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Deficient Cat With Chronin Nail Bed Infections

by TraceyH - July 23, 2009

Sadie is a 14 yr old cat who has had chronic purulent nail bed infections for about a year. She's been treated by many TCM and regular vets. She's thin, has chronic diarrhea, generally poor appetite, cool extremities (except for affected toes), mild to mod. gingivitis and waxy ears. She's heat seaking and every time she goes on antibiotics she gets bloody diarrhea. Pred has helped toes a bit and she's currently on 5mg a day.

A previous vet had her on raw food and Rehmannia 8 but the owner doesn't think it helped and she got diarrhea on the food.

I've had her on Hoxsey-like and SMS and pulse has gone from thin, superficial and fast to bit more moderate depth but still thin and fast since on SMS. Stool still cow-pie soft from last course of antibiotics (about 4 - 6 weeks ago) although no longer bloody.. Tongue is red and she has ++ heat radiating from top of head. Lately I've had her on Qing Ying Tang instead of Hoxsey-like to see if any better effect (too early to tell).

I've been doing acupuncture to tonify SP and KI qi, dispel damp heat and move blood..but can't say as she is any better. I'm thinking the SMS is too cooling and she needs more tonification and am also worried about the ongoing pred use. Her affected toes still quite sore and smelly but better since on pred.

Any suggestions?

Thanks Steve,

Tracey

by naturevet

July 23, 2009

Hi Tracey,

Just leaving the pulse and tongue descriptions for a second, this case might be one I use Bu Zhong Yi Qi Tang for. It tonifies the Spleen and boosts the Qi to the upper burner, and from there out to the periphery of the body to where it can warm the extremities and improve the immune response to the nail beds. In the process, it would be expected to deal with soft stools, boost the appetite, and even improve the immune response against any oral pathogens. GV 20 is often an effective formula for animals that respond to the formula, and commonly results in radiant heat from the vertex.

So given all that, and especially if your acupuncture has been helping, I`d give it a try.

It`s only if the inflammatory response is severe and nasty that it would give me pause, and I`m guessing that`s not the case here with so many deficiency symptoms.

Otherwise, the compromised digestive function after antibiotics makes me think of Wei Ling Tang, or perhaps San Ren Tang, although I wouldn`t necessarily expect any direct benefit from those in nail bed infections.

Let us know how it turns out!

Steve

by TraceyH

August 16, 2009

HI Steve,
This cat initially did a bit better on BZYQT (stools had bit more consistency, appetite perked up). Her nail bed infections waxed and waned a bit but I figure it is too early to see a significant response yet. She has however had bloody diarrhea for the last couple of days now (has been on BZYQT for about 2.5 weeks)and her appetite has dropped. Should I add SRT? Use it alone or with BZYQT?

Thanks,
Tracey

by naturevet

August 16, 2009

Hi Tracey,

If there's no impact of the BZYQT on the nail bed infections, my next idea is to pursue the Damp Heat approach. Xian Fang Huo Ming Yin can deal nicely with appendicular infections and fits the Damp Heat picture. San Ren Tang might help stabilize the digestion. I'd probably just start them and stop the BZYQT.

Now if the nails are a lot better, try just dropping your dose of BZYQT, or taking the cat off, then re-starting again but at a much lower dose.

Good luck!

Steve

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