Question Details
Vomiting Cat
by Lauren Chattigre - March 6, 2010
Hi Steve, hope you're doing well and enjoying the spring weather.

Reese is a 11yr FS DLH with chronic vomiting since 2/09. The o says she used to eat c/d dry until then for recurrent UTIs (not sure if she had crystals and I don't have those records), but since then she's tried various hypoallergenic diets to no avail. Vomit is about every other day, either undigested food right after eating, or yellow fluid. Occasional dry heaving, and she is prone to hairballs unless o gives laxatone. Cat is loving but skittish and doesn't like to be held; very sweet and cooperative during exam. App/Stool/Thirst/Urination normal. She sometimes gets "eye goobers" in her left eye. She tends to be a little itchy when o doesn't give digestive enzymes. Body condition is thin (3-4/9). Coat is dry. Cranial abdomen is non-painful but has a slightly doughy feel. Intestines a slightly gassy. Kidneys feel small but smooth. Tongue is slightly red toward tip with normal moisture. Pulses are slightly thin, rapid, wiry, slippery. T/P improved after acupuncture with GV20; BL18, 21, 23; ST36; SP6; PC6.

I have recommended full bloodwork and urinalysis. Cat's T4 from other clinic a year ago was normal, though high end. In the meantime though I'd love to get some help understanding the TCM presentation for this cat and what herbs and acupoints would be good. It seems like there's evidence of damp (Hx uti's or crystals, doughy abdomen), food stagnation (vomiting undigested food right after eating, though appetite is normal), possible LR/GB heat (vomiting yellow fluid), blood deficiency (underweight, dry coat, itchiness, thin pulse and small kidneys also makes me think of yin deficiency but there's no increased thirst). It doesn't seem like there's LR qi stagnation, except that the pulses are wiry. And I'm not sure what the gas means. Thanks for your help!
Replies
by naturevet
March 8, 2010
Hi Lauren,

The rapid slippery/wiry pulse and red tongue suggest Damp Heat. If the problem has persisted a while, then Damp Heat can damage Yin to create dryness symptoms. The vomiting after eating doesn't have to imply food stasis, since Phlegm obstruction of the Stomach produces the same effect. But Bao He Wan, a food stasis formula, is indicated for this kind of Heat and excitability. So it's an option, especially when you see digestive enzymes reduce itch. BHW is the original 'digestive enzyme' formula in Chinese medicine.

Otherwise, Si Miao San or San Ren Tang are options. SRT is a better choice for now, if you're convinced the pulse had obvious tone and finger lift.

Zhi Bai Di Huang Wan is also an option, since it hydrates while clearing Heat. ZBDHW is probably the best bet, given the Heat and Yin deficiency and possible hyperthyroidism. It should be a safe place to start.

Steve
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