View Question

Autoimmune Hemolytic Anemia Cat

by

I will try to be brief. I have seen this cat since 2 yrs. of age 9/05. Came with history of two blood transfusions back to back 5 months previous due to suspected autoimmune hemolytic anemia. He is neutered male he has been tested multiple times for felv/fiv always negative. Has been tested several times for blood parasites all negative. He has been treated with doxycycline several times -- just in case. He has responded best to combo of danazol and pred. this got him thru his 1st crisis before he came to me.

Pulse and tongue at first presentation in 2005 was yin deficiency with false heat. Good natured cat, ravenous apetite -- at the time was on nutro dry --- I changed him over to Steve's real food raw and Wellness canned. Placed him on Da huang &Zi Cao Gen for 3 months before weaning off the prednisilone and the danazole each seperate and gradual by 12/05.

Owners started homeopathic lycopodeum on their own in 1/06.

3/06 renal enzymes elevating, Increasing white cells by 4/06 pcv 22 % . In patient's ravenousness ate piece of foam and caused duodenal blockage. Exploratory sx to remove foam -- found ulceration biopsy was intestinal mast cell.

Started patient on Xue Fu Zhu Yu Tang for mast cell situation.

6/06 off Da Huang Zi Cao Gen now for 2 weeks. Low T4

12/06 pulses profoundly yin deficient, gingivits, red tongue -- started Zuo Gu Wan

4/07 raw skin lesions -- no fleas etc. started external wind

6/08 pcv 11 % back onto danazol and pred. and that is where we are to this day. With two recurrences of these episodes I am reluctant to take him off of these meds. But, owners would like him off the danazole, as would I, but pred alone does not seem to control his AIHA

Any herbal recommendations? He is active and alert, good apetite stools etc. Multi cat and dog household

I have thought about Lithospernum 15 with Anemarrhena added as he does run yin deficient with false fire rising.

I see from your Kan Herb index you might advise Xiao Chai Hu Jia Qin Jiao Tang but I am not yet enough of an herbalist to really grasp how this would fit this fellow. My simplistic thought would be Zhi Bai Di Huang Wan to drain the heat and tonify the yin
and add xue fu zhu yu tang to move the blood. But, with such a chronic and severe situation do we dare go there. These owners just really want to try. Do I need some formula for "deep seated damp heat blood" issue????

I welcome your thoughts and suggestions.

Additional info. We are in Charlotte, North Carolina -- enviromental damp heat for sure! Both his episodes have been in summer --first one in July the second occurrence three years later in June.

by naturevet

February 22, 2009

I'm almost wondering if the problem is not hemolysis, but a failure of the bone marrow to resume normal function. Bone marrow suppression is a common sequela of IHA and ITP, and pred certainly improves animals in part by stimulating it. The benefits of Danazol, an anabolic, also suggest the problem is as much about deficiency as any heat.

Likewise if you are seeing Kidney Yin deficiency, that has to be part of the picture, and makes sense from this deficiency perspective. What I would try is Yi Guan Jian, which we've had good success at stimulating bone marrow function with in chronic hemolytic and ITP cases. It's content of Dang Gui and Rehmannia gives it significant bone marrow stimulating effects. At the same time, it's indicated in the management of GI ulceration. So it fits from several different angles.

I'd give it a try. Good luck!

You must be logged in to reply

CuredCases.com