Darwin's clinical pathology interpretation

[VeroniqueM]

Hello Dr Jeff!

Thank you for the time spent in consultation for my cat Darwin yesterday in regards to his chronic kidneys, pancreas and heart issues. Following up on that, I just wanted to let you know that I spoke to a clinical pathologist from the laboratory about Darwin's blood work results and here is their interpretation:
- in regards to severe azotemia possibly increasing the pro-BNP heart result, what they consider severe azotemia is in association with a creatinine above 440 umol/L because of an alteration of the glomerular filtration rate at that level and above. Darwin's creatinine is at 268 umol/L so they feel that his azotemia is not likely severe enough to affect his pro-BNP result and therefore a certain stretch and stress of his myocardium is likely going on.
- in regards to the spec-FPL potentially increasing with kidney disease, this situation occurs generally when there is poor perfusion to the pancreas due to the kidney disease. Again, in Darwin's case, they don't consider his kidney disease to be severe enough to have an impact on the spec-FPL and therefore they feel that his high spec-FPL is likely due to an issue with his pancreas or IBD. He also receives subcutaneous fluids every day which should helps his body's perfusion.
- in regards to the high B12, they don't usually see that high value as being clinically significant. It can sometimes be associated with neoplasia or liver disease but of course further diagnostic tests are required to better assess those possibilities. In Darwin's case, all liver values are within normal range and his last neoplasia index test done in January was normal.

An abdominal ultrasound and heart ultrasound should be done to further assess his condition and I will try to arrange for those tests to get done in the near future.

I did forget to mention during our consultation that his blood pressure was rechecked this week on June 14th and it was 138/99 which is much better than last time on May 28th when it was 155/98. Maybe the Aconite helped his blood pressure on top of helping his vomiting bloody mucus issue?

Following our consultation:
- you wanted to verify the relationship between the Aconite that he currently takes and Lycopodium?
- we also discussed Abies nigra remedy and you mentioned that you might have pertinent information that you could share on that remedy?

Again, thank you so much for all your time!
With gratitude,

Véronique

 

[Dr. Jeff]

Hi Veronique-

Thanks for the reminder after our HMDM call to check on these.

Yes, Lyco and Ars are known to be related (tho not strongly). Aconite is more frequently a useful remedy, but is not the remedy I was wondering about.

I searched the Abies Nigra info and there is indeed a short monograph about it. But it is not well known and most symptoms have been stomach related (see summary):

Summary:
Abies nigra tends to be chilly, depressed, discouraged, nervous, constipated, have difficulty to concentrate, and, especially, have indigestion.

This indigestion is characterized by a sensation of having an undigested hard-boiled egg stuck in the esophagus or pit of the stomach. The pain is constant and compels him to cough which doesn’t ameliorate.

The stomach pain tends to be worse after eating, especially after a large meal, from touch, even of the clothes, bending double and better from stretching.

Hard and dry stools.

No appetite in the morning, high at noon and night with wakefulness.

The genius of this remedy appears prominently in the stomach.

 

[VeroniqueM]

Yes, I apologize for my mistake. Indeed it was the relationship between Arsenicum and Lycopodium that you were referring to in our last HMDM call. And Arsenicum album was the remedy he was taking prior to the Aconite he's currently taking. And than you for the info on the remedy Abies Nigra.

Unfortunately, Darwin seems to have a bit of a relapse. He received his last dose of Aconite on June16th, but yesterday early morning he vomited a hairball with grass and blood-tinged mucus again and his BEAM has been down to a grade of about 5.5-6. He's having more frequent abdominal pain episodes (especially late evening and during the night, but he was in a meatloaf position this morning also around 9h), so I'm afraid his specFPL might be rising.
His appetite was increased 2 days ago even though his general BEAM was down, but yesterday he was back to eating mostly late pm, evening and night (not eating his meat morning and early pm).
I find I have to clean the corners of his eyes more often in the past few days because he's getting brown mucus again like he did last fall. And he is back to asking to drink from the tap more often in the last couple days.
He isolates himself more, especially in the morning and at night.

I'm unsure what is the next step: redose Arsenicum, redose Aconite or a new remedy? I think you were considering maybe Lycopodium?

Thank you so much,

Véronique

 

[Dr. Jeff]

No problem whatsoever Veronique!

Did he respond to the 6/16 Aconite dose?

If not, you may want to consider a test dose of the Lyco 6c.

 

[VeroniqueM]

His BEAM went up from 6 on June 15th before the Aconite dose to 8.5 on June 16th following the dose and 7.5-8 on June 17th, then back down to 6.5 on June 18th, about 6 on June 19th, 5.5-6 yesterday (and vomited bloody mucus yesterday early am) and about 6 this morning. The effect of the last dose didn't seem to last as long, but I had also given him the dose at 9 succussions instead of 10 hoping to minimize the aggravation (mild abdominal pain episodes displaying the meatloaf position within 1 to 1 1/2 day following each dose). He still diplayed the meatloaf position following the last dose (about 12 hrs after the dose) but only once instead of twice (2 episodes) following the June 9th Aconite dose.

I did see a slight head tremor once in the last couple days (like I was seeing last fall before the start of his homeopathic treatment) and he tends to want to eat grass more repeatedly when going outside in the last 2-3 days. No new symptoms.

Should I repeat Aconite or try Lycopodium?

Thanks again,

Véronique

 

[VeroniqueM]

Sorry Dr Jeff!

Following the previous message above and reviewing my notes on my Darwin, there is one thing I think I should add: Saturday during the night he did at one point lay comfortably on his side sleeping and he drooled as he was lying on his right side (didn't see him drool but saw a little wet spot under his mouth when he later lifted his head). He was purring on and off and sleeping on and off while on his side as I was petting him so I'm not sure exactly if the drooling occurred while he was purring or not. Either way, he doesn't commonly drool when he's purring (as I know some cats do). I'm not seeing any ulcers nor anything unusual in his mouth.

Not sure if it's important in his case, but just thought I would mention it just in case.

His BEAM is up to 7-7.5 since my previous message today (above), his appetite is up today because he had eaten 1/2 his breakfast meat plate by lunch (often times he leaves his breakfast untouched) and this pm he's climbing up on furniture and on top of cupboards, places that he couldn't seem to be able to reach onto lately.

Lastly, I saw a large bowel movement in the litter box this pm that contained pieces of grass (99% sure it's from Darwin and not my other cat) so I thought it might be encouraging that he's passing the grass in his stools as opposed to vomiting it (sometimes accompanied by bloody mucus).

Gratefully,

Véronique

 

[EdwinA]

Hi Veronique.

Have you tried herbs like dandelion, nettle, parsley, cordyceps and reishi?

As well as being very safe
- though Google will tell you they’re potentially very dangerous - tonics for the whole body, especially the kidneys, they are proven to produce marked improvements in blood levels of kidney markers. Also improve appetite, detoxify etc.

 

[VeroniqueM]

Thank you for the suggestion!

I did use Rx vitamins Renal Feline for a couple of months which contains cordyceps among other ingredients and didn't see much change in his kidney values (if anything, it even increased slightly) and then I became hesitant about the rhubarb extract that it contains as rhubarb is sometimes known to be high in oxalates (I would have to verify with Rx Vitamins about their rhubarb extract, maybe their extract is fine that way) but for now I stopped using it especially since Darwin was shedding calcium oxalate monohydrate crystals in his urine 2 wks ago and on another urinalysis done 1 1/2 month ago also.

I'm also using Aminavast and Rx vitamins Amino-B-Plex supplements.

I will look into those additional ingredients you mentioned.

Thanks again,

Véronique