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Hyperthyroidism With Added (?) Hepatic Issues

by mikemesley - November 29, 2009

A 14 year old cat has recently been diagnosed with hyperT and began Tx with oral carbimazole. Has (finally) showed some response to Tx as far as T4 levels are concerned, dropping from 90+ to 36 today. However, initially PU/PD was a big feature of the disease and we were concerned re kidneys. Crea was mildly elevated originally. On carbimazole, kidney function looks fine, but hepatic enzyme levels have risen fairly sharply. However, I'd still call them "deficient" enzyme levels (ALT, AST, ALP all mild-mod elevations, and the cat certainly looks deficient.
Only other relevant info in Hx is the rash it recently developed. It has had skin rashes before, but not to this extent - we were concerned re drug reactions etc but settled well on long acting prednisolone shot. O even describes REDUCTION in PU/PD after cortisone shot! This made me consider autoimmune-type or microvascular-type liver issues as possible western diagnoses.

Red, small, dry tongue.
Heat signs in skin. Rapid, wiry pulse.
BL23 pain and responsiveness.

So yin deficiency with empty heat seems fairly obvious. Liver and Kid both seem involved.

My initial go-to formula was to be YGJ. This seems a good choice as far as I can tell. Any other ideas anyone has about other potentially beneficial Txs for this cat? Also diets that would be beneficial in particular - or just regulation blood/yin building home-mades?

Thanks for your help! Stay warm (we are down under!)

Mike

by naturevet

November 30, 2009

Hi Mike,

I have a case like this that responded well to Qing Ying Tang. It's anti-itch; has the Yin tonifying effects that support renal function (the other option that springs to mind is Zhi Bai Di Huang Wan here); and moves Blood (also good for liver enzyme elevation). YGJ is also a good call, but is only suited to mild itch.

There are probably a lot of right answers here, but the cryptic response you saw to cortisone is exactly what we'd expect in a Yin deficient patient. Add Yin, and the Heart Fire becomes more cooled, lessening thirst. At the same time, increased Kidney Yin allows for better Kidney Qi (which is a mix of Yin and descending Heart Yang), which allows for better urine concentration.

Have a good one. It turned chilly here, with lots of ice and snow on the ground now.

Steve

by mikemesley

November 30, 2009

The strike of the Tai Yin - as winter slides ever closer.

Fortunately for me we are nearing the end of the Shao Yang, with only a few weeks before maximum Yang Ming sun-facing!

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