When I saw him in Jan 2020, he had a bilateral ear infection (erythema, dark brown yeasty debris), coat was dry and dull, pulses were deficient, tongue was lavender with vertical fissures, dry. I assumed Liver Blood deficiency and Wind Invasion and put him on SWXFY, but he got worse so I ended up trying CSWLT instead. Only mild improvement with O applying Viaderm to soothe the occas minor hotspot. I didn't see much of Theo until the following Spring and O cont'd CSWLT throughout. He was only mildly itchy, rare hotpsot if swimming and O slowly weaned of CSWLT.
In April of 2022 I removed a benign apocrine ductular mass off his back (shiny purple hairless = Blood Stasis), has never returned. By Sept 2022 she was back with Theo due to ear infections, occas hotspots, and pruritus. This all seemed to ramp up after O chose to give him Nexgard all summer?? He had LF interdigital erythema with papules, dorsal midline and right chestwall had patchy erythema with crusty yellow scabs - O requested Viaderm, no herbs.
Once again revisited skin in Jan 2023 - all about the same wrt skin. Pulses toned, still on raw diet, lesions all over back, ventral abdomen, perianal, periorbital, periaural, perioral. Likes to scratch his face the most. Viaderm really helps 2-5 days in a row, skin will settle down quickly. His tongue was still lavender-pink, moist, normal sized, and a toned pulse. I realize my mistake now, but I assumed Wei Qi deficiency and ShaoYang disharmony and put him on BZYQT and XCHT. These both also only helped minimally but he was worse off. TOday he was in again and I think I now realize this is a deep-seated pathogen and Blood Heat/Stasis with Wind Heat Invasion so have started him on Qing Ying Tang. I never saw his lesions as particularly alarming, red, and hot. Maybe because the owner kept applying Viaderm like a body lotion! His tongue and pulse never seemed all that intense either. The tongue rarely went anywhere from lavender. Looking back the panosteitis in the history should have alluded me to Blood Heat? Can you guide me here? Am I on the right track? Owner is getting frustrated.
Grateful for your help as always!