Question Details
Chronic Skin In A Dog
by veerled - November 27, 2014    View Case Report
I have been asked to treat an english bull terrier with an encyclopedia of notes. She is 9 years old, speyed, no other apparent health issues. Very stocky. is on cooked grain free diet. Owner will not contemplate raw. She is currently on low dose prednisolone and immunotherapy. Allergy panel showed environmental allergy to almost anything ( dustmite, etcetera) Lesions are blood filled blisters between toes, around tail, on outside legs, ventrum not to bad. There is definite furunculosis on pressuer point. Recently she went from seeking heat to trying cooler places. High dose steroids makes her crazy. An interdigital cyst is developping though the foot not smelling yeasty and pussy, anti bacterial drying wahs helps settle. She is NOT pruritic at all/ Last month she developed bladder infection which cleared with antibiotics. no excssive moistness anywhere, she is dry and now dry skin lesions appearing on dorsum, crusty. Her tongue is fleshy with no coating and full pink but not purple nor lavender. Pulse strong, not wiry but not lifting massively either. She has tendency for loose stool and this has increased since on essential fattty acids. Behaviour wise she has mellowed. I think SRT or SMS seem to not fit because of lack of bad itch, I am thinking of trying Yian Fang Huo MIng Yin because of the foot lesion, but then this will be way too cooling and so looking at Blood deficinecy but the blood blisters that break open dont match up with that. The cystits looks at Damp heat with SRT and SMS fitting again... so Should I start there after all???
Also I updated an old question. Do I just update it in my question section and then you do get to see that... beacsue update does not appear in forum
Replies
by naturevet
December 9, 2014
Hi there,

First thing to mention, because I tend to forget it myself: if you've tried a lot of therapies and/or the dog is on a 'clean' meat and vegetable diet, yet you've seen no success, remember to try elimination diets to identify possible food allergies. These are rare, I believe, but need to be kept in mind when treatments fail.

Regarding this case, I see something you can try first. Here's my analysis:
- Involvement of the sides and dorsum, as opposed to the abdomen, implies a Heat pathogen invasion, and a need to boost peripheral circulation. So using acute acting formulas like Si Miao San is less indicated
- Blood stasis is suggested by the nature of the lesions, as well as the furunculosis on pressure points, which are classic for the condition in that they are focal and persistent
- Heart Fire is implied by the craziness on pred and the cystitis
- Blood and Yin deficiency is implied by the lack of tongue coating and dry hair coat
- The GI signs in response to essential fatty acids implies a Dampness drying and Heat clearing effect is needed, even as circulation is enhanced, and Blood and Yin are tonified

There's only one formula I know of that fits those criteria: Qing Ying Tang. I'd start with it.

One final thing you can do - some sort of topical astringent for the feet. Look for preparations that contain Horse Chestnut or Witch Hazel in health food stores. You'll find them in the sections with products for hemorrhoids or varicose veins. Use per the product instructions

Hope that helps you out

Steve
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