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Atopic Dermatitis In A Westie

by JULIE SCHELL - June 8, 2009

Hello, I have been treating a 3 year old male neutered Westie for atopy. We performed full skin/ blood / urine work up, etc and allergy testing. He's allergic to several foods and environmental products so he is on home made diet (based on www.petdiets.com) and allergy serum injections. He's a Damp Heat dog (smelly, itchy, yeast/ cocci dermatitis, pachydermatitis, erythemia and hyperpigmentation on groin and sides and axilla). I'm using acupuncture and herb formulas including Si Miao San, Qing Yin Tang and Nettles Tincture as well as Western medicine including Cerenia injection (injectable Cephalexin-type antibiotic), probiotics and Ketoconazole. I've even had him on chlorpheniramine as an anti-histamine. The antibiotics and ketocondazole work well and he improves, however as soon as he is finished them he starts to itch again. he's been on 5 weeks now of cephalexin. He's coming today for another recheck, but I assume he is still Damp Heat and maybe Wind because he is itchy and red and smelly and losing fur. He has been on prednisone from his original vet but we have weaned him off of this 2 months ago once he saw me for referral. He gets weekly bathings and we've even tried 'Gold Bond' topically in his axilla to help decrease the heat and dampness. We've tried him on Atopica (oral cyclosporin) but he cannot tolerate it because he becomes aggressive. He cannot tolerate prednisone because it made him fat and cranky. For acupuncture I've been doing heat and dampness clearing points (esp ST36, Sp6, Gv20, GV4, etc). We have only done acupuncture about 3 times, 1 month apart. What types of herb formulas do you recommend at this time? Thank you very much! Julie

by naturevet

June 8, 2009

Hi Julie,

If the dog is on Qing Ying Tang, it may be keeping him a little on the Damp side. An aggravation with cyclosporine is something we would expect to see in Damp animals.

If you're sure he's Damp, he may do better on modified Long Dan Xie Gan Tang, which includes half of Si Miao San, a couple of Blood movers and coolers, and some herbs to dispel Wind Damp. If the pulse is superficial and the paws are hot, this is a way to go.

If the pulse is deep, then San Ren Tang might be a better choice. Also, if there is ANY aggravation from antibiotics or ketoconazole (e.g. loss of appetite or loose stools), then modified Wei Ling Tang is a better choice.

Generally Damp animals with skin problems respond to one of these three formulas.

Hope that helps,

Steve

by JULIE SCHELL

June 8, 2009

Thank you Steve. He is definitely hot in his paws with rapid, superficial pulse so I prescribed the Long Dan. I will definitely let you know how he does.
Thank you so much!
Julie

by mikemesley

June 10, 2009

This is pretty much exactly a case we are seeing presently. Initially QYT worked well on him, but he has become more resistant. It looks like some LDXGT may be in order here too!

by JULIE SCHELL

June 10, 2009

Thank you for your insights!
Julie

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