Thai - Autoimmune disease

Date of the Consultation : 15^th January 2014

Description of the patient:

"Thai" is a spayed mix breed female canine, born 25^th August 2011. She lives with her owner and is a very friendly bitch. Her owner describes her as a bitch with a strong headed personality but very sweet, very playful, who likes people, is very affectionate and protective with the ones she loves. The negative traits, she has some aversion to “smelly” people with which she shows her aggressive side and is very territorial.

Main complaint:

Origin of the complaint : In September 2013 she developed a scab on her face on top of her nose, the owner said it looked like she had been bitten although she had no fight or close encounter with any animal. The local vet suggested cortisone cream but with no effect, the situation got much worse and developed into a very raw sore all over her nose area, as in the picture, she lost her fur over the nose, the skin looked red and had scabs.

Possible causative factors : There is a possible genetic factor since she does look as a Collie Shepherd mix breed dog. She was very attached to the son of her owner that had to go to study elsewhere, there could be a possible emotional trauma although she does not seem particularly depressed. She had a very aggressive vaccination protocol in her first years,: during her first 20 months of age she got 10 shots (one Distemper/Parvovirus, followed by a pentavalent, then another pentavalent and a rabies, then three doses of a non core vaccine, then again a pentavalent and a rabies and finally a shot of a non core vaccine). Five months after the last vaccine she developed Canine Discoid Lupus Erythematosus (this diagnosis was made by means of a biopsy).

Modalities of the main comlaint:

Time of occurrence, aggravation or amelioration : In the morning it looks better (whittish) and it gets worse in the afternoon turning red.

Side of the body : On top of the nose and there is another similar lesion in her left arm and left lower lip.

Frequency of appearance : Constant

Extensions of the complaint to other parts : It has extended backwards and in the left lower lip and left arm.

Other complaints:

She has pruritus in the anus and has arthritic pain.

Personal medical history:

Suppressive therapies and vaccinations : In order to try to control this situation she got antibiotics and a cortisone treatment that did not solve the problem. The owner describes that she changed a lot when she got the cortisone pills, that and the null effect of the medication were the reasons to seek a different approach. When she got the cortisone she got irritable, impatient and would no longer play with other dogs.

Traumas : Could have an emotional trauma after the son of the owner left home.

Acute infectious diseases : None, the owner does not recall any acute ailments or fever.

Other : She gets worming pills every three months, an external antiparasite treatment every month with a spot on product and another antiparasitic collar every six months. 

Familiar medical history:

No information.

Physical generals:

Reactions to temperature : She likes to take sun baths, other than that she does not seem affected by any change of weather or temperature.

Sleeping habits : She has no particular sleeping habit.

Food modalities : No information.

Water consumption : Normal.

Oestrus cycle : Never had any since she was spayed before puberty.

Mental and emotional symptoms:

Thai is mentally very healthy, no emotional or mental symptoms were present at the time of the consult. Only when she got the cortisone therapy she had some disturbances at this level, but since the owner decided to drop those treatments she balanced back to normal.

Analysis:

Prognosis:

Anatomopathological analysis : The pathology is only affecting the physical sphere and the most external part of the physical sphere (the skin) although the appearance of arthritic rheumatic pain already tells us that the disturbance might be moving inwards.

Depth of the disturbance from homeopathic point of view : When the main ailment resides only in the skin we can be certain that the depth of the disturbance is superficial. 

Personal medical history : Overvaccination is a known trigger to predisposed patients to autoimmune diseases. The suppressive therapy with cortisone also affected Thai in a mental/emotional sphere meaning she is easily disturbed by this kind of medication but I would not blame her for that since cortisone is a very strong medication that affects the body in many site and very deeply.

Familiar medical history and hereditary predisposition : There is no information on her family but she does look like a collie breed and this breed is predisposed to this ailment we even call it the Collie Nose Syndrome. This genetic predisposition could be an obstacle to a cure.

Conclusion : Thai has never had any disease until now. According to her vaccination protocol she probably could be suffering from Vaccinosis and although she has developed an autoimmune disease she has been able to keep the disturbance in the skin. She is also sensitive to cortisone but as soon as the drug was taken off she stabilized quickly. She probably belongs to either group C level 7 or upper level of group A according to Vithoulkas scale of health.

Selection of symptoms:

This case has very few symptoms to grab on, besides the actual symptoms of the main ailment.

Peculiar symptoms : 
She is a stubborn (obstinate)
Lupus itself could be considered a peculiar symptom
It gets worse in the afternoon

Intense symptoms : 
The actual symptoms of the lupus can be described and considered intense. 


Repertorisation:

Differentiation of the remedies:

Prescription with potency:

Lycopodium seems to be the best remedy but due to the fact there are not so many keynotes and that there is a possibility of a vaccinosis syndrome, I decided to first try Dr Tinus Smits protocol (for more information on the subject follow the link) and only then, according to how the symptoms change, I will decide how to proceed. This will allow me to understand if it is a case of vaccinosis and if so, confirm the use of the protocol. A heavy vaccination protocol like the one Thai has undergone can be a burden to the immune system and this does not allow the patient to show us a clear picture of the remedy. She started the protocol the same day of the consult  on the 15th January 2014.


Follow up 1 : 17th February 2014

Reaction to the prescription : She is almost completely cured, she has been eating grass and vomiting since she started with the protocol, has some muscle pain instead of articular pain, before she started the protocol. Still has some pruritus in the anus.
Analysis of the reaction : This is a very good reaction. The rheumatic pain has been pushed superficially to the muscles, the new gastrointestinal symptom shows that Thai is "cleansing".      
Conclusion : The use of this protocol permits to clear the symptoms, sometimes even cure the whole ailment but only time will tell. If the predisposition needs to be dealt with in the future, at that time treating it with a classical approach might be more efficient since the immune system has been cleared of the vaccinosis and only the predisposition of the patient remains.
Prescription to the follow up : Since Thai is still vomiting, according to the protocol we will follow the last potency of the Isotherapeutic remedy (also called a Tautode).

Follow up 2 : 19th March 2014

Reaction to the prescription : She is no longer taking any medication and has developed symptoms of Lupus on the tip of the nose. It has been two weeks since she stopped the Isotherapeutic remedy because she no longer vomited.

Analysis of the reaction : The Isotherapeutic remedy has exhausted its action, it is now time to retake the case and analyse how to proceed with a Classical approach.     

Conclusion : After analyzing the case all the symptoms remained just the intensity has ameliorated, therefore I decided upon the remedy that best fitted her mental state and also included the physical ailment.

Prescription to the follow up : Lycopodium 15CH twice a week. I decided not to go higher because this is a very sensitive patient, she reacts quickly to medication (Homeopathic or Allopathic) therefore I did not want to shake excessively the immune system, there is always time to raise the potency.

Follow up 3 : 22nd April 2014

Reaction to the prescription : She is completely cured!   

Conclusion : The use of Dr Tinus Smits protocol before a classical approach to patient that might be suffering from vaccinosis autoimmune ailments is clearly helpful.

Prescription to the follow up : No more prescrition.

Follow up 4 : 25th May 2014

Thai is still doing very well, with no medication, and there has been no relapse whatsoever. Will keep you posted for the next years to come if anything changes.

Follow up 5 : 18th May 2015

Thai came in for a general check up, it had been a year since the last visit. She is doing perfectly well, I decided to do a Vaccicheck test to screen her vaccine titers and she revealed to have good titers. No medications were suggested. 

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.