Multi-Model Clinical Review

CASE EVIDENCE BUNDLE v1 ======================= PATIENT ------- Name: Hustle Owner: Hillian Species: Dog Breed: Sex: Desexed Status: Entire Life Stage: Adult Activity Level: Moderate Current Weight kg: 14.00 Ideal Weight kg: 15.00 BCS: 4.00 CASE ---- Case ID: 8 Title: RAC test 6 Primary Complaint: Reflux, Skin itching , Wt loss Status: Open Date Opened: 07/06/2026 CLINICAL NARRATIVE ------------------ Last 3 months of 2025, Hustle was on 100% Barf as she had reflux previously when fed any kibble. Xmas 2025 I introduced PetnPro kibble as I could not get her to maintain a good weight.... she was at least 1- 1.5 kgs too light. She was looking the best she has in years by End of January, she was on 50% PetnPro with barf. March she was in season 8th to 30th. Around the 23rd March I realised she has some rash on her belly, groin area. It was red, crusty circular lesions, and was itchy. Vet 15th April (Animal Wellness) Many different causes possible, including hormonal. The kibble was stopped at 1st April. Barf continued 100% of diet. Xiao Feng San started after vet visit, along with herbal cream and weekly washes in oatmeal shampoo and conditioner. Seemed to improve for a week, but by day 6 after wash she was very uncomfortable again. The rash cleared from belly and groin and was then along the spine and tail from the mid lumbar area. Once that began to clear, it started on her sides and flank....now it is neck underarms and forward half nipples. It is very red and some scabs and crustiness to start, then the red goes and there are dry flakey roundish scabs all over the area. Currently she seems the worst, there is lots of redness of the skin, chest and neck area.... some of her nipples have lesions around them, and there is some swelling, almost as if she's having a phantom pregnancy. The lesions are appearing as red round areas with the hair thinning and and coming away. I didn't continue with the herbs once they were finished, as she had reflux with it and she has dropped down to 14kgs. I am losing the battle for her atm, she is wearing shirts during the day to stop her scratching and I am using tissue salts to contract the itch..... it all helps but her skin is still deteriorating. I have stopped all chicken as well, doesn't seem to have helped, and she is still too underweight. Pet Mince Direct Essential Barf V2 Since at least September last year, until beginning of May. Ingredients: Pork Meat, Chicken Meat, Chicken Bone & Cartilage, Beef Liver, Pork Liver, Beef Kidney, Pork Kidney, Mullet, Salmon, Beef Spleen, Seasonal Vegetables (Broccoli, Cauliflower, Celery, Spinach, Kale, Sweet Potato, Pumpkin, Carrot, Zucchini, Green Beans, Beetroot, Cucumber), Sunflower Seeds, Chia Seeds, Spirulina, Chlorella, Barley Grass, Alfalfa, Brewers Yeast, and Kelp. I have since had her on their SUPER COOL BARF Ingredients: Emu, Quail, Mackerel, Goat Meat, Turkey Meat, Lamb Tripe, Lamb Hearts, Lamb Liver, Lamb Kidney, Lamb Bone and Cartilage, Turkey Bone and Cartilage, Blackberries, Blueberries, Strawberries, Raspberries, and Seasonal Vegetables (Broccoli, Cauliflower, Celery, Spinach, Kale, Sweet Potato, Pumpkin, Carrot, Zucchini, Green Beans, Beetroot, Cucumber), Wheatgrass, Chlorella, Barley Grass, Alfalfa, Chia Seeds, Sunflower Seeds, Brewers Yeast, Kelp. and also BIG DOG SENSITIVE SKIN Ingredients Tasmanian salmon, Turkey (meat, crushed bone & cartilage), Pork (meat, crushed bone & cartilage), Lamb (heart, lung, liver, kidney, trachea), Goat (heart, liver, lung, kidney, trachea), apple, green bananas, carrots, lettuce, green beans, sprouted wheatgrass, orange, strawberries, blueberries, nettle and dandelion tea, psyllium, goats whey, kelp, turmeric, organic fulvic acid. She is on at least 500g per day. Treats, are either Roo based with no Chicken, Venison air dried Or salmon based, again no Chicken INITIAL DIFFERENTIAL NOTES -------------------------- CLINICAL INTAKE DOCUMENTS ------------------------- Count: 1 Document: Clinical Intake - 13/06/2026 18:51 Type: Clinical History Source: Clinical intake / AI consult Uploaded: 13/06/2026 18:51 Last 3 months of 2025, Hustle was on 100% Barf as she had reflux previously when fed any kibble. Xmas 2025 I introduced PetnPro kibble as I could not get her to maintain a good weight.... she was at least 1- 1.5 kgs too light. She was looking the best she has in years by End of January, she was on 50% PetnPro with barf. March she was in season 8th to 30th. Around the 23rd March I realised she has some rash on her belly, groin area. It was red, crusty circular lesions, and was itchy. Vet 15th April (Animal Wellness) Many different causes possible, including hormonal. The kibble was stopped at 1st April. Barf continued 100% of diet. Xiao Feng San started after vet visit, along with herbal cream and weekly washes in oatmeal shampoo and conditioner. Seemed to improve for a week, but by day 6 after wash she was very uncomfortable again. The rash cleared from belly and groin and was then along the spine and tail from the mid lumbar area. Once that began to clear, it started on her sides and flank....now it is neck underarms and forward half nipples. It is very red and some scabs and crustiness to start, then the red goes and there are dry flakey roundish scabs all over the area. Currently she seems the worst, there is lots of redness of the skin, chest and neck area.... some of her nipples have lesions around them, and there is some swelling, almost as if she's having a phantom pregnancy. The lesions are appearing as red round areas with the hair thinning and and coming away. I didn't continue with the herbs once they were finished, as she had reflux with it and she has dropped down to 14kgs. I am losing the battle for her atm, she is wearing shirts during the day to stop her scratching and I am using tissue salts to contract the itch..... it all helps but her skin is still deteriorating. I have stopped all chicken as well, doesn't seem to have helped, and she is still too underweight. Pet Mince Direct Essential Barf V2 Since at least September last year, until beginning of May. Ingredients: Pork Meat, Chicken Meat, Chicken Bone & Cartilage, Beef Liver, Pork Liver, Beef Kidney, Pork Kidney, Mullet, Salmon, Beef Spleen, Seasonal Vegetables (Broccoli, Cauliflower, Celery, Spinach, Kale, Sweet Potato, Pumpkin, Carrot, Zucchini, Green Beans, Beetroot, Cucumber), Sunflower Seeds, Chia Seeds, Spirulina, Chlorella, Barley Grass, Alfalfa, Brewers Yeast, and Kelp. I have since had her on their SUPER COOL BARF Ingredients: Emu, Quail, Mackerel, Goat Meat, Turkey Meat, Lamb Tripe, Lamb Hearts, Lamb Liver, Lamb Kidney, Lamb Bone and Cartilage, Turkey Bone and Cartilage, Blackberries, Blueberries, Strawberries, Raspberries, and Seasonal Vegetables (Broccoli, Cauliflower, Celery, Spinach, Kale, Sweet Potato, Pumpkin, Carrot, Zucchini, Green Beans, Beetroot, Cucumber), Wheatgrass, Chlorella, Barley Grass, Alfalfa, Chia Seeds, Sunflower Seeds, Brewers Yeast, Kelp. and also BIG DOG SENSITIVE SKIN Ingredients Tasmanian salmon, Turkey (meat, crushed bone & cartilage), Pork (meat, crushed bone & cartilage), Lamb (heart, lung, liver, kidney, trachea), Goat (heart, liver, lung, kidney, trachea), apple, green bananas, carrots, lettuce, green beans, sprouted wheatgrass, orange, strawberries, blueberries, nettle and dandelion tea, psyllium, goats whey, kelp, turmeric, organic fulvic acid. She is on at least 500g per day. Treats, are either Roo based with no Chicken, Venison air dried Or salmon based, again no Chicken NUTRITION EVIDENCE ------------------ Nutrition source rule: calculations must use accepted Review Centre food, treat and supplement entries, not raw clinical intake text. Nutrition assessments: 1 Latest Assessment ID: 92 Date: 13/06/2026 Feeding Goal: Maintenance Current Diet Type: Mixed / to be verified Body Weight kg: 14.00 Ideal Weight kg: 15.00 BCS: 4.00 Appetite: Not recorded Digestive Notes: Stool Quality: Skin / Coat Notes: Owner Reactive Foods: Owner Tolerated Foods: Nutrition Calculation Summary: Energy: 788.7 kcal/day Protein: 120.34 g/day Fat: 93.23 g/day Carbohydrate: 5 g/day Accepted Review Centre Calculation Lines: - Sensitive Skin Raw Diet | 500 g/day | 788.7 kcal | Match: Matched | DAMNIT-V reactive groups: - Pet Mince Direct Super Cool Barf | 300 g/day | 0 kcal | Match: Matched | DAMNIT-V reactive groups: vague_meat_source;lamb;fish;egg;wheat_gluten;barley_gluten_grain;oats;kelp_iodine RAC / AUDIOMIXER EVIDENCE ------------------------- RAC reports: 5 Positive classified RAC markers: 80 Report: RAC / Audiomixer Report Created: 07/06/2026 02:48 Evidence Layer: BODY Evidence Subdomain: Unclassified / Needs Review Classification Status: Auto-classified RAC DAMNIT-V Summary: No positive RAC markers currently mapped to DAMNIT-V domains. RAC Snapshot Evidence: RAC evidence summary generated from classified RAC marker results. Positive RAC markers: 22 of 24. BODY evidence: 22 positive markers. MIND evidence: 0 positive markers. SPIRIT evidence: 0 positive markers. SOUL evidence: 0 positive markers. DAMNIT-V RAC domain signals: No positive RAC markers currently mapped to DAMNIT-V domains. Ontology review required for 0 marker(s). Report: RAC / Audiomixer Report Created: 07/06/2026 02:48 Evidence Layer: SPIRIT Evidence Subdomain: Consciousness States Classification Status: Auto-classified RAC DAMNIT-V Summary: No positive RAC markers currently mapped to DAMNIT-V domains. RAC Snapshot Evidence: RAC evidence summary generated from classified RAC marker results. Positive RAC markers: 14 of 15. BODY evidence: 0 positive markers. MIND evidence: 4 positive markers. SPIRIT evidence: 10 positive markers. SOUL evidence: 0 positive markers. DAMNIT-V RAC domain signals: No positive RAC markers currently mapped to DAMNIT-V domains. Ontology review required for 0 marker(s). Report: RAC / Audiomixer Report Created: 07/06/2026 02:48 Evidence Layer: BODY Evidence Subdomain: Unclassified / Needs Review Classification Status: Auto-classified RAC DAMNIT-V Summary: No positive RAC markers currently mapped to DAMNIT-V domains. RAC Snapshot Evidence: RAC evidence summary generated from classified RAC marker results. Positive RAC markers: 23 of 24. BODY evidence: 23 positive markers. MIND evidence: 0 positive markers. SPIRIT evidence: 0 positive markers. SOUL evidence: 0 positive markers. DAMNIT-V RAC domain signals: No positive RAC markers currently mapped to DAMNIT-V domains. Ontology review required for 0 marker(s). Report: RAC / Audiomixer Report Created: 07/06/2026 02:48 Evidence Layer: BODY Evidence Subdomain: Food Reactivity Classification Status: Auto-classified RAC DAMNIT-V Summary: A: - Mycotoxins -all1 | Inhalant Allergens | RAC 10 | Normal / no concern N: - Fodmap group marker | Food Burden Analysis | RAC 25 | Significant concern - Lectin -Legume | Food Reactivity | RAC 20 | Mild concern - Lectins-Soy | Food Burden Analysis | RAC 20 | Mild concern - Sulphur group marker | Food Burden Analysis | RAC 20 | Mild concern - Histamine group mark | Food Burden Analysis | RAC 15 | Mild concern - Lectin group marker | Food Burden Analysis | RAC 15 | Mild concern - Oxalate Group marker | Food Burden Analysis | RAC 15 | Mild concern - Gluten Marker | Food Burden Analysis | RAC 10 | Normal / no concern - Lectin - Peanut | Food Reactivity | RAC 5 | Normal / no concern - Lectins- Nightshades | Food Burden Analysis | RAC 5 | Normal / no concern - Linolenic acid | Vitamins / Micronutrients | RAC 5 | Normal / no concern - Purine group marker | Food Burden Analysis | RAC 5 | Normal / no concern RAC Snapshot Evidence: RAC evidence summary generated from classified RAC marker results. Positive RAC markers: 13 of 15. BODY evidence: 13 positive markers. MIND evidence: 0 positive markers. SPIRIT evidence: 0 positive markers. SOUL evidence: 0 positive markers. DAMNIT-V RAC domain signals: A: - Mycotoxins -all1 | Inhalant Allergens | RAC 10 | Normal / no concern N: - Fodmap group marker | Food Burden Analysis | RAC 25 | Significant concern - Lectin -Legume | Food Reactivity | RAC 20 | Mild concern - Lectins-Soy | Food Burden Analysis | RAC 20 | Mild concern - Sulphur group marker | Food Burden Analysis | RAC 20 | Mild concern - Histamine group mark | Food Burden Analysis | RAC 15 | Mild concern - Lectin group marker | Food Burden Analysis | RAC 15 | Mild concern - Oxalate Group marker | Food Burden Analysis | RAC 15 | Mild concern - Gluten Marker | Food Burden Analysis | RAC 10 | Normal / no concern - Lectin - Peanut | Food Reactivity | RAC 5 | Normal / no concern - Lectins- Nightshades | Food Burden Analysis | RAC 5 | Normal / no concern - Linolenic acid | Vitamins / Micronutrients | RAC 5 | Normal / no concern - Purine group marker | Food Burden Analysis | RAC 5 | Normal / no concern Ontology review required for 0 marker(s). Report: RAC / Audiomixer Report Created: 07/06/2026 02:48 Evidence Layer: SOUL Evidence Subdomain: Soul Dimensions Classification Status: Auto-classified RAC DAMNIT-V Summary: A: - Tradescantia - Wandering Jew | Contact Allergens | RAC 26 | Significant concern - Canine Allergy Sig. | Immune Assessment | RAC 25 | Significant concern - Clioquinol | Contact Allergens | RAC 20 | Mild concern - 16-Mould Qld | Inhalant Allergens | RAC 15 | Mild concern - Benzocaine | Contact Allergens | RAC 15 | Mild concern - Couch Grass1 | Inhalant Allergens | RAC 15 | Mild concern - Cynodon_dactylon | Inhalant Allergens | RAC 15 | Mild concern - Imidazolidinyl urea | Contact Allergens | RAC 15 | Mild concern - Rubber accelerants combined | Contact Allergens | RAC 15 | Mild concern - Tradescantia pallida Purple Heart | Contact Allergens | RAC 15 | Mild concern - 13-Grasses Qld | Inhalant Allergens | RAC 10 | Normal / no concern - 15-Shrubs | Inhalant Allergens | RAC 10 | Normal / no concern - 17-Insects | Inhalant Allergens | RAC 10 | Normal / no concern - Buffaloe Grass | Inhalant Allergens | RAC 10 | Normal / no concern - Couch Grass | Inhalant Allergens | RAC 10 | Normal / no concern - Neomycin | Contact Allergens | RAC 10 | Normal / no concern - Nickel | Contact Allergens | RAC 10 | Normal / no concern - Polyester | Contact Allergens | RAC 10 | Normal / no concern - Buffaloe Grass 1 | Inhalant Allergens | RAC 5 | Normal / no concern - Callestia - Inch Plant | Contact Allergens | RAC 5 | Normal / no concern - Callestia - Purple Vine | Contact Allergens | RAC 5 | Normal / no concern - Cis-trans-Quaternium-15 | Contact Allergens | RAC 5 | Normal / no concern - Diphenylguanidine | Contact Allergens | RAC 5 | Normal / no concern - Ethylenediamine | Contact Allergens | RAC 5 | Normal / no concern - Kikuyu Grass | Inhalant Allergens | RAC 5 | Normal / no concern M: - C_GIT_ID1 | RAC System Evaluation | RAC 20 | Mild concern - HPA axis | Endocrine / Hormonal Axis | RAC 20 | Mild concern - HPG-axis | Endocrine / Hormonal Axis | RAC 20 | Mild concern - Adipose PCT marker_Canine | Metabolic / Adipose Inflammation | RAC 15 | Mild concern - C_HEPATIC_ID1 | RAC System Evaluation | RAC 10 | Normal / no concern - C_RENAL_ID1 | RAC System Evaluation | RAC 5 | Normal / no concern - HPT axis | Endocrine / Hormonal Axis | RAC 5 | Normal / no concern N: - Cobalt | HTMA Minerals | RAC 31 | Strong concern - Fere1 | Food Reactivity | RAC 30 | Significant concern - C_TUMOUR_SIGNAL | Cancer Signals | RAC 20 | Mild concern - Lamb1 | Food Reactivity | RAC 20 | Mild concern - Wheat - Lectins | Food Burden Analysis | RAC 20 | Mild concern - Chicken1 | Food Reactivity | RAC 15 | Mild concern - Oat - Lectins1 | Food Burden Analysis | RAC 15 | Mild concern - Barley -Lectins1 | Food Burden Analysis | RAC 10 | Normal / no concern - Beef1 | Food Reactivity | RAC 10 | Normal / no concern - Calcium Shell1 | HTMA Minerals | RAC 10 | Normal / no concern - Corn LTPDx1 | Food Reactivity | RAC 10 | Normal / no concern - Pork - 19-02-2024 22:36 | Food Reactivity | RAC 10 | Normal / no concern - Sardine1 | Food Reactivity | RAC 10 | Normal / no concern - Barramundi1 | Food Reactivity | RAC 5 | Normal / no concern - Chromium Colloidal | HTMA Minerals | RAC 5 | Normal / no concern - Rice - Lectins1 | Food Burden Analysis | RAC 5 | Normal / no concern I: - Autoimmune_NK | Immune System | RAC 15 | Mild concern - T4-TH17+Cytokines-level1 | Immune System | RAC 15 | Mild concern - T4-TH2+Cytokines-level1 | Immune System | RAC 15 | Mild concern - C_IMM_ID1 | Immune System | RAC 10 | Normal / no concern - C_RESP_ID1 | RAC System Evaluation | RAC 10 | Normal / no concern - Pain combined4 | Primary Body State | RAC 10 | Normal / no concern - Stress Inflammation | Primary Body State | RAC 10 | Normal / no concern - TReg + Cytokines-level1 | Immune System | RAC 10 | Normal / no concern - AutoimmuneSig_Canine | Immune System | RAC 5 | Normal / no concern - C_PAIN_ID | Primary Body State | RAC 5 | Normal / no concern - T4-TH1+Cytokines-level1 | Immune System | RAC 5 | Normal / no concern - Visceral Pain1 | Primary Body State | RAC 5 | Normal / no concern T: - Vegetable Rancid - 08-01-2024 23_111 | Environmental Toxicity | RAC 25 | Significant concern - Acetylaldehyde1 | Environmental Toxicity | RAC 15 | Mild concern RAC Snapshot Evidence: RAC evidence summary generated from classified RAC marker results. Positive RAC markers: 79 of 96. BODY evidence: 72 positive markers. MIND evidence: 6 positive markers. SPIRIT evidence: 0 positive markers. SOUL evidence: 1 positive markers. DAMNIT-V RAC domain signals: A: - Tradescantia - Wandering Jew | Contact Allergens | RAC 26 | Significant concern - Canine Allergy Sig. | Immune Assessment | RAC 25 | Significant concern - Clioquinol | Contact Allergens | RAC 20 | Mild concern - 16-Mould Qld | Inhalant Allergens | RAC 15 | Mild concern - Benzocaine | Contact Allergens | RAC 15 | Mild concern - Couch Grass1 | Inhalant Allergens | RAC 15 | Mild concern - Cynodon_dactylon | Inhalant Allergens | RAC 15 | Mild concern - Imidazolidinyl urea | Contact Allergens | RAC 15 | Mild concern - Rubber accelerants combined | Contact Allergens | RAC 15 | Mild concern - Tradescantia pallida Purple Heart | Contact Allergens | RAC 15 | Mild concern - 13-Grasses Qld | Inhalant Allergens | RAC 10 | Normal / no concern - 15-Shrubs | Inhalant Allergens | RAC 10 | Normal / no concern - 17-Insects | Inhalant Allergens | RAC 10 | Normal / no concern - Buffaloe Grass | Inhalant Allergens | RAC 10 | Normal / no concern - Couch Grass | Inhalant Allergens | RAC 10 | Normal / no concern - Neomycin | Contact Allergens | RAC 10 | Normal / no concern - Nickel | Contact Allergens | RAC 10 | Normal / no concern - Polyester | Contact Allergens | RAC 10 | Normal / no concern - Buffaloe Grass 1 | Inhalant Allergens | RAC 5 | Normal / no concern - Callestia - Inch Plant | Contact Allergens | RAC 5 | Normal / no concern - Callestia - Purple Vine | Contact Allergens | RAC 5 | Normal / no concern - Cis-trans-Quaternium-15 | Contact Allergens | RAC 5 | Normal / no concern - Diphenylguanidine | Contact Allergens | RAC 5 | Normal / no concern - Ethylenediamine | Contact Allergens | RAC 5 | Normal / no concern - Kikuyu Grass | Inhalant Allergens | RAC 5 | Normal / no concern M: - C_GIT_ID1 | RAC System Evaluation | RAC 20 | Mild concern - HPA axis | Endocrine / Hormonal Axis | RAC 20 | Mild concern - HPG-axis | Endocrine / Hormonal Axis | RAC 20 | Mild concern - Adipose PCT marker_Canine | Metabolic / Adipose Inflammation | RAC 15 | Mild concern - C_HEPATIC_ID1 | RAC System Evaluation | RAC 10 | Normal / no concern - C_RENAL_ID1 | RAC System Evaluation | RAC 5 | Normal / no concern - HPT axis | Endocrine / Hormonal Axis | RAC 5 | Normal / no concern N: - Cobalt | HTMA Minerals | RAC 31 | Strong concern - Fere1 | Food Reactivity | RAC 30 | Significant concern - C_TUMOUR_SIGNAL | Cancer Signals | RAC 20 | Mild concern - Lamb1 | Food Reactivity | RAC 20 | Mild concern - Wheat - Lectins | Food Burden Analysis | RAC 20 | Mild concern - Chicken1 | Food Reactivity | RAC 15 | Mild concern - Oat - Lectins1 | Food Burden Analysis | RAC 15 | Mild concern - Barley -Lectins1 | Food Burden Analysis | RAC 10 | Normal / no concern - Beef1 | Food Reactivity | RAC 10 | Normal / no concern - Calcium Shell1 | HTMA Minerals | RAC 10 | Normal / no concern - Corn LTPDx1 | Food Reactivity | RAC 10 | Normal / no concern - Pork - 19-02-2024 22:36 | Food Reactivity | RAC 10 | Normal / no concern - Sardine1 | Food Reactivity | RAC 10 | Normal / no concern - Barramundi1 | Food Reactivity | RAC 5 | Normal / no concern - Chromium Colloidal | HTMA Minerals | RAC 5 | Normal / no concern - Rice - Lectins1 | Food Burden Analysis | RAC 5 | Normal / no concern I: - Autoimmune_NK | Immune System | RAC 15 | Mild concern - T4-TH17+Cytokines-level1 | Immune System | RAC 15 | Mild concern - T4-TH2+Cytokines-level1 | Immune System | RAC 15 | Mild concern - C_IMM_ID1 | Immune System | RAC 10 | Normal / no concern - C_RESP_ID1 | RAC System Evaluation | RAC 10 | Normal / no concern - Pain combined4 | Primary Body State | RAC 10 | Normal / no concern - Stress Inflammation | Primary Body State | RAC 10 | Normal / no concern - TReg + Cytokines-level1 | Immune System | RAC 10 | Normal / no concern - AutoimmuneSig_Canine | Immune System | RAC 5 | Normal / no concern - C_PAIN_ID | Primary Body State | RAC 5 | Normal / no concern - T4-TH1+Cytokines-level1 | Immune System | RAC 5 | Normal / no concern - Visceral Pain1 | Primary Body State | RAC 5 | Normal / no concern T: - Vegetable Rancid - 08-01-2024 23_111 | Environmental Toxicity | RAC 25 | Significant concern - Acetylaldehyde1 | Environmental Toxicity | RAC 15 | Mild concern Ontology review required for 0 marker(s). RAC MARKERS BY DAMNIT-V DOMAIN ------------------------------ DAMNIT-V A - Tradescantia - Wandering Jew | RAC 26 | Significant concern | Layer: BODY | Subdomain: Contact Allergens | Class: Contact allergen RAC evidence - Canine Allergy Sig. | RAC 25 | Significant concern | Layer: BODY | Subdomain: Immune Assessment | Class: RAC evidence - Clioquinol | RAC 20 | Mild concern | Layer: BODY | Subdomain: Contact Allergens | Class: Contact allergen RAC evidence - Benzocaine | RAC 15 | Mild concern | Layer: BODY | Subdomain: Contact Allergens | Class: Contact allergen RAC evidence - Imidazolidinyl urea | RAC 15 | Mild concern | Layer: BODY | Subdomain: Contact Allergens | Class: Contact allergen RAC evidence - Tradescantia pallida Purple Heart | RAC 15 | Mild concern | Layer: BODY | Subdomain: Contact Allergens | Class: Contact allergen RAC evidence - Rubber accelerants combined | RAC 15 | Mild concern | Layer: BODY | Subdomain: Contact Allergens | Class: Contact allergen RAC evidence - Couch Grass1 | RAC 15 | Mild concern | Layer: BODY | Subdomain: Inhalant Allergens | Class: Inhalant allergen RAC evidence - Cynodon_dactylon | RAC 15 | Mild concern | Layer: BODY | Subdomain: Inhalant Allergens | Class: Inhalant allergen RAC evidence - 16-Mould Qld | RAC 15 | Mild concern | Layer: BODY | Subdomain: Inhalant Allergens | Class: Inhalant allergen RAC evidence DAMNIT-V I - Autoimmune_NK | RAC 15 | Mild concern | Layer: BODY | Subdomain: Immune System | Class: Immune RAC evidence - T4-TH2+Cytokines-level1 | RAC 15 | Mild concern | Layer: BODY | Subdomain: Immune System | Class: Immune RAC evidence - T4-TH17+Cytokines-level1 | RAC 15 | Mild concern | Layer: BODY | Subdomain: Immune System | Class: Immune RAC evidence DAMNIT-V M - HPA axis | RAC 20 | Mild concern | Layer: BODY | Subdomain: Endocrine / Hormonal Axis | Class: Endocrine axis RAC evidence - HPG-axis | RAC 20 | Mild concern | Layer: BODY | Subdomain: Endocrine / Hormonal Axis | Class: Endocrine axis RAC evidence - C_GIT_ID1 | RAC 20 | Mild concern | Layer: BODY | Subdomain: RAC System Evaluation | Class: Gastrointestinal RAC system screen - Adipose PCT marker_Canine | RAC 15 | Mild concern | Layer: BODY | Subdomain: Metabolic / Adipose Inflammation | Class: Adipose / metabolic inflammatory RAC evidence DAMNIT-V N - Cobalt | RAC 31 | Strong concern | Layer: BODY | Subdomain: HTMA Minerals | Class: Nutritional RAC evidence - Fere1 | RAC 30 | Significant concern | Layer: BODY | Subdomain: Food Reactivity | Class: Nutritional food reactivity RAC evidence - Fodmap group marker | RAC 25 | Significant concern | Layer: BODY | Subdomain: Food Burden Analysis | Class: Nutritional FODMAP burden RAC evidence - C_TUMOUR_SIGNAL | RAC 20 | Mild concern | Layer: BODY | Subdomain: Cancer Signals | Class: Direct cancer-signalling RAC evidence - Wheat - Lectins | RAC 20 | Mild concern | Layer: BODY | Subdomain: Food Burden Analysis | Class: Nutritional lectin burden RAC evidence - Sulphur group marker | RAC 20 | Mild concern | Layer: BODY | Subdomain: Food Burden Analysis | Class: Nutritional sulphur burden RAC evidence - Lectins-Soy | RAC 20 | Mild concern | Layer: BODY | Subdomain: Food Burden Analysis | Class: Nutritional lectin burden RAC evidence - Lectin -Legume | RAC 20 | Mild concern | Layer: BODY | Subdomain: Food Reactivity | Class: Nutritional food reactivity RAC evidence - Lamb1 | RAC 20 | Mild concern | Layer: BODY | Subdomain: Food Reactivity | Class: Nutritional food reactivity RAC evidence - Oat - Lectins1 | RAC 15 | Mild concern | Layer: BODY | Subdomain: Food Burden Analysis | Class: Nutritional lectin burden RAC evidence - Histamine group mark | RAC 15 | Mild concern | Layer: BODY | Subdomain: Food Burden Analysis | Class: Nutritional histamine burden RAC evidence - Oxalate Group marker | RAC 15 | Mild concern | Layer: BODY | Subdomain: Food Burden Analysis | Class: Nutritional oxalate burden RAC evidence - Lectin group marker | RAC 15 | Mild concern | Layer: BODY | Subdomain: Food Burden Analysis | Class: Nutritional lectin burden RAC evidence - Chicken1 | RAC 15 | Mild concern | Layer: BODY | Subdomain: Food Reactivity | Class: Nutritional food reactivity RAC evidence DAMNIT-V T - Vegetable Rancid - 08-01-2024 23_111 | RAC 25 | Significant concern | Layer: BODY | Subdomain: Environmental Toxicity | Class: Environmental/toxic RAC evidence - Acetylaldehyde1 | RAC 15 | Mild concern | Layer: BODY | Subdomain: Environmental Toxicity | Class: RAC evidence DAMNIT-V Unassigned - Apathy Base | RAC 26 | Significant concern | Layer: SPIRIT | Subdomain: Consciousness States | Class: Consciousness-state RAC evidence - Enlightenment 700 -1000 | RAC 25 | Significant concern | Layer: SPIRIT | Subdomain: Consciousness States | Class: Consciousness-state RAC evidence - 2.Inh Negative-T8-L1 | RAC 25 | Significant concern | Layer: BODY | Subdomain: RAC State Assessment | Class: Inhibitory/fight RAC body-state evidence - 2.Inh Negative-T12-L5 | RAC 21 | Significant concern | Layer: BODY | Subdomain: RAC State Assessment | Class: Inhibitory/fight RAC body-state evidence - I am not loveable -ve2 | RAC 20 | Mild concern | Layer: MIND | Subdomain: Mind States | Class: Mind-state RAC evidence - 2.Inh Negative-T10-L3 | RAC 20 | Mild concern | Layer: BODY | Subdomain: RAC State Assessment | Class: Inhibitory/fight RAC body-state evidence - 2.Inh Negative-LU | RAC 20 | Mild concern | Layer: BODY | Subdomain: RAC State Assessment | Class: Inhibitory/fight RAC body-state evidence - 2.Inh Negative-C4-T4 | RAC 20 | Mild concern | Layer: BODY | Subdomain: RAC State Assessment | Class: Inhibitory/fight RAC body-state evidence - 2.Inh Negative-BL | RAC 20 | Mild concern | Layer: BODY | Subdomain: RAC State Assessment | Class: Inhibitory/fight RAC body-state evidence - 2.Inh Negative-HT | RAC 20 | Mild concern | Layer: BODY | Subdomain: RAC State Assessment | Class: Inhibitory/fight RAC body-state evidence - 2.Inh Negative-LI | RAC 20 | Mild concern | Layer: BODY | Subdomain: RAC State Assessment | Class: Inhibitory/fight RAC body-state evidence - 2.Inh Negative-C4-T4 | RAC 20 | Mild concern | Layer: BODY | Subdomain: RAC State Assessment | Class: Inhibitory/fight RAC body-state evidence - 2.Inh Negative-T12-L5 | RAC 20 | Mild concern | Layer: BODY | Subdomain: RAC State Assessment | Class: Inhibitory/fight RAC body-state evidence - Shame Base | RAC 15 | Mild concern | Layer: SPIRIT | Subdomain: Consciousness States | Class: Consciousness-state RAC evidence - Fear Base1 | RAC 15 | Mild concern | Layer: SPIRIT | Subdomain: Consciousness States | Class: Consciousness-state RAC evidence - Courage Base | RAC 15 | Mild concern | Layer: SPIRIT | Subdomain: Consciousness States | Class: Consciousness-state RAC evidence - C_BLADDER_LUT_ID1 | RAC 15 | Mild concern | Layer: BODY | Subdomain: DAMNIT-V Organ/System | Class: RAC organ/system screening evidence - I cannot do this -ve2 | RAC 15 | Mild concern | Layer: MIND | Subdomain: Mind States | Class: Mind-state RAC evidence - I am worthy +ve2 | RAC 15 | Mild concern | Layer: MIND | Subdomain: Mind States | Class: Mind-state RAC evidence - I am loveable +ve2 | RAC 15 | Mild concern | Layer: MIND | Subdomain: Mind States | Class: Mind-state RAC evidence PATHOLOGY / LABORATORY EVIDENCE -------------------------------- Pathology reports: 0 IMAGING EVIDENCE ---------------- Imaging reports: 0 EVIDENCE BUNDLE NOTE -------------------- This bundle is the shared evidence source for Snapshot and Multi-Model review. Case-specific DAMNIT-V reasoning should be generated from this bundle, not from isolated keyword rules.

Conventional Veterinary Model: - Presenting problem summary - Reflux history with kibble feeding. - Chronic skin itching and rash with red, crusty circular lesions. - Progressive skin lesions spreading from belly/groin to spine, tail, sides, neck, underarms, and nipples. - Weight loss, currently 14 kg vs ideal 15 kg, BCS 4/9. - Rash with redness, scabs, hair thinning, and nipple swelling resembling phantom pregnancy. - Likely differentials - Allergic dermatitis (environmental/contact/inhalant). - Food allergy or intolerance (notably chicken, lamb, fodmaps, lectins). - Hormonal influence (seasonal estrus noted, nipple swelling). - Secondary bacterial or fungal skin infection possible. - Serious rule-outs - Immune-mediated skin disease. - Endocrine disorders affecting skin and weight (HPA, HPG axis mild RAC concern). - Neoplasia (mild RAC tumour signal). - Missing tests - Skin cytology and culture. - Hormonal panel (thyroid, adrenal, reproductive hormones). - Food elimination trial with strict novel protein and low reactive diet. - Allergy testing (intradermal or serum). - Monitoring markers - Weight and BCS trend. - Skin lesion progression and pruritus severity. - Response to diet and topical treatments. - Concurrent patient-state findings - RAC strong concern for cobalt mineral imbalance. - Significant food reactivity to Fere1 (unknown specific), fodmap group, lamb, chicken, lectins (legume, soy), sulphur, histamine, oxalate. - Significant environmental/contact allergens: Tradescantia, canine allergy signature, mould, benzocaine, rubber accelerants. - Mild immune activation (autoimmune NK, T4-TH2, T4-TH17 cytokines). - Mild endocrine axis concerns (HPA, HPG). - Environmental toxicity (vegetable rancid) significant. Traditional Chinese Medicine Model: - Possible patterns - Damp-Heat manifesting as red, itchy, crusty skin lesions. - Blood deficiency/stasis suggested by hair thinning and scabbing. - Liver Qi stagnation due to hormonal cycle and skin inflammation. - Spleen Qi deficiency contributing to weight loss and poor nutrient assimilation. - Kidney Yin deficiency possible with phantom pregnancy signs. - Channel involvement likely Liver and Spleen channels affecting skin and digestion. - Food energetics - Avoidance of chicken and lamb aligns with reducing Heat and Damp producing foods. - Inclusion of cooling berries and vegetables supports clearing Heat and Damp. - Herbs Xiao Feng San initially helped but caused reflux, indicating possible Spleen/Stomach disharmony. Homeopathic Model: - Remedy-picture themes - Skin eruptions with itching, redness, crusting, and circular lesions. - Hormonal influence with nipple swelling and phantom pregnancy signs. - Constitutional observations include weight loss, sensitivity to food changes, and seasonal flare. - Modalities missing - Characteristic aggravations or ameliorations (time of day, weather, scratching response). - Emotional or behavioral changes linked to skin condition. - Specific sensations (burning, stinging, crawling) on lesions. Anthroposophic Model: - Nerve-sense system involvement indicated by skin sensory irritation and pruritus. - Rhythmic system imbalance suggested by hormonal axis mild RAC concerns and seasonal estrus effects. - Metabolic-limb system affected by weight loss and skin trophic changes. - Life process themes include impaired transformation and elimination (skin as excretory organ). - Organ-process themes focus on liver detoxification and endocrine gland regulation. - Environmental toxicity and mineral imbalance (cobalt) may disrupt metabolic-limb system. Cross-Model Agreement: - All models highlight skin and immune system involvement. - Endocrine/hormonal axis implicated across Conventional, TCM, and Anthroposophic models. - Nutritional and food reactivity concerns consistent in Conventional and TCM models. - Environmental/contact allergens and toxicity recognized in Conventional and Anthroposophic models. - Divergence in emphasis on emotional/mind states in Homeopathic and Anthroposophic models versus Conventional. - Tensions between dietary management and reflux side effects noted. Rule-In / Rule-Out Priorities: - Rule-in - Allergic/contact dermatitis (Tradescantia, canine allergy signature). - Food reactivity to Fere1, fodmaps, lamb, chicken, lectins. - Hormonal influence (HPG and HPA axis mild RAC concern). - Rule-out - Neoplasia (mild tumour signal, needs confirmation). - Immune-mediated skin disease (autoimmune markers mild). - Evidence pending - Infectious secondary skin infection. - Endocrine panel results. - Allergy testing outcomes. Testing / Treatment / Diet Trial Priorities: - Physical tests - Skin cytology and culture. - Hormonal blood panel (thyroid, adrenal, reproductive hormones). - Allergy testing (intradermal or serum). - Diet / nutrition review - Strict elimination diet avoiding identified reactive foods (chicken, lamb, fodmaps, lectins). - Monitor for weight gain and skin improvement. - Supplement review - Address cobalt mineral imbalance cautiously. - Consider anti-inflammatory and skin barrier support supplements. - Response-to-treatment markers - Reduction in pruritus and lesion size. - Weight stabilization or gain. - RAC follow-up priorities - Monitor changes in food reactivity and immune markers. - Reassess environmental allergen exposure. Next Snapshot Trigger: - New clinical signs or worsening skin lesions. - Results from allergy and hormonal testing. - Response or adverse effects to elimination diet trial. - Changes in weight or BCS. - New laboratory or imaging findings. Clinical Caution: - This is not a diagnosis. - Veterinarian must interpret all findings in clinical context. - Consider multi-factorial nature of skin and systemic signs. - Monitor closely for secondary infections or systemic illness.