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Looking for homeopathic tx for a cat with possible pancreatitis/IBD

Dr. Jeff

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You're welcome, Veronique!

I agree, it doesn't sound like his minor blip of improvement warrants a redose.

Does the terrible breath persist?

How did he do last night and how is he today so far?
 

VeroniqueM

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Good morning!

The terrible breath seems to have substantially decreased.
He stayed overall quiet last night, but seemed a little more energetic for a while this morning and ate some of his meat right away when I gave it to him so appetite slightly increased. He's back to sleep now, but in a comfortable-looking sleeping position: curled up chin on his tail.
Will be sending the web update form soon.

Thank you,

Véronique
 

VeroniqueM

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Hello!

Just wanted to quickly send an update on Darwin since he's responding I think really well so far to his Phosphorus 6c remedy (first dose given Feb 5th) :)

He did vomit 2 days after and 3 days after his first remedy dose, no hairball but one vomit had plant pieces in it.
4 days after the remedy dose (yesterday), he scratched in front of his right ear and developed a red lesion there that lasted about a half day. It is the same side as his last similar lesion that he developed on Feb 3rd shortly after his last Sulphur 12c dose (right ear then also but it lasted 1 1/2 days before it went away that time).

His BEAM has been up to 6.5-8 pretty much all the time since the first Phosphorus dose and his appetite definitely improved, but yesterday his BEAM started coming down to a grade 5.5 in the evening and only back up to 6 this morning so I gave him his second Phosphorus 6c q-tip/10 succussions dose this morning.
When his BEAM was up before yesterday evening, I was seeing him display younger behaviors again and he was almost back to his old younger self :)

Looking forward to see how he will respond to his second remedy dose!

Thank you for your patience in answering all my numerous questions along his treatment plan.

Gratefully,

Véronique
 

VeroniqueM

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Hello!

First of all, thank you Dr Jeff for giving me the opportunity to practice my first year homeopathy student knowledge, of course under your guidance with the multiple consultations Darwin has had with you, through this great but for me puzzling learning experience on my own cat!

After a fair amount of research in different Materia Medicas about the remedies we previously discussed (Calcarea carbonica, Lycopodium, Nux vomica and I also wondered about Arsenicum album and Hyoscyamus), I tried finding the similarities of these remedies with Darwin's case (unfortunately I didn't have enough time to sort out the dissimilarities and to grade the similarities in order of importance). Of course, when looking at remedies, one can always find some similarities with almost any case! And I find Darwin's presumed abdominal pain is hard to describe with the symptoms he gives (ex. location of the pain is difficult to pinpoint).

Before comparing the remedies, going back about his symptoms, he has internal symptoms of elevated BUN, creatinine, SDMA and specFPL. But what has lately concerned me were his episodes where he lies sternal with his pupils dilated, not wanting to move, staring blankly in front of him although he is conscious if I call his name. If I pet him, he looks away from me (so doesn't like to be touched I think) and his facial features also change during those episodes (see photos below). His ears are down and I even think I see a sardonic grin (risus sardonicus) on his photo, am I over imagining this? With his rising specFPL, it's reasonable to think that those episodes might be related to pain from chronic pancreatitis. I tested him 4 days ago with a drop of buprenorphine following our last discussion and he almost instantly got better, but he relapsed a couple hours later and I gave him a little more buprenorphine which helped him again. He actually had a really good day the next day likely from the residual effect of the pain medication.
But the episodes started again more strongly yesterday, so I followed your advice and gave him Nux vomica 30c (I was lucky I had some) q-tip dose that I succussed only 5 times because I was worried about an aggravation. It helped him substantially. He was having those episodes mostly in morning and early evening and the first day he received Nux vomica he didn't have an evening episode, but this morning it was back strongly where he even adopted the "meatloaf" position. I gave him another same dose of Nux vomica which helped but not as fast as it did the day before.
Modality wise, I've been observing him closely and he's worse in the morning (with or without eating, but even worse after eating), in the afternoon eating doesn't seem to make him worse, but around supper time or early evening he gets worse again typically after eating and he tends to be better later evening and during the night (although he had an episode right after eating last night around 3ham).

So all these remedies mention pain in the abdomen, mostly worse after eating, twitches of the face or limbs which he sometimes gets, bad breath, skin eruptions (he has had red lesions alternatively in front of his ears going from one ear to the other a couple months ago) and joint pain or rheumatism (he has arthritis in his left hip from a fracture on his femoral head that occurred about 12 years ago but I don't notice any distinct lameness with him).

Actually, Nux vomica was not as well represented related to the hip joint pain, but I guess it doesn't really matter if it gets used more as an acute remedy. Hyoscyamus was missing a fair number of the modalities involved and the abdominal pain described didn't seem to match Darwin's as much as the other remedies.

Arsenicum album is the only one I saw mentioning uremia (which he has), but Darwin doesn't have the anxiety and restlessness that often characterizes that remedy. Arsenicum also mentions the black stools which Darwin has.

Lycopodium seems to match quite well aside from the abdominal distension, gas and eructation (and it doesn't seem to cover the kidney issue as well from the Materia Medicas' perspective). But his appearance that aged rapidly while sick (although the recommended diet changes and his homeopathic therapy since last fall seemed to help that appearance :)), morning nausea and vomiting and being worse after eating certainly matches really well. Also, temperament wise, he can be a bit of a bully to our other cat and he tends to want to dominate him which can be a trait of that remedy. The symptom back pain better by urination was interesting: I'm not sure if he has back pain, but he has been markedly cheerful after urination a repeated number of times. It even mentions rheumatic tension in left hip (which he has). According to Hering, it's a good remedy for deep seated progressive chronic disease. But Hering also says that the treatment of chronic diseases should not be commenced with Lycopodium unless clearly indicated, that it's better to first give another antipsoric remedy. Darwin has been on Sulphur before and more lately Phosphorus and Pulsatilla (unsure if these last 2 are considered antipsoric?) so Lycopodium would not be his first antipsoric remedy. My hesitation comes in the fact that the triad Sulphur-Calcarea-Lycopodium is often (but not always) used in that particular order so following that order Calcarea would come after Sulphur. In Dr Hahnemann's Chronic Diseases, it is mentioned that Lycopodium is especially effective when indicated after the previous use of Calcarea.

But I found Calcarea carbonica didn't seem to have as many similarities as Lycopodium in Darwin's case. And both Dr Hahnemann and Hering state that Calcarea is used more frequently with the young. I wonder what Dr Hahnemann means when he writes that with older persons very rarely can Calcarea doses be repeated at once without injury? And then Hering writes that it cannot often be repeated in the old unless higher potencies are used. Darwin is 15 years old so he's certainly an elderly patient.

So, based on all this (and Dr Jeff I also sent you by email my more detailed remedies similarities' lists):
LYCOPODIUM???

I'm looking forward to see what you think Dr Jeff!

With much gratitude,

Véronique

Darwin acute episode March 12,21.jpg
Darwin acute episode March 12.jpg
 

Dr. Jeff

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Wow, you put a lot of time and effort into this post Dr. Veronique! Thanks so much for sharing it. And you're more than welcome for any small help from my end. It's an honor and pleasure to get to work with a vet as dedicated to homeopathy as you are. Thank you so much. ? ? ?

Yes, studying these "big" remedies is a long process. But it's worth it IMHO because the more familiar we are with these polychrest remedies the more we can help our patients (and pets). I like to think of the study of remedies as the study of dis-eases. They are great ways to understand the healing process and to learn what to expect as the body heals.

One wonderful way to learn remedies is by reading cases. There are dozens of old homeopathic journals available for free online that can be found with a Google search! This is is even one of the strategies when fleshing out remedies for the Materia Medica Project of Dr. Saine´. Along with a detailed description and the "genius" of the medicines are every case that we can find from the literature.



There are also some great books with cases such as Nash's Leaders (one of my favorite authors), Clinical Experiences from Erastus Case and Hering's cases compiled by Paul Herscu:



Oh, and there are so many other cool ones to read and reference. It's super exciting to see how rich the homeopathic literature is. As @Dr. Christina likes to say, the one "problem" with the study of homeopathy is that we need to get bigger bookshelves! ;)

Another great way to learn remedies is through Hering's diagnostic method of remedy comparison. You got a little taste of tis when doing this recent study, and you might like to learn more about it:


I need to run for a yoga class now, and think that 10 succussions for the Nux at the earliest warning that he is going into an episode, would be fine.

Let's also start a separate thread about interpreting kitty facial expressions, pain and the feline grimace scale.

Yes, I concur about Lycopodium...
 

VeroniqueM

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Thank you for all these great references and links which I am looking forward to read ?

And I just wanted to add that the only reason why I used Nux vomica yesterday and the day before was because it’s the only remedy I had out of the remedies discussed for his differential. His episodes were getting considerably worse as I was waiting for my order of remedies, so I felt like I really had to try something while waiting for my order and I remembered you mentioning the Nux vomica for his acute episodes (and I happened to find a 30c as the lowest potency that I had).

So now that I finally received my order of remedies late yesterday including Lycopodium and several other ones, I’ll be ready to change his remedy whenever you think the time is right. I will update you in a week.

Thanks again!

Veronique
 

Dr. Jeff

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Wonderful Veronique!

Fantastic example of the best remedy being the one on hand.
 

VeroniqueM

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Hello Dr Jeff,

I just need a little guidance as to what I should do next... I tried booking a recheck appt for this week, but there seems to be none available until next week so I'm wondering what to do in the meantime.

Since we last spoke last Friday, I did not use Nux vomica. The abdominal pain episode he had while I was in appt with you didn't last more than a few minutes so I did not treat.
I gave him his first dose of Arsenicum album 6c q-tip/10 succussions Saturday April 10th at 10h30am, no major change after: BEAM slightly down, appetite slightly down and sleeping a little more on that day, but April 11th pm he was feeling playful although his appetite was still not great. He has been having short episodes of abdominal pain about twice April 10th and maybe 3 times April 11th, but they were milder and he was purring even during the episodes. By the time I would decide to treat he would be over it so I did not treat them.
Because there was no major change, I gave a second dose of Arsenicum album April 11th (yesterday) 7hpm.
He had a longer abdominal pain episode that night although symptoms remained mild, but this morning it lasted almost 2 hours with ups and downs in the severity of the symptoms through the episode (once I found him in the meatloaf position but he changed position right away when I entered the room). His pupils are dilating more especially around the episodes the last couple days (similar to the older episodes he was having before the Nux vomica but they seemed less painful until this morning). His appetite has quite improved today though after the morning episode, he even had a short playful episode end of morning right after urinating in his litterbox (this playful after urination behavior I saw it several times before using Nux vomica) but he's not very energetic, his mood is not great, he's not very talkative and he tends to hide more especially when he's not feeling well (but if I go see him and pet him he will purr and seems to enjoy the company where in the past he didn't seem to want to be touched during his episodes). If I pet him around the abdomen area during an episode though, his ears come down even though he keeps purring.
His symptom picture is starting to resemble what it was before the Nux vomica: for ex. last night and this morning he was typically worse after eating his meat and I even heard him burp on Sunday. In the afternoon, he doesn't get worse as much after eating although yesterday he had a short episode in pm after being playful (not sure if he had eaten just before).
Persistent symptom: he still asks to drink from the tap a few times per day even though he now gets his SQ fluids SID, he started displaying that behavior more often on April 8th.
New symptom: since Saturday, he has displayed involontary movements (at least I think they are involuntary because he almost looks surprised when it happens and it's a quick movement) maybe once or twice per day. For ex., he'll be sitting and his front leg will come up and forward (at first I thought he was bringing it up to groom it), but the front paw stayed up in the air for a few seconds and he brought it back down. Sometimes the front paw just comes up like a twitch and goes back down. Once I saw him sneeze and that brought his right front paw up likely involuntarily then he brought it back down.
Other new symptoms:
- today I noticed twice that he tried to stretch after getting up and he stopped 1/2 way into the stretch as if there was pain or stiffness
- today I also heard the heart murmur again grade 1 to 2, had not heard it since April 7th. Sleeping resp rate still normal at 16/min

I'm guessing he will likely have another episode tonight (not sure what the severity of it will be). If he has another episode, how should I treat it?
He was responding well to Nux vomica 10 succussions, but is this more palliative for him since it doesn't seem to be the right simillimum according to his aggravation response to the 15 succussions dose? Do you think the Nux vomica doses can change his symptom picture and make it more difficult to identify the right simillimum? If not, maybe I can use it in acute abdominal pain until the right chronic remedy is identified.
Should I try another dose of Arsenicum album or does he have enough symptoms now that indicate Lycopodium? Or maybe I should just wait? Although I don't like to see him having too many of these abdominal pain episodes...

If you prefer that I send in a complete web update form, I can also do that.

Thank you for all the help!

Véronique
 

Dr. Jeff

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Hi Veronique!

It sounds like he may have had a response to Ars, so you may want to wait a day before redosing.

If you feel the need to treat an episode tonight, perhaps use Nux 30c 10/Q-tip instead.

I think it's too soon to change to Lyco.
 

VeroniqueM

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All right, thank you!
I will wait another day at least before potentially redosing with Arsenicum album and observe him further. I was also unsure about the Lycopodium.

Your help is much appreciated!

Veronique
 

VeroniqueM

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Hello again!

I didn’t use Arsenicum album since Sunday pm dose, but he had a fairly strong abdominal pain episode last night (not purring, pupils dilated, but more prostration like his past episodes) which I treated with Nux Vomica 30c 10/q-tip dose.
He responded well to the Nux vomica dose within an hour and was purring cuddling with us during the night and no obvious painful episode this morning, but he had a strange different kind of episode this morning that did not seem pain related: pupils all dilated, pacing around with a stressed almost frightful look on his face which lasted about 45 min to an hour.
I saw him running with our other cat later on once today for a short time, otherwise he has been very quiet and hardly purring at all no matter what I try. His appetite is still fairly good, but he’s not interacting as much with us.
I saw a jugular pulse left side as he was resting sternal position this pm and on heart auscultation I hear a constant gallop rhythm today on the first beat, HR: 124 to 136. I saw him on sternal position this pm as he seemed to have another abdominal pain episode although milder than last night and his pupils were almost normal size. I did not need to treat it since it didn't last long, he started walking around a little more afterwards and even greeted me at the door when I came back to the house, but went back in sternal position again after. The episode this pm seemed to happen not long after eating his meat. Overall his vitality seems to be decreasing.

Sorry about all the questions, I’m just very nervous about his heart symptoms and I’m just afraid to take him over the edge if I make a bad decision. So same plan? Arsenicum album 6c 10/q-tip today or do I wait longer or maybe you would have a different advice in light of what is currently going on? Should I maybe use Nux vomica 30c 5 succussions or a lower potency if he has another episode that needs to be treated or even not use it at all anymore until I can get further testing done on his heart? I think that I might skip his SQ fluids tonight. With his heart symptoms, do you think Belladonna might become a better choice of remedy for his acute abdominal pain episodes?

With much gratitude,

Veronique
 
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