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Cushing\'s Disease And Mast Cell Tumor

by Pamela Page - June 3, 2009

Hi,

I have been seeing a 12-year old F/S Chocolate lab for a year for hind limb weakness attributable to bilateral ACL injuries and also neurological degeneration. An abdominal ultrasound also revealed one enlarged and one atrophied adrenal gland. A Low Dose Dexamethasone Suppression test confirmed hyperadrenocorticism. Additional blood chemistries revealed mild liver enzyme elevations. She has responded remarkably well to regular acupuncture treatments, a liver supplement (Thorne's Hepagen C) and Si Miao San. She has had occasional bouts of inappetence and diarrhea, which responded well to supportive care and bland diet. Feb 5th, a large soft SQ mass was noticed near her left shoulder. Fine needle aspirate and cytology results were suspicious of Mast Cells, but she went to a different vet for 2nd opinion, who treated her for an infection with antibiotics, and the mass went away. On May 12th, the mass returned, again I was concerned it was mast cells, and sent her to an oncologist, who concurred. During that time Fannie had inappetence and diarrhea, so I put her on Wei Ling Tang in a.m., keeping her on Si Miao San in pm. Her GI system responded very well to this, and her mast cell tumor again disappeared, before she could have it surgically excised. Was Wei Ling Tang responsible for this? I am looking for herb suggestions to help support her and prevent that mast cell tumor from reappearing. Shall I keep her on the current protocol, or are there better choices? Her tongue tends to be pink to red, pulses tend to be weak and soft. Her frame is lean/frail. Her mobility and neurological symptoms have not really been an issue anymore, except when she is feeling poorly from GI issues. A recent urine cortisol:creatinine test was normal. Thanks for suggestions to help "Fannie"!

Pam

by naturevet

June 3, 2009

Hi Pamela,

Interesting case. Given the response to antibiotics, you're probably wondering if you likewise just got lucky with the Wei Ling Tang or if it somehow helped reverse the mast cell tumor. At this point, it's hard to know, but it's safest to speculate and see how it might have been effective, in order to get some direction.

If the signs of Cushing's are much abated, then I wonder if we should back off from the SMS. The reason why is that SMS generally decreases peripheral and mucosal circulation, and so could possibly hamper immune surveillance of the skin if used beyond when needed. WLT could conceivably reverse this effect with its aromatic constituents, possibly explaining why you saw the improvements. A formula that improves peripheral circulation but in an anti-Damp Heat way is San Ren Tang. It has Yi Yi Ren in it, which is credited with major anti-neoplastic activity. Using it alone, or with WLT, might thus help reduce tumor recurrence. But if we do that, we are stepping down (but not eliminating) activity against hyperadrenocorticism, so it would be nice if the dog was no longer particularly affected by this diagnosis.

I guess that's my take on the situation. If we're on the right track, you should see positive changes of some sort. You could just try it for a few weeks and see what happens....

Steve

by Pamela Page

August 22, 2009

Hi Steve,

Update on "Fannie". We switched her to San Ren Tang as the sole Chinese herbal formula, she is on joint and other supplements as well. She has gradually developed more heat signs, in particular, panting, and a redder tongue, and pulses are becoming less weak. Also, her appetite is off and on. Her mast cell tumor on her left shoulder has not appeared again, but at her last visit, I found a new one behind her left right knee. So, unfortunately, she does not seem to be doing as well overall. Would you recommend a different herbal formula, or simply add in Wei Ling Tang again? Thanks for your input! And also congratulations on the Veterinary awared you received in Canada! You certainly deserve it.

Pam

by naturevet

August 23, 2009

Hi Pamela,

You could go back to the WLT, but you'd have to do the SMS again as well, since WLT by itself would be too warming, given the return of the dog's heat signs. Since this combo worked last time, it's worth trying again, given that a hybrid formula like SRT didn't work.

Thanks for keeping us updated and for your congratulations!

Steve

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