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Lip Licking

by CorinneC - April 1, 2024

Quigley is a 12yo FS chocolate lab that I've been seeing for 5 years. Last summer she came to me for lip-licking in the midst of some urinary incontinence. After some diagnostics we realized that she had a parathyroid mass and it was subsequently removed. But the lip-licking started up again. She has been on a homecooked or dehydrated raw diet for a few years. The owners did try Pepcid, pain relief, bland diets, probiotics but no change. She does get Cytopoint for seasonal allergies (worst Jan - April). She will sit and lick at all times of the day, no real correlation with food, but ramps up at night and keeps Os up too. O thinks it is correlated to ears as she will stop licking if O rubs her ears. Ears on PE were NAF. Lip licking was at it worst starting in Feb. I removed some seb cysts and cleaned her teeth last week, gave her Cerenia intra-op and there was no licking that night??? Then gave PO Cerenia next day and apparently it was the WORST night of licking they have ever had. I started her on Halscion as her tongue and pulses were WNL. Thinking acid reflux?? but no improvement with Pepcid which is odd.

Any other brilliant thoughts?!?!
Corinne

by naturevet

April 2, 2024

Hi Corinne

I would wonder about Shao Yang disharmony given the lateral neck tumor. It's also consistent with licking/nausea, Stomach dryness, urinary incontinence, and the history of fresh food. Since the dog is allergic, then Chai Hu Si Wu Tang (aka Cessorex) is a good choice and may help. You may also need Yi Guan Jian as well to quell the licking and nausea, although it is in Halscion. So maybe Halscion + Cessorex might do the trick?

Hopefully this helps you out!

Steve

by CorinneC

April 3, 2024

Thanks Steve, I llike the idea of Cessorex and Halscion together. I have actually used it for another patient, not just licking but definitely acid reflux alongside allergies. I have another dog, 11yoMN Havenese X, that has NO allergies (apparently) but has O up all night every night this last 2 mth with licking/swallowing/gulping that goes on and on. If O doesn't intervene, he starts to whimper and cry. Initially iff O gave him a small amt of food he would settle, but no longer working either. O then takes him outside and occas settles from this, but sometimes on bad nights he won't settle, will just sit and stare, furthest away from O. Presently on and off all night, started off as once/night, now cycling every 3 hours, usually 12am and 3am are standard. In the day, has great EN, but still regurgitates 30% of meals, lots of hacking sounds like he's trying to clear something from his throat. I started him on Halscion too last week. O is sleep deprived and frustrated that it hasn't made an ounce of difference with the night issues but his separation anxiety is at least better. Good toned (a little wiry) pulses, tongue lavender-pink, moist, normal size. Tried Pepcid SID in Jan - did this 7 nights then good for 2-3 weeks, then all came back. Ad Beast GutSoothe also worked initially but again signs all came back. Fed Tom and Sawyer Kangaroo and sweet potato. Any thoughts with this? Maybe it IS allergies too with timing in Victoria (Feb starts everyone up!) and Cessorex??? He has a long history of pancreatitis and elevated liver enzymes, ITP (resolved nicely with TCM I thought??). Maybe Adoptrex?

by naturevet

April 5, 2024

Hi Corinne,

Since he responded to Halscion, he's a Shao Yang dog. Adoptrex sounds like a good next thing to try given the pancreatitis. If not, then maybe XCHT?

S

by CorinneC

April 8, 2024

Done! Started Quigley on Cessorex and Joey on Adoptrex today!
Corinne

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