Question Details
Pruritis In A Dog
by Augerdvm - October 8, 2014    View Case Report
Jazz is a 9.5yo Pitbull/Lax X presented for atopic dermatitis, Pruritus and Increased aggression on Vanectyl-P
This dog was originally a rescue. Has been on/off Van-P for 8 years. Received a set of vaccines @ rescue then repeated shortly afterwards. Skin issues seemed to have started on from that point. Affecting primarily armpits and upper half of body. Relatively intense Pruritus. Skin issues resolved promptly with Vanectyl-P however dog become more aggressive on this med even at lower doses. If owner stops meds the Pruritus returns. Dog has even bitten owner when she reacted to a spider. Dog is very dog aggressive.

Previous Medical Problems: (please attempt to list from newest to oldest if possible)

Recent bloods show increased BUN/Creat/AlkP
Was allergy tested (serology) – positive to Corn, Rice, Oatmeal, Soybean and various weeds.



Current Medications (including dose/frequency/effect) : N/A
1. Vanectyl-P – owner has stopped since bit girlfriend

2. Banadryl—minimal effective

3. Cortisoothe Shampoo

Current Supplements (including Vitamins and Arthritis products): N/A
1. None

Current Diet (Brand, Amount, Frequency, Wet/Dry) :

Orijen 6 fish


1. Appetite Increased
Weight Change : About same

2. Thirst About the same

3. Stool About the same occ Diarrhea(soft)

4. Vomiting No

5. Stomach Noise Yes

6. Gas/ Burping No Halitosis (Bad Breath) No

7. Sneezing Yes occ fits Any discharge? No
8. Coughing No

9. Panting Increased esp after exercise

10. Urination About the same concentrated clear/yellow

11. Sleeping About the same

12. Sleeps through the night? Yes

13. Dreams when sleeping? Yes, occasionally

14. Restless during the day? Yes always “on alert”
Restless at night? No _______

15. Energy level (overall) Increased

16. Energy level better at any particular time of day? No

17. My pet prefers Cool places or weather and Hard surface

18. Pain: No

19. Skin : Smelly / Itchy / Localized thorax, axilla & feet

20. Pick one of these 5 descriptions that best describes your pet’s personality :

??Dominant, very active, moves fast, competitive, stubborn, gets mad when he doesn’t get his way, barks at strangers.
??Excitable, hard to calm down, likes to be center of attention, mischievous, wags tail when greeting strangers.



EXAMINATION FORM


Constitution: Fire

Shen: Disturbance -- increased aggression, restless, high prey drive


Tongue

Color: Red
Coat: Thin
Moisture: Normal
Size: wide/Swollen/Thick

Pulse:
Depth: Superficial
Rate : Fast Forceful
Quality : toned bounding
Weaker slightly on RIGHT (Qi/ Yang)


Active Points on Palpation

_XX__BL-20 _XX__ LIV-13
_XX __BL-23

Ears, Head and thorax felt hot to touch, feet warm. thickened skin to axillae with moist (non exudative) skin. Could sense distinct cooler areas over TL area (BL20-23). Most sensitive on LIV13 would turn and growl

Am suspecting underlying Spllen deficiency with damp/damp heat but there was so much heat on this dog ( suspect heat was causing shen disturbance) that I've started the dog on Qing Ying Tang and plan to reassess him in 2 weeks.

Your thoughts would be greatly appreciated as always Steve


Daren
Replies
by naturevet
October 13, 2014
Hi Daren,

Your plan makes sense to me. In addition, or instead, you could pair Long Dan Xie Gan Tang (or Long Dan Er Miao San) with QYT, or with Chai Hu Jia Long Gu Mu Li Tang, or both. These two formulas pop into my mind when the pulse is superficial and bounding, with the patient being decidedly hot, and where there is a clear need for immune modulation. CHJLGMLT addresses immune modulation, while both LDXGT/LDEMS and CHJLGMLT address manic and aggressive behavior.

I doubt you'll see a worsening with QYT, but if you don't seen an acceptable level of improvement, I'd probably add both formulas

Steve
by Augerdvm
October 21, 2014
Just added in an update on this case under the update link but it doesn't seem to register on the forum.

Rechecked after 2 weeks:
owner noted improvement in pruritus. and is now only requiring 25% of original Van-P dose.
appetite increased and drinking less.
owner notes more moist skin in axilla and groin
stools slightly softer but well formed
behavior better towards owner's girlfriend

on exam:
Tongue: thin, wide, lavender-pink, moist
Pulse: strong but not bounding, toned, mid-ranged, slightly rapid
Heat still palpable on top of head but better
no active points noted. no reaction to Liv14
no resentment to cranial abdominal palpation.

Assessment: improved from heat standpoint but more damp/damp-heat signs showing up

Plans:
Added LDEMS (Damp Heat Derma Relief) to the QYT (Cool the Blood) until next recheck in 2 weeks.
by naturevet
October 21, 2014
Hi Daren,

No update was actually made to the case itself. Do you mind doing that? It appears you may not have hit 'enter' when you listed the treatments used and the outcomes

Steve
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