She has a yeast otitis externa AU and moist erythema on undersides of all 4 feet. She is arthritic and has a good appetite, but sometimes it is decreased. Panting a lot also. The papillomas bother her and cause her to lick them and they bleed. Stiff gettting up and lying down. Enjoys the colder weather. Restless at night and dreams.Only other abnormality is odor to perivulvar region secondary to urine soaked fur. Owner hasn't noticed incontinence though.
Pulse is deep, difficult to feel and weak. Tongue is pale pink and
moist.
Overall I think she has damp heat with spleen qi deficiency. I think SMS would work best for this patient but am wondering if I need to do anything else for the papillomas.
Thanks-
Erica