I love some help with sweet, gentle Bruno, a 12 year MC German Shepard. His owners have fed him raw and cooked fresh food his entire life...lucky boy.
We live in the Northeast, particularly damp (to be honest, always damp). About 8 months ago, he started to have anal gland issues: very full, not impacted, very loose: more damp with occasional heat.
He presented to me as owner wanted another opinion on anal gland issue and his increasing skin itching.
On initial exam: He is certainly Earth. I think his TCM dx is blood and kidney yin deficiency with low grade damp ( a little heat: some blood in the anal gland material).
Physical exam: He has a "baboon" perianal area: thick and lichenified and black. His flanks are also lichenified, dry with low grade itch. He licks these areas often, sometimes scratches. He feels yeasty as well as dry. His pads are dry. He also has mild nasal dermatitis (ulcerated lesion). He does have palpable mild hepatomegaly. His blood work from previous dvm was normal with mild ALP elevation (I don't have the exact numbers). He does prefer to be cool, but not especially thirsty. Pretty mellow guy.
Pulses: weaker on left than right, a little stronger than I expected.
Tongue: Lavender/dark brick red (stagnation)
So I started with the excess using acupuncture to dispel wind, damp as well as tonify the kidney yin and blood. Gave B12 at BL23 and GV20.
Started Dispel Damp and Nourish the skin at 3 tabs twice daily (He is about 80 lbs). We added a probiotic (proviable). After about 2-3 treatments he started to grow a little perianal hair and the skin was noticeably softer, itching was less. Then we hit some major environmental allergy junk which affected everyone. So he started itching again, dorsal epidermal collarettes with moist big flakes, anal glands full again. We were back to square one. I added Qi Bai Mai Ran Dan by Evergreen (don't recall my logic honestly): did OK but still itching. Finally had to give in and give him 2 days of low dose pred to give him some relief which it did for about 2 weeks.....but of course we are still itching.
So I am thinking about still conitnuing dispel damp and nourish the skin, adding Si Wu Xiao Feng yin and possibly at kidney yin or spleen qi tonic.
Any thoughts on if my logic is sound ?
If so, how to make that formula and have it be balanced and not too cloying, support the spleen, tonify and move blood and get rid of the low grade irritating itch...
I started with acupuncture to dispel wind, tonify Kidney yin