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Pheochromocytoma

by AchieveAnimalWellnessDrMattMuir - November 22, 2018

Have a 13 year old dog, mini poodle,

Previously IBS/IBD-like syndrome, V+ main sign.
Gall Bladder ectomy due to mucocele 2yrs ago
Anxious dog

Presenting complaint to me 12 approx mo ago for ALT/ALKP elevations

Pulse highly toned, superficial, tongue purplish-red.

Originally used XYS but enzymes increased, swapped over to XCHT and numbers have crept down over 6months from 900 to 450. Protein/BUN/Chol/Gluc WNL

Vomiting resolved, anxiety settled.

Heard a heart murmur recently, low grade, Rx echo.
Dog presented for unusual behaviour, frozen stance, non painful on abdo exam, increased resp effort. Chest rad reveal LAE.

Elected immediate referral for cardiologist assessment as our ECG wasnt working.

BP was measured at 220 (in a big hospital) systolic. Placed on Amlodipine standard dose.

I am not sure if the hypertension is a ginseng abuse-like syndrome from the XCHT, I elected to swap to XFZYT for immediate term until specialists were happy.

She was referred for u/s and a pheochromocytoma was detected, urine catelcholamines pending.

My query is what Ren Shen does for adrenal cortex moderation in this cancer process. My understanding it is amphoteric in cushings/addisons use through its feedback loop, however not sure if this is case with a functional adrenal tumour re: catecholamine release.

Insights would be much appreciated.

Best

Matt

by naturevet

November 23, 2018

Hi Matt,

Ginseng levels are pretty low in XCHT, so it would be unlikely to aggravate a pheochromocytoma. In fact, I have used XCHT derivatives containing Ginseng to treat the condition (namely Chai Hu Jia Long Gu Mu Li Tang). Off XCHT, I would worry that the dog might do worse, because it has a significant anti-cancer effect in addition to reducing the liver enzymes. XFZYT used alone may actually raise those liver enzymes back up. If you had simply been asking what to do, I would have used both XCHT and modified XFZYT together, and expected benefits.

As to how Ginseng works, it is not via a direct action on the adrenal cortex. It works along the HPA axis, reducing adrenal gland activity and cortisol output where it is too high, and prompting its release where it is too low. So, Ginseng would 'read' adrenal output as too high in a pheochromocytoma, and reduce output of CRH and ACTH in response.

Hope that answers your question! You could look at adding Dan Shen in as an additional Blood mover that benefits the Heart, yes has abundant anti-cancer activity

Steve

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