A Case Study - Hives

Ellie, 3 year old Paint mare

Primary Complaint on 12/2/99:

Hives from nose to tail, most severe on face. The hives break to open sores. When the hives are bad Ellie becomes lethargic and won't eat. The hives first started in Nov. 1998 and responded to a course of NaquazoneT (steroid, diuretic combination). She had a second episode in Aug. 1999 at which time she was very uncomfortable. She also stopped drinking and had a severe attack of colic. On Sept. 11, 1999, her hives returned and resolved after 5 days of NaquazoneT.

Her hives returned on Sept. 18, 1999, and she was started on prednisone. Her hives could be controlled on high doses of steroids but would return when the dose was decreased. As of the first consultation on Dec. 2, 1999, Ellie was being maintained on prednisone and hydroxizine. Her diet had been changed many times with no improvement and she was becoming aggressive and irritable. Ellie had been vaccinated for Flu, Tetanus, and Rhino in Feb. 1999 and had been dewormed regularly with pyrantel pamoate and ivermectin. Other health concerns included a hoof abscess in Aug. 1999 and a staph infection on her face.

Assessment:

I felt Ellie's hives were a result of poor digestion. I suspected she was not breaking down the proteins in her feed and these undigested proteins were being absorbed into her blood and causing an immune reaction. I also felt she had a dysbiosis condition in her intestines causing chronic inflammation. This looked to me like a classic "leaky gut syndrome" and I felt the high doses of steroids and antihistamines were aggravating the underlying condition.

Treatment:

Stop all medications. Start 5 SpectrabioticT (Probiotic and enzyme) twice a day. 1 tsp. Super Blue-GreenT Algae twice a day.

I wanted the Spectrabiotic to aid her digestion and rebuild a healthy bacterial population in her intestines. Blue-green algae was used to supply vitamins and trace minerals as well as easily digested protein. Blue-green algae has also been useful for helping to heal "leaky gut syndrome."

Follow-up: Jan. 7, 2000

Owner reports Ellie has been good since 5 days into treatment program. Ellie did not want to eat the Spectrabiotic capsules at first, so she mixed the powder with molasses and gave it to her directly in her mouth. Then she started eating them well in her food. She stopped the Spectrabiotic on Christmas day but continued the algae. Today she has a few hives but is otherwise healthy, happy, and eating well. She has not given any drugs since our last consult.

Treatment:

Give 5 Spectrabiotic twice a day for 10 days then cut back to 5 once a day. Continue Blue-green algae.

Follow-up: Feb. 8, 2000

Results of allergy test at Bio-Medical services showed multiple allergies to grasses, insects, pollens, molds, and alfalfa. Ellie had done well while on 5 Spectrabiotic twice a day, but her hives returned when the Spectrabiotic was decreased to 2 twice a day. Ellie was not exhibiting any digestive symptoms but she was again irritable and did not want to be touched. There was not much other than the skin symptoms to prescribe on homeopathically.

Ellie's owner described her as being frantic. She said she had muscle spasms when she ate grain. She did not want to be touched, was aggressive and wild-eyed. This sounded to me like Belladonna and I wondered if Calc Carb might be the correct chronic remedy for her. I could have prescribed Belladonna, but experience has shown me that using acute remedies for acute flare-ups of chronic disease tends to palliate symptoms. Once I have had curative reaction in a case with a deep acting remedy I will sometimes use an acute remedy for a flare-up, knowing I will be going back to the deep acting remedy to keep the case moving forward.

In this case I decided to focus on healing Ellie's digestive tract. It had only been two months and we had seen good results when her digestion was supported. I wanted to see a clear picture on a remedy before prescribing.

In March 2000, I received some before and after pictures of Ellie showing how the hives had improved. She was doing very well and the owner was pleased.

I did not hear back. So, when I called on Oct. 15, 2001, to get a follow-up report, Ellie had improved about 95% with the spectrabiotic and algae but her owner felt she still had some lingering skin sensitivity. Her vet offered to provide allergy desensitization injections at cost, so these were started in May 2000. At first Ellie reacted violently to the injections with severe hives on her neck and shoulders. Over a 6-month period her reactions decreased and her skin symptoms improved. Her owner also felt putting her on a strict diet of grass hay, oats, and flax oil helped. Her testing had shown her to be very sensitive to alfalfa. On questioning, I determined Ellie had now developed strong symptoms of chronic disease.

Current symptoms as of Oct. 15, 2001

Ellie's mammary glands stay swollen at all times. When she comes in heat, her glands get sore. The swelling is more pronounced when she is in heat and it extends forward along her belly up to the girth area. She sweats much more than other horses when ridden. Although she likes attention, she can have an attitude about being ridden. She seeks shade and occasionally has a thick white discharge from her nose. She still occasionally gets hives which resolve when the Spectrabiotic is increased for a few days. She normally gets only 1 capsule a day and 1 tsp. of algae. Her skin is also thick around her chest.

I worked up the case using the rubrics:

Skin; hard; thickening, with Skin; eruptions; urticaria; nodular Chest; swelling; mammae

The four remedies at the top included Rhus tox, Calc carb, Dulc, and Lach. Of these, only Calc carb is a deep acting remedy and the one I thought might be right before. Rhus tox is a complement to Calc carb and it might be helpful as an intercurrent remedy. I feel the allergy injections are acting in a palliative way and the other symptoms will continue to develop unless the chronic disease is addressed. I am sending Calc carb 30c to be given twice a day for three days and will get a report in 1 month.

This case is a good one to study several healing principles. First, in my opinion, improper digestion is the underlying cause of many conditions. Stress, medications, vaccinations, and environmental toxins can all contribute to problems with digestion. In many cases, reestablishing a healthy population of beneficial bacteria in the digestive tract will resolve secondary symptoms. When the intestinal lining has had time to heal, toxins and poorly digested proteins will no longer be absorbed into the blood.

The liver is responsible for filtering the blood , which comes directly from the digestive tract. The toxins and large protein molecules cause stress on the liver and impair its function. When the liver is stressed it is common to see symptoms such as irritability, muscle stiffness and hormonal imbalances. Allergies are yet another symptom of liver stress. In Traditional Chinese Medicine, the Liver is responsible for helping the body to adapt to change. Allergies from a TCM viewpoint demonstrate the body's inability to respond to its environment.

The allergy desensitization injections are designed to wear down the body's resistance to substances. They do not treat the underlying imbalance to the immune system. They generally act in a palliative manner and do not seem to have the side effects of steroids. In Ellie's case, they do seem to helping with her skin, but now other symptoms are showing up.

My goal is to correct Ellie's underlying poor digestion with homeopathic treatment and nutritional support and eventually stop her allergy injections.