I have a frustrating cat patient that I'm not making much headway with, so after some advice on the next step.
Ollie is an 8 year old MN DSH.
Problem list;
Chronic intermittent vomiting (usually of initially undigested food and bile or hairballs)
Intermittent inappetence at time of nausea/vomiting
Lip licking, overgrooming, tooth grinding (seems to correlate to when having episodes of nausea/vomiting)
No diarrhoea, if anything can be a little constipated
Treatments trialled in past with another vet;
Pred trial - no improvement
TCVM herbs trial (6 gentleman) - initial improvement then relapse
Prev workup via med specialist - Nov 2020 - Diagnosis: DDx IBD +/- Helicobacter gastritis . Was treated with triple antibiotic combo at this time.
Diet trials - no long term benefits.
Probiotics long term - somewhat helpful
Cerenia injs and tablets - symptomatic relief
Vit B12 injs
He is anxious, timid, but dominant over other cat in house. 100% indoor with access to cat run. Nausea/inappetance/vomiting episodes seem to happen every 2-3 weeks - he will be good for a week, then start to lip lick, then a few days later vomit. He seems good after vomiting, will then eat his meal. Not overweight, has lost weight in past when vomiting episodes have been worse. No increase appetite or thirst noted.
Ollie eats dry food and canned food - I have tried every possible fresh food / air dried / raw / dehydrated treats etc with no luck. The best we have got is switching him to low carb, high protein wet foods.
He is impossible to examine, so my initial diagnosis was really on clinical signs - Liver Qi Stagnation, Liver overacting on Spleen, Spleen Qi Deficiency with Damp. The on my possible list was also TBO (due to Damp) and Stomach Yin Deficiency (secondary to Stomach Heat from TBO)?
I trialled San Ren Tang for 3 weeks - no change (no better, no worse)
Also B12 in St36/Liv13/BL 20 weekly x 6 - no change
He is on Fortiflora probiotic (the only one he'll eat in his food)
He has been on a moderate-high dose of Full Spectrum CBD BID for last 2 months with no real improvement (only the tooth grinding has significantly reduced).
I'm stuck with which herbal blend to try next!
The partial response to LJZT made me wonder if WLT would be worth trialling - addresses the Damp, could be helpful if Helicobacter is still involved, for nausea, gastritis etc)
Also considering YGJ for possible Stomach Yin Deficiency / Liver Qi Stagnation.
Would it be best to pair either one of the above with XCHT (1:1 ratio or other?).
I do think he would respond to an unprocessed diet, but have tried so many things and ways of trying to change him over with no success!
Thanks for your help on this one,
Sophie