View Question

Chronic Vomiting And Diarrhea In A Cat

by CorinneC - July 13, 2023 View Case Report

Henry is aan 11yo DMH MN cat with a history of chronic diarrhea since April 2022 with no weight loss. The diarrhea started after the O noticed noisy breathing when he was sleeping. That seemed to resolve but the diarrhea persisted and eventually he started vomiting as well. Henry had a positive Tritrichomonis result, normal bloodwork (gen panel, UA, TLI), and no response to dewormer, Ronidazole, Prednisolone (actually D+ became worse), Metamucil, food trials (including Z/d), and herbal supplements (SMS, WLT, SRT, and XCHT). He mostly stops vomiting on Cerenia, but the diarrhea never goes away. O's notice Henry will cry sometimes after BM's, abdomen feels tense and uncomfortable. Prior to April 2022 he had been having normal BMs, no vomiting, on a regular store bought kibble.

He had an abdominal ultrasound Sept 2022 - reactive lymphadenopathy likely associated with infectious enteritis; mild thickening of the small intestinal muscularis layering: likely associated with chronic enteritis of infectious origin as patient is unknown trichomoniasis. Trichomonas infected patient, versus inflammatory bowel disease, versus much less likely small cell lymphoma.

O became frustrated and started offering different diets to see what he could handle. For the last 4 mth Henry had done "really well" in her opinion (no vomiting, but diarrhea persisted) on Snappy Tom tuna and cheese canned food. He has lost some weight but only fat after being on poor quality kibble (Sc Diet and Z/d), he is now a nice wt, BCS 4.5/9. I saw him today because he had started to vomit again this last week. His tongue is still dark pink-purple, swollen and moist; pulses are mostly toned. He is in decent spirits but O does sense he is low energy since vomiting restarted. He still has a lovely soft coat.

He screams Dampness and Damp Heat to me. I thought the XCHT might have been an option too but he seems to vomit with every herb and the diarrhea never went away except for a bit with SRT and then only minimally.

Please help Henry!!!

Thanks again,
Corinne

by naturevet

July 19, 2023

Hi Corinne,

Any chance of feeding this cat something that doesn't come from a factory for a while? if he can be convinced to ea real food and his diarrhea improves, then he is Damp for sure.

You've tried most anti-Damp formulas. The exception are Wind Damp expellers. It may be good idea to explore them, since he got a bit better for a while on SRT, and SRT has Wind Damp expelling power, but not a lot of it, I would try something with a more committed action in that way, such as Huo Xiang Zheng Qi San. If it is a deep-seated infection, then that should help a lot.

A few other ideas, particularly if the cat goes on a real food diet and is not helped:

- Bu Zhong Yi Qi Tang, for dysbiosis and chronic loose stools. Can be used alone, or with
- Xiao Chai Hu Tang, which I used for my own cat in this state, or
- Yi Guan Jian, which can be used with XCHT, if you ever get to thinking he might be Blood deficient

One of those ideas should work. The purplish tongues suggest BZYQT or XCHT as a first stop

Steve

by CorinneC

July 25, 2023

I was pondering the idea of HXZQS as well but feeling lost! This cat will NOT eat any real food. SHe says she has tried. I will reinforce her trying yet again though and see what happens. Fingers crossed!

You must be logged in to reply

CuredCases.com