A Path With Paws

Here is the article that everyone has asked for and I have been hesitant to write. How to treat that nasty, oozy, itchy skin with herbal treatments. If you haven’t read Itchy Dogs – the Link Between Inflammation and Diet please start with it first. Consider this article part two.

Why have I resisted writing this article?
Mostly because skin is one of the most frustrating things to treat. The reason for that is it often takes a long time to see improvement. There can be a lot of ups and downs along the way. It involves switching formulas as you go along, using multiple formulas together and understanding your dog’s (or cat’s) disease.

I rarely see mild skin disease in my practice. Usually by the time dogs come my way they have been on multiple drugs, diets and supplements. They are often hairless or with large areas of baldness and redness. And their human caregivers are often in tears. Skin disease that is resistant to treatment can be more heartbreaking than cancer. These dogs scratch until they bleed, they are often in e collars or jackets, they itch all the time, they don’t sleep at night and everyone is miserable. Ok they aren’t all quite so bad but many are.

Even with everything I do I feel like I can only get about 60% of these dogs to a good place. But remember that about 90% of dogs I see have already tried everything so in reality 60% isn’t bad. It usually takes time, 6-18 months to get good improvement and most importantly it takes people who are willing to be patient.

1. Where to start – Diet! So before anything else – Dogs with severe skin inflammation and itching need to be on a 100% raw diet unless they absolutely can not tolerate it and then they should be on cooked whole foods diet. The diet should be 100% grain free and very low in starch – so no potatoes. If you haven’t read part one Itchy Dogs – the Link Between Inflammation and Diet, go and read it now! I have cleared some dogs up with just a shift to 100% raw food.
2. Keep any medications that are helping on board as you work with herbs. I want to see how the dog is doing and if I pull away medications too fast I may not be able to tell what the herbs I am adding are doing compared to what the drugs are or are not doing. These dogs are uncomfortable and it takes time for herbs to work. I want them to stay comfortable as we work at the root of the disease.
3. I almost always put these dogs on a liquid alcohol nettles tincture at a dosage of 0.2ml per 5lb of body weight 3-4 times a day. This reduces the itch and also starts the process of desensitizing your dog to any environmental allergies they may have. If you buy this commercially it can be quite expensive. I make it in large batches for my clients or have them learn to make it themselves at home. To make nettles tincture fill a mason jar with 1/3 dried nettles (I use Mountain Rose Herbs). Fill to the top with Vodka. Shake lightly daily for 3-4 weeks. Drain and make sure to squeeze the nettles leaves to get the liquid out.
4. Chinese herbals – Almost all my dogs go on one or two of these formulas. We are often jumping back and forth between them, adjusting dosages and making small changes. Because of this it is best to have a holistic vet to help you. Often the first changes are improvements in skin quality, reduction of lesions and improvement in pulse/tongue. The itch is the last part to go and can take 6-12 months to improve significantly. Part of why I start nettles is that it can have a more immediate effect on itch. Below are the most common formulas I use.
   • Qing Ying Tang – When I get a dog in with severe itching and they are scratching constantly, if they are bald and there skin is hot and/or red, I immediately put them on a formula called Qing Ying Tang. This formula helps with blood flow to the skin, has antibiotic properties and reduces inflammation and “cools the blood.” If you are into pulse diagnosis these dogs often have a superficial fast “hot” pulse. They may actually have cold feet even with their body radiating heat. They have so much inflammation in their skin that the blood flow has been impaired. The first step is to get back the blood flow to clear out any infection and inflammation. It is not uncommon for them to get worse for a few days when you start this formula and then they get better.
   • Si Miao San – this is one of the workhorses of Chinese medicine, and though milder than prednisone, often something we will reach for as we pull dogs off of prednisone. This is a great anti-inflammatory formula and works well for yeast. It is really good for itchy skin mostly on the belly, arm and leg pits and in skin folds. If most of the inflammation is centered in these areas I start with this formula. In the dogs I start on QYT I often find in 2-3 weeks they will improve and than get worse again, with the inflammation now being worse in the pits and on the belly. When this happens I add in SMS but keep the QYT also. Over time I teach the dog’s people to work with balancing these two formulas. If the pits and belly get more itchy –more SMS and less QYT. If the back and sides are the focus of the itch then more QYT and less SMS. This formula can also improve dogs with chronic yeast infections in their ears. Si Miao San is also a formula I use quite often for dogs prone to diarrhea and smelly gas so if you are unsure if you should start with QYT or SMS and your dog is very gassy, SMS might be the way to go
   • Xiao Feng San – this is a formula I use often for mild itch and in dogs with more severe itch that have skin that still looks healthy. These dogs will often act like they are biting at bugs and the place of itch will rapidly shift. This formula can be used short time for mild periods of environment allergies and more long time for dogs with chronic itch. Make sure you check for fleas if your dog is acting this way. This formula is a milder mix between helping with inflammation and improving blood flow.

   

   • Si Wu Xiao Feng Yin – this is a formula that I don’t use that often but sometimes it is very appropriate. I use it mainly for dogs with itchy skin that is dry and flaky where the itch is along the back and on the sides of the body. This formula helps with blood flow to the skin but is not as cooling as Qing Ying Tang. These dogs also do well on a fish oil supplement. This is also a formula I sometimes switch dogs on QYT to as they are doing better when the itch is mainly on the sides and back.
5. I have long held off on writing this article because I think it is so important to work with a holistic vet on this issue. You really need someone to direct you. This is a hard issue and I find we are often going back and forth between formulas. I sometimes adjust formulas to better suit a dog or use formulas not in this list. I hope this can still be of help for those of you out there without vet access and also to vets who want to work with Chinese medicine and help their clients.
6. Remember this takes time! Many of these dogs have had skin disease for years. It can take a year or more to get them back in balance.

Happy, healthy skin travels!

Degenerative myelopathy is a grave diagnosis. There is still so little we know about this disease and there is no known cure or even a treatment that can control symptoms long term.

I’m not going to dive too deeply into DM but just briefly cover the condition. DM is a degenerative nerve disorder of dogs. We most often compare it to ALS in humans and though it is a similar disease in presentation there are many differences. (In DM unlike ALS it is the axons of nerves that are effected and there is no glutamate build up). DM causes a progressive lose of nervous function starting in the hind legs and progressing to the front of the body. It can look very similar to a disc compression issue when it starts. We know there is a genetic mutation that has a large role in DM and this mutation can be tested for by your veterinarian. Not all dogs with the mutation will get DM. However in a dog with progressive hind limb weakness where disc disease has been ruled out, a positive mutation test is usually considered diagnostic. There is some thought that early and repetitive trauma to the spinal code in the thoracic spine is a precursor to this disease for dogs with the genetic mutation.

We cannot reverse or even stop the progression of this disease but there are things that can be done to slow it down. Even with slowing things down, it is hard to get more than a year of time after diagnosis and often times it is less.

Dr. Clemmons has developed a protocol that many folks follow. Unfortunately most people only use part of his protocol, the supplements he recommends. This protocol is actually three fold and for the best results all parts of his protocol should be followed. I’ve also added in some herbals that seem to help slow down progression used by Dr. Steve Mardsen.

1. Diet – these dogs should be on an unprocessed diet high in antioxidants. Whole foods are going to be the best – either a cooked stew, raw diet or homemade diet. Ideally high in multicolored vegetables and some fruits, low in grains and with good quality meat or fish. (Fish must always be cooked)



2. Physical exercise and body work/manipulation – this ideally would include swimming or hydrotherapy to keep the muscles strong, massage to improve muscle function, acupuncture to help with blood flow, and chiropractic adjustment to help keep the spinal system in alignment. Although all parts of this protocol are important the very most important is physical exercise every day if possible.
3. Herbs and supplements – these would include antioxidants to help prevent cell damage. Here are Dr. Clemmon’s recommendations. I also recommend an herbal containing Chai Hu, Milk Thistle and Curcumin. I use a modification of Xiao Chai Hu Tang with added Milk Thistle and Curcumin. One of my favorite veterinary herbalists, Dr. Mardsen, has done some of his own work with this disease and found that Chai Hu or bupleurum has much added benefit in that it stops inflammation in the spinal cord and reduces one of the main players in the disease, superoxide dismutase. Curcumin and milk thistle have long been used with DM to reduce gliosis and cytokine production in the spinal code leading reduction of inflammation.

I hope that sometime in the future we will understand more about this disease and will have a cure or better treatments. It is so hard to see those we love struggle.

More reading on Dr. Clemmon’s protocol and DM

• Hopeful News for Degenerative Neurologic Diseases
• Dr. Roger Clemmons and the Fight against Degenerative Myelopathy of German Shepherd Dogs

While I have had some amazing changes in 2014, including opening Kingdom of Basil our holistic clinic for people and their animals, I am happy to move onto a new year. Here’s a list of goals I would like to accomplish in the new year

Here’s to a wonderful 2015!