I have a patient that has been diagnosed with Pituitary dependent Cushing's. He also has significant proteinuria and stifle instability. He's had both stifles repaired but they feel they need to redo one side as is still unstable but with the Cushing's/proteinuria - they are wanting to wait to get more stable. He has some panting at night, great appetite, PU/PD and otherwise in good spirits. I've usually always reached for Four Marvels or Ophiopogon, but with the prorteinuria - I'm wondering about Three Seeds or XCHT/Benefit Hips and Knees!? Was curious on your thoughts, thank you!
Question Details
Cushing's With Proteinuria And Stifle Dz
by
nicolleredig
-
December 1, 2019
I have a patient that has been diagnosed with Pituitary dependent Cushing's. He also has significant proteinuria and stifle instability. He's had both stifles repaired but they feel they need to redo one side as is still unstable but with the Cushing's/proteinuria - they are wanting to wait to get more stable. He has some panting at night, great appetite, PU/PD and otherwise in good spirits. I've usually always reached for Four Marvels or Ophiopogon, but with the prorteinuria - I'm wondering about Three Seeds or XCHT/Benefit Hips and Knees!? Was curious on your thoughts, thank you!
Replies
by
naturevet
December 6, 2019
Hi Nicolle,
If the proteinuria is < 1, then I would proceed with this approach first: Si Miao San and a real food diet. We always start with a real food diet that is low in starch. Animals that respond to that alone will benefit from Si Miao San added in. Meanwhile, the diet itself will likely lower proteinuria by reducing tubule damage and tendencies to renal inflammation.
If the proteinuria is much higher and more clinically relevant, and there is no improvement of symptoms on a real food diet, then Minor Bupleurum or its derivatives (like Benefit Hips and Knees) would probably be the first thing I reached for, either alone or in tandem with San Ren Tang
Hopefully this advice helps you out! Let us know if we can be of further assistance
Steve
If the proteinuria is < 1, then I would proceed with this approach first: Si Miao San and a real food diet. We always start with a real food diet that is low in starch. Animals that respond to that alone will benefit from Si Miao San added in. Meanwhile, the diet itself will likely lower proteinuria by reducing tubule damage and tendencies to renal inflammation.
If the proteinuria is much higher and more clinically relevant, and there is no improvement of symptoms on a real food diet, then Minor Bupleurum or its derivatives (like Benefit Hips and Knees) would probably be the first thing I reached for, either alone or in tandem with San Ren Tang
Hopefully this advice helps you out! Let us know if we can be of further assistance
Steve
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