many chronic digestive and inflammatory conditions improve when nutrition is optimised.

• Learn more about whole food diets in Integrative Veterinary Medicine
• Balanced canine recipes

NAS Gut Probiotic

Provides targeted microbiome support and is commonly used alongside herbal formulas in dogs with chronic digestive dysfunction.

→ NAS Gut Probiotic

Pure Colostrum

Supports gut barrier function, immune regulation and gastrointestinal health.

→ NAS Pure Colostrum

Mushroom Elixir & Longevity Mushrooms

May provide additional support for recovery, resilience and long-term wellbeing in patients with chronic disease.

→ NAS Mushroom Elixir and NAS Longevity Mushrooms

For many chronic masses, tumours and growths, improving circulation and reducing stagnation is an important first step.

→ Xue Fu Zhu Yu Tang and Kan Essentials Blood's Palace (Xue Fu Zhu Yu Tang)

• slow growing masses
• nasal tumours
• lung nodules
• chronic growths
• older patients
• poor circulation

Think: stagnation and impaired circulation may be contributing to the development and persistence of the growth.

→ Xue Fu Zhu Yu Tang and Kan Essentials Blood's Palace (Xue Fu Zhu Yu Tang)

• adrenal tumours
• lymphoma
• chronic inflammatory disease
• endocrine disorders
• multiple chronic symptoms
• disease that never fully stabilises

Think: these conditions often reflect a Shao Yang-type dysregulation, where regulation and healing never fully resolve.

→ Consider Xiao Chai Hu Tang, Halscion, Voltrex and/or Cessorex

These formulas are closely related and are selected according to the individual patient's overall presentation.

• red masses
• painful masses
• inflamed growths
• hot lesions
• rapidly changing tissue reactions

Think: inflammation is an active component of the presentation.

→ Xian Fang Huo Ming Yin and Kan Essentials Sublime Joint Formula (Xian Fang Huo Ming Yin)

• multiple fatty masses
• overweight or easy keeper
• metabolic dysfunction
• inflammatory obesity

Think: Dampness and metabolic dysfunction may be contributing to the presentation.

→ Si Miao San and Kan Essentials Four Marvels (Si Miao San)

Many animals with chronic masses, tumours or cancer may benefit from a combination of nutritional, herbal and lifestyle support.

Whole Food Diet Resources

Many chronic inflammatory and neoplastic conditions appear to respond best when nutritional foundations are optimised.

• Learn more about whole food diets in Integrative Veterinary Medicine
• Balanced canine recipes

Milk Thistle

Particularly useful for:

• patients receiving multiple medications
• long-term inflammatory disease
• liver support
• ageing patients

→ Milk Thistle

Turkey Tail Mushrooms

Traditionally used to support:

• immune function
• healthy ageing
• long-term resilience
• patients undergoing conventional cancer treatment 

→ Turkey Tail Mushrooms

Mushroom Elixir & Longevity Mushrooms

May provide additional support for:

• healthy ageing
• resilience
• recovery
• long-term wellbeing

→ NAS Mushroom Elixir and NAS Longevity Mushrooms

NAS Omega Oils

Particularly useful for:

• chronic inflammation
• inflammatory skin disease
• cancer support programs
• healthy immune function

→ NAS Omega Oils

Kidney disease often fluctuates between periods of inflammation and periods of reduced circulation and declining kidney function.

A useful test to discuss with your veterinarian is the Urine Protein Ratio (UPC). This simple urine test can help determine whether inflammation or reduced kidney circulation is the dominant issue and may help guide formula selection.

As a general guide:

• higher UPC ratios often indicate inflammation and may suggest a need for Voltrex
• lower UPC ratios and stable chronic kidney disease may suggest a need for Rehmannia 8

• chronic kidney disease
• chronic renal failure
• increased thirst and urination
• ageing kidneys
• declining kidney function

Think: reduced circulation and declining kidney function may be limiting the kidneys' ability to recover.

→ Rehmannia 8

Three Seeds (San Ren Tang) is commonly combined with Rehmannia 8 to provide additional support for kidney function, fluid regulation and proteinuria.

→ San Ren Tang and Kan Essentials Three Seeds Combination (San Ren Tang)

• worsening kidney values
• protein loss through the kidneys
• inflammatory kidney disease
• kidney disease that appears to be progressing
• elevated UPC ratios

Think: inflammation may be contributing to ongoing kidney damage.

→ Voltrex

Voltrex may be preferred where inflammation appears to be driving ongoing kidney damage.

Ask yourself:

Is the liver underperforming because it is not receiving enough healthy blood flow?

Or

Is the liver overwhelmed by stagnation, inflammation and excess accumulation?

As a general guide:

• mild to moderate enzyme elevations often suggest an underperfused liver
• very high liver enzymes and a clinically unwell patient often suggest a stagnation or excess pattern

Liver enzymes should be monitored regularly, typically every 3–4 months, or sooner in unwell patients. If liver values continue to worsen despite treatment, a different formula or treatment approach may be required.

• mild to moderate liver enzyme elevations
• chronic active hepatitis
• older patients
• poor circulation
• stress-sensitive patients
• digestive sensitivity
• liver disease that never fully resolves

Think: the liver may not be receiving adequate blood flow and nourishment.

→ Xiao Yao San and Kan Essentials Happy Wanderer (Xiao Yao San)

→ Cessorex

Xiao Yao San may be preferred where digestive weakness, stress sensitivity or reduced resilience are prominent.

Cessorex may be preferred where liver enzyme elevations occur in a patient that is otherwise relatively well and asymptomatic.

• very high liver enzyme elevations
• hepatitis
• gall bladder disease
• pancreatitis
• acute liver disease
• clinically unwell patients
• fluctuating inflammatory disease

Think: stagnation, inflammation and excessive accumulation may be overwhelming the liver.

→ Voltrex

Voltrex may be preferred where active inflammation appears to be driving ongoing liver damage.

• liver masses
• chronic fibrosis
• longstanding liver disease
• severe stagnation patterns

Think: impaired circulation and blood stagnation may be contributing to disease progression.

→ Ge Xia Zhu Yu Tang

Whole Food Diet Resources

Many chronic liver conditions appear to respond best when nutritional foundations are optimised.

A fresh, minimally processed diet containing appropriate plant material may help support the microbiome, reduce inflammatory burden and improve long-term liver health.

• Learn more about whole food diets in Integrative Veterinary Medicine
• Balanced canine recipes

Milk Thistle

Milk Thistle is commonly used to support liver health and may be particularly useful where inflammation, stagnation or elevated liver enzymes are present.

It is most commonly used alongside formulas addressing excess or inflammatory liver presentations, although it is generally well tolerated in most liver patients.

→ Milk Thistle

Think: chronic inflammation and metabolic dysfunction are often contributing to the disease process.

→ Si Miao San and Kan Essentials Four Marvels (Si Miao San)

A fresh, minimally processed diet is an important part of management.

→ Learn More About Whole Food Diets

If the condition does not respond to a fresh food diet and Si Miao San, consider:

→ Halscion

Some patients appear to have a stronger adrenal component rather than a predominantly metabolic presentation and may respond better to Halscion.

Think: metabolic dysfunction and impaired glucose regulation are affecting the whole body.

A fresh, minimally processed diet is an important part of management.

→ Learn More About Whole Food Diets

→ Si Miao San and Kan Essentials Four Marvels (Si Miao San)

→ San Ren Tang and Kan Essentials Three Seeds Combination (San Ren Tang)

Both formulas may be useful in diabetic patients. San Ren Tang is often better accepted by cats because of its milder taste.

Think: a progressive neuroendocrine disorder where herbal support often changes as the disease progresses.

Early disease

• Hot 
• Sweaty 
• Delayed coat shedding 

→  PPID Stage 1

Progressive disease

• Loss of topline 
• Muscle wastage 
• Reduced stamina 

→  PPID Stage 2

Advanced disease

• Cold 
• Frail 
• Weak 

→  PPID Stage 3

Think: obesity, insulin dysregulation and laminitis are the primary concerns.

→ Equine Metabolic Syndrome Blend

Nutrition and weight management remain essential.