Dennis - a tetraperesic cat

Abstract :

"Dennis" is a male Persian feline born the 27th of June 2012 from a litter of two male cats, his brother is a normal healthy cat and he has always been smaller. He lives with his brother, mother an uncle and another stray cat. He was referred to a homeopathic consultation by a conventional veterinarian on the 29^th April 2013 aged 10 months due to tetraparesia that started on December 24^th 2012 when he had a bath and immediately lost the strength of his rear extremities. This situation aggravated during the next four months despite been heavily medicated with anti-inflammatory and antibiotic and ended with him being completely enable to bear his weight, with stiffness of all his limbs and painful cracking of his joints. Xrays, routine blood works and specific blood works to rule out infectious disease had been performed in the attempt to find the causality. It was further referred to a neurologist for a diagnostic CAT Scan of the head and cervical spine that revealed the causality of his ailment to be an enlargement of the left ventricle. A homeopathic approach was able to cure the symptoms using Rhus toxicodendrum and Kalium carbonicum.

Date of Consultation : 29 April 2013

Description of the patient: 

"Dennis" is a male Persian feline born the 27th of June 2012 from a litter of two cats, both male, his brother is a normal healthy big cat, he is much smaller than his brother. He lives with his brother, mother an uncle and another stray cat.

History of the case:

December 24^th 2012 he had a bath and immediately lost the strength of his rear extremities.

January 2013 they took him to a local vet who gave him a cortisone shot that did not ameliorate the symptoms therefore he was referred to another vet who took Xrays and blood samples which gave up nothing else but a mild anemia, so he was medicated with Non Steroid Anti-Inflammatory Drugs (NSAIDs) and a diet to ameliorate the anemia. The NSAIDs (Meloxicam) in the beginning helped a little but then he was back to the same condition so the dose of the NSAIDs was raised with no effect.

February 2013 he had two epileptic fit, the first one was only a spastic rigidity of all his limbs that lasted for a few seconds but no tonic-clonic movements. Whilst the second, three weeks later, lasted more than a few seconds and developed into a real tonic-clonic epileptic fit with all muscles affected. The owner thinks that probably since this last epileptic fit he suffers from blindness, unfortunately the owner is not able to determine which one if these epileptic fits was the one that left Dennis blind.

Beginning of April 2013 he had a grooming that left him tetraparesic, with spastic rigidity.

Main complaints at the first homeopathic consult on the 29^th April 2013:

Age : 10 months

Temperature : Hypothermia = 37,6ºC

Weight : 2Kg

Nervous system : spastic tetra-paresia. Cranial reflexes are normal except the 2^nd (ophthalmic) = Blindness. Spinal reflexes normal maybe the patellar reflex is augmented. No menace response due to blindness, pupil reflex extremely slow, palpebral reflex is normal, the fundus is normal although the optic nerve seems rather small and very dark.

Muscle-skeletal system : muscles are stiff, not painful and there is no loss of muscle mass, his articulation are hard to bend, they tend to crack and are painful at the beginning of any movement but then they tend to bend easier and the pain wears off.

Gastrointestinal system : his bowel movements are not frequent, sometimes needs help, the owner uses baby enemas when he has not done in two days.

Medication at the time of the consultation : He is taking 0.4ml of Meloxicam (0.5mg/ml) = 0.2mg every day which according to his body weight (2kg) he is taking a dose of 0,1mg/kg of Meloxicam a day since January 2013.

Origin of the complaint : Since he was bathed and groomed

Possible causative factors : Wet, cold.

Modalities : The owner says he is better from motion, at the beginning he doesn´t likes to be moved as his articulations crack and his muscles are rigid, but then as he “heats up” he likes it and loves the massage. He also gets in a better mood after eating and is definitively aggravated by cold.

Time of occurrence, aggravation or amelioration : He is always in the same condition

Side of the body : All four extremities

Frequency of appearance : Constant

Description of pain : The pain is on his big joints, shoulder, elbow, hip and knees

Extensions of the complaint to other parts : I cannot consider the epileptic fits an extension of the complaint since it is very difficult to conclude what could have triggered the fits.

Other complaints:

Hypothermia : The lack of vital heat is probably due to the excess of medication, it will be recommended to stop the NSAIDs and see if this by itself improves the body temperature.

Anemia : He was anemic in January.

Epilepsy(?) : The first epileptic fit he had during the day he was in bed and was relaxing.

Blindness : The second epileptic fit he had while sleeping at night was longer and more intense and according to the owner is probably the reason that left him blind but couldn´t be certain.

Personal medical history:

Suppressive therapies and vaccinations : no vaccines, no worming but has been treated chronically with NSAIDs and at the beginning with cortisone.

Traumas (physical, emotional, mental) : none

Acute infectious diseases : none

Others : Heavy medication

Familiar medical history:

Brother, mother and father are in perfect health.

Physical generals:

Reactions to temperature : He is worse from cold.

Sleeping habits : Sleeps well, cannot say which side since he is not able to move properly.

Food modalities : He likes to drink milk, not cold or warm but room temperature.

Mental and emotional symptoms:

No intense mental or emotional symptoms.

He does not seem depressed although his condition could make him feel so.

He is alert.

Analysis:

Prognosis:

Anatomopathological analysis:

The disturbance is located in the central neurological system, the fact that he has normal spinal reflexes allows us to rule out the peripheral nervous system as being part of the disturbance and the fact he had epileptic fits that left him blinded confirms that the ailment is in the central nervous system.

Analysis to rule out Toxoplasmosis, Feline Leukaemia, Feline Immunodeficiency virus, Neospora, and Tick Fever diseases, were performed and all results came back negative. A CAT Scan of the brain was recommended.

Depth of the disturbance from homeopathic point of view:

His vital force has been extremely disturbed by very mild stressors (bath and grooming) and has overreacted producing deep disturbance in one of the most important organs/system – the central nervous system. The disturbance is therefore deeply rooted.

Personal medical history:

There is no medical history of acute diseases, or any condition that could have predisposed the organism to such a deep disturbance.

Familiar medical history and hereditary predisposition:

His father is doing well according to neighbours; the mother and brother are both normal healthy cats with no chronic ailments and they both live in the same house he lives.

Conclusion:

He was born with a very low vital force, instead of getting a cold or a flue due to a bath he got paraparesic, then when he had an epileptic fit and lost his vision, finally when he was groomed he was left with tetraparesia. Therefore all instabilities in his equilibrium leave a deep disturbance. So I can conclude that his vital force is extremely week and he must be in lower level of group C, probably level 8 or 9.

Selection of symptoms:

Peculiar symptoms:

Loss of vision after epileptic fits

Chilliness or lack of vital heat

Cracking in joints

Desire for milk

Bathing and hair cutting aggravates

Eating ameliorates

Intense symptoms:

Paralysis of extremities

Pain and stiffness of joints

Cold aggravates

Constipation

Repertorisation:

Flat repertorisation

Differentiation of the remedies

Rhus toxicodendrum: this remedy has many keynotes of the patient. Lippe describes it in his Keynotes as rheumatic drawing and tearing pains in the limbs wore during rest, relieved by continuous motion. He also has written the stiffness of the joints, worse when rising from rest. The remedy has also the typical onset due to getting wet. It is a cold remedy that also aggravates by cold, ameliorated by motion, desires milk, cracking joints, stiffness, etc… There are only two symptoms of the case that are not in this remedy, the aggravation due to haircut and the loss of vision after convulsion although it is present in the rubric vision - loss of vision. Also Rhus tox is known for the ailments from getting wet and is in many rubrics that may consider bathing in a negative way (bath aggravates, aversion to bathing, cold bathing aggravates), so there is a strong connection with the onset of the ailment.

Sepia: Is also a cold remedy, aggravated by cold. It also has as a keynote the stiffness of the joints. Also related to the onset “after getting wet”. But what contradicts it is that Sepia has as a an aggravation during and right after eating.

Mercury: This remedy has as keynote a stringing pain in the limbs which is not quite well the pattern of Dennis. Besides that I cannot relate the case further to this remedy.

Kalium carbonicum: Has as keynotes the tearing pain in the limbs, and aggravation during rest. Twitching of the muscles is also a keynote of the remedy that can be translated to the stiffness of Dennis extremities. Constipation is also a keynote. It is also related to the onset of the ailment in the way that it is also a remedy that is known for ailments caused by getting wet. It is also a remedy that has a general lack of vital heat and is aggravated by cold. This medicine could also be of great help to the case.

Phosphorus: The only one keynote that confirms this medicine is amelioration after eating.

Prescription with potency:

29-April-2013 : No prescription. I asked the owner to first take away the NSAIDs and come back in three days for a new evaluation.

03-May-2013 : The temperature did not improve in spite taking out the NSAIDs. He had 37,4ºC body temperature. Every symptom remained equally intense. 

PRESCRIPTION: Rhus toxicodendrum 30CH diluted in water three times a day.

Follow up 1: 13^th May 2013

Reaction to the prescription: The temperature is finally getting better 38,2ºC, he is less stiff but besides that there are no further recoveries. I urged for the brain CAT Scan and the opinion of a Veterinary Neurologist, the owner said he would do it at the end of the month.

Analysis of the reaction: Although Rhus tox helped in a way by raising the temperature and lowering the stiffness it did not touch the main ailment, only managed to palliate symptoms.

Conclusion: Either similar but not similimum, bad potentisation or wrong potency.

Prescription to the follow up: It was advised to raise the potency to 200CH in water.

Follow up 2: 11^th June 2013

Reaction to the prescription: No further reaction. The owner performed the CAT Scan that revealed an enlarged left ventricle. The Neurologist suggested it could be hereditary since all blood work was normal and put Dennis back on NSAIDs because he was in pain at the time.

Analysis of the reaction: No reaction or very mild reaction to temperature.

Conclusion: Wrong remedy.

Prescription to the follow up: Kalium carbonicum 30CH in water. The decision of the homeopathic medicine was based in the analysis of the first consultation and with the help of an experienced homeopath and one of my mentors, master Erik van Woensel (I am eternally grateful to you and George Vithoulkas for all you have both taught me!!!)

Follow up 3: 17^th June 2013

Reaction to the prescription:  He is finally starting to move and to walk by himself, although the pain seems to have worsen because he needs NSAIDs twice a day. He had a very fluid transparent nasal discharge and an eczema on the tail appeared.

Analysis of the reaction: It is a very good reaction. The fact that the pain is worsening give us the idea of an aggravation and the fact that he had some nasal discharge and the development of eczema also confirms that the remedy is acting. He had been unable to walk since January so the fact that he is now able to walk by himself makes it a miracle to the owner eyes.

Conclusion: Correct remedy.

Prescription to the follow up: It was advised to keep the potency but to give it directly in the mouth (not diluted) and only twice a day and recommended to slowly drop the dosage of the NSAIDs.

Follow up 4: 01 July 2013

Reaction to the prescription: On the 29^th of June he took his last dose of NSAIDs and is since he is still with no pain. He keeps improving, can now even jump. The vision is still compromised, meaning that he still remains blind and only follows the sound, that doesn´t stop him from catching flies and running like a kitten.

Analysis of the reaction: Although we could say it is a partial recovery due to the fact he is still blind, there has been an excellent reaction to the remedy. Patients belonging to group C normally need more than one remedy, while patients belonging to group D are incurable cases. Probably the time to find a new remedy is coming but I need to be certain that the first remedy has done all it could do.

Conclusion: Correct remedy.

Prescription to the follow up: It was advised to keep the potency and the frequency.

Follow up 5: 23^rd July 2013

Reaction to the prescription: There has been no improvement in the vision, the gait is still ataxic and has not improved any further. At the moment he is neither in pain, nor cracking of the joints or any signs of stiffness of the limbs. The paralysis is now a mild ataxia. The constipation is also solved. His desire for milk is still there and he has a selective appetite. The owners have neither bathed him nor clipped his hair; therefore this predisposition/modality cannot be confirmed or ruled out. We are in summer at the moment so again the aggravation from cold modality cannot be confirmed or ruled out. The lack of vital heat is definitively not there anymore. From the original repertorisation the only symptoms that remain are the desire for milk, the loss of vision and the amelioration after eating. New symptoms are the weakness of back legs/ataxia, eczema on the tail and the selective appetite. The watery discharge from the nose is very mild and transitory, only for a day and only after the first dose of remedy (Kali carb 30CH). Also when I checked his pupillary reflex he had a slow reflex of the left one and an absent reflex on the right, while the optic nerve seemed less dark but this is a very subjective observation.

Analysis of the reaction: No further reaction.

Conclusion: Potency need to be raised in order to determine if the remedy has done all it could or if a new one may be needed.

Prescription to the follow up: It was advised to raise the potency to 200CH give it once and see if there is a reaction.

Follow up 6: 30^th June 2013

Reaction to the prescription: A little liquid nasal discharge the day after he took the remedy, but the overall situation seems unchanged.

Analysis of the reaction: The nasal discharge appeared again, just as when he had the first dose of the 30CH potency, so this made me think it could be that Dennis may need a more frequent repetition of the remedy.

Conclusion: Either the frequency is low, the potency is low, the remedy is not well potentised or the remedy has stopped acting.

Prescription to the follow up: It was advised to keep the potency but give the remedy once a day for three consecutive days and wait to see if there is a reaction.

Comments: Dennis as for today 21st May 2014 is a healthy blind cat that no longer requires any medications, I have tried many remedies to try to influence in his sight without any improvement, but I still look for other approaches to try to help him, hopefully one day I will find his remedy and he might recover his vision, nevertheless his owners inform me that it does not 

seem to bother him unless they move the furniture since he is absolutely lively and able to catch flies better than his brother.