Signalment

• Species: dog

Disease Notes

• Certainty: confirmed
• Final Status:

Treatment and Outcome

Problem Notes

• Chronic Puritis: Linna is a 2.5 year old female spayed Presa Canario who resides in Ontario and presented as a second opinion on the use of Chinese herbs for her allergies. As per her owner she has been itchy since her owner purchased her at 12.5 weeks of age. Linna was the only surviving puppy after a c-section and was hand raised with minimal socialization. She has only been vaccinated for parvovirus as a puppy.
  
  Linna has been itchy since her owners got her particularly around her neck/face/axilla/feet/lower abdomen and inner thighs. She was seen as a puppy by a dermatologist –skin scrapes negative. Intra dermal testing positive- dust, sheep epithelia, grass, malassesia and nettle. Had one dose of Revolution for possible sacroptic mange but owner did not repeat treatment as there was no improvement was seen after the one dose .
  Owner reports as a puppy Linna’s skin was hot/dry/flaky around neck/face/axilla, feet and thighs and that she was restless, anxious and barked a lot.
  
  Owner took Linna to a homeopath and found no improvement after a number of homeopathic treatments.
  
  Last fall while living in BC Linna was seen by an alternative veterinarian and owner had a good response to Si Wu Xiao Feng Yin with Si Wu Tang added. Some chewing on her feet returned when prednisone was discontinued but Yin Chaio was added and the pruritus resolved again. Owner had a 3 month period where Linna did not require prednisone. However, owners then moved from BC to ON in Nov and a month later the itchiness returned. Linna was then seen by another local veterinarian and started on Wind Toxin and Qing Ying Tang however her owner reports that this also did not help with the itching so it was discontinued.
  
  Owner restarted Si Wu Xiao Feng Yin/Si Wu Tang the end of July this year and reports some improvement in her itching.
  Diet- raw beef/turkey and duck along with some dark greens.
  Behavior- reactive, aggressive and difficult to focus. Always on high alert and stressed easily. Displays food aggression and will sometimes attack the other dog in the household.
  Had a heat cycle in May in since then aggression has escalated towards people including all members of the family - (in particular the husband).
  
  On examination
  Hair coat-fine dander throughout her hair coat
  Tongue lavender
  Pulse was thin and weak.
  Feet warm
  
  Linna recently had a laprascopic overioectomy. Her bloodwork revealed the following changes. ALT 153 (RR 18-121) and ALP 319 (RR 5-150).
  I initially started Linna on Xiao Yao San to address her aggression however her owner discontinued it after a couple of days as she reported it caused diarrhea.
  Linna allergies are now getting worse (itchier) and she is back on a low dose of prednisone to which she responds very well to. Her owner however really does not want to use any conventional medication. I was wondering if Long Dan Er Miao San would be a reasonable choice to try? Or would you have another suggestion.