Question Details
Old Cat With DM, CRF And Constipation
by doris - December 16, 2009
Hello STeve,

I have a complicated case that really needs your advice.

This 16 years old , fat DSH cat, MN , was diagnosed with diabetes mellitus for 6 years and was well controlled with hill's w/d diet and insulin injection twice daily.
It has intermittent constipation but was not bad enough to need regular medication to manage this problem. However since May 2009, the cat had several episodes of constipation and enema was needed to relief the problem. Blood test revealed the cat has Grade 2 chronic renal failure. I put the cat on cisaprid 5 mg twice daily, LRS sc inj 200 ml daily and weekly acupuncture (To promote movement of the Large Intestine, tonify Kidney, and relief Dampness as in fat cat with DM--KI 3 KI 7 SP 6 ST 36 CV 4 CV 6 CV 17 BL 20 BL 23 BL 25). the cat was responsed ok to the treatments but still has difficulty to pass stool out every now and then.

Then I slowly introduced BaWei Di Haung Wan and SanRen Tang to the cat at low dose, the response was not satisfactory until I added Xiao ChaiWu tang to it as well. However, since winter arrives in Nov, the problem was worse again. It rains sometimes in Hong Kong during winter and the onwer reckons the cat seems to pass stool with more difficulty when the weather is humid , but better in dry cold weather.

At the moment, the cat is on Meat based diet + some Royal Canin Dibetic dry food, Insulin injection twice daily, LRS 300ml sc inj daily and cisaprid 5 mg bid. The tongue is pink , slightly swollen, pulse is fast, deep and slightly weak. It never seeks warm. It has very good appetite. It drinks lots of water daily despite having sc fluid injection, and urinated a lot. Stools were hard, dry and large in diameter and were passed out with tenemus still. I have changed the acupuncture points to target the TH function but not seems to be helping much. (LI 4 TH 5 SP 6 ST 36 ST 40 KI 3 CV 4 CV 6 CV 17 BL 22 BL 25)

What other herbs I can try on this cat?

Thank you for your help.

Regards,
Doris
Replies
by naturevet
December 19, 2009
Hi Doris,

A response to Xiao Chai Hu Tang suggests the constipation is primarily a peristaltic issue, since that is how the formula works for smooth muscle complaints - by having an antispasmodic effect. It is this action that allows it to relieve cough due to collapsing trachea as well. So while the lack of response to other Damp formulas and Kidney tonics is surprising, at least we have an idea where to go from here. To follow the lead of the XCHT, I'd also add in Wei Ling Tang. It is anti-diabetic, drains Damp (which the cat seems to need if it is worse in humid weather), and improves peristalsis. So that is the next thing I'd try.

Steve

by naturevet
December 19, 2009
I'd also probably continue the Rehmannia Eight given the renal azotemia.

S
by doris
December 20, 2009
Thanks veyr much Steve, I will give it a try .
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