Question Details
Horrible Skin In A Dog
Dear Steve,

I have a 12 year old, female spayed, Rhodesian Ridgeback mix patient that developed a really bad skin rash when the dog moved from one area to a new part of the San Francisco Bay Area in the spring of 2007. Both locations are similar in terrain, but the new location may be warmer, in general, and possible has more pollution, poorer air quality.
The patient underwent a full work-up including hypoallergenic diet, bloodwork, allergy testing and biopsy. The biopsy was not definitive, but suggestive of possible sebaceous adenitis or SLE. The dog does improve with prednisone. The owners were about to start the allergy shots for 'Susie' when, miraculously, the skin cleared up completely in the fall and winter.
Starting March of 2008, the problem has recurred and is worse and involving nasal planum ulceration, geographic hairloss on trunk and limbs, feet, and pads with scaling, secondary pyoderma, some otitis externa and conjunctivitis.
She is currently on 20 mg pred EOD, cannot decrease dose without marked worsening of the skin. A month's worth of antibiotics helped, but the problem still waxes and wanes without clear overall improvement.

Susie had a combination of dampness and blood def. signs. I have her on a raw Venison food, Tang-kuei and peony, flax oil (doesn't tolerate fish), 10,000 IU Vit A daily, probiotic while on antibiotic, and the pred. Also Pyoben baths. She was on Hill's z/d when she came to me. Owner is using topical green tea when lesions (esp feet) are annoying the dog.

What I find puzzling about this case is how it cleared up last fall, I am hoping it will do so again, but the lesions certainly look more auto-immune than even the most severe cases of atopy I've seen. Have you seen an auto-immune disease triggered by seasonal allergies? What would be the best TCM or holistic approach beyond what I've done.

The dog is fairly sensitive to acupuncture in that she is pooped out for a couple days after a treatment. I've only seen her three times, so far, but have decreased the number of needles and the time they were in place.

Thank you for your thoughts on this unique case.
by naturevet
August 19, 2008
If you're sure about the Blood deficiency signs and the Damp signs, then the formula that addresses these while dealing with more severe skin lesions is Xiao Feng San. For it to be most appropriate, the pulse wojuld have to be quite wiry and forceful. If the green tea substantially relieves discomfort, then it suggests a bitter anti-inflammatory approach is indicated. Xiao Feng San can do that despite being a Blood tonic, but DGSYS is too tonifying. Long Dan Er Miao San (K'an Veterinary Essentials) springs to mind as another alternative for you, but is less blood tonifying.

Spring and summer are the times when Yang is dominant. Fall and Winter is when Yin is dominant. The aggravation during summer suggests a very Yang presentation, again indicating an aggressive cooling approach is needed. Autoimmune diseases in Chinese medicine frequently present as Wind invasions as do allergies, so they aren't as different as they seem, at least from a TCM perspective. If the ventrum has been spared, then a Wind Invasion component is present. XFS and LDEMS both will address this.

Hope this helps you out.

September 27, 2008
Dear Steve,

I re-biopsied this dog and unfortunately, she has Mycosis fungoides. I have seen a couple cases of this recently and should have recognized the possibility. Do you have any gems regarding treatment beyond chemo and safflower oil? Hoxsey? Other Chinese formulas?
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