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Obstipation

by mikemesley - August 19, 2009

10yo cat, generally still lively etc but has recurrent bouts of constipation in past mildly responsive to lactulose and coloxyl. Hasn't had problems for approx 6 months.
Thin, HR120 in exam, pulse extremely wiry but surprised me by being relatively slow and notably superficial. Quite weak pulse I'd say too.
Tongue red, small, dry - I'd call it like a ZBDHW type tongue maybe.
Cat gets very upset after a few minutes of handling.
Severe response to palpation at BL20, BL22, and at base of tail - maybe BL 35 I guess.
No acupuncture done - if you want to know what happens - you do it!! Too aggressive.
Extreme amounts of dry faeces in colon - approx diam of palpable colon = 35mm (1 1/3 inches?)

I remember at one stage you said when pulse is opposite of what you think, there may be TB stasis - and with BL22 having such a strong reaction felt XCHT might be the go - BUT with the red, dry tongue might CHJLGMLT be more appropriate? Can I use cascara in conjunction with these?

Thanks for your advice everyone.

Regards from Oz
Mike

by naturevet

August 20, 2009

Hi Mike,

Cascara can be used in any case where heat or stasis is suspected.

With heat and skin irritation, I think of San Ren Tang. But it doesn't address Yin deficiency, although it does moisturize the colon. It fits the activity at BL 22, the pulse and the reddish tongue.

Empty Heat cats generally have a more pounding forceful wiry pulse. In that case, any number of formulas may aid. I would perhaps try Yi Guan Jian (since Dang Gui in the formula helps lubricate the colon); or ZBDHW as you suggested, especially if I suspected an inflammatory bowel type of disorder. In Yin deficiency, even oils will help if added to the diet (e.g. flax), but they can be aggravating if the cat is actually a Damp Heat case more amenable to San Ren Tang.

If in doubt, you can use Rehmannia Six and San Ren Tang together, to get a lubricating yet Damp draining effect.

Hope that helps you out!

S

by mikemesley

August 22, 2009

Hi steve
Think I'll give combo of SRT and Reh6 a go - I feel there is heat and stasis present currently, but his good response to fluid therapy over the weekend would suggest to me Yin Def is highly probable as a contributor to this stasis (the stagnant pool theory?).
SRT as damp/heat drainer but also importantly as TB lubricator?
I feel he might be ready for Cascara combo now as well.
Another vet in the clinic recommended euthanasia over the weekend and now O is talking about partial colectomy - but I feel we haven't given this enough of a go yet. In your experience could we conceivably get a decent result without Sx, enemas etc from here?

Thanks Steve
M

by naturevet

August 23, 2009

Hi Mike,

I always say "It's not a surgical case until Cascara says it's a surgical case". In short, in anything but very weak debilitated animals, it should be tried first, since it frequently gets things going, so that the other herbs can then resolve the problem.

Steve

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