Question Details
Lymphoma B Cell
by kderfuss - June 26, 2022
Good evening Steve,
Jackson is a 12 year old m/c lab mix dx'd with lymphoma in January and began tx at a local hospital. He did not tolerate the chemo, stopped eating, had steady diarrhea and lost a lot of weight coming in at 39#. He was on prednisone, ondansetron, metro, acid reducer, cerenia, immodium, mirtazapine and laverdia. Initially his tongue was thin, red and pulses were rapid, thin and slightly wiry. He was literally skin & bones. I was not hopeful.

We started acu, rice congee (I know this isn't low carb but he needed to eat) and slowly transitioned to cooked meat and eggs along with a high protein kibble, Si Miao San and Liu Jun Zi Tang and over the last 5 months I have been able to eliminate most of his medication - still on prednisone 10 mg M&W&F, the 2 herbals, proviable, rx clay and sucralfate. His pulses have become more moderate, his tongue is more normal and he is eating well and looks great. Peripheral ln wnl, stools normal. He is 54#

So here is my dilemma. His blood work now shows increased ALT 273, SAP 329, BUN 55, Creat 1.9. UA no protein, urine C&S negative. We have an u/s scheduled for this week. I started to decrease the Si Miao San 1 week ago. The ALT and SAP could be from the pred, but the increased renal values were a surprise.

As always, I appreciate your knowledge and advice. Without the BW I would think he is perfectly normal!
Karin
Replies
by naturevet
June 27, 2022
Well, Karin, I think you pegged it correctly given your success thus far. A pat on the back seems in order! The response to everything you've done seems to suggestion Spleen Qi deficiency with secondary Dampness as the central problem. That begs the question of what condition could be a sequelae of that if we use SMS (+/- LJZT) for an extended period. The answer would seem to be Blood or Yin deficiency.

I would wonder about just adding Yi Guan Jian in and seeing if the values improve. The other differential diagnosis for concomitant liver and kidney enzyme elevation is Shao Yang disharmony. I would expect higher values, though, and proteinuria with a UPC > 3. In the absence of that, I'd try the Yi Guan Jian first

Hope that helps! Please let us know how it goes!

Steve
by kderfuss
June 27, 2022
Thank you! These owners are super worried and we'll see what the u/s shows tomorrow. Thank you for making me feel better about this case. And Jackson thanks you as well. I will add the Yi Guan Jian.
Peeling the onion on this one for sure.
Karin
by kderfuss
July 22, 2022
Good morning Steve,
Jackson't ultrasound was great. There were a few small nodules in the liver and spleen which had been in the initial scan in January, but the mesenteric lymph nodes and intestines were normal. No sign of lymphoma. I added in the Yi Guan Jian, he is tolerating it. I have lowered his pred to 5 mg twice / week, sucralfate on the pred days, proviable daily, and RX clay at bedtime. We will recheck blood work in 3 months, and I will be sure to let you know.
Thank you, and have a great day
Karin
by kderfuss
July 22, 2022
Good morning Steve,
Jackson't ultrasound was great. There were a few small nodules in the liver and spleen which had been in the initial scan in January, but the mesenteric lymph nodes and intestines were normal. No sign of lymphoma. I added in the Yi Guan Jian, he is tolerating it. I have lowered his pred to 5 mg twice / week, sucralfate on the pred days, proviable daily, and RX clay at bedtime. We will recheck blood work in 3 months, and I will be sure to let you know.
Thank you, and have a great day
Karin
by naturevet
July 25, 2022
Fantastic work, Karin! Such good news
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