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Chinese Herbal Formula Used to Treat Flea Allergy Dermatitis

Chinese Herbal Formula Used to Treat Flea Allergy Dermatitis

By Christine Johnson, DVM, CVCH - Oakland, CA

Author: Chi Institute/Monday, November 1, 2010/Categories: Student Case Reports, TCVM Newsletter, 2010 Winter Issue

Abstract
A six year old, 9.25 lb, female spayed, domestic short hair cat was presented for examination. The cat had been pulling fur out excessively and chewing on her coat intensely for three to four weeks. She was diagnosed with parasites and External Wind. Her treatment consisted of a combination of a Chinese herbal formula, Jing-Tang Herbal’s External Wind, aquapuncture, manual parasite removal and nutritional supplementation. Her signs subsided quickly and her coat returned to normal.

History
A six year old, 9.25 lb, female spayed, domestic short hair cat was presented for examination. The cat had been pulling fur out excessively and chewing on her coat. Although she had done this on and off for over a year it had greatly intensified the month preceding her examination.

The cat lives with one dog and three other cats. These other animals show no dermatologic abnormalities. When the cat was adopted from a rescue organization at a few months of age she was missing her lower left hind leg below the femur. She was described to be generally in good health with a rare cough and occasional congestion sounds, although no sneezing or nasal discharge. She had similar signs the previous year of hair pulling and was treated with a combination of three Bach Flower remedies; Crab Apple, Cherry Plum and White Chestnut. This improved her signs at the time but the signs had reoccurred despite repeated use of the Bach Flower Remedies. All cats were fed a commercially available raw food diet; alternating formulations of Primal and Natures Variety. In addition they were on three supplements by Earth Animal; an herbal remedy for reducing fleas, ‘ No More Fleas’, a nutritional supplement for reducing fleas and dermatitis ‘Internal Power’, and a general daily nutritional supplement ‘Dr Bob’s Daily Health Nuggets for Cats’. The patient also enjoyed some treat food like yogurt or pumpkin from time to time. 

 The cat was given an injection of vitamin B12 at acupuncture point GV 14 (Da Zhui). She was started on External Wind, a Chinese herbal formula by Jing-Tang Herbal. Eight grams of External Wind was mixed into a liquid flavor agent in a two ounce glass container. This resulted in an 8gm/60ml or 0.13gm/ml concentration. The owner was instructed to refrigerate the container between uses and shake it well before use. The cat was given one milliliter (0.13gm) of the flavored herb mixture orally twice a day for two weeks, then another six weeks at least once a day, twice a day when the owner was able to give it. The two supplements by Earth Animal for fleas, ‘No More Fleas’ and ‘Internal Power’ were stopped. A new supplement by Standard Process, Antronex, was started at one tablet a day. The dog in the house was started on the flea control product Advantage. Flea combing of all cats was increased and house carpet treatment of Flea Busters was applied. 

Western Physical Examination
The patient was very active, bright, alert and responsive. She was well hydrated and had good dentition. Her mucus membrane color was pink. Her coat was thin. She had many scabs over the lumbar and sacral areas of her back. Fleas were seen in her coat. She had good body condition although she had no left hind leg below the femur. She had a normal heart rhythm at 130 beats per minute. She was eupneic with no abnormal respiratory sounds. Her abdomen palpated normally. She had no palpably enlarged lymph nodes.

Traditional Chinese Medicine Examination
Although she had a good Shen overall, the cat was disturbed by her skin and coat. This itchiness was described to be causing her to be restless and unhappy. Her coat was thin. She had many scabs over the lumbar and sacral areas of her back. Fleas were seen in her coat. She had a fast pulse and a moderately red tongue. 

Western Diagnosis

Although the other four pets in the house were reported to have neither parasites nor dermatologic changes; fleas were seen on the patient during examination. As fleas were seen along with scabs on her lumbar region, the patient was presumed to have flea allergy dermatitis. No diagnostic tests were performed.

Traditional Chinese Medicine Diagnosis
The cat showed external parasites. The signs of skin chewing, scabs and restlessness were caused by pathogenic wind. In addition her moderately red tongue, itching, scabs and sore indicated Heat invasion. Her ultimate diagnosis was Wind-Heat invasion. Her overall appearance, pulse and tongue supported this external excess condition.1

TCVM Treatment Principles
The traditional Chinese medicine treatment princiles were to alleviate itching by clearing External Wind, cooling Blood and detoxifying.

Formula and Individual Herb Selection
The Chinese herbal formula by Jing-Tang Herbal, External Wind, was chosen to clear External Wind, cool and activate Blood, and detoxify in order to alleviate itching. The standard dosage of the Chinese herbal formula External Wind, by Jing-Tang Herbal, is 0.5 grams per 10 to 20 lb of body weight twice a day. In this case eight grams of External Wind was mixed into a liquid flavor agent in a two ounce glass container. This resulted in an 8gm/60ml or 0.13gm/ml concentration of the herb formula. The cat was given one milliliter (0.13gm) of the flavored herb mixture per dose.  The patient was started and continued on 0.13gm per dose since a larger volume appeared difficult to administer and it was being combined with other forms of treatment. She was monitored for adverse effects from the treatment.

The formula External Wind contains the following herbs and main actions:
1. Jing Jie-Schizonepeta: This herb clears Wind-Cold, releases the exterior and alleviates itching. It enters the Lung and Liver channels. It is indicated in cases of pruritic skin eruptions. 2, 3  

2. Cang Er Zi- Xanthium: This herb clears and opens the Lung. It expels Wind-Damp to relieve itching and rashes.2, 3, 4  

3. Jiang Can- Bombyx: This herb clears Wind, stops spasm as well as itching. It enters the Liver and Lung channels. It detoxifies. It is indicated for Wind-Heat causing itching and skin lesions. 2, 3

4. Chi Shao Yao-Paeonia: This herb cools Blood, clears Heat and promotes the circulation of Blood. It is indicated for Heat in the blood manifested as eruptions. 2, 3     

5. Mu Dan Pi-Moutan: This herb cools Blood, clears Heat and activates Blood to resolve stagnation. In laboratory studies it demonstrates strong anti-inflammatory actions by inhibiting prostaglandin synthesis and decreasing permeability of blood vessels. It is indicated when there is Heat in the Blood level manifested as eruptions. 2, 3, 4             

6. Di Fu Zi- Kochia: This herb clears Wind and eliminates Damp Heat. It is indicated in skin disorders with pruritus or Damp-Heat signs. 2, 3 

7. Bai Xian Pi- Dictamnus: This herb clears heat, relieves toxicity, expels Wind, dries Damp and stops itching. It is indicated for treatment of sores and skin rashes due to Wind-Heat. 2, 3           

Results
The patient improved rapidly. Within ten days her intense itchiness had subsided and she was a lot happier. Her skin and coat returned to normal over the next weeks. She has not had any further episodes of intense itchiness nor other illness to date. She showed no adverse reaction to the treatments used. 

Discussion
This case shows how Chinese herbal formulas can be combined with other treatment forms such as aquapuncture, nutritional supplements and flea removal, in order to have a faster response. The aquapuncture point GV14 was chosen to help clear heat and quiet the spirit.5 The owner preferred minimal use of pesticides or other chemical control of the fleas so only the dog of the house was given the product Advantage and manual removal of fleas was used on the four cats. The nutritional supplement Antronex by Standard Process was started to help detoxify her liver. 

Skin disorders are commonly caused by Wind attaching the exterior of the body. The formula used in this case, External Wind, is well suited to clear such Wind and Wind-Heat invasions. The patient showed an excess pattern since her overall immune system, Zheng Qi was not weak but the Xie Qi of invading pathogens, parasites and Wind, were strong. 6 This suggested that she would be able to clear the pathogens with a formula to treat an external condition like Wind –Heat. The standard dosage of the Chinese herbal formula External Wind, by Jing-Tang Herbal, is 0.5 grams per 10 to 20 lb of body weight twice a day. The patient was given 0.13gm twice a day since a larger volume appeared difficult to administer and it was being combined with other forms of treatment. 

The combination of treatments was chosen since no contraindication was anticipated by their combination and in fact the rapid resolution of the cat’s condition suggested a synergistic action of the prescribed treatments. The only contraindication for use of the herbal formula chosen would have been if the patient has substantial signs of deficient Blood or Qi for Cang Er Zi, of blood deficiency with cold or pregnancy for Mu Dan Pi, or of deficiency and cold for Chi Shao Yao and Bai Xian. 3, 4   

References
1. Xie H, Preast Vanessa Xie’s Veterinary Acupuncture. Ames, IA: Blackwell Publishing, 2007; 316
2. Xie H. Chinese Veterinary Herbal Handbook 2nd ed. Preast V. Reddick, FL: Chi Institute of Chinese Medicine, 2004; 185.

3. Lan Xu, Zong. Pocket Handbook of Chinese Herbal Medicine. Miami, FL: Waclion International Inc. 2005; 17, 31, 42, 66, 128,134, 161, 

4. Chen John K., Chen Tina T. Chinese Medical Herbology and Pharmacology. City of Industry, CA: Art of Medicine Press, Inc., 2004; 63, 160-161, 163

5. Flaws Bob, Acupoint Pocket Reference. Boulder, CO: Blue Poppy Press, 2005; 74
6. Xie Huisheng, Preast Vanessa Traditional Chinese Veterinary Medicine Volume 1 Fundamental Principles. Beijing, China: Beijing University of Aeronautics & Astronautics Printing House, 2005; 228-231




 

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