Question Details
Swollen Front Feet In A Cat
by
sniggins89
-
June 10, 2023 View Case Report
Replies
by
naturevet
June 11, 2023
Hi there,
Whenever I hear the words 'lymphocytic plasmacytic', my first assumption is that the problem is essentially vascular rather than immune mediated. I'm not sure about you, but I was never really fully taught the complete arc of the inflammation process because when I went to vet school it was not fully elucidated. Everyone knew about the triggers of inflammation and the inflammatory cascade. What was missing was knowledge about how inflammation ends. I think the assumption was that it would just fizzle out once whatever antigen or insult that triggered it was destroyed. It took another five or more years after I graduated for research to uncover that inflammation does not fizzle. It must be turned off, through a process called 'active resolution'. If that process does not unfold, inflammation continues. Even now, I suspect most veterinarians have not heard that phrase, because until pharmaceutical companies come up with a drug to promote resolution, the issue is considered as rather moot. That is not, however, accurate at all. A large body of evidence suggests that is how alternative therapies and real food diets partially act - by promoting active resolution. Why is it relevant here? Because the cell populations in the interstitium of inflamed tissue change over time. They begin and end with monocytes and dendritic cells, which are there to essentially keep watch. Neutrophils and granulocytes are the hallmark of the acute phases of inflammation, which is marked by leaky dilated blood vessels and the 4 cardinal signs of rubor (redness), dolor (pain), calor (heat) and function laesa (loss of function). After this phase (which is the phase mediated by the innate immune system such as complement fixation) comes the slower but eventual response of adaptive immunity, marked by lymphocytes. If inflammation does not progress beyond this point, inflammation enters a limbo state. A pahologist viewing a slide typically sees these cells as evidence of antibody mediated disease, but these cells show up in ALL inflammatory tissues, not just immune mediated and autoimmune conditions. The real problem is a failure to push past this point.
What is needed to resolve inflammation? What things are acted upon in Active Resolution? It turns out it is the endothelium. That's it. The gaps between the endothelial cells need to close, allowing Starling forces to once again be operative, draining off fluid from the interstitium and all the cells it contains. Endothelial buds need to grow new vessels, and the endothelium needs to allow vessels to dilate. It also needs to no longer be 'sticky', allowing the adhesion of lymphocytes and neutrophils. When these events don't occur, it is called endothelial dysfunction. Endothelial dysfunction is especially likely to be present in tissues that are poorly vascularized to begin with, such as the digits. That's why people with rheumatoid arthritis manifest it most in their DIPs and PIPs - because that is where circulation is poorest. In the dog and cat, the pads of the paws are made up of fat, which is famously poorly vascularized. Thus, rather than look at this as an autoimmune type of process targeting a specific anatomical region, I'm proposing we look at it as unresolved inflammation triggered by something the cat scratched or dug or tackled while hunting, like a chemical irritant.
Processed food diets are without a doubt a major driver of endothelial dysfunction in people and animals. The issue is the impact of food processing on insulin, and the impact of insulin on endothelial function. Job one for this cat is to move them onto any real food diet if they are not already there. Nutritional balance isn't critical for the first few weeks, so any real food - roast chicken from the grocery store even - is going to be useful to test the theory. That being said, sardines represent a balanced and complete diet for cats.
The second job is to use 'Blood movers' to resolve the issue. The easiest one to start with is Xian Fang Huo Ming Yin (Angelica and Mastic Combination) from Natural Path; sold as Sublime Joint Formula from Kan Essentials. The former is a powder and the latter is sold in liquid or tablet form. Even topical application of the herb, by mixing 10g of the powder into a basic wound healing (e.g., calendula-based) salve is likely to help. The cat will undoubtedly clean its paws, taking care of the challenge of oral ingestion. Otherwise, there are the pill and liquid forms. The liquid is a glycerite. The alcohol component may need to be steamed off to make it palatable.
Another formula to use instead of in addition is Hoxsey-Like Formula, which is now available to vets as a pure glycerine extract. No alcohol in there at all, making it easier to give. All of these options are available at A Time to Heal. You can use both together
Hopefully after such a long-winded explanation, this helps you out. Please let us know how it goes, but I am optimistic you will see an improvement, particularly if you can get the owners to explore feeding real food
Steve
Whenever I hear the words 'lymphocytic plasmacytic', my first assumption is that the problem is essentially vascular rather than immune mediated. I'm not sure about you, but I was never really fully taught the complete arc of the inflammation process because when I went to vet school it was not fully elucidated. Everyone knew about the triggers of inflammation and the inflammatory cascade. What was missing was knowledge about how inflammation ends. I think the assumption was that it would just fizzle out once whatever antigen or insult that triggered it was destroyed. It took another five or more years after I graduated for research to uncover that inflammation does not fizzle. It must be turned off, through a process called 'active resolution'. If that process does not unfold, inflammation continues. Even now, I suspect most veterinarians have not heard that phrase, because until pharmaceutical companies come up with a drug to promote resolution, the issue is considered as rather moot. That is not, however, accurate at all. A large body of evidence suggests that is how alternative therapies and real food diets partially act - by promoting active resolution. Why is it relevant here? Because the cell populations in the interstitium of inflamed tissue change over time. They begin and end with monocytes and dendritic cells, which are there to essentially keep watch. Neutrophils and granulocytes are the hallmark of the acute phases of inflammation, which is marked by leaky dilated blood vessels and the 4 cardinal signs of rubor (redness), dolor (pain), calor (heat) and function laesa (loss of function). After this phase (which is the phase mediated by the innate immune system such as complement fixation) comes the slower but eventual response of adaptive immunity, marked by lymphocytes. If inflammation does not progress beyond this point, inflammation enters a limbo state. A pahologist viewing a slide typically sees these cells as evidence of antibody mediated disease, but these cells show up in ALL inflammatory tissues, not just immune mediated and autoimmune conditions. The real problem is a failure to push past this point.
What is needed to resolve inflammation? What things are acted upon in Active Resolution? It turns out it is the endothelium. That's it. The gaps between the endothelial cells need to close, allowing Starling forces to once again be operative, draining off fluid from the interstitium and all the cells it contains. Endothelial buds need to grow new vessels, and the endothelium needs to allow vessels to dilate. It also needs to no longer be 'sticky', allowing the adhesion of lymphocytes and neutrophils. When these events don't occur, it is called endothelial dysfunction. Endothelial dysfunction is especially likely to be present in tissues that are poorly vascularized to begin with, such as the digits. That's why people with rheumatoid arthritis manifest it most in their DIPs and PIPs - because that is where circulation is poorest. In the dog and cat, the pads of the paws are made up of fat, which is famously poorly vascularized. Thus, rather than look at this as an autoimmune type of process targeting a specific anatomical region, I'm proposing we look at it as unresolved inflammation triggered by something the cat scratched or dug or tackled while hunting, like a chemical irritant.
Processed food diets are without a doubt a major driver of endothelial dysfunction in people and animals. The issue is the impact of food processing on insulin, and the impact of insulin on endothelial function. Job one for this cat is to move them onto any real food diet if they are not already there. Nutritional balance isn't critical for the first few weeks, so any real food - roast chicken from the grocery store even - is going to be useful to test the theory. That being said, sardines represent a balanced and complete diet for cats.
The second job is to use 'Blood movers' to resolve the issue. The easiest one to start with is Xian Fang Huo Ming Yin (Angelica and Mastic Combination) from Natural Path; sold as Sublime Joint Formula from Kan Essentials. The former is a powder and the latter is sold in liquid or tablet form. Even topical application of the herb, by mixing 10g of the powder into a basic wound healing (e.g., calendula-based) salve is likely to help. The cat will undoubtedly clean its paws, taking care of the challenge of oral ingestion. Otherwise, there are the pill and liquid forms. The liquid is a glycerite. The alcohol component may need to be steamed off to make it palatable.
Another formula to use instead of in addition is Hoxsey-Like Formula, which is now available to vets as a pure glycerine extract. No alcohol in there at all, making it easier to give. All of these options are available at A Time to Heal. You can use both together
Hopefully after such a long-winded explanation, this helps you out. Please let us know how it goes, but I am optimistic you will see an improvement, particularly if you can get the owners to explore feeding real food
Steve
by
sniggins89
June 13, 2023
Hi Steve,
Thank you so much for this wonderful, detailed reply! I thought the same thing, that the immune response would just stop once the triggers were gone. I will get these supplements and get the cat started on them pronto! Should the Doxycycline be discontinued immediately or wait till some of these herbs get on board? The cat is a bit of a picky eater. What real food diets do you recommend? Raw, freeze dried raw, home cooked and where to get recipes? We did a regular salt foot soak and the next day the swelling was down and the gray dot in the center of the paw was gone. Do you think Epsom salt is better that regular/kosher salt for the foot soak? Again, thank you so much for all your help and suggestions!
Sincerely,
Diane Snyder
Thank you so much for this wonderful, detailed reply! I thought the same thing, that the immune response would just stop once the triggers were gone. I will get these supplements and get the cat started on them pronto! Should the Doxycycline be discontinued immediately or wait till some of these herbs get on board? The cat is a bit of a picky eater. What real food diets do you recommend? Raw, freeze dried raw, home cooked and where to get recipes? We did a regular salt foot soak and the next day the swelling was down and the gray dot in the center of the paw was gone. Do you think Epsom salt is better that regular/kosher salt for the foot soak? Again, thank you so much for all your help and suggestions!
Sincerely,
Diane Snyder
by
naturevet
June 13, 2023
Hi Diane
I emailed you this info, but for the folks playing along at home:
For the kitty, I guess they could start with regular salt, but Epsom salts are probably stronger for bringing down swelling. Here are some basic instructions for making the salt bath so they can get the proportions right: https://www.youtube.com/watch?v=q0V3hm3Fkno. Don't add the alcohol. If they use aromatics, then I would choose ‘Blood moving’ ones like Frankincense, Rosemary, or Sage. Or they could stick with salt and water.
As for the right type of food, anything that is not canned or kibble should help. Many pet supply stores sell pre-made fresh food diets. Even canned sardines constitute a balanced whole food diet. Or they could explore what real meats the cat will consistently eat, then build a diet around that by making their own food. Nutritional balance isn’t critical during those few weeks of figuring out what the cat will eat. It can be as easy as buying a roast chicken from the grocery store for now. If they must feed processed, about as processed as you can get without being inflammatory is freeze-dried food. Anything more than that – even air dried – has considerably more inflammatory potential.
Good luck!
I emailed you this info, but for the folks playing along at home:
For the kitty, I guess they could start with regular salt, but Epsom salts are probably stronger for bringing down swelling. Here are some basic instructions for making the salt bath so they can get the proportions right: https://www.youtube.com/watch?v=q0V3hm3Fkno. Don't add the alcohol. If they use aromatics, then I would choose ‘Blood moving’ ones like Frankincense, Rosemary, or Sage. Or they could stick with salt and water.
As for the right type of food, anything that is not canned or kibble should help. Many pet supply stores sell pre-made fresh food diets. Even canned sardines constitute a balanced whole food diet. Or they could explore what real meats the cat will consistently eat, then build a diet around that by making their own food. Nutritional balance isn’t critical during those few weeks of figuring out what the cat will eat. It can be as easy as buying a roast chicken from the grocery store for now. If they must feed processed, about as processed as you can get without being inflammatory is freeze-dried food. Anything more than that – even air dried – has considerably more inflammatory potential.
Good luck!
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