Question Details
Sebaceous Adenitis In A Dog
by CorinneC - February 3, 2019    View Case Report
Zofi is a 2.5yo intact female Vizsla that lives with Raffi!

At 6 months old, Zofi started breaking out in in dry rashes over chest and head. She had blood tests, went to a dermatologist (tried Apoqule, Cytopoint, Atopica but nothing worked to resolve lesions). No actual skin biopsies were ever done but the dermatologist diagnosed tentatively with sebaceous adenitis and put her on Vanectyl-P 1 tab BID which has maintained her since.

On exam Zofi is a lively, sweet girl! Her forehead fur is thin, centrally the skin is dry with scabs. Her dorsal back is diffusely pruritic (ripples when scratched) and produces a fine white powdery dander. Both ear pinnae margins appear flea bitten with patches of alopecia. Her pulses are well toned to taut and her tongue is ruddy red, flabby, wet.

I diagnosed her with Liver Blood deficiency and Wind Invasion and I put her on Si Wu Xiao Feng Yin. Within 3-4 days owner said that Zofi reacted to the herbs and skin flared up so she stopped them. She had also just switched from raw venison to goat as well so she took a break and restarted the herbs 2 weeks later. 3 days later Zofi's skin flared again with intense flaking and itch?!?!

I have recently started her on Qing Ying Tang for Blood Heat and she seemed to improve but owner only took enough for 2 weeks. Se came back in and Zofi looked better skin-wise but now has subtle alopecia/thinning of: fur on chest, OU periocular, medial axillae, nasal planet and inner flanks. Am I on the right track? Or should I be looking at tonifying the Spleen a bit with Xiao Yao San?

Raffi and Zofi are in the same household, so I feel like I've got a double-whammy on my hands if I can't help at least one!

Forever in your debt Steve. Thank you in advance!
Replies
by naturevet
February 5, 2019
Hi Corinne,

If the animal has not responded to an unprocessed diet, then we can rule out most Damp Heat formulas.

The worsening on SWXFY would make me not want to try other Blood tonics. The formula likely pushed a blood supply into a region that was more acutely inflamed than it appeared. QYT has a strong surface cooling effect, so it was able to counter that.

If now you're seeing ventral skin issues instead of dorsal, then it makes me wonder about a Shao Yang disharmony, which regulates the flow of Yang between the regions. Normally we use Si Wu Tang with Xiao Chai Hu Tang to address these problems. It should be safe to do so here, despite the reaction to SWXFY, because XCHT is partly anti-inflammatory, and because QYT has Blood tonics, which were well tolerated

I'd suggest dispensing a small amount of each formula, and giving a half dose of each twice daily. If the Blood tonic approach is too much, we can stop it and continue the XCHT

Another option is to continue the QYT, since it is partly effective and add in the XCHT

Hang in there, and hopefully the owner will, too. I feel like you're close with this one.

Steve
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