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Periocular Dermatitis In A Dog

by jschell - June 22, 2018 View Case Report

Hello, My own dog has some sort of weird and severe peri-ocular skin inflammation, 2 weeks duration includes erythema, crusts and scabs from self excoriation. Normal on blood analysis Awaiting result of culture. Systemic antibiotics, topical prednisolone drops, topical antibiotics (Tobrex) and oral NSAIDs are not helping her. Apoquel started last night and she itches less, but inflammation is still there. I am still awaiting her culture results.
She had Nexgard on June 16 but this started June 13. She gets Heartgard June 1 and the first of each month.

Pulse slightly wiry and thin and improved with BL40 treatment.

I have not done a biopsy yet but I suspect she has some sort of immune reaction. Would Stem Cell Therapy help?

Maybe Xiao Chai Hu Tang or Si Miao San?

Thank you!
Julie

by naturevet

June 22, 2018

Hi Julie,

The response to BL 40 suggests a Wind invasion component. The two winds at this time of year that affect dogs are secondary to either Blood deficiency or Dampness. Do either of those seem likely given her past history? We couldn't rule out Qing Ying Tang either

Generally, periocular dermatitis is either a Shao Yang or Blood deficiency disorder. Qing Ying Tang (which can be considered a Shao Yang formula) would be my first choice given the localized nature of the problem, but the severity of the lesions. Blood deficient dogs will sometimes respond to it, or it will pave the way for them responding to Si Wu Xiao Feng Yin in the future, so I'd be tempted to start there. Let us know how it goes!

Steve

Qing Ying Tang

by jschell

June 23, 2018

Thank you very much Steve! That is a great idea. I started her on Qing Yin Tang tonight. I'll post updates. This is so strange-- it has never happened to her or any of her line before. I've owned dogs in her line for over 20 years.

Thank you!!
Julie

by jschell

June 27, 2018

Good news! She is no longer itchy around her eyes. Her culture/sensitivity results showed Methicillin Resistant Staphy pseudointermedius heavy growth and Pantoea sp moderate growth. Even though I started her on Clavaseptin on June 21, 2018, I noted that she is improving (even though these bacterias were insensitive to Clavaseptin). I started Qing Yin Tang on June 22 and started feeding salmon and sardine home cooked food recipes (Complete and Balanced), which I feel are both contributing to her improvement. Her periocular skin is no longer ree and no more eyelid skin crustiness. Very mild crust is present now . Good improvement.

The question is whether I should change antibiotics and put her on a course of Zeniquin (marbofloxacin) which the bacteria are sensitive to.

Definitely improvement was seen on the Qing Ying Tang and salon/sardine recipes, but I want to be sure that she cures. I'll for sure continue diet but am wondering about starting Zeniquin as well.

Thank you!
Julie

by naturevet

June 27, 2018

Hi Julie,

There are antibiotic effects in QYT, so maybe the current protocol will be enough? It certainly could be. So whatever drug is well tolerated should work fine, if the culture says there is sensitivity to it.

I'm glad your dog is feeling better!

Steve

by jschell

June 27, 2018

Thank you so much Steve! I really appreciate your help! I'll definitely post updates.

The dermatologist feels maybe there is or was underlying Demodex, even though her scraping was negative, and she was on Nexgard. I really did not want to do a skin biopsy if I didn't have to because the lesions iwere so close to the eye I for sure could have caused eyelid deformity.

No matter what, I am sure the new tonifying diet, herbs, acupuncture will help prevent recurrence.
Thank you again!
Julie

by naturevet

June 28, 2018

QYT can aid Demodex, so it just reinforces our decisions

S

by jschell

June 28, 2018

Yes!!! So true! Awesome! Herbs are amazing!
Julie

by jschell

August 4, 2018

Excellent healing. I will continue to monitor well

by jschell

August 22, 2018

Looking great! I discontinued her Qing Yin Tang. Still on home cooked food. Nice to see her improved and cured! Thank you Steve and curedcases.com!!!

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