Question Details
Allergies And Vomiting In A Dog
by CorinneC - April 10, 2019    View Case Report
Grimm is a 5yo German Shepherd with the most lovely personality! Gentle, calm, and kind with everyone. He came to me last August for chronic allergies (started at 6mo) and vomiting blood. His owner was using Prednisone sparingly when his allergies flared but he was not on Pred for 1 week at our exam. He had just been in an intense agility trial with lots of travel so I suspect this bloody vomit was secondary to stress and anxiety. He was fed a good quality raw diet (lamb and turkey then), high doses of salmon oil, excellent appetite, but history of loud and frequent borborigmy. When he is having a vomiting episode he tries to eat lots of grass. They typically occur at night and he usually only vomits bile. Sucralfate has been the only medication to stop this vomiting.

*at 6mo tentatively diagnosed with panosteitis, put on Deramaxx and proceeded to vomit blood. O says this is when allergies began.

**at 1yo he was diagnosed with Pseudomonas infection along his dorsal spine (extremely painful, 1.5-inch think crusts, lateral sides looked like raw hamburger according to owner).

His present allergies are composed of acute flare-ups of red and itchy ears that progress to hairloss at ear tips from his incessant scratching. He also rubs his face, scratches at sides of chest and abdomen, has lower energy, wakes up whining and then proceeds to scratching (appears uncomfortable). Prednisone makes the skin way better in a couple days (so need to decrease Heat and tonify Yin), sublingual serum was tried to no effect, and he appears to be sensitive to chicken, beef, and pollen. Allergies are worse in Spring and Fall. He is not temperature sensitive, nor does he have vivid dreams.

On exam he "looks" healthy. Overtly full coat with a very slight greasy texture. He has thin fur around both pinnae tips, mild erythema, minor tiny flakey scabs. His dorsum crawls a bit when scratched, found a few dry scabs. His pulses are deficient for such a big guy, tongue dark pink, wet. Interestingly, his penis hangs out ALL THE TIME. O says this has always "been a thing" (I initially thought SP qi sinking but now I'm wondering about a Shaoyang disharmony - hopefully makes sense to you too as case unfolds).

I started him on Si Wu Xiao Feng Yin for skin relief, to tonify Liver Blood and resolve Wind Invasion. He ended up getting more itchy on SWXFY and the vomiting increased. Reconsidered my strategy (I was just starting the CIVT grad course in skin, GIT, etc) and put him on Yi Guan Jian to tonify Kidney and Liver Yin and Liver Qi, stopped SWXFY. In the midst of all of this o started on Pepcid AC BID. Ears started to improve but vomiting bile persisted off and on. Owner stopped herbs in December as became increasingly itchy again and started feeding him turkey necks when belly gurgling increased, seemed to help.

Recheck with me April 8/19: just had skin flare-up 3-4 weeks (ears look flea-bitten, dry scabs on dorsum, coat otherwise healthy-looking if not a little dry. On Pred and within 2 days, signs much reduced. Pulses are still deficient and now narrow to me, tongue is dark pink/red, central lavender area, flabby, wet.

I'm not sure where I'm going wrong here? The SWXFY seemed to fit the skin perfectly but he reacted. The Yi Guan Jian seemed to fit the GIT signs but no real improvement. Please share your wisdom!!!

Thanks you,
Corinne
Replies
by naturevet
April 12, 2019
Hi Corinne,

I see the Stomach Yin deficiency, and Shao Yang disharmony is often cause, because if the Shao Yang gate isn't working, it traps Heat in the Yang Ming

I'm not sure why SWXFY was so aggravating, though, but YGJ was good call. Since the Shao Yang is likely the ultimate cause of problems you may see more benefits once you add in Xiao Chai Hu Tang

Other signs and symptoms that fit a Shao Yang disorder:

  • Spring and fall aggravations

  • Yang Ming channels are the most inflamed

  • Stasis tongue

  • Weak pulses (in cases where there is accompanying Blood and Yin deficiency)

  • Immediate Improvement with pred

  • Lack of improvement or resolution on raw diets



Hopefully you will see an improvement with XCHT. Continue the YGJ while trying it, or use a 2:1 mix of Xiao Chai Hu Tang to Si Wu Tang if you're not going to continue the YGJ

Please let us know how it all goes!

Steve
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