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Agressive Itchy Dog

by LJH - October 14, 2009

Hi Steve,
I've been to see a 6yr M(N)Golden Retriever for intense pruritis.He had a couple of hotspots over dorsal lumbosacral area earlier this summer, resolved, then a month ago started intense itching causing excoriations of axilla and flanks with mild rash ventrally. Regular vet put on steroid and antihistamine and improved vastly but recurred as weaned off meds. He swims alot in summer but doesn't seem much worsened by wet. When I saw him he had a generally thinnish dryish haircoat worse on ventral chest and abdomen with little erythema, a few scales,alopecia at axilla with some excoriations caused by chewing. Ears absolutely clean, not reddened, no Hx of anal gland problems but so intensely itchy that a touch sets him off scratching frantically. Slightly overweight and snores. Fed a commercial organic raw diet. Has alot of eructation, borborygmus and flatulence(improved alot since put on digestive enzymes and probiotics last week)I started him on Qing Ying Tang and Nettles Tincture for intense itch, worsened by anxiety/excitement along with Quercetin and it has helped some(On 7 days, off steroid and antihistamines)Pulse slightly rapid, a little thin, slightly weak and wiry. This dog has a very broad end to his tongue almost like pictures I've seen of people with emotional instability. That is his second serious problem. His mother is descibed by the owners as "crazy" and this dog is very like her. Mother died of Lymphoma shortly after whelping and full brother also died at age 5yr of lymphoma. This dog has always been obsessive about human contact, licking people's hands, wanting to be touched but has always been untrustworthy with other animals. In the last year has worsened. He seriously attacked his Retreiver housemate and now has to be kept in a different part of the house or muzzled when together. Owner says his hyperactivity/anxiety is helped a bit by rescue remedy but quickly progresses to aggression(animals only not people).She says he "just explodes" He was tried on Clomicalm which made him much worse with the aggression.Wonder if there isn't some SP Qi def and Dampness lurking under the Blood Def and if either can't be affecting the Shen. Any thoughts you might have would be very helpful and much appreciated. Thanks,
Llewanda

by naturevet

October 14, 2009

Hi Llewanda

I agree that the digestive signs and the craving of companionship (an Earth symptom) should make us think of the Spleen at the bottom of all this. If he happens to be eating something he's allergic to, but in raw form, allergies can be much more severe. So it's worth experimenting wtih different foods as an extra line of pursuit.

How could this manifest in behavioural problems? If Phlegm is obstructing the Heart orifices (clouding his thinking, in other words), it can show up as aggression. Or, if the dog was Blood deficient from Spleen deficiency, it can create anxiety and 'the need to strike the first blow', or intimidate perceived threats.

But, on the other hand, you've already accomplished quite a bit in a week if the dog is slightly better despite having its drugs discontinued. So I'd hold these theories in the back of your mind, or jot them in your chart, but see the Qing Ying Tang experiment through. If the dog is Damp, the behaviours will persist, since Qing Ying Tang is moistening. If he's Blood deficient, they'll improve, since it contains Blood tonics. If a severe Heart Fire is present and is causing both severe itch and a flash temper, he'll improve.

So you'll know a lot more in probably a couple of weeks, as you observe his response.

Good luck!

Steve

by LJH

November 4, 2009

Hi Steve,
Looks like the early improvement with this dog was shortlived. About a week ago he started getting red "bumps" in axilla and sides of muzzle and general erythema ventrally with one area on dorsal rump of yellowish large flakes. Itchiness flared up again as well, didn't improve when owner restarted antihistamines.While finishing the last couple of days of his Qing Ying Tang I started adding in a tiny dose of Si Miao San and he worked up to 1/2 tsp BID. I obviously zigged when I should have zagged as the last 2 days he has had a huge flare up. Nothing much for flakes, scales, crusts etc but erythema now dorsally and ventrally. Ears no wax or discharge but range through the day from pink to bright red. He is scratching frantically and pulling out hair(which was thin to begin with). Chewing worst axilla, flanks, dorsal rump and lateral thighs. Has rubbed out much of the hair on the left side of his neck. His already excitable/anxious nature has become frantic. We took him off herbs and restarted VanectylP last night to try and calm things down. The owners have been hestitant to try changing diet but have agreed to at least try only the lamb based raw food and stop the beef they were alternating with. He has severe poultry issues so I had suggested rabbit.His tongue is a bit pink/red at the end with more pale and a thin white coat in middle and caudal. Pulse was still on the thin and weak side but felt less wiry and more slippery.Generally felt warm all over including ears except paws were cool. I wondered if the inward draining of the Si Miao San was the issue and if something like San Ren Tang would have been better. Think he had Spleen issues that resulted in Blood deficiency and Damp Heat that now I've turned into Wind as well.As you can see at this point I'm not sure where to go so any thoughts that might help clarify would be appreciated. Thanks,
Llewanda

by LJH

November 7, 2009

Hi again Steve,
Just an update. The pruritis improved quickly on the steroid and antihistamine(2days) and the owner tells me that the paws feel fairly warm to her where they were quite cool compared to the rest of him when I saw him. Thanks for any thoughts.
Llewanda

by naturevet

November 8, 2009

Hi Llewanda,

What I would do at this point is give the dog another several days on the drugs, then re-evaluate him while still on the full doses and see what you would diagnose him with now. In other words, when you evaluate him, pretend the drugs aren't even in use and start all over again. The drugs will slighly amplify his original complaint, even as they deal with the sequelae of it. In other words, they'll prune branches, but not cure the root. When he comes back to see you, what you'll be looking at is his root problems. You could then focus on that, such that treatments for the branch would no longer be required.

After the root is gone, you'll be able to discontinue the drugs slowly and safely.

Steve

by LJH

November 17, 2009

Hi Steve,
After rechecking this dog on steroids I'm not sure if I'm any closer to the root or just wandering around unable to see the forest for the trees. Tongue was less pale with a brick shade not clear pink, thin white coat at back but not toward the tip. Pulse superficially felt his usual weak, thin and slightly wiry but as you pressed deeper it was somewhat stronger and slippery. I interpreted that as a Deep pulse indicating a need for a formula that moves outward. I still think Sp def progression to Damp Heat and Blood Def. and that sorting the protein in his raw diet is a big factor.The thin, dry haircoat and low grade very pruritic lesions with a preponderance of lesions along sides of body(flanks)and axilla/inguinal areas certainly looks like Blood Def. Qing Ying can be helpful for the intense itch and moves blood outward but is quite moistening so could exacerbate Damp Heat on its own.Si Miao San addresses the Damp Heat but draws inward so could impair periferal blood flow leading to secondary infection. Could maybe increase expulsive effort by adding Dang Gui?San Ren Tang disperses, drains damp and clears heat but might be too drying, not Blood tonifying enough.Wondered about Chu Shi Wei Ling Tang for allergic dermatitis as it supports Sp. moves blood periferally but this dog has evidence of Heat and I thought CSWLT more addressed Damp issues. I didn't really think SiWu Xiao Feng Yin was as useful with intense itch though it addresses Blood Def. and Expells Wind. Modified Long Dan Xie Gan Tang I thought was for a more forceful pulse. Maybe need to try 2 formulas. Sorry to be so wordy and obviously so very stuck with this case but your thoughts/ suggestions would again be appreciated. Thanks.
Llewanda

by naturevet

November 18, 2009

Hi Llewanda,

SMS plus DG would be where I'd go. I like your logic.

Steve

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