Welcome to Acu in Practice highlighting Coors the cat, Phase 2 of his journey with renal disease. Just as a reminder, he was 12 and diagnosed as IRIS stage 2b renal insufficiency when he first began the Integrative Program, including acupuncture. Phase 2 was basically his 3rd year of treatment and symptoms/signs included:
Progression of Phase 1 symptoms (increased thirst and urination, elevated BUN/CRET, hind end weakness with LS sensitivity) …PLUS … “pickier” appetite, weight/muscle loss, episodes of pancreatitis with vomiting, dandruff, increased heat seeking.
Pulse: deep, weaker and choppier than Phase 1 (more deficiency, more stagnation)
Tongue: pale pink in center, edges not as red as Phase 1, moisture/coating – relatively normal.
Western Diagnosis: Renal Insufficiency IRIS stage 3, intermittent pancreatitis, atrophy
TCM Diagnosis: Kidney Qi/Yang and Yin Deficiency, Spleen Deficiency with Damp accumulation leading to Damp Heat in Spleen and secondary Spleen/Stomach Disharmony, Bi and Wei syndrome progressing, increased evidence of Blood deficiency.
*As the Kidneys weaken and Essence declines, there is less fuel for the Spleen/Pancreas to perform its functions of digestion. When the Spleen becomes deficient, it is susceptible to Damp accumulation and Damp Heat from the friction of the Stagnation caused by the Damp. With Spleen and Kidney Deficiency, Blood deficiency becomes more prominent.
Acupuncture plan:
Chong Mai – PC 6 with SP 4: Extraordinary Vessel that is “Sea of Blood,” and connects Kidney with Stomach and Post Natal Qi (food Qi).
Kidney Qi Deficiency: BL 23, GV 4, Lumbar BH, KID 3 (Via Bladder 60), BL 17 (For Blood), ST 36 and GV 4 tonify Source Qi
Kidney Yin deficiency: BL 23, KID 6, SP 6
Spleen Qi Deficiency with Damp Heat: BL 20, BL 21, PC 6, ST 36 and SP 6
Bony Bi Syndrome: as above for Kidney, plus ST 36 and SP 6 (move Qi and Blood), BL 54
Combat Wei: SP 6, BL 17, BL 20
Blood Deficiency: BL 17
Herbal plan:Patient declines. A good option would be to continue a Kidney Tonic and to add a formula that supports the Spleen, such as Six Gentle Pets by Kan Herb or Gui Pi Tang.
Food Therapy: All moist food, a combination of canned and home cooked toppings. Toppings included ground beef (lean), egg, sardine.However, patient was becoming pickier about all foods.
Western therapy:Azodyl (for increased BUN and CRET). SQ fluids twice per week.
Coors was still living a relatively normal quality of life – participating in his daily activities and interacting with his owners. His “pickiness” around food was becoming a real challenge during this phase and he often acted hungry but then did not eat his food, indicating that the stomach was being affected by the other deficiencies. This was also one of the most stressful parts for his owners, as with many owners of cats with renal disease. They were doing their very best to encourage him to eat and to offer a variety of foods. As their veterinarian, it was also important to provide a little extra support and encouragement for the humans!
Stay tuned next week for Coors the cat – Phase 3 of renal insufficiency.
This post is created by Nell Ostermeier, DVM, CVA, FAAVA and is intended for informational use not to replace medical advice.