Journal of Integrative Veterinary Therapies
Total Page：16
File Type：pdf, Size：1020Kb
journal of integrative veterinary therapies March 2012 Volume 2, Issue 1 journal of integrative veterinary therapies contents veterinary chinese medicine 5 Herbal Therapy in a Dog with Severe Atopic Dermatitis Leilani Alvarez DVM 13 A Chinese Medical Approach to Cholangiohepatitis in the Dog Lauren A Bauer DVM 22 Integrative Management of Canine Allergic Bronchitis with Veterinary Chinese Herbal Medicine Tom Schell DVM DABVP (eq) 28 Use Of Huo Xiang Zhing Qi San for the Treatment of Recurrent Diarrhea in a Juvenile Poodle Dr Grace S Y Li western veterinary herbal medicine 35 Monograph: Alkaloids Holly Mash BVSc IVAS MRCVS 40 Monograph: Radix Astragali Mary Ellen Sayre DVM 43 Holly’s Herb Walk Holly Mash BVSc IVAS MRCVS 47 Study shows how Primates learn about Herbal Self-Medication CIVT Staff regulars 3 JIVT: An introduction 34 Clinical Pearls of Wisdom 49 Research Updates 52 About JIVT The Peer Review Board encourages JIVT: An introduction contributions to the Journal on all areas The Journal of Integrative Veterinary of integrative veterinary medicine. Therapies (JIVT) is a quarterly publication of Instructions for contributions are on the CIVT. The Journal publishes material on all last page. For full instructions go to www. aspects of integrative veterinary medicine civtedu.org, membership, journal. including Chinese and Western herbal Editorial Committee: Barbara Fougere, medicine, natural nutrition, environmental Lyndy Scott, Karen Goldrick, Steve medicine, philosophy, history, clinical cases Marsden and Joanna Milan. and commentary. The College was founded in 2008 and The Journal is peer reviewed. is the world’s first distance education Members of the Peer Review Board are: institution specializing in evidence based natural medicine for animals. Our mission Steve Marsden DVM ND MSOM Lac Dipl is to provide international leadership in CH RH (AHG) Edmonton, Canada delivery of comprehensive and quality Susan Wynn DVM RH (AHG) CVA CVCH veterinary natural medicine education that Atlanta, USA is evidence based. We aim to bridge science and tradition to benefit animal health Barbara Fougere BSc BVMS BHs (Comp and wellbeing by integrating the best of Med) MHSc (Herb Med) CVA CVBM CVCP natural medicine and conventional health MOrd D&T CMAVA MNHAA Sydney, care practices. We encourage an ecological Australia and environmentally aware approach to the health of our animals, ourselves, our Nancy Scanlan DVM MSFP CVA communities and our planet. California, USA Joyce Harman DVM MRCVS CVA Washington, USA Letters to the Editor We welcome and encourage your letters Richard Palmquist DVM and feedback. We envisage that your Los Angeles, USA words will be part of a vibrant and ongoing dialogue within a growing community of Jean Dodds DVM Los Angeles, USA integrative veterinarians and allied health Lyndy Scott BSc BVMS MBA MANCVS FAICD professionals. Perth, Australia Email your letters to [email protected] Hue Karreman DVM Lancaster County, USA civtedu.org JIVT 2(1) March, 2012 3 civtedu.org JIVT 2(1) March, 2012 4 Herbal Therapy in a Dog with (Haliwell 2006). Appropriate diagnosis of Severe Atopic Dermatitis AD is based on the patient’s signalment, Leilani Alvarez DVM clinical signs and history of disease (Favrot et al. 2010). Favrot’s criteria for diagnosis of AD include five of eight satisfying criteria, which yield a sensitivity of 85% and specificity of 79% to differentiate dogs with AD from dogs with chronic or recurrent prutitus without AD (Table 1). Dogs with AD usually have skin lesions consisting of erythematous macules, patches and papules. However, in most patients, the skin lesions are due to self-induced trauma, including excoriations, alopecia, lichenification and hyperpigmentation (DeBoer & Hillier 2001). The areas most commonly affected include Abstract the face, concave ear pinnae, ventral neck, Herbal therapy provided effective axillae, groin, abdomen, perineum, ventral treatment for a dog with severe atopic tail and extremities. One must also be dermatitis that had been refractory to careful to rule out other pruritic conditions, conventional therapies. A combination which can mimic AD including scabies, of conventional therapies, acupuncture, demodicosis and infectious bacterial and herbal medicines and dietary changes were yeast pyodermas. used to treat the patient and, in the last Experts in the field of dermatology have 15 months, the condition has been well agreed that intradermal tests and allergen- managed with the integrated approach. specific IgE tests cannot be used as the sole This case demonstrates that herbal therapy means of diagnosing AD (Hillier & DeBoer can be a successful treatment option for 2001). Instead, results from these tests can refractory atopic dermatitis cases or as be used to implement allergen-avoidance complementary treatment for patients with interventions and targeted immunotherapy dermatologic problems. against select allergens. Introduction Current practice guidelines on successful Atopic dermatitis (AD) is a common treatment of AD state that a combination dermatologic diagnosis in dogs consisting of several interventions and treatments of chronic relapsing pruritic skin (Olivry et is often necessary to achieve satisfactory al. 2010). Dogs are genetically predisposed results (Olivry et al. 2010). These measures to this inflammatory skin condition, which include: Identification and avoidance of is characterized by specific clinical features flare factors (such as fleas, food, dust mites, associated with IgE antibodies, usually pollens or other environmental allergens); directed against environmental allergens improvement of skin and coat hygiene and civtedu.org JIVT 2(1) March, 2012 5 care; and reduction of pruritus and skin history of aggression and anxiety issues lesions with pharmacological agents (such since she was first acquired as a puppy. as glucocorticoids, antihistamines, essential Prior to presentation, the patient had been fatty acids, tacrolimus and cyclosporine). treated by a board-certified dermatologist for three years, including treatments Herbal medicine has shown some with hyposensitization injections, promise in the treatment of AD. Several antihistamines, steroids, antibiotics, human studies have demonstrated that Atopica® (cyclosporine) and medicated a combination Chinese herbal medicine, baths. Despite these therapies, the patient’s Zemaphyte® is helpful in the management symptoms were not well controlled. of atopic eczema (Chung 2008, Hon et al. 2007, Zhang 2005, Xu et al. 1997). Intradermal skin testing revealed she was Zemaphyte®contains Ledebouriella reactive to several tree pollens, house saseloides (pictured next page), Potentilla dust mite and tobacco. Serum IgE testing chinensis, Clematis armandii, Rehmannia for aeroallergens revealed positive titers glutinosa, Paeonia lactiflora, Lophatherum to several species. The dermatologist gracile, Dictamnus dasycarpus, Tribulus developed a vaccine combining these terrestris, Glycyrrhiza glabra (licorice) and results with those of the intradermal Schizonepeta tenuifolia) skin test and the patient received the As well, in a randomized double-blind appropriate course of hyposensitization placebo-controlled trial with dogs it was injections. After six months of weekly shown that Phytopica® (Intervet-Shering injections, the owner reported the Plough), a Chinese herbal supplement and pet’s pruritus was not improved and a derivative of Zemaphyte®, significantly she continued to have flare-ups. The reduced the dose of methylprednisolone dog also received Staphage Lysate required to control pruritus as compared to injections for over a year. The owner placebo (Schmidt et al. 2010). Phytopica® reported the injections helped initially, contains Rehmannia glutinosa, Paeonia but the dog continued to have severe lactiflora and Glycyrrhiza uralensis (licorice). outbreaks with bloody excoriations, An earlier randomized, controlled study on especially in summer time. After almost the same product showed favorable results two years, Staphage Lysate injections in the treatment of atopic dogs compared were continued but hyposensitization to placebo (Nagle et al. 2001). injections were discontinued. Case presentation Most recently, she had some relief with A 7-year-old, female spayed German the antihistamine, hydroxyzine, and initial Shepard dog, weighing 67 lbs (~ 30 kg) relief with Temaril P® (trimeprazine 5 mg and living primarily indoors, presented in and prednisolone 2 mg), but these were early summer with a primary complaint of no longer helping. The owner bathed the severe atopy that had not responded to pet every 2 to 3 days with hypoallergenic conventional medicine. Her allergies first shampoo. The pet had had an episode manifested when she was a year old and of severe colitis six months prior to had worsened over the years. She had a presentation. When presented, she had a civtedu.org JIVT 2(1) March, 2012 6 great appetite and no current vomiting, We elected to continue the essential fatty diarrhea, coughing or sneezing. acids but discontinued the Temaril P®. We changed the diet to fresh raw frozen food Conventional evaluation with high protein and low carbohydrate, On Iiitial exam, the pet was bright alert using cooling proteins including fish, soy and responsive and had normal vital signs. or rabbit. She also received five weekly Her demeanor was anxious and fearful. acupuncture treatments aimed at reducing On physical exam, she had severe moist pruritus, inflammation and to calm her erythematous lesions in the periocular