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Another Itchy Dog

by sophiek - March 22, 2026

Hi Steve

Sorry for bombarding you, but I have another skin case that I am going round in circles with.

Onyx is an 11 year old MN French bulldog. Itchy and otitis externa intermittently for 8 years. Initially treated for many years with intermittent prednisolone and topical ear ointments. Very lethargic “bombed” on prednisolone so could only use a low dose (not sure what this means in TCM?). Cytopoint initially was effective but then not effective last few doses.
Last 4 years itch much worse. Much worse after goes out into garden (not just this garden, at other houses too). Always smelly like corn chips. Smell improves after medicated bath but itch remains the same. Very strict with diet as any small variation > flatulence, diarrhoea. On a balanced fresh food diet with adequate vegetable matter and probiotic. Lip licks+.
Treated about 4-5 months ago by another holistic vet who started on QYT and Xian Feng San. No response to this at all.
He has also had PEA and quercetin with no response.

Exam;
Very itchy – any touch > itches and chews. Very greasy to touch dorsum. Fine scurf over rump. Mild erythema of skin ventral neck and sternum only – owner reports has itched until bled here in the past. Hot all over, including paws. Yeasty smell. Feet not particularly inflamed but skin is thickened / elephant like skin on backs of feet.

P – superficial – mid level, quite broad, fast, not particularly toned, compressible at deep level but can still feel it (doesn’t disappear), slippery.
Less slippery (I think) with Sp 9. More rounded / toned with GB 34.

T – wet, red-lavender, gums very red

So again – I am confused!
I was thinking QYT due to the overall heat and intense itch, possible secondary skin infections, but I’m not sure if the pulse fits (seems to be more of a Damp Heat pulse?).
Also there was no response when a previous vet treated him with QYT, though Xian Feng San was used at the same time (too much blood to the skin worsening inflammation or could Xian Feng San counteract the effect of QYT?).

But then maybe he is a Damp Heat dog – greasiness, secondary skin infection, corn chip smell and Pulse all fits. But what doesn't fit is that he is on a low carb fresh food diet, which fits more with an underlying immunological / gut issue (more with Shao yang disharmony)

The inflammation on ventral neck, and lip licking also make me think of YGJ for Stomach Yin Deficiency / Heat – which would fit more with a Shao Yang Disharmony…. Though there is not a Full pulse to fit with that. And he’s so so greasy, I’m worried that if I use something like Cessorex that it will worsen the heat and inflammation of skin.

I’m also a bit confused with the pulse. I was certain it was slippery (felt like it was moving all over the place), but not sure why it would become more toned / rounded with GB 34. Please help!

Thank you,
Sophie

by naturevet

March 22, 2026

Hi again,

I think you're doing a great job of collecting data and asking all the right questions. Regarding this case, I agree that if it was a QYT case, they would have seen a response. I also agree that he seems Damp, but how can this be if he's on a real food diet? The answer is that he may be too Spleen deficient to properly process it.

This is not very common, but does happen. Often these dogs develop some lichenification in the form of elephant-hide-like skin in chronically inflamed areas. I use Chu Shi Wei Ling Tang to address that. CSWLT strengthens the Spleen, allowing the owner more latitude in the use of different diets. This underlying Spleen deficiency is why the dog went flat on pred (which is Cold and Wet, making it a weakened and cold Spleen's worst enemy).

He also shows signs of more acute Damp Heat, which CSWLT will not address and may even aggravate, so I'd pair it with Si Miao San. Acute inflammation is signaled by the exquisite sensitivity of the skin to touch and the aggravation with even slight activity in warm weather (such as going outside in the garden).

Why the inflamed chin underside if he's Damp? Normally (especially in real food fed dogs) this is a 'hook' indicating Shao Yang disharmony, since it's entrapment of Yang in the Stomach that produces all that redness and inflammation in the Stomach channel. In reality, though, extreme Heat of any cause can cause the Stomach channel to become inflamed, including Damp Heat. In practice, though, it's much less common.

So, you've got a case that seems to provide the exceptions that prove the rules. Hopefully, giving CSWLT and SMS together will get this case on the road to better skin health. Maybe try half doses of SMS to start with, so the overall impact is Spleen tonification. If he seems to get to much redness in response to that, given equal amounts of SMS and CSWLT.

Hopefully, that works for you and that I haven't steered you wrong. Let us know what happens!

Steve

by sophiek

March 24, 2026

Thanks so much Steve, that makes things clearer!
Did you mean to try half doses of SMS first, but if the skin gets too red to try CSWLT/SMS combo? Or the other way around?

Also - with the tongue in brachycephalic breeds - how much emphasis do you place on colour? This guy has very red gums, but T was red-lavender... I wondered if the lavender was because of the poor oxygenation in this breed vs true tongue colour?

by naturevet

March 25, 2026

I would try 1/2 dose of SMS and a full dose of CSWLT to start, so the herb ratio is more supportive. If you need more anti-inflammatory effects, use more SMS.

Pulses always matter more than tongue. SMS treats Stasis so if the purple is real, you have that base covered. But, SMS is not primarily a Blood mover, so if only the Heat is real, that is SMS's primary focus.

For animals that you have know a long time, you'd interpret the changes you see. For example, if the purple is darker than normal, it's meaningful. Otherwise, if you just don't know, gum color and pulse diagnosis is more reliable

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