Question Details
Feline Infectious Peritonitis
by mikemesley - June 15, 2009
Any basic tips re FIP and its causes and manifestations from a TCm perspective?

I have one that seems to me to have presented as an External invasion of Cold and Damp -> initial sign is unilateral (Left sided) highly proteinaceous pleural effusion.

Also- warm seeking, purple tongue (was breathing with difficulty by this stage), tracheal sensitivity that resulted in extreme cough with watery discharge from nose/mouth, hepatomegaly mild, R eye inflamed,normal temperature, pulse - couldn't really classify. Not up to acupuncture yet as just diagnosed today. Stabilised well after chest drained of approx 170mls fluid.

Replies
by naturevet
June 15, 2009
Hi Mike,

FIP is a tough condition to treat, but lately, through Dr. Jodi Van Tine, we've seen some successes from taking a TB obstruction approach. In the Chinese medical model, water is supposed to descend through all three burners down to the bladder, under the guidance of descending Lung Qi. The Triple Burner is the corridor where this descent occurs. So an obstruction here produces ascites, pleural effusions and the like. The obstruction occurs in the middle burner, producing hepatomegaly, possibly splenomegaly, and a purplish tongue. Lung Qi also has problems descending, leading to the cough. The TB channel ends at the eye. Eye redness is thus not uncommon in TB cases.

Xiao Chai Hu Tang is well suited to these cases. It's not much of a diuretic, but it has a complex immune modulating effect, without being either purely suppressive or purely tonifying. It addresses very well extreme tracheal sensitivity and is a smooth muscle dilator. There are literally dozens of studies looking at its benefits on liver pathology. So, all in all, it's a good choice for this patient, at least to start. Down the road, a pure Kidney deficiency picture eventually appears, calling for something like Rehmannia Eight. But I wouldn't introduce tonics yet until you've opened the TB up.

Good luck. It could be a really fun case for you, and I'm sure followers of the forum here will be interested to see how it goes.

All the best,

Steve
by mikemesley
June 17, 2009
Sounds spot on with the pulse that is difficult to feel and the super purple tongue too.
Any reason for the cold signs? Maybe the underlying KID deficiency?
by naturevet
June 17, 2009
Yes, that's right. TB obstruction creates Source Qi deficiency, which is really Kidney Qi deficiency. Kidney Qi tonics don't work, though, until the TB obstruction is relieved. So eventually you'll be able to address the chilliness directly.

Good luck! I'm sure people would love to hear how this goes.

S
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