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Atopy In A Dog

by Dreudog - May 6, 2020 View Case Report

Hi Steve,

This dog is a 6 yr old SF Labrador. I first saw her last fall w/ a history of yr- round pruritus, worst late summer, some in spring/early summer and low grade itch in winter.

That exam:

- a bit shy
- skin and ears have many small pink papules, mild erythema, alopecia ventral neck. Feet OK. Mild seborrhea and odor.
- T: pink, moist
- P: middle, toned

I sent her w/ CHJLGMLT, which she took for several months. T & P (which were kind of unremarkable) reminded unchanged thru winter, and her itch dropped downs expected. Owner declined fresh diet.

March; itch and seborrhea have ^ some. Started Si Miao San.

early April; owner has agreed to start commercial cooked diet.
late April; is on home cooked diet, SMS 3 tabs BID, itch is still ^ w/ spring weather.

We discussed allergy testing and oral desensitization, ramped up her antihistamines to TID, restarted seborrhea mousse, quercitin/nettles.

Not sure what direction to go w/ her now, herb-wise? she looks like a SMS case, eps. late summer. But her pulse and time of worsening aren't a great fit, right?

Thnx,

Cathy

by naturevet

May 8, 2020

Hi Cathy,

A big tip-off for me that a case is a Shao Yang disharmony is when they neck ventrum gets inflamed. Simple Damp Heat rarely does that. I also associate Shao Yang disharmony with the late summer flare-ups, as well as those that occur in spring time. If the homemade diet is meat- and vegetable-based, without a lot of carbs, but isn't helping, that clinches it for me.

So why didn't CHJLGMLT work if that is the case? I find these Shao Yang cases always need concomitant Blood tonification. So I use a 2:1 mix of XCHT and Si Wu Tang to get the ball rolling. I would try that next!

Steve

by Dreudog

May 11, 2020

Thanks, Steve; did not know that aboiut ventral neck lesions. That is away from the BG channel, yes? So what's the relationship?

And then if the Shao Yang cases usually need blood tonifying, when would you use CHJLGMLT in a Shao Yang type case? Maybe when more behavioral issues are present, and then add a blood tonifier also? I'm always nervous about adding those in these clearly damp cases.

:) Cathy

by naturevet

May 13, 2020

Hi Cathy,

The ventral neck redness comes from Yang being bottled up in the Yang Ming channels (the Stomach, in this instance), as a result of an excess in the Shao Yang.

As for when to use CHJLGMLT, I have used it temporarily when the patient is very anxious and the pulse is very superficial, but I do not find a big clinical benefit until a couple of weeks later, when Yang has internalized enough for me to use XCHT. Even then, I haven't found XCHT to work consistently until it is paired with Si Wu Tang. I have noticed a benefit of 'Chai Hu Si Wu Tang' even in cases with lesions we would ordinarily classify as Damp.

Note that XCHT itself is quite an effective formula for anxiety and aggression, so as long as the pulse is internal, you can jump right to its use

Steve

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