I am trying to make sure that my thought process is correct and that my follow up plan makes sense. Thank you for your help.
"Tinker" is a 14 1/2 yo DSH cat. Hx: perineal urethrosomy in 1996 b/c of FLUTD, diabetes mellitus in 2006. (SP Qi Def leading to Damp Heat and Yin Def).
When I first saw him, he was experiencing a diabetic neuropathy which resolved when we got his diabetes better controled (via proper insulin dosages and changing his diet to a low carb)
While fine tuning his insulin, he began to lose weight again, was PU/PD again, was dehydrated, and the gingiva was increasingly eryth. As we altered his insulin and used Ab'tics (Orbax), he seemed to improve but not resolve. There was +++heat over his head region. His pulse was a dark/ruddy color and his pulse thin and tight.
A dental with extractions ensued and biopsies said lymphocytic plasmacytic stomatitis. Within a week of the dental, he worsened and was very painful. He began to lose weight again b/c he was not eating.
I used Prednisolone b/c (I have to confess, I knew it would work, and it came down to a do or die situation). But now I want to get him off the Pred, as the Pred is (big surprise), affecting his bg levels.
In retrospect, I think I should have used Hoxsey-Like formula immediately after the dental but I hesitated b/c I wasn't sure if the dental alone would have been enough to help with the problem. And then when everything fell apart, I should have used the Hoxsey, but didn't b/c I didn't have the confidence. So here we are... At present, his tongue is now red, his pulse is still toned/firm, his coat has greasy/large flakes and he is Pu/Pd again (his bg is back up to 22.1 mmol/l). So he is still has a lot of Damp Heat. But his mouth looks great and he is far more comfortable!
I have decreased his Prednisolone to 5 mg EOD and increased his Glargine. If we introduce herbs at this point, should the emphasis be on tonifying or clearing heat (or even draining Damp)? I am thinking that ZBDHW is a good choice. (do you think so, too?) How would you introduce it while getting him off the Pred? not to mention altering his insulin...
Many things that I would have done differently, but I would like to learn from this case. I just want him off the Pred because in the near future I think I will make him globally deficient. Thank you on behalf of a really sweet elderly man who adores his old adorable cat. (and me)
Rita