Last week I was consulted for a 4th opinion on a 5 year old F/S Maltese with a 2 1/2 year history of chronic draining tract. It started out as a lump on her jaw, that was not responsive to antibiotics and steroids. It was surgically explored and found to have bone involvement, biopsy sent out came back as chronic suppurative inflammation with reactive bone. The lump returned and was again surgically explored, and this time the bone was curetted and cauterized with a silver nitrate stick, because the vet thought it might be a bone cyst. A pinpoint, open, draining sore has remained ever since, with an initially purulent, now clear discharge, which dries to form a dark scab over the hole. Bacterial culture and senstivity done at the second surgery was negative, but a subsequent one done on the discharge, was positive for Pseudomonas aeroginosa. A follow-up culture the next month was negative, but she was still on antibiotics. She has been on about 5 different classes of antibiotics, with the last round being zeniquin (fluoroquinolone) followed by azithromycin, for a total of about 3 months. The lesion improves while on antibiotics, then returns. It is currently under the chin, between the mandibles, I cannot palpate any obvious connection to the bone, but suspect either osteomyelitis, a bone sequestrum, or nidus of some kind. The herbal formula that I thought might fit is Xian Fang Huo Ming Yin. Do people think this or another formula could resolve this condition, or is a third exploratory surgery indicated? Dental radiographs were discussed with the clients, but they so far have declined them due to cost. The dog's teeth all look fine externally. She is a sweet dog, not aggressive, tends to be timid, variable appetite, tongue pink, pulses slightly rapid, slightly soft.
Thanks for any input anyone might have!
Pam