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Nodules In Ears

by ericahawker - May 15, 2009

Hi Steve--

I have 5 mth old Rottie as a patient that has multiple intradermal bumps/nodules in both pinnae. They were first noted at 3 mths of age. She has no other skin lesions and is not pruritic. Recently the owner reports have coalesced into larger nodules and are firm, non-painful. No response to topical 1% hydrocortisone.

She eats Chicken Soup for the Dog Soul kibble and the owner isn't willing to switch the diet at this point.

She seems to be a hot patient to me with blood stasis in the ears. She is a very sweet, outgoing dog. Lies in the shade and does not like to cuddle. Stools are soft, semi-formed and light-brown in color. Urinates frequently, small amts. Ravenous appetite and normal thirst. Very energetic and sleeps a little during the day. Spayed at 6 wks of age at shelter. Tongue is pink, moist. Strong, superficial, synchoronous pulses. I was thinking Long Dan Xie Gan Tang.

Am I way off base here?

Thank you-
Erica

by naturevet

May 16, 2009

Hi Erica,

I agree the general traits of the dog are toward Damp Heat, suggesting a formula like LDXGT. Given the soft tending stools, however, and the lack of lesion severity, I think you could downgrade the cooling attributes of the approach just a little, and go for Si Miao San. If you're on the right track, the dog will respond, and we can go up or down in formula intensity from there, depending on what's left to treat.

I've never heard of that dog food before. The name scares me! If the dog responds, the owner must switch to as low a carb diet as she can find, or the dog has a lot of problems ahead of it. If the current pet food fits the bill, that's fine. I'm not familiar enough with it to make that call.

Lastly, any link to vaccinations here? Did they come on shortly after a booster? If so, looking at it from an autoimmune perspective may be helpful, leading us to consider formulas like Qing Ying Tang, SMS, and Dang Gui Yin Zi.

Do you think the lesions are hives? If so, homeopathic Apis may help resolve them. Hives are due to Wind Damp Heat, and often come on secondary to Damp Heat accumulations internally.

Lots to consider there, anyway. In a nutshell: Si Miao San with or without Apis or perhaps another antihistamine.

Steve

by ericahawker

May 17, 2009

Thanks Steve.

The dog food has an annoying long and sappy name but is not that bad in terms of other foods that I see. But I will recommend a grain free and less processed diet. Hey, could you also send that inflamm/diet article to me when you get a chance? I would love to give it to owners when making these recommendations.

Thank you!!

Ingredients
Chicken, turkey, chicken meal, ocean fish meal, cracked pearled barley, whole grain brown rice, white rice, oatmeal, millet, potatoes, egg product, tomato pomace, chicken fat (preserved with mixed tocopherols), duck, salmon, flaxseed, natural chicken flavor, salmon oil (source of DHA), choline chloride, dried chicory root, kelp, carrots, peas, apples, tomatoes, blueberries, spinach, dried skim milk......

by naturevet

May 17, 2009

Hi Erica,

I sent the article to Mona to forward on to people attending the course. If you haven't received it yet, maybe give her a buzz.

In terms of inflammatory potential of a diet, the carbohydrate content on a dry matter basis will give you an indicator. I generally look for dry foods with a maximum carbohydrate content of 25%. Wet foods should be even lower, perhaps a maximum of 15%. Many are much higher than that, especially the ones that don't list this number directly.

Here's a reminder on how to calculate the number if it's not listed. First, add all the numbers listed. If they don't add up to 100, the missing number is the carb content.

Next subtract the number for water to get the amount of food that is dry matter. Divide the carb number by the dry matter number to get carbs on a dry matter basis.

Good luck with the case!

Steve

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