Question Details
Intense Fear, Anxiety, Aggression In A Dog With Skin Issues
by CorinneC - June 13, 2024
"Duke" is an 8yo MN Patterson terrier who was dopted as a rescue from California at 2-3yo, in rough shape - afraid of everything, skin infections, ear infections, riddled in ticks, afraid of water (took 3 days for him to drink water by diluting chicken broth), extremely malnourished, UTI, paws burnt. Assume he was in some kind of fire - afraid of burning smells, fires, stove noises.

After 1 yr developed severe separation anxiety (destroying doors but hasn't done this for a long time), tx with Clomicalm, helped a lot until 1yr ago when he stopped eating (may not have been helping for awhile because Os noticed new behaviours had been arising - screaming in the car, heavy panting when confined, have never been able to crate train him. Newer yet - howling when left. Not on any anti-anxiety meds now.

Tried Cytopoint for skin issues - no change. Severe rxn to Bravecto, 2 doses - got worse right after each dose - seems this is when all the issues really ramped up. Skin became raw, bleeding, lost patches of fur, looked like he had mange when he had a flare-up. At that time started Apoquel - helps unless it gets out of control. Tried restricting foods - no improvement.

Fed raw diet since adoption - Berrymans turkey, beef
Vaccinated since adopted - shelter, then after rescued and neutered, Bordetella since. Adored Beast Vaccinosis protocol 2016-17

Happier since on thyroid meds (not as lethargic, pulling toys out of toybox), lost a bunch of well-needed wt. Vet only used T4 result to diagnose but seemed to really help.

After 8pm when lying down in livingroom with family, cannot pet him or he will growl, if continue to pet him he will bare his teeth. If female O gets up, standing near husband, Duke wants to attack either of them if one is towering over the other. Started a few years ago, ~3-4 yrs.

Has full on attacked daughter, bit daughters dogs' nose the other day, does not like Brianna's dogs at all. No longer walked with Brianna's dogs.

Ok with other dogs - has a friend Boxer "Big Duke". But if Jody sits down around other dogs, he will attack.

Goes out on the boat, gets over-excited when leaving boat - will jump up and actually bites at Jody, gets so excited he has jumped into water, have to lock him below to dock boat.

BM 1-2 per day, WNL. Urination WNL, likes to leave his scent! Appetite excellent (but on Pred, not usually motivated by food, less gentle with treats at present)

Bathing with Douxo Seb q4 days in flare up, once weekly when ok
On the following meds when I met him:
Apoquel 16mg 1/2 tab SID, Pred 5mg BID (now on 1/2 tab SID), Thyro-tabs 300mcg SID.
-tried off Apoquel - started licking at paws, typical response to yeast
-just off abx and antifungals (lingering yeast around paws and nailbeds)

Could not examine this dog well so no tongue dx but pulse feel toned to taut. Growled at me, but will go with me away from O and allow a muzzle and exam. Skin at this point looked WNL.

WIth all this history and clinical signs, I assumed a TCVM diagnosis of Spleen Qi deficiency, Spleen Qi Sinking, Liver Blood deficiency, Liver Qi Stagnation, ShaoYang disharmony

Put him on Halscion and BZYQT

Recheck 1 mth later and no major change but had been tapering Pred and no major skin eruptions. I wondered about some of the aggressive issues ramping up around the start of the Bravecto issues and start of Apoquel. Os could not confirm 100% but seemed to think it matching timing-wise. He has a mild Lt ear infection, did Claro. Pulses toned. Skin WNL. TOday I added Long Dan Xie Gan Tang for Liver Fire.

I know its a novel to read through and I apologize for that! Just wondering if you have any experience and thoughts on anything else that might help this boy? Do you think my current protocol makes sense? I am now weaning him down to alternating days of Pred and Apoquel as well to see if the skin holds.

THANKS IN ADVANCE!!!!
Corinne in Victoria
Replies
by naturevet
June 16, 2024
Hi Corinne,

I like your approach. Halscion was top of the list for me, too. I would actually maybe have tried it by itself first. It's true that BZYQT helps balance Halscion, but given how over the top this dog is, it seems he needs some downbearing. That's particularly true of dogs who are aggravated during the evening hours. If Long Dan Xie Gan Tang doesn't help, then consider Halscion alone, maybe in double doses.

Let us know how it goes!

Steve
by CorinneC
June 17, 2024
Ok, great. I will see how he does over the next week or so. I had thought he needed the BZYQT because he was so intense and I assumed Wei Qi deficient as well???? But the need to downbear makes sense too. If we're not seeing much progress I will drop the BZYQT and LDXGT and see too.

There is just so much to know. I LOVE your musculoskeletal dz "cheat sheet" BTW!! I wish there was one for everything!! LOL

Thanks so much!
Corinne
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