Looking for input on a case with chronic pancreatitis layered onto IBD.
Signalment / Brief History:
Lincoln – 7-year-old NM domestic shorthair.
History of suspect inflammatory bowel disease (muscularis thickening on AUS), chronic pancreatitis (elevated Spec fPL and lipase), and reactive hepatopathy earlier this year (ALT previously as high as 1370 U/L). Presented for this and had AUS & BW Oct 20, 2025.
He improved clinically and biochemically on diet change (sous-vide cooked raw) and Wei Ling Tang. Weight gain has been slow but steady. But now not gaining any further weight, not stretching out his back legs like he used to so owners wonder if maybe he has some pain. Had a history of asthma and constipation which have since resolved. Had a history of overgrooming and alopecia on ventral abdomen which the overgrooming resolved but hair not growing back.
Recent Clinical Picture:
Excellent appetite
No vomiting or diarrhea
Weight gain plateaued
Lower energy than expected
No abdominal pain noted on exam
Alopecia persisting but skin appears normal and no overgrooming noted
Recheck bloodwork today shows:
ALT 221 (? from 1370)
Lipase 2191 (?; consistent with chronic pancreatitis)
SDMA 16 (mild ?; all other kidney values WNL)
Liver values have greatly improved, but persistent lipase elevation suggests ongoing chronic pancreatic inflammation.
TCM Examination (today):
Tongue: dark pink, minimal coat
Pulse: fast, thin, deep, small
TCM Pattern:
Liver Yin & Blood Deficiency with Deficiency Heat
Spleen Qi Deficiency with residual Damp
No strong signs today of Damp-Heat.
Current TCVM Treatment
Wei Ling Tang – 1/8 tsp BID
Diet: Sous-vide, which has been very stabilizing; I’m recommending postponing any transition to raw due to ongoing pancreatitis.
Questions for Guidance
Does Yi Guan Jian seem appropriate as the next step for chronic pancreatitis with Deficiency Heat?
Would you continue Wei Ling Tang alongside it?
Thank you!
Martha