Question Details
Puritic Cat
by
How are things? I have a difficult case that I could really use some guidance on.
"Amber"- 7 yr old FS DSH
HX-
She is an indoor only cat who moved into a small apartment in Oct. She lives alone with her Owner.
Prior to that she was in a big house with a yard , a dog , and other people. O said she was very happy there.
She started having skin problems in August. Srcatching started on the front legs, axillary, neck and behind the ears.
Diagnostics done at her vet.
Skin scapes- (2)- NEG
CBC/Chem- Normal, Fecal- Normal
Treatments-
started 9/6/09
Depo injection, Gentacin spray, Advantage, and a Leukemia vax same day.
10/16-
Not much improvment- itching, alopecia, papules (excoriation) TX- Depo shot, Hypoallergenic diet HP, clavamox
11/ 22- still very puritic around axillary, ears, abdomen
TX_ prednisone, miticide injection, Malased spray, Covenia (ab) injection- has been on Hp diet x 3 weeks.
12/02- still puritic- dispensed Baytril and started Fexofenadine
12/15- no change in status-

I saw the cat 1/9/09
Owner stopped all medications 2-3 weeks prior because they were not helping. She stopped feeding the HP 2 weeks prior ( cat did not like it). and started feeding nutro ultra holistic for cats brand canned.

On presentation the cat was slightly anxious, although the o says she is a very mellow cat.
She historically vomits hairballs every 2-3 weeks and has a tendency for "stress" diarrhea.
She has trouble sleeping and wakes up to chew on her front legs. She will spent hours licking and chewing.

On Physical exam- Her pulses were fast, and empty. Her tongue was red and moist, no coating, normal thickness.
Her skin was very red, with hair loss on bilateral front legs, ventral thorax/abdomen and the cranial aspects of her pelvic limbs. There were small papules on her antebrachium and tibial areas.
Her body felt hot all over but mostly on the inflamed areas.

I was able to acupuncture GV 14, BL12, BL 22, BL 25. She did not tolerate any needling except on the BL, GV channels. (When I needled anyplace on her limbs she acted like I stuck her with a cattle prod)
I gave her a diagnosis of Damp heat with Blood heat
I started her on Si Miao San and Nettles.

1 week later - she is still very puritic, but is sleeping much better. Her skin was less inflamed, sl cooler to the touch, but still very sensitive. The redness had moved about 1/2 inch more dorsally up from the abdomen.
She still only tolerated needling on her back Shu points. (GV 14, BL 12, BL23, BL25)
Thinking that there may be an underlying blood def problem I started her on Si Wu Xiao Feng Yin. as well. I also gave her an E-collar to wear.

2 weeks later- She seems more comfortable, not wanting to scratch and chew as long as the collar is on. Sleeping and eating well. Hair is starting to regrow and skin in pink.
Her tongue is light red and moist, pulses fast and somewhat forceful.
Still very sensitive to touch and does not tolerate much needling. Bl12, Bl 17,BL 23, BL 28 (for the dematome)
I added Essential FA (liquid) and Nutricalm ( from Rx vitamins) to try to calm her shen.

1week later 2/6/09
O says she seems happier and calmer, is more playful. She vomited after giving the fatty acids She wears the collar always ( does not think about chewing and scratching when it is on) and when you take it off all she wants to do is chew and scratch at her front legs.
Her hair is growing back ( from lack of chewing) and is a normal color. She has small scabs on her shoulders from her back feet scratching. She is still very sensitive to touch and she hates the acupuncture. Pulses still fast, forceful and empty. Tongue pink/red, moist

Her puritis is still so intense, her skin does not have any lesions that she does not cause by excoriation, I am not sure if I need to be more patient or if the treatments are not right.
I read that cats do not typically get blood deficiency and it seems more to me like blood heat.
I have though about starting her on Hoxey formula but haven't.

We have talked about sending her to a dermatologist for allergy testing but the dermatologist requested she be off of all herbs for 2 weeks prior to seeing her, and I still think there is a chance I can help her.

I am sorry that this is so long. This is my first on line type consult and am not sure if I could have made this more concise.
If there is a fee for something like this then please let me know.
Replies
by naturevet
February 9, 2009
Typically, cat skin cases need 4 to 6 weeks to substantially resolve, this one longer (2 months?) Given its severity. Blood tonics often slow the healing down, since they are usually Dampening to cats. Essential fatty acids are also often problematic. I suspect if you just hang in there with SMS the cat will get there. Acupuncture weekly I guess. Try and make the food no-carb (I.e. No grains). If the cat is heat intolerant and thirsty, a daily dose of homeopathic sulfur can also help. Most likely the bulk of the problem is dietary.

Hope this helps! Another option is SRT if BL 22 keeps coming up as active, but for now SMS seems well-tolerated
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