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Lymphoma

by lsargent - August 30, 2009

Good Afternoon,

I have been asked to research the treatment of a 4 y/o F/S DSH who is positive for FeLV and now has mediastinal lymphoma. She receiived a depomedrol injection last week and her appetite is improved and breathing normal where she was dyspneic previously.

Her tongue us red with no coating, which was interesting post steroid injection-aren't they cooling? Her pulses are thin and regular, not bounding and very superficial.. The left is more palpable than the right which is only very superficially palpable and disappears with any pressure.
I told the owner that I have never treated any cancer, and we are aiming for good quality of life not cure. She agrees and is not thinking positively about chemotherapy, so here goes-any help from anyone who has treated any of these cases and what kind of responses are seen.

Thanks in advance,

Lois Sargent, DDVM

by naturevet

August 30, 2009

Hi there,

We had one canine case where the thymic lymphoma completely went into remission with Xue Fu Zhu Yu Tang with San Leng and E Zhu.

The tongue, pulse and response to steroids would almost suggest a Lung Yin deficiency type of problem, however. Formulas to address that (e.g. Lily bulb Decoction, Rehmannia Six, etc.) aren't as strongly anti-cancer, though. Still you could try them. Maybe Zhi Bai Di Huang Wan might be a place to start, since it's anti-cancer activity may be a little stronger.

Anyway, those are my observations. Hopefully you'll get some input from Erin Bannink.

Steve

by lsargent

August 30, 2009

Thanks, Steve, I don't find the second formula that you mention (San Leng with E Zhu) do you compound this formula and if you had a choice, which would you choose?

Lois

by naturevet

August 31, 2009

Hi Lois,

If you order from Mona, she'll compound it for you. Otherwise, we can do it.

As for where to start, I guess it would be with XFZYT plus SL and EZ. It does have a Blood and Yin nourishing effect, so it's not inappropriate.

Good luck and let us know how it goes,

Steve

by bannink

September 5, 2009

Hi Lois,

Just got back in town and catching up on the forum reading. Mediastinal LSA in young FeLV positive cats has about the poorest prognosis so this will be a tough one. Prognosis with chemo is only 2-3 months so I would love to hear how this kitty responds. Modified Xue Fu Zhu Yu Tang is also my initial gut reaction for these. It would be interesting to know if pleural effusion was contributing to the dyspnea initially if you have that kind of info - might make a difference in the formula choices. Pleural effusion is very common with these cases and the prednisone may have significantly reduced that now along with decreasing the size of the mediastinal mass. Unfortunately I would not expect that result to be long-lived. If the cat has heat signs and had pleural effusion (anxiety would be a nice supportive sign too), I would wonder about thinking about something like Chai Hu Jia Long Gu Mu Li Tang in addition to the modified XFZYT. We can often use these formulas together for intrathoracic tumors and it can fit with the red tongue. It can help with respiratory signs like dyspnea (rebellious Qi) and pulmonary edema (Damp) as well as Qi deficiency signs due to lack of mixing of Yin and Yang - like weakness and poor appetite. It contains Fu Ling and Gui Zhi which have diuretic activity. This formula also contains Xiao Chai Hu Tang which I like for added antineoplastic action, but it has more affinity for the upper burner than the Xiao Chai Hu Tang. Those would be my thoughts. Steve, please feel free to chime in.

I have not treated any FeLV+ mediastinal LSA cases with herbs alone yet so can't give you any anecdotal info on responses.

Best of luck with this case.
Please let us know how this kitty does, good or bad.

Erin

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