Question Details
Dermatitis & Obesity In A Shar Pei
by rojo_clare - January 18, 2010
Dear Steve

I would like some advice on a case I saw yesterday please. I haven’t treated many skin cases with herbs yet and this is not quite the classic skin case I was anticipating!

6-year-old female speyed Shar Pei 34.7kg (CS 5/5)
Abandoned at 4 years old and rehomed to current owners
Presented for TCM assessment of chronic obesity and skin problems.

Diet: 80g fourlegs (raw mince + veg balls), 1 cup blanched non-starchy veg + approx 1 tablespoon of eagle pack daily.

Owner reports chronically itchy ears and loves to rub her back along the ground but not super itchy. Hasn’t been able to get any weight off her despite a few changes in diet. Skin itch does not respond to anti-histamines, has never been on steroids.

Appetite – medium, often only eats half her meal, not food obsessed
GIT – softish formed stools, sometimes a bit smelly/gassy
Thirst – small-medium amounts often, owner thinks to quench loud raspy throat
Prefers warmth, first dog by the fire, sleeps under a blanket even in summer.
Snappy towards people but likes being around other dogs.
Very loud snorty/grunty, long soft palate, soft snore all night. Sleeps well.

Clinical Examination
Obese but otherwise relatively ‘normal’.
Coat – mild seborrhoea, no dandruff, only very mild inflammation around tail folds and jowls. No lesions/papules/collarettes etc. Doesn’t appear to be an itchy dog!
Ears – bilateral yeasty waxy moderate inflammation
Tongue – pink, bit thin, normal coating, very small amount of froth, mouth in general quite dry, (not a drooly dog like you would expect). Shallow longitudinal and horizontal cracks.
Pulse – VERY difficult to find – deep, weak, easily compressible
Normal heart and lung auscultation.

Laboratory
Bloods from yesterday all within normal limits including thyroid.


Reading through your notes from the Sydney herbal course…this dog strikes me as a deficient skin condition with damp present but not really much heat. Must be some degree of Spleen deficiency due to low appetite, soft stools.

Could the low grade itch be a Blood deficiency even though no dandruff?
Would Chu Shi Wei Ling Tang be appropriate for this dog? Or another you would recommend?
What do you think of this dog’s diet?

Thank you very much for your advice. Great that you have the forum up and running – has been invaluable to me to look through other cases.

Cheers

Clare Ellis
Willunga Veterinary Services



Replies
by naturevet
January 19, 2010
Hi Clare,

I'm torn between CSWLT, which you suggested, and San Ren Tang. I'm quite sure one will work. The snoring and suggestion of pharyngeal congestion is more likely to respond to SRT. But the chilliness and deficiency are classic for CSWLT. So it's a toss up. I'd probably go with your idea first. If the itch increases at all, then SRT is the better choice.

Steve
by rojo_clare
January 20, 2010
Thanks Steve

I think I can get hold of CSWLT to we'll give that a try first.

Cheers

Clare
by rojo_clare
February 24, 2010
Hi Steve

Have had this girl on CSWLT for about 4-5 weeks now. Owner thinks less low grade itch present and more lively in herself. She also sits in front of the fan or in the breezeway a lot more now.

On exam tongue is very frothy today (purplish also but owner has to prize this dog's mouth open for me to look so suspect is more from that). Also top of head is bit red around skin folds (wasn't before) but not itchy, and ears are still a bit red.

Seems she is now hotter and damper than before even though not more itchy.

So I am thinking that perhaps San Ren Tang may be the better option for this dog as you originally suggested. Agree?

Cheers

clare
by naturevet
February 25, 2010
Yes, SRT is what I'd try next.

Good luck,

Steve
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