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Lymphoma In A Cat

by ninamalik - January 15, 2020 View Case Report

Hi Steve and Dr. Bannink,
I want to ask you about my own 18.5 year old, MC DSH. He was diagnosed this week with intermediate to high cell lymphoma of the gastrointestinal tract. I am trying to pick out herbs for him but finding it difficult to decide trying to play mommy and veterinarian at the same time. Right now he is on Prednisolone 5 mg SID, Mirtazipine PRN, Keppra, and Atenolol. He has a history of mild HCM/MR. And four years ago he had a stroke and developed seizures that are well-controlled on Keppra. He also has stage 2 CRF which is well-controlled. I am starting him on Vit B12 today and he is a regular acupuncture patient of mine. I have ordered compounded Lomustine for him that will arrive next week. I am not considering IV chemotherapy for him due to his age and station in life. He is old and weaker but eating and rarely vomiting on the Prednisolone. He currently is having a herpes recrudescence since his intestinal aspirates last Friday. He weighs 4.7 kgs. About six months ago he started showing hind end weakness which is why I increased his acupuncture treatments (probably the beginning of the lymphoma in hind sight?). His tongue is reddish and his pulses are deficient. He often has an active point at GV3 and BL 21. Any herbal suggestions would be most appreciated. My gut was to start with Si Miao San but like I said I feel I can't think through him because I am too close to home.
Hope you are well and appreciate your time,
Dr. Nina Malik

by naturevet

January 21, 2020

Hi Nina,

So sorry to hear about your kitty. You do so much for holistic medicine and the animals in your practice. Hopefully we're able to help you out a little bit in turn.

The weak pulse and red tongue suggest a Yin deficiency. Commonly, Stomach Yin deficiency produces activity at BL 21. So one option is Yi Guan Jian, perhaps to help heal any raw intestinal lining. It will also support his kidneys. Stroke can be a product of Yin deficiency and is one more reason to consider it as a place to start.

Another Yin tonic is actually Ginseng, and it's hard to go wrong in cancer in cats giving them Liu Jun Zi Tang. This formula fits both active points and the herpes recrudescence, by combating the stress that drives it.

Either or both of those is probably a good place to start. SMS is a better choice for Hot Excess cats, and he seems Hot and Deficient.

Let us know how it goes. Erin cruises through regularly, so she may have some thoughts as well.

Steve

by bannink

January 21, 2020

Hi Nina,

Yi Guan Jian seems like a reasonable place to start based on what you describe. It may have the additional benefit of supporting bone marrow (Di Huang/Rehmannia and Dang Gui/Angelica). I worry about underlying Spleen Qi deficiency and pathologic Damp/Phlegm in my intestinal LSA kitties though so I would monitor for that after starting the formula. But given you're kitty's conglomeration of conditions I might start there too and see how he does.

If you find the Yin tonics in Yi Guan Jian are too moistening (worsening vomiting or diarrhea) for his digestion to handle or are unmasking an underlying spleen Qi deficiency/Damp, Liu Jun Zi Tang is a good option but will not give you the bone marrow support you might end up needing with CCNU. I often reach for more blood tonifying formulas in anticipation of myelosuppression in these guys.

Another intermediate option which is thermally neutral would be a formula called Ren Shen Yang Ying Tang. This is one of my favored formulas for my deficient cancer patients who have a pale tongue and weak pulse and need some Spleen support. It isn't an overly warming formula so should be okay to use here despite the red tongue. It will provide the Ginseng/Ren Shen and the spleen support (contains Bai Zhu, Fu Ling, Zhi Gan Can and Chen Pi ) we get in Liu Jun Zi Tang but also contains blood tonics (Shu Di Huang/ Rehmannia, Dang Gui/ Angelica, and Bai Shao/White Peony root). So that might be another formula to consider. I often use this for support during chemotherapy.

Erin

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