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Posted on 04-11-2017
While most of our clients see the benefits of Homeopathy, few see all the "behind the scenes" work that goes into picking the remedy that will make your pet better. Many hours of pouring over books, computer programs, charts, and emails lead us to the ONE and the ONLY remedy that will work for your dog or cat. Then the doctor has to pick the right potency, or strength to treat your dog. While picking a lower, "safe" potency is the preferred slow approach, sometimes a stronger 1M or a daily LM are a better fit for the case.
We thought it might benefit of our clients to see what goes into one straight forward case work up. Miss Leah had been treated server times by other doctors for a reoccurring skin issue that mostly affected the sebaceous gland at the base of her tail. While different treatments had lessened the severity of it, none had completely alleviated the issue. It was to the point that this treat loving kissing girl would because very agitated and unhappy if anyone even touched her back end. Treating the tail topically was becoming a nightmare for Leah. We turned to homeopathy to offer her, and her mama, some relief!
Here are the notes and case work up for Miss Leah's case:
Amount to feed per day
Rice white rinsed and cooked
¾ Cup measured before cooking
Pear or bananna
This diet was created for Leah based on her food allergy requirements.
Supplement: Seaweed Calcium
Step 2: Physical Exam:
Approximately 1/3 of the way down the tail, there is alopecia, redness, and moist discharge. Leah bites this area and it is sensitive to the touch. She seems agitated when the tail is handled and quickly moves out of the way. The affected area is approximately 4 cm in length and 2 cm in diameter with some areas of black pigmentation. The owner also reports that she turns quickly and licks her anal gland area.
There are no keynote symptoms
The most prominent symptom that made me consider Sulphur as the top remedy is the location of the symptoms – the anus or rectum is often a primary location for symptoms requiring Sulphur (Vermeulen, 1499).Also for Sulphur: Pruritis especially from warmth in evening.Sulphur patients have eruptions that are scratched and tend to ulcerate and exude offensive discharge (Vermeulen 1504).Sulphur patients tend to be lean persons and persons of nervous temperament, quick motioned, quick tempered, plethoric, skin excessively sensitive to atmospheric changes (Vermeulen 1505).
Mercurius patients may also have symptoms involving the rectum as is apparent on the repertorization.When reading about these symptoms in Vermeulen – none of these rectal symptoms match those of Leah (1050).Mercurius symptoms of the rectum include constriction, tenesmus, burning and itching of anus and adjacent parts after stool.Leah’s itching seemed to occur regardless of the passage of stool.Leah also has no mind symptoms of Mercurius which could include a slow weak memory, mistrustfulness, restless at night, violent impulses, and changing place continually.The skin of Mercurius patient is almost constantly moist and has vesicular and pustular eruptions.Itching is worsened by warmth of bed.While Leah’s tail gland is moist, the remaining skin is normal. The resulting scabs and inflammation are not vesicular or pustular in nature, just swollen and moist (1053), with mild ulceration.
Lycopodium patients are often afraid to be alone, and extremely sensitive with an aversion to undertake new things.They become headstrong and haughty when sick and have a loss of self confidence (Vermeulen 974).Anxiety, angry and sad are all emotions of lycopodium, but are not shared by Leah.
Digestive symptoms are common in the lycopodium patient.The rectal symptoms often include constipation.Anal itching is often related to excoriations which bleed easily and are itching and moist.This is not the case in Leah whose anus had no physical abnormalities, just pruritis.
Phosphorus patients are often fearful, and sensitive or hyposensitive, excitable and easily irritated (Vermeulen 1227).Leah is none of these when considering her emotional symptoms.Phosphorus patients are tall slender patients with narrow chests and thin skin.They are weakened by loss of fluids with nervous debility and emaciation (Vermeulen 1238).Phosphorus does have smarting of the rectum and needlelike stitches when not at stool, rectal polyps, and proctitis Vermeulen 1233).
Step 4: PLAN
Rx Sulphur 200c, prescribed May 23, 2017.
Supportive care: Tail kept clean with dilute lavender spray used daily with caution.
Owner reported on May 24, 2016: I gave Leah 10 pellets last night. She seems a little more lazy this morning, not wanting to go out to potty as early as she usually does. She was outside in the yard from about 9:00 to 2:00 laying in the shade. When my husband let her in around 2:00 she slept a lot which isn’t unusual after she has been outside. She wasn’t licking her behind, but I noticed her doing that when I got home. She really seemed to be acting pretty much the same except for licking herself less.
Follow Up Evaluation:
August 10, 2016
S: In the past couple of weeks she has started to lick her rectal area. Previous remedy helped in 3 days tail is completely healed.
O: This area is very sensitive to the touch when the temperature is taken or anal glands expressed. Anal gland discharge was tan in color, and of a normal amount and consistency. During this visit it was noted that her tail was no longer alopecic and she was not itching this area. No new symptoms were noted. Her overall pruritus was improved but not completely gone. Note this was in August – a time of year that in general the pruritus is improved.
A: Problem LIST:
Rectal pruritus – Improved for the past 2 months but recently worsened.
Skin itching – Improved
Tail gland pruritus and inflammation – healed
Overall wellness – excellent
B. Homeopathic Work up:
Most of Leah’s symptoms have subsided and she is emotionally well. Given the length of time it has been since she had a remedy, it was reasonable to repeat the remedy and potentize the remedy slightly.
P: Rx: Sulphur 200c 10 pellets dissolved in ¼ C water, succussed 24 times and 3cc was given to the patient.
Owner update November 2016
Leah is doing GREAT! I used the sulphur pellets on her for the second time after I brought her to see you last time. She responded in just a couple days after just that one dose. I also used the wipes with Lavender Essential oil on her hinny for a couple weeks.
Couldn’t be BETTER!
January 30, 2017. Presented for uncomfortable anal area. Owner gave one dose Sulphur 200c at home before appointment with no instruction. Tail continues to be completely healed. Anal glands examined and did not need to be expressed, no discharge present in gland.
Call to owner one week later – she reported that she was feeling fine.
Vermeulen, Frans 2000. Concordant Materia Medica
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