Hi, my patient is a young, 6 months, female cat with congenital heart disease. U/S report as follows; The echocardiogram shows a smaller left ventricular chamber with left ventricular walls toward the upper limit of normal, moderate right ventricular hypertrophy and mild left atrial size. The changes to the heart are consistent with a pressure overload to the right heart, which is likely due to pulmonary hypertension with the enlarged pulmonary artery segment and marked elevations in the pulmonic insufficiency. The pulmonary hypertension is likely a congenital lesion and idiopathic in origin in a cat of this age but pulmonary thromboembolism may also be playing a role. The changes put the cat at risk for developing exercise intolerance, syncope with exertion or right heart failure in the future and this the may at least contributing to the lack of weight gain. She is Ht Qi deficient but has good shen and appetite with no exercise intolerance, respiratory symptoms (so far). She is on Coenzyme Q10, Reishi, hawthorne supplements. Is there any contraindications of Night Blooming Cereus with pulmonary hypertension? She is scheduled for BP measurement (yes we have very small cuffs for our tiny patients, and very nice for those raptors that are brought in). I wondered if the stem product H&A has might be too stimulating and flower tincture better? Is there a source for a flower tincture? I will also need to let alcohol evaporate and mix with Oat Glycerite for compliance and feline liver function. Will this decrease the effectiveness? Thank you so much from snowy Canada (finally) and apologies for length Sandy

She is on Coenzyme Q10 (the Ubiquinol form works better than Ubiquinone- Co-Q-10) I wondered if the stem product H&A has might be too stimulating and flower tincture better? Probably not, and no I know of no source for the flower tincture Is there a source for a flower tincture? I will also need to let alcohol evaporate and mix with Oat Glycerite for compliance and feline liver function. Will this decrease the effectiveness? No , this should be fine

thank you!