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Chronic Feline Renal Failure

by lsargent - March 18, 2010

Hellos again,

Here's a slightly happier scenario-16 y/o m/n DSH with renal failure of ~3 years. He looks great, no vomiting although his BUN and Phos are high, creat is not. He is about 5% dehydrated and the owenr is giving raw beef skirt steak, scallops and tilapia as well as a canned holistic food and some dry as he likes to crunch. His tongue is pink and not swollen, pulses thin, wiry and deep on the left as his leg developed a slight edema. His haircoat is not dry or flaky but doesn't have the luster of a young cat, and he weighs just over 9#. Would Lui Di Huan Wan be a good start for him? He is also on calcitriol and is easily stressed into spilling glucose in his urine. Previously was diagnosed with DM after a significant round of depo for skin issues. Can the raw fish be too dampening for him as he had diarrhea from the tilapia?

Thanks for your thoughts,

Lois

by naturevet

March 19, 2010

Hi Lois,

I would start with Rehmannia Eight, not Rehmannia Six (Liu Wei Di Huang Wan). I've never understood the popularity of Six over Eight. Rehmannia Eight is inherently safer, and less Dampening (i.e. more easily digested), and more therapeutically powerful. I'd also choose Eight over Six for this case in particular because of the hind limb edema, which Rehmannia Eight is much more indicated for. It also addresses the deep wiry pulse. Wiry indicates internal stasis. In Kidney cases, this is from 'cold coagulation', or an excessively Yin state. It needs some Yang to counterbalance it, which Rehmannia Six does not possess. In contrast, Rehmannia Six pulses are often quite moderate or even slippery, unless the animal is really Hot from the Yin deficiency, in which case it becomes bounding. Both formulas do, however, have Cornus in them, which has been recently identified as (surprisingly) the main component in Rehmannia Six that normalizes blood glucose.

So I'd start with Rehmannia Eight, until proven otherwise, unless the cat is very heat intolerant. Also, if the cat improves with sub Q or IV fluids, it supports the idea of using a Rehmannia formula over an anti-inflammatory one.

Hope that helps. If it does, you should see laboratory improvements - reduced glucosuria and azotemia. Let us know if that happens.

All the best,

Steve

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