Pet "P" is a 10 yr old FS Calico DSH that weighs 13.4lbs (6.1kg). Pet "P" presented in February 2011 for a presumed UTI. The patient started to have multiple urinary tract infections since September 2010. The symptoms that the pet exhibits during these episodes are urinating outside of the litterbox, hematuria and stranguria with pain and irritability. Prior to the February visit, the pet was restarted on oral antibiotics without the relief of symptoms. Diagnostics included a CBC/Chemistry Panel , radiographs, urinalysis, and a urine culture and sensitivity (C&S). In order to do a thorough examination and diagnostics, the pet had to be sedated due to the aggressive behavior. Radiographs did not reveal masses nor stones, blood work was normal, urinalysis was normal, except for the high specific gravity of >1.050, and the urine C&S did not reveal bacterial growth in 24 and 48 hours. While waiting for the results, the pet was started on an anti-inflammatory that has helped with the hematuria and stranguria. A Western diagnosis is Feline Lower Urinary Tract Disease.
The Eastern exam was limited due to the pet’s temperament . Pulses were not able to be felt, active acupuncture points were not palpated, and the tongue seems red when the cat hissed. Abdominal palpation elicited pain or was an aggressive reaction. The patient’s Eastern diagnosis is Liver Yang Rising due to the aggression, Liver over controlling the Stomach and Spleen causing Dampness to be produced, and Damp Heat leading to Blood Stasis within the Bladder causing severe pain and hematuria. The treatment goal for the pet was to drain damp, cool the bladder, relieve the stasis and tonify the Stomach and Spleen. Recommendations for this pet was to replace the dry food with a low carbohydrate, high protein wet food to reduce the Damp being produced by the Spleen on dry, processed kibble and to reduce the urine specific gravity, continue with anti-inflammatories, and to begin with Long Dan Xie Gan Tang (LDXGT). LDXGT was chosen since it is typically used for “excessive” cases, irritability, Liver Yang Rising, Damp accumulations and Damp Heat symptoms. The owner is aware that an herbal formula change might be needed after either the pet’s symptoms subsides or gastrointestinal side effects occur indicating the pet needs Spleen support and a proper diet is not adequate. As a result, the next formula to try that supports the Spleen and drains Damp Heat will be Si Miao San (SMS) due to the Spleen support of Atractylodes in this formula. LDXGT was the first choice since Gentian, Scutellaria and Gardenia clear Heat from the Liver and Heart while drying Damp in the lower burner. Bupleurum and Angelic prevent Qi and Blood stasis. Rehmannia cools the Blood while protecting and replenishing Yin. Plantago, Alisma and Poria drain Damp from the lower burner and cool the upper burner. If the owner can give this cat the herbal formula, a recheck is scheduled two weeks after starting the herbs or sooner if the pet shows any gastrointestinal problems.
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