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Chewing At Feet

by ericahawker - October 27, 2009

Hi Steve--
I have been seeing a lot of chronic skin cases where the owners are interested in chinese herbs, but I have only gotten few to respond. I am wondering if I am interpreting them correctly. Just saw your telemedicine conference through VBMA on TCM and herbs, so I plan to sign up for that!

Anyhow, I have a 3 yr old MN Sheltie that has recently gotten over a bad bout of pancreatitis and also been gnawing at all of his paws since July 2008. Improves on Temaril-P, but relapses if owner decreases to once daily admin.
He recently changed to Wellness Core red fat and has done very well with that even after the pancreatitis. Great appetite. Prefers hard and cool surfaces; high activity level, no urine or bowel issues. Sleeps near vents or on an armchair. Does not like to walk on grass, esp wet grass and nervous with gusts of wind.

On exam, all 4 feet have thin hair on dorsum of feet with moderate erythema and dry skin. Thin yellow scales on dorsum and greasy haircoat.
Pulse was deep and moderate strengh. Tongue was pink. I suspected damp heat and started him on SMS.
At the 2 week recheck, no improvement at all with pruritus. Now tongue is lavender-pink, and pulse is strong and moderate depth.
Perhaps I should consider more of a wind invasion?

Xiao Feng San seems the closest formula, but I am not sure it would be the best.

Thanks!
Erica

by naturevet

October 28, 2009

Hi Erica,

I've had poor results with Xiao Feng San in animals. Unless the dog looks overtly Blood deficient, it's not likely to help in my book. The source text described XFS cases has having a rapid forceful and bounding pulse, and certainly when I see skin complaints in humans with that pulse, I know the formula will work. But in cases where even the pulse matches nicely in animals, the formula has been less than impressive in efficacy. It's strong cooling nature is why the pulse associated with it is so forceful.

When I analyze this case, I see where you got the Si Miao San. We see signs of Heat and 'excess' (i.e. nastiness and well developed symptoms). What would make me not choose SMS, though, is the pulse and lesion distribution. The dorsal distribution implies Wind invasion (i.e. in this case, a Wind Damp Heat). The deep pulse implies we need a formula with expulsive effort. Remember we can create that in SMS by simply adding additional herbs to it. If the dog is Blood deficient, then adding Dang Gui may be all you need, and in my book would be more likely to work than XFS. Remember in class we also talked about how you should be able to add Ku Shen (Sophora) if the animal is more purely Damp, but has a yeast overgrowth. Otherwise, my first thought would be San Ren Tang. It does tend to disperse, drains and dries Damp, and clears Heat.

So that's my take, for what it's worth. Which may not be much since I'm assuming a lot of these cases that haven't worked out have been ones I've advised upon...?

Good luck anyway!

Steve

by ericahawker

October 28, 2009

Hi Steve--

Thanks for the advice. How come things always seem so simple when you explain them? Guess, that is why you are the teacher!

These derm cases tend to get complicated in my head and some of these chronic ones just seem hard to crack! As for the ones that haven't worked out, many of them I have tried to just do on my own. Hopefully the more I learn with TCM, the less frustrated I will become with these skin cases.

Thanks. Hope your boys have a happy Halloween!

Erica

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