Hi All!
Snoopy: I think it is important to clarify that this appears to be a very sensitive cat in that ALL the remedies she has been given has effected her in someway. Perhaps I am moving on too quickly though (I have to remember that she didn't get into this condition overnight!)
David: Thanks for the info; I did consult my MM (Clarke) and China-Ars description was short but to me appeared to pull symptoms from both china and ars that still fit the picture of this cat, have I got that right?
Dr. Leela: there was a mix-up at the apothocare and the China-ars won't arrive until today so...
Dr.B: I did give Apis 30c and it did have a favourable effect in that it seems to have started the flow of urine and produced some thirst in the cat (return of symptoms consistant with kidney failure?). She did not eat much at all yesterday though and the Apis has not aided her appetite either. However she did not have any diarhea last night and actually slept (the Apis seems to have taken the restlessness out of her as well!). However, this morning she did have another bout of diarhea, but no more vomiting and of course no interest in her food either.
So to all:
* brn watery diarhea (mostly in mornings)
* little to moderate thirst
* little to no appetite (has become worse over the last 36 hours)
* large amount of urine at one time (need to qualify that she is receiving subQ fluids which will obviously increase urine flow and produce more watery urine; however I believe it important to note that it has increased even though her subQ fluid replacement is still in the same amounts or a little less which before the Apis only produced a very small amount of urine)
* emaciated, skin and bones, concave abdomin
* eyes sunken in and dark, excess skin hangs around face (under eyes)
* mouth pink and wet in a normal way
*anus looking slightly enlarged and sore, is no longer dribbling stool (able to hold it until in the litter box)
* coat and skin soft and unblemished
* active but no longer restless
What do you think? Should I let the Apis have a little more time or should I go with the China-ars (even though the Apis appears to have changed her symptoms?)Thanks to everyone for your input!

If Apis has produced such good results and has altered the symptoms this much, then I think china-ars will not fit the bill now, as it came up on the basis of previous symptoms. I would suggest you move up the potency ladder, give her a dose of Apis 200c.

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Dr. B<br /><br /><a href="http://www.doctorbhatia.com" target="_blank">www.DoctorBhatia.com</a><br /><br /><a href="http://www.hpathy.com" target="_blank">www.Hpathy.com</a><br />Homeopathy for Everyone

That sounds like a good idea!

Dr. Leela--you're right, I wouldn't have waited too long to see if carbo veg was going to have an impact on the pathology. If only the mentals were affected by the remedy with no action on physicals, I would have had to leave it. It's true that often in physical pathology, we persist in taking a constitutional case when what we really need is a remedy for the diarrhea or retention of urine or bone pain, or whatever serious condition exists.

Looks like Dr. B makes another good call!

Snoopy

And I would say too: Look how important it is to know the pathology! To know the diagnosis; to know which organ is failing, which system is failing; because in the end, Dr. B chose the remedy known for kidney failure, though the others had similar symptoms. Knowing which remedy will "cause" the pathology
the patient has is all-important.

Snoopy

DavidJK thanks for sharing your experience. It is wonderful and informative.

Would you like to comment on your good healthy and resulting statement that you covered malerial patient with calc phos by keeping two different remedies aspect. Very interesting!

On which symptom of your patient you prescribed calc phos and got result.

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<b><a href="mailto:drsalim@inbox.com.pk">drsalim@inbox.c om.pk</a></b>

Well I'm still going to differ with Dr. B.
My impression is that the Apis has had only a partial effect - on the problem the dehydration has caused to the kidneys.
In all probability its a good interim prescription - sort of a HEring's Law of remedy need, treat the last produced symptom first - if you see what I mean.

BUT obviously the Apis has not been able to deal with the main pathology which is the prolonged diorrhea and loss of appetite and thirst which has cause the dehydration in the first place. The vomiting was not in the chief complaint originally, it came up after the Carbo Veg which was also only a partial remedy.

See Snoopy, the kidney failure was a result of the chief complaint not the cause of it.
I still think the China Ars is indicated. I don't think this is a shift of sympotms that rules out China Ars. I still see the same sympotms of the chief complaint.

Anyway this is just my opinion.
Hope it helps.
Warm regards,
doctorleela

PS; Kkrista, you'll find a COMPLETE description of China Ars with all the symptoms of your chief complaint in Clarke. All the best!

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Oh...! You're saying the kidney failure is a result of whatever is wrong.

I thought krista said that the thirst came back, urination came back, and the diarrhea stopped--at least for a while. Hmmm.

Well, I'll certainly be following this with interest!

Snoopy

PS; I'd prefer to wait for the China Ars till the complete action of the Apis 30 is over, to see what's left. MAybe another 24 hours at the most?

I was thinking about it again - there is a chicken and egg situation here in a sense, as no one saw the cat when things were starting.

So revise my opinion slightly - I think Apis was a very good suggestion from Dr. B.

[ 27. July 2002, 17:47: Message edited by: doctorleela ]

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There is one other remedy I might consider, which is Tub.

I have treated alot of people with HIV/AIDS, and this cat sounds like some of the cases I have seen. The three remedies I have found to be most useful to stop this decline are Ars, China, and Tub.

There is a rubric, Emaciation with Diarrhoea - Carc and Tub as the only listed remedies.

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David Kempson.<br />Dip.Homoeopathic Medicine.<br />Lecturer Australian College of Natural Therapies (Brisbane Campus)<br />Member AHA, AROH, HMA<br />Member Australian Homoeopathic Association. Member#0442.

Quite a discussion while I was gone. Because I was taking a holiday weekend (ah I can still feel the sand and hear the rush of the waves...) I decided not to go up to 200 with the Apis when I wasn't around to watch her. I will try to address some of which has been written.
Firstly it is important to note that "kidney failure" was suspected but not confirmed by testing (unfortunatly we really can't justify spending big bucks on older animals whose placement is questionable when so many younger animals with long lives ahead of them also require our help). Renal failure seems to be very common in cats these days (hello-diet!) and I will always suspect it in older animals,that are dehydrated, nauseaus and having diarhea. I believe this is the case with this cat. When kidney failure has gone on untreated in cats, eventually the kidneys just stop, toxins build up in the bloodstream and cause the nausea and diarhea -I guess the argument could be made that the Apis has caused the symptoms, but given my experience I do believe that it has brought back old symptoms.
I had someone looking after the cat over the weekend and they reported that she did eat reasonably well on her own (only needed force feeding to start her eating), and the stool, although still diarhea was less frequent (urine and thirst cosistant). I had loaded her up with subQs on Friday night before I left and that held her until Sunday evening. Her fluid absorbtion is still quite slow and it will pool in her legs (making them look swollen, but its fluid) and eventually be absorbed. This tells me that her circulation is not great, but she is older and toxins from the kidney failure may have affected her circulatory system /heart as well. Overnight I noticed that her stool is a little less watery than before the weekend and a consistant brown colour (thickening slightly). Her NRG has improved (she is jumping on everything!). I think there has been significant improvement to warrant Apis 200c rather than start with China-ars or consider tub or calc, but this case got too complicated for me days ago, what should I do,is it too soon for 200 Apis, any recommendations? A sincere thanks to all for your your past and future imput.

[ 29. July 2002, 17:18: Message edited by: kkrista ]