Question Details
Possible Cancer And CRF In A Cat
by alaska2mt - September 29, 2021    View Case Report
Peanut is a 19yr SF 'Kidney' cat who has gotten acupuncture/herbs for years for her kidney disease. She is currently on: Kan Reh 8 Combo, Standard Process Feline renal support, lactulose and transdermal amlodipine. She recently had unrelenting GI signs. A trip to the emergency room revealed a mass in the lungs and thickened GI tract with enlarged lymph nodes. GI lymphoma is suspected. Further diagnostics have been declined. She Prednisolone was added to her meds as well as Cerenia. She also regularly gets SQ fluids.

On recent exam, she actually looks great. eating well, good coat quality, wiry pulse, and hasn't needed lactulose since the addition of prednisone. Would there be an herb you would add?

Thank you!
by naturevet
September 30, 2021
I guess my first thought is to try Xiao Chai Hu Tang (e.g., in the form of Kan's Benefit Hips and Knees). This might be especially helpful if the azotemia has not really improved in response to use of Rehmannia 8. I've had good luck with this formula reversing the lymphadenopathy and lymphoma-like changes you're seeing in the abdomen, and it is also appropriate for pulmonary masses, the pred-responsiveness, and the wiry pulse. If you go this route, follow up in a couple of weeks and ensure the azotemia has not been aggravated by the introduction of the BH&K.

If azotemia has dramatically improved on Rehmannia 8, then try adding in San Ren Tang first, especially if the symptoms prompting the emergency room visit were reminiscent of Dampness. It can be helpful in cats with a wiry pulse.

by alaska2mt
October 11, 2021
So, if we start the XCHT, do we stop the Rehmannia 8?

by naturevet
October 12, 2021
I guess start by using them together. If XCHT is wrong for the dog, the azotemia could briefly worsen, but Rehmannia will prevent that from being too significant. So, follow up in about ten to fourteen days to ensure no significant worsening.

If you don't see worsening, then significantly reduce the Rehmannia and continue the XCHT. At that point, in another ten days or so, you should see improvement. If you do, you're clear to stop the Rehmannia for a bit. Note, though, that once improvements stop accruing on the XCHT, you'll need to switch back to Rehmannia to 'finish the case'

Hope that makes sense!

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