I have had felt confident in the western/tcm approach on many derm cases in the past. I use the Manual of Nat Vet Med. However, this case is tough for me. Much of the information I have is second hand from the owner and past veterinary experiences.
Bailey is a 9 year-old hound mix. She presented to me for help with lichenification of her perineum. At that time, very few other dermatiological problems were noted.
Bacterial otitis externa is the most significant dermatological problemin her history. It began at 1 year old. Pred and Otomax resolved symtoms temporarily many times. The ears are worse in the Spring and Fall. At that time they are swollen, hyperpigmented, malodorous, and have a moist discharge. She also licks her paws and genitals and reacts to vaccines. The owner had tried Salmon and Sweet Pot and also Kangaroo and Oats trials with unclear results.
In 2005 her adventure with a vet school began. She was seen for her ears. They put her on all the anti's (bacterial, fungal, inflammtory) and she looked better. Soon thereafter a CAT scan was performed to image her middle ears. A TECA was considered. However, her stomach bloated and turned after the anesthesia and she had a gastropexy. Then, after that surgery, her esophagus ulcerated and eventually strictured. She had a peg tube and difficult time living for several months. Eventually, the owners were able to keep her at a BCS of 2/9 with a gruel feeding. The regurge of slimy clear liquid is worse now. It is a major player for the dog and owner again. She seems to hold food down, but vomits water. The owner keeps explaining that it is like a mucous plug needs to be vomited, then she can hold water down after that. She sounds phlegmy and raspy in her pharyngeal region now. Her pulse is rapid, floating and forceful in my best assessment. Her tongue is a pale lavendar with maybe a slight whitish coating.
I finally assesed her as having damp heat secondary to a spleen deficiency and just began treatment with modified long dan xie gan tang and sp9, cv3, bl25, gb41, gv14, li11, and liv13.
Any suggestions would be very appreciated. I am happy to pay a consultation fee.
Thanks in advance.
Perrin Heartway, DVM