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Chronic Dermatitis In A Dog

by CorinneC - February 3, 2019 View Case Report

Raffi is a 9yo MN Vizsla with a history of chronic pink itchy skin on his belly and feet. He was originally diagnosed with dust mite allergies years ago. He has tried sublingual dust mite allergy trial as well as many course of antibiotics and steroids. The sublingual treatment did very little in the way of improvement and abx and steroids help him but never resolve his skin issues. He was eventually put on Atopica which he has been maintained on for the last 4 years. The owner came in seeking a more holistic option. He just switched to a good quality raw diet 3 mth ago and owner noticed his energy and coat improve but no change wrt skin.

He has a tendency to eat clay soil and mud.

Raffi has moderate toned to slippery pulses and a ruddy pink, wet, flabby and centrally swollen tongue. Both of his outer pinnae have white "freckling" or spots, subtle periocular alopecia, and his entire inguinal region is erythematous (bright pink), and skin is rough/thickened and hairless. All 4 feet have minor alopecia on tops of all toes.

I diagnosed him with Damp Heat due to chronic Liver Blood deficiency and Spleen Qi deficiency. I gave him Si Miao San 1 tsp BID to start with but was contemplating adding Dang Gui to treat the Liver Blood as well.

After 3 weeks on SMS his belly turned beet red and the owner stopped giving the herbs :( I'd love your take on this Steve as I'd really like to help Raffi. He's such a sweet boy and I hate the thought of Atopica lifelong.

by naturevet

February 5, 2019

Hi Corinne,

If SMS didn't help, and made things worse, then we know we need some sort of dispersing treatment.

We can rule out CSWLT and other anti-Dampness formulas as a strategy, because of the lack of response to an unprocessed diet

That leaves us with the following differentials: Wei Qi deficiency, a Shao Yang disharmony, or a pure Blood deficiency. Blood deficiency can actually occur with either, or at least is commonly addressed at the same time, so we can just try to figure out if either of the first two are present

If antibiotics alone helped, we would know to use a Wei Qi tonic of some type, most likely Bu Yang Huan Wu Tang. It may be useful to try that if his skin is currently broken out still - just use Cephalexin or something and see what happens

If TB- or GB-related points (e.g. BL 19, GB 25, GB 34, BL 22) aided the pulse, you'd know to try Xiao Chai Hu Tang. Often, you need to use Si Wu Tang at the same time, but with a robust pulse, you could try it alone first.

We can pretty much rule out SWXFY and QYT on the basis of pulse - the former being either thin and taut, or floating; and the latter being deep, hard, full and toned.

Hopefully that helps. It would be highly convenient if both dogs in the same household needed the same thing!

Let us know if we can help further

Steve

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