Well, as Dr. Luc once said, “Case-management in homeopathy is poor worldwide.” And even James Tyler Kent had to acknowledge, “Why do we lose so many cases from the second prescription on?” This is why I am so anxious to share this dog case with you, as there is no doubt that what Kent and Dr. Luc were saying is true.
This dog case first appeared in one of my old “Questions Patients Ask” articles. I was reading it over because I was looking for something to send to the mother who is in the Quiz this month! She was potentially spoiling her daughter’s case by prescribing during an aggravation! I said, “Please read ‘Questions Patients Ask-13’ and scroll down to the dog’s case!” And I thought to myself, if the dog’s case is that important, why doesn’t it have an article of its own?! (Just like “The Aggravation Zapper” used to be buried in an interview I did with Diane Fuller from 2004.)
Eczema in dogs is a serious, pervasive and very disturbing problem for both the pets and and the pet “parents” as well. The cause is, more often than not, the over-vaccination schedule dogs are subjected to in veterinary practice, as explained in my interview with animal-advocate, Catherine O’Driscoll.
Dog owner, Rebecca, had joined the hpathy Veterinary Forum to ask for help with her dog suffering from eczema. Seasoned homeopath, “D”, volunteered to help right away. Things must have been going badly because hpathy team-member, Shirley Reischman, wrote to me and told me, “Go to the Veterinary Forum and help the dog!” And so it began. There are many lessons to be learned here! See below:
Please help the dog!
Shirley, who had been following a thread on the Veterinary Forum at hpathy.com wrote to me and said, “Elaine, please jump into the ‘Itching Dog’ topic, I’m worried about the dog!” So, I sighed and said OK. I think there are a lot of case-management lessons we can learn from this, so I am presenting it to you now, and hope that it is enlightening. Here you see Rebecca (“R”), the owner of the dog, being helped by homeopath, “D”
My comments are interspersed in blue italics:
…Hello Rebecca! What you said about the dog trying to be friends with other dogs who don’t like her (sorry she was attacked by the neighbor’s dog, I hope she’s alright) and also what you said about her being a dog who is submissive and wanting to please, makes me think of Staphysagria.
Now, I’ve read the case over from the beginning and I’ve copied and pasted it below. I am quoting from the text but will jump in to comment in italics as needed:
R: When reviewing Lena’s history, I see this: 11/27/13– 1 dose rhus tox 30C. Itching intermittent, gave 4 or 5 doses of calc carb
12/18/13– 1 dose rhus tox 30C when she was itching/scratching terribly. She calmed down in a few minutes and went to sleep.
Whoa! Stop! OK, there it is, Rebecca! “1 dose rhus tox 30C–she calmed down and went to sleep.” That’s it! This is what we’re looking for after a remedy, you can’t do any better than this! If the dog relapses from this improvement, give the remedy again; but otherwise, don’t do anything!
3 days of arsenicum
12/25/13 1 dose of rhus tox 30C when she was itching/scratching terribly. Once again, she calmed down in a few minutes and went to sleep.
Wow! You see? You repeated Rhus tox and the exact same thing happened–calm and fell asleep! This is confirmation for Rhus tox!
Since she calms down from the dose of rhus tox, does this mean it is just palliative or is a cure working?
Palliation does not help the patient in general! “Calm” is the gold star! When calm takes over, that is a deep-acting remedy, and the right remedy, period!
I want to do what is right, so will not dose anything else for now. Thank you very much.
D: Alright we need to work through this systematically. First thing I would suggest is to repeat the Rhus-tox each day for one week.
What? OMG! No, no, no!!! We know the single dose of 30C on an as-needed basis works! It’s worked twice now! Why would we change anything? Why would we not stick with what’s working? By giving it every day–while she’s WELL? We are certainly risking either an aggravation or a canceling-out of the remedy. And it would be hard to tell the difference between the 2.
D: …Make sure you are hitting (succussing) the bottle 3 times before each dose.
The next step, assuming that this does not further improve her, would be to obtain Rhus-tox 200c and give her a single dose. Don’t do this until you make a report of her progress here. Then we can make further decisions based on her response.
R: I don’t know if I can take of week of this! Two days of the one-dose-per-day of rhus tox and itching is worse.
See? Look what happened — an aggravation! (It might have been a good idea to do “the Aggravation Zapper” in the 12th cup at this point.)
The scratching/chewing episodes are much more frequent and more violent, with little bumps coming back on her legs. I’m afraid she’ll chew/scratch her skin open.
D: This is an aggravation. Stop immediately! Did this occur after one dose or two?
R: Still waiting for the psorinum to arrive, should be today or tomorrow.
The itching has improved somewhat. Her itching is not constant and the bouts are shorter, but intense. She seems especially itchy on her face now and also her front legs. The itching is still worse upon waking.
The aggravation is wearing off. It is therefore incumbent upon us to wait and do nothing.
D: So she is slowly improving? That is interesting, and that is since the last aggravation on Rhus-tox 30 isn’t it?
R: Yes, some improvement since the rhus-tox, but still itching.
D: Do you want to try one more dose of Rhus-t 30 before we move to a new remedy?
No, no, no!!! The aggravation is in the process of wearing off! Dosing now will only aggravate again OR antidote Rhus tox altogether, and it’s possible that we won’t be able to distinguish the difference between the two.
R: I gave her the one dose yesterday morning. Before the dose, she was itching a little more than she had been for a few days. After the dose, no immediate reaction. No improvement as of today. She is somewhat more itchy it seems.
This is a sign that the potency is no longer working. You said the dog’s itching had increased, you gave the remedy, and nothing happened. So the remedy has lost its “punch”. You have to “plus” your bottle (raise the potency) at least once, possibly 2 or 3 times. It’s very simple. Pour out 90% of your bottle, refill with water half way, succuss 40 times. You’re now one potency higher. See if that works, see if the itching stops. If not, plus your bottle again.
D: Just wait for one more day, if no improvement repeat the dose again.
No, no, no, the potency has stopped working! Nothing good can come from repeating it again, maybe another aggravation?
R: I waited a day, no improvement, so repeated the dose. She seems worse…
There it is.
… more scratching all over and chewing at her feet.
D: Alright don’t use Rhus-tox again. Wait to see what happens. Let me know if the Psorinum arrives.
So, as you can imagine, “D” is giving up on Rhus tox; the case seems hopeless and erratic, but Rhus tox was the right remedy! After not knowing how to keep the case moving, Psorinum was started! Has the case been lost? It is clear that the case was so easily curable back in the beginning, but by the time the case was so thoroughly mismanaged, the right remedy turned into a weapon of mass destruction!
We have two options here: We can start over again with Rhus tox 6C in water (3 succussions before each dose), with a tentative dosing schedule of three times a day, to be adjusted up or down as per the dog’s reaction to it, or, we can give what looks to be the dog’s constitutional remedy–Staphysagria 30C, one dose.
I think my vote would be for starting with Rhus tox 6C since the itching is the chief complaint and I don’t know for sure that Staphysagria will address the itching. Why 6C? The 30C has been abused and might not work anymore or cause another aggravation. I’d rather try a potency the dog has not developed a tolerance or a hypersensitivity to; I don’t want to go too high because the dog might aggravate again. Always remember the rule: A striking improvement precludes further dosing, repeat if a relapse ensues. If there’s an aggravation, stop dosing; wait, an amelioration may follow.
I just heard back from Rebecca:
After a week of not scratching so much on 6C, this week Lena has gotten worse again and the bad smell has returned. I have not given the rhus tox on a regular basis as you said. I gave it on an “as needed” basis, basically a dose in the morning when she was really itchy. But now, Lena is itching almost constantly again. Should I start a regular dose, or leave her off it totally to see if she improves on her own?
I told Rebecca to first try giving the 6C more often, and if that didn’t work, raise the potency to 7C.
You might ask, How did we know the remedy was Rhus tox? The dog loved warmth! She lies in front of a heater! This is very peculiar for itchy dogs who often seek a cold spot to lie on. The dog was initially given Sulphur, you can see how inappropriate the Sulphur prescription was, knowing the grand keynote of Sulphur– “worse heat”. The dog is also worse on waking and better outside on car rides but starts itching again as soon as she walks in the house. So, we’ve got three Rhus tox keynotes here: better outside/worse inside, better heat/hot applications, worse in the morning on waking.
Here is the last update I received from Rebecca:
Hi Elaine, thanks for sharing my dog’s tale of woe! Lena is a little better. The big problem is MY ignorance about finding a balance… knowing whether itchiness is from an aggravation or she just needs another dose. She is now at the point where she has long periods of rest, but still will scratch for a while periodically.
I wrote back saying, “‘Long periods of rest’ sounds good to me!”
What are our take-aways here?
- When you see “Calm” after a remedy, Stop Dosing! “Calm” is all you can ask for! It’s what we’re looking for! You’re permitted to dose again if the patient’s distress comes back.
- No arbitrary dosing schedules that you force the patient to stick with regardless of response! As Hahnemann says in The Organon, aph. 246, as long as improvement lasts, no further medicine of any kind should be given. So, if your homeopath says, “Take your remedy 3 times a day,” but after the first or second dose you feel completely fine, that’s it! You’re done! I don’t care what the homeopath said, no more dosing unless and until the case relapses!
- Don’t repeat while an aggravation is in progress or starting to wear off. If the aggravation is wearing off, chances are an improvement is going to follow. If that’s the case, you can dose again once the improvement begins to decline.
- Always have your remedy (one or two pellets) in a half-filled bottle of water so you can succuss 2 to 5 times before each dose. Otherwise, your patient will develop a “tolerance” to the remedy and it will stop working and eventually aggravate.
- Potencies can easily stop working; so, be prepared for that. That’s just a fact. Don’t be surprised or dismayed when it happens, and don’t think it means you have the wrong remedy, just raise the potency! I go into how to do that in my FAQ article:
- Aggravations happen–a lot! Learn how to do the Aggravation Zapper rather than letting your patient suffer.
- When you think you’ve made a mess of things, go down to the 6C. Sometimes you need only one dose of a 6C for the case to straighten out! Again, remedy must be in water and succussed before each dose, and consider the possibility that because it’s such a low potency, it MIGHT have to be given several times a day; BUT, as soon as the case improves, give less and less often, and always remember, a striking improvement means no further dosing! Wait for the case to start relapsing, then dose again. Know that your 6C is such a low potency that it will most likely wear out so be prepared to plus your remedy bottle to the next potency when this happens.
For more information on case-management, see my FAQ article:
Bye, see you again next year!
Elaine Lewis, D.Hom., C.Hom.
Elaine takes online cases and animal cases too!
Write to her at [email protected]
Visit her website: www.ElaineLewis.hpathy.com