Question Details
Lick Granuloma In A Dog
by pindvm - February 18, 2021    View Case Report
Julius is a 7y 11 mo, MN, old Cattle dogX who developed a lick granuloma on Dorsal LH metatarsus in March 2020. Since then he has seen 2 DVMs, and one dermatologist. Currently finishing 4th round of antibiotics, daily topical synoptic and mupuricin, trazodone and gabapentin orally. The wound is covered in a DogLegg (which he has already destroyed once). He becomes frantic to chew it whenever DogLegg is off. Trazadone helped, Gabapentin didn't seem to. One upper wound has healed. lower is about 1cmx 2cmx0.5cm raised, grayish pink. O says it is significantly smaller than when they started with the Dermatology specialist. The put him on Purina HA (hydrolyzed) diet. He is walked 45-60 min a day. BCS 4/9. Rest of his coat is shiny. He has seasonal (spring) allergies - mild itching and runny eyes. Owners cannot trim nails. Normal stool, great appetite. Mild separation anxiety. Exam - BARH, calm and friendly, water personality, watches o closely, 2/6 lame LH, tight T5-S1 and L ilium. Didn't like flexion and extension of feet. Tongue pink, moist, Pulse L -1,-3, -2, R -2,-3,-3. Rate WNL, slightly tight on R. Coat shiny, no scale, pads soft. DX - mild Shen Disturbance, Qi stagnation, ?Blood stagnation. TX - Osteo mobilized lower back, worked legs and feet, removed dogleg and he went wild trying to get to the area. Had owners hold him and did surround the Dragon around the wound, and Liv 3. He tried to eat needles so I pulled them and replaced DogLegg. He was fine once it was on. I will try I'm on Xiao Yao San to support blood and liver and because his pulses responded to Liv 3 and Mushrooms to get his immune system working. Not sure what to do for the wound. Its not really hot and angry or cold and non healing. He's not really Damp or hot or cold. I worked with them on behavior ( he seemed to be using chewing for attention) and added working games to wear him out more. Any other herbal suggestions? Im thinking the Yang suppression is due to the drugs. I will also start testing foods and try to get him off HA ASAP.
Replies
by naturevet
February 19, 2021
Hi Deb,

I would try Modified Xue Fu Zhu Yu Tang for this dog. It is a Blood and Liver Qi mover, yet has the turmeric in hit to reduce inflammation. It is also a Blood tonic, which might help the dog's Shen, anxiety and obsession with the area.

To support the mXFZYT, I would also use Xiao Chai Hu Tang at the same time. It will further reduce the stress the animal is experiencing, and enhance the flow of blood to the lesion that the mXFZYT is promoting, so the problem can be actively resolved.

Lastly, I would wonder about applying some topical essential oils. I find them very useful for drawing out infections (which almost always are inside these granulomas) as well as breaking down the granuloma itself (since they function as topical blood movers). In Canada we use a product called Cothivet. It's ingredients include the following, in case you want to make your own mixture: Centella asiatica mother tincture 89.50%; Lavender officinalis natural essential oil; Rosemary officinalis natural essential oil; Aesculus hippocastanum mother tincture; Thyme officinalis natural essential oil; Cypress officinalis essential oil; Medicago sativa mother tincture

Try some or all of those topically while using the herbs orally. Alternatively, you can take Xian Fang Huo Ming Yin granules and mix 10g or so in a few ounces of ointment, and apply it topically. Try to use a Calendula-based salve, since it will help to break down the induration. Apply it once or twice a day.

Hopefully after just a few days to a week of this approach, the lesion will look dramatically better. Let us know how it goes!

Steve
by pindvm
February 25, 2021
Hi Steve -

I contacted the owners and I guess he's doing really well on the mushrooms and Xiao Yao San. It is healing very rapidly according to them, but he is still frantic to get to it which makes me think the problem is still there. He also got frantic in a Wind storm so Blood is probably an issue. I'm going to give them a couple of weeks then recheck. We can't get the Cothivet but they do have DermaGel. Ingredients are similar Water, Alcohol, Propylene Glycol, Sorbus (Pyrus Sorbus) Extract, Glycerin, Hydrocotyle (Centella Asiatica) Extract, Calendula Officinalis Extract, Hydrogenated Castor Oil, Sodium Bicarbonate, Sweet Marjoram (Origanum Majorana) Extract, Lavender (Lavandula Angustifolia) Extract, Thyme (Thymus Vulgaris) Extract, Sage (Salvia Officinalis) Extract. Not as clean as yours. it comes as a spray or a gel. If its not healing I may try that and switch the herbs.

Thanks for all the help!

Deb
by naturevet
February 25, 2021
Sounds good. Try the Dermagel and keep going!

Steve
by pindvm
March 21, 2021
Julius is doing much better on Xiao Chi Hu and Xue Fu Zhu you tang. Brace has been removed after it caused a bad wound under it and he chewed a new wound below it. Both dog and owners are much calmer and happier. Training continues with all positive. Topical DermaGel and herbs have all wounds starting to heal. He mostly leaves wounds alone without restraint. Continuing herbs and topical.
by pindvm
April 7, 2021
O called. They have a visitor this week and Julius is licking more. Discussed keeping his schedule and adding more training and walks with the visitor. Wondering if I should have him on a Kidney tonic too? He is a Water personality. He has responded well to herbs and training. Hate acupuncture and is usually worse after.
by pindvm
April 14, 2021
Julius is stalled in improvements. Still has open wound - though healthy looking granulation tissue. Just not closing. He is licking a bit. Was nervous with having visitors and one owner traveling during the last 10 days. Pulse weakest SP/ST no points seemed to change it. Having owner start testing foods this month to try to get him off HA. Continued XCHT and mXFZYT.
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