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 with red, crusty, circular lesions progressing over months. - Weight loss, currently 14 kg vs ideal 15 kg, BCS 4/9. - Rash distribution shifting from belly/groin to spine, tail, sides, neck, underarms, nipples. - Lesions include redness, scabs, crustiness, hair thinning, and nipple swelling. - Likely differentials - Allergic dermatitis (food and/or environmental). - Hormonal influence (seasonal estrus noted). - Infectious causes (secondary bacterial or fungal infection possible). - Serious rule-outs - Immune-mediated skin disease. - Neoplasia (lesions around nipples, mild RAC tumour signal). - Endocrine disorders (mild RAC concerns for HPA and HPG axes). - Missing tests - Skin cytology and culture. - Hormonal panel (thyroid, sex hormones). - Food trial with strict elimination diet. - Allergy testing (intradermal or serum). - Monitoring markers - Weight and BCS trends. - Skin lesion progression and pruritus severity. - Response to diet and topical treatments. - Concurrent patient-state findings - Mild RAC concerns for immune activation (T4-TH2, T4-TH17 cytokines). - Mild RAC concerns for endocrine axes (HPA, HPG). - Strong RAC concern for cobalt imbalance (HTMA). - Significant RAC food reactivity (Fere1, lamb, chicken). - Significant RAC food burden from FODMAPs and lectins. - Significant RAC environmental/contact allergens (Tradescantia, canine allergy signature). - Significant RAC environmental toxicity (vegetable rancid). Traditional Chinese Medicine Model: - Possible Liver Qi stagnation due to chronic itching and skin lesions. - Damp-Heat pattern suggested by red, crusty, itchy lesions with scabs. - Blood deficiency or Blood Heat indicated by hair thinning and skin dryness. - Possible Spleen Qi deficiency contributing to weight loss and poor nutrition assimilation. - Channel involvement likely Liver and Lung channels (skin and itching). - Food energetics: avoidance of cold/damp foods may help; current diet includes cold-natured fish and raw meats. - Herbs used (Xiao Feng San) target Wind-Heat and Dampness but discontinued due to reflux. Homeopathic Model: - Remedy-picture themes include chronic skin eruptions with itching and crusting. - Constitutional observations: sensitivity to food changes, hormonal influences, and environmental allergens. - Modalities missing: detailed characteristic symptoms such as aggravation or amelioration factors, mental/emotional state. - Need to clarify modalities related to heat/cold, time of day, scratching behavior, and mental state for remedy selection. Anthroposophic Model: - Nerve-sense system involvement suggested by skin irritation and sensory discomfort. - Rhythmic system possibly affected due to hormonal cycling and immune dysregulation. - Metabolic-limb system involvement indicated by weight loss and nutritional imbalance. - Life process themes: impaired skin barrier and detoxification processes. - Organ-process themes: liver and digestive system stress from food reactivity and environmental toxins. - Need to consider supportive therapies for metabolic and rhythmic system balance. Cross-Model Agreement: - Multiple models indicate liver involvement (TCM Liver Qi stagnation, Anthroposophic liver stress, Conventional immune/endocrine axis). - Immune dysregulation and allergy/allergen sensitivity consistent across Conventional and RAC evidence. - Nutritional burden and food reactivity supported by RAC and Conventional findings. - Environmental/contact allergens strongly implicated by RAC and Conventional evidence. - Divergence in certainty about neoplasia (mild RAC tumour signal but no clinical confirmation). - Tension between need for herbal support (TCM) and reflux intolerance (clinical). Rule-In / Rule-Out Priorities: - Rule-in - Allergic dermatitis (food and environmental). - Hormonal influence on skin condition. - Nutritional food reactivity and mineral imbalance (cobalt). - Environmental/contact allergen exposure. - Rule-out - Neoplasia (pending diagnostic confirmation). - Infectious secondary skin infection (pending cytology/culture). - Endocrine disorders (thyroid, adrenal testing needed). - Evidence pending - Autoimmune skin disease (mild RAC immune signals). - Detailed food allergy testing and elimination diet response. Testing / Treatment / Diet Trial Priorities: - Physical tests - Skin cytology and fungal/bacterial culture. - Hormonal panel including thyroid and sex hormones. - Allergy testing (intradermal or serum). - Diet / nutrition review - Strict elimination diet avoiding identified reactive foods (lamb, chicken, FODMAPs, lectins). - Review cobalt status and consider mineral balancing. - Supplement review - Avoid herbal formulas causing reflux; consider alternative anti-inflammatory topical agents. - Evaluate need for anti-itch supplements (fatty acids, zinc). - Response-to-treatment markers - Monitor skin lesion progression and pruritus. - Track weight and BCS changes. - RAC follow-up priorities - Reassess food reactivity markers after diet trial. - Monitor immune and endocrine RAC markers for changes. Next Snapshot Trigger: - New clinical signs or worsening skin lesions. - Results from skin cytology, culture, and allergy testing. - Response or adverse reaction to elimination diet or treatments. - Hormonal assay results. - Significant weight change or new systemic signs. Clinical Caution: - This is not a diagnosis. - Veterinarian must interpret all findings in clinical context. - RAC evidence supports but does not confirm specific diseases. - Clinical monitoring and diagnostic testing remain essential.