I am treating a 4 year old MC Vizsla. He presented to me in August with the diagnosis of autoimmune vasculitis. His Left ear tip was raw, open and intermittently bleeding. The pinnal margin on both ears seemed swollen. His skin was relatively cool including his extremities. His ear intermittently sprays the room with blood when he shakes his head. Owners are discouraged with this. Some left eye discharge as well. Acupoints were subtle. Pulse was deep, strong and slow. He was on prednisone. I treated Bl-40 and GB-34, and GV-14. Rx: Yunan baiyoao orally and topically. Qing Ying Tang.
Over the phone 3 weeks later, I was told that the bleeding was under control. The primary vets had him on prednisone all summer as well as Pentoxyphylin and tacrolimus. I switched him to XCHT in the middle of September.
I saw this dog for the second time this Friday. The ear had not been bleeding, however, it still was open and both pinnal margins were inflamed. His skin was hot all over. This made finding active points very difficult for me. Pulse was strong and slippery. No other skin lesions.
He had a history of intermittent diarrhea recently. I added probiotics. Both temporal fossas looked excessively prominent like he had muscle atrophy bilaterally of the temporal muscles. Both of his eyes had a thick, clear mucus discharge. He looks ill even though his energy is good.
I kept this dog on a low dose of XCHT and added Hoxsey for all the heat. I will tell the primary to run a Thyroid panel and to try to get this dog off the systemic pred. I thought that the topical tacrolimus was inhibiting wound healing and discouraged its use.
Do you have thoughts on the temporal atrophy as well as the overall presentation?
Kevin Landau