Signalment
- Age: 1 years
- Sex: female spayed
- Breed: Wheaton Terrier
- Species: dog
Disease Notes
- Certainty: tentative
- Final Status: slightly better as of day 149 of treatment
Treatment and Outcome
Problem Notes
- Originally Moist Dermatitis: I originally treated Peaches for SP Qi deficiency and Damp Heat. She came in after several math of "allergic skin disease" where she had had several ear infections, runny eyes, and generalized pruritus where she would scratch until she caused skin trauma and suppurative lesions. She had been treated with rounds of antibiotics and Vanectyl-P but the skin issue always returned. On my exam, her skin was warm to hot to the touch, erythemic, and greasy with a mild yeasty odour. Her ears had always been a problem, inner pinnae were dark brown in colour and had a yeasty odour. Her chest and axillary skin were slightly erythemic with porphyrin-staied fur; her dorsal fur was thin and you could see her skin easily, with a greasy feel to the coat. She had toned pulses and a pink-lavendar slightly swollen tongue. I diagnosed Damp Heat (chronic inflammation) and put her on Si Miao San. She did extremely well after only 3-4 weeks and looked quite normal when she came in for a recheck so I switched her to Chu Shi Wei Ling Tang.
1 week later Peaches went to emergency for an apparent allergic reaction the herbs! I did not examine her but the report says she was extremely pruritic and had scratched herself raw in areas. Her ear pinna looked chronically thickened, erythematous but no active debris. Her skin felt greasy overall, her entire body was affected by moderate erythema and pruritus. She has 2-3 lesions on her ventral chest that were very inflamed, ulcerated, and open due to self trauma with purulent exudate. They put her on Vanectyl-P and abx. The owner is very upset, not at me, but that she had been doing so well and we are now back to square one.
Did she actually have an allergic reaction? Have you seen this? Or did I move too fast on changing from SMS to CSWLT?
Any help would be much appreciated!
Day 149
Notes:
Owner went to local DVM who put her on Vanectyl-P and antibiotics. Client then returned to my clinic and demanded refunds for everything I had done because dog was "SO MUCH BETTER" on steroids and antibiotics and "I should have done this as well!" Thankfully my boss would not refund her and suggested that she reconsider as she had sought out a holistic opinion in the first place to stay away from drugs of any kind.