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Best Advice for Dogs with Skin Issues
I still need to publish a real post about Mr. Stix's full backstory, but this feels more pressing. For nearly 18 months, Mr. Stix's permanent nakey spot (from unknown injuries before he was rescued, including 15 fractures and this big patch of coat missing) has featured several inflamed, peeling areas. Initially I tried to fix it myself at home with things like aloe vera, vaseline, a veterinary ointment called animax that the shelter had give us while we fostered him most of 2019, etc. It's sort of a combination of steroids, antibacterial, and antifungal stuff. I took him to see our main veterinarian in spring 2020, when there was a 2-month wait to get into see a board-certified veterinary dermatologist. It has been quite a journey since then, and it's nowhere near over. Here's my best advice for dogs with skin issues.
Before I tell the ongoing saga with Mr. Stix's skin. Here is my best advice for dogs with skin problems.
See a board-certified veterinary dermatologist as soon as you can. Yes, your main veterinarian can probably help, but it's honestly best to go right to the top experts.
Agree to whatever skin scrapings / cytology the veterinary dermatologist recommends. This provides information about what types of secondary infections currently grow on your dog's damaged skin.
Do NOT assume every skin issue is allergies. It often is some sort of allergic process, but NOT always and assuming so (and acting accordingly may only delay real solutions and subject your dog to all kinds of quack advice and home remedies).
Buy the best quality fish oil and Vitamin E supplements you can afford, if it's recommended for your particular case of a dog with skin issues.
When necessary, agree to the skin biopsies (yes, like minor surgery) and have them reviewed by a veterinary pathologist that specializes in dogs with skin issues. The one we used is at Texas A&M.
Follow your veterinary dermatologist's advice and plans, and keep the faith. These dogs with skin problems often don't improve quickly. (I need to take my own advise. See below.)
Mr. Stix's Story as a Dog with Skin Problems
This is what Mr. Stix's nakey spot looks like when it's normal. Photo from May 2019 soon after his hip surgery. The bald patch is permanent. That's not the issue.
This is how bad the red / peeling areas got in mid-2020 when we saw our main veterinarian, who added a low-dose of oral Vitamin E and some topical too and told me to keep using the animax.
This is how it looked when Mr. Stix first saw the board-certified veterinary dermatologist in early August 2020, but the specialist had me STOP the animax and instead use a prescription anti-bacterial ointment (mupirocin) ... as well as add a better quality oral fish oil and continue both topical and oral Vitamin E (but at a higher dose twice a day). We knew from the skin scrapings / cytology they did onsite that Mr. Stix had a bacterial infection.
But, without the daily topical steroids (which long term are a bad idea), Mr. Stix's skin got much, much worse -- even breaking open and scabbing over.
Our veterinary dermatologist had recommended doing the skin biopsies right away in August 2020, and I *almost agreed to it then, but I was VERY worried about the cuts resulting in skin that would NOT heal. And, I figured it was at least worth a try to use the prescription antibiotic ointment and other supplements and stuff.
But, by around Thanksgiving, it was clear we had to do the biopsy. That photo is kind of gruesome, so you can see it here, if you want. I wish I had done the biopsy sooner. I feel like I wasted time from August through November.
Post-Biopsy Diagnosis
As I expected, despite all the know-it-alls trying to tell me it was an allergic issue, it turns out that Mr. Stix instead has an autoimmune condition called erythema multiforme. They believe it was triggered by the trauma of his earlier injuries. They don't think it is life-threatening. They don't think it will spread to other areas of his skin. Just the already damaged, permanent nakey spot.
With that information in hand, we updated the treatment plan to include a topical, non-steroidal anti-inflammatory ointment (tacrolimus -- often pricey, but we used a Good RX coupon at Costco to get the cost down). They use a version of this medication orally for people who have had various kinds of transplants. It's the smallest / safest option for treatment, and that's where we started.
I was so hopeful it would work at the once-daily application, but the skin still didn't heal completely.
So, in early 2021, we started applying it twice daily on the advice of our veterinary dermatologist.
But, it still hasn't healed completely. It often improves a lot and then comes roaring back, so we had another appointment to see the specialist last week. We had to try something new.
Enter the Big Immune-Suppressing Drug
Despite my concerns and form of veterinary PTSD about major immune suppression drugs (after our experiences with Lilly), I agreed last week to add oral cyclosporine, which is also a drug that people get after various transplants. Mr. Stix would need to take it daily for life.
It smells like it's made from skunk butts, so each gel-cap pill is individually packaged, and you keep them in the freezer because that can help with nausea it can cause (since it's recommended you give on an empty stomach).
I found some good info on this med, and our veterinary dermatologist assured me that it has been safely used in veterinary medicine for like 20+ years, etc.
The med only comes in doses of 25 mg, 50 mg, and 100 mg, and at his size Mr. Stix's ideal dose is around 88 mg once a day. So we went with 75 mg (25+50) to err on the lower side.
It takes like 3-7 days for the med to build up in the blood to therapeutic levels, but it takes more like 4-6 weeks to know if it's going to help the skin (or not).
We made it to day 4, then the barfing started.
Anxiety
I wish I could say that this is all going to be fine, but I just don't know. I feel like I just have to accept that the skin will never fully heal, even though seeing his raw spots up close while applying the topical med twice a day and topical Vitamin E once a day causes me so much angst and anxiety.
I supposed to check in with our veterinary dermatology team next week to confirm that Mr. Stix's weirdness and apparent suffering has improved.
It took a lot of convincing to get Mr. Champion of My Heart to agree to try the cyclosporine, so even if the specialist comes back and recommends maybe a lower dose, I doubt we'll want to risk it ... because Mr. Stix sure seemed to be having some neurologist issues to me, and after the Lilly situation, I just cannot do that again.
He is only 3 years old. I don't want to make anything worse. It honestly felt like I'd poisoned him.
The good news is that most of the time his skin doesn't seem to hurt or itch or anything -- though I do have pain meds, if he needs them. It mostly just looks bad, and he has to wear a no-lick collar for about 20 minutes after I apply his meds so that he doesn't lick it off.
His nakey spot is prone to sunburn anyway, and the topical tacrolimus increases the risk of burning, so I used his earlier sun-reflecting coat (which started to look ragged) as a pattern and sewed him a new / light sun protection coat. He looks very cute in it.
https://championofmyheart.com/2021/08/05/dogs-with-skin-issues/
Great Advice About Dogs That Anyone Can Easily Follow
Anyone can go out and get a dog and bring him home. However, if you wish to properly care for your dog, you must know what you're doing. Pay attention to the following helpful advice so that you can make sure your dog has everything it needs in order to live and long and healthy life.
Make sure your house is free of doggy danger. Create a safe area to bring a new puppy into the home. Place any meds or household cleaning supplies out of reach, and place any trash cans in a cabinet. Some very common plants are quite toxic to animals, so always make sure they are out of reach.
Don't give table scraps to your dog. That encourages him to beg and makes him not want his own food. Giving your dog table scraps isn't good for his health as it could result in weight gain and digestive problems. Insist that your dog wait away from the table during family meals to avoid temptation on his part - and yours.
Although the sound may be cute, your dog's nails shouldn't click along the floor when it walks. That's a sign that the nails are too long. The nails should actually just barely touch the ground. Seek the advice of a professional on what tools are the best for giving your dog a pedicure.
Avoid issues of jealously if you have more than one animal. Particularly if you bring a young dog into the home of an older dog, problems can arise. Be considerate of the patience and energy levels of your senior dog and make sure his feelings aren't hurt by giving the new guy all the attention.
Be prepared to have a lot of patience with your dog during potty-training. Much like children, dogs learn at different speeds and ages and your canine may be slow or stubborn. Have good resources at your fingertips to assist your efforts and remember not to get angry when your dog has "accidents" as that will only impede his progress.
If you notice your dog gets dry skin in the winter, you probably need to brush him or her more often. Doing so will get rid of old fur and help get their oil glands working properly. Try brushing once in the morning and once in the evening to see if it makes a difference for your pet.
When choosing a dog for your home, don't forget to estimate the size it will be as a full grown adult. This is especially true if you have small children at home. Although a small puppy will be cute, it may grow into a large, one hundred pound dog. Do some research on the average adult size of the breeds you are considering.
If you live with other people, make sure they are aware of your training "rules." It is important that everyone redirects the dog off of the furniture, for example, and that they use the same language when doing so. If everyone's rules are different, your dog is just going to get confused, which will make the training process much longer and more difficult.
Respect your pet. When out on a walk, do not force your dog to interact with other people or animals if he does not want to. There is a reason why your dog may not want to get too close, and it is important that you listen to him. If you try and make him interact, your dog may begin to act out over time.
Clean up after your dog when they go to the bathroom in public. https://budgetfight8.bloggersdelight.dk/2021/08/15/5-tips-about-australian-shepherd-english-shepherd-you-cant-afford-to-miss/ let their dog do their business wherever they please whether its on a sidewalk, neighbor's lawn, etc. They can do their business in public, but you must take a bag with you to clean it up when they're done so that it doesn't cause an unsightly and smelly mess for someone else.
Brush your dog's teeth every week. Use a child's toothbrush that is soft, some nylon pantyhose over your finger, or a gauze pad. Don't use regular toothpaste. Instead, try using a baking soda and water paste or toothpaste made for dogs. Clean their teeth one to two times a week.
Never leave your dog inside your vehicle. Remember that your dog needs supervision and that it could become dehydrated very quickly, especially during the hot summer months. It is best to leave your dog at home for a few hours if you have to go somewhere and cannot take your dog inside.
If you have younger children in the home, make sure that you try to teach them what behavior is appropriate with your dog. Let them know the rules and what they are allowed to do. Some dogs are more tolerant of being jumped on, pulled on, and played with than other dogs.
Make sure that you buy an appropriate sized collar for your dog in order to ensure its health and safety. If the collar is too lose, it may become snagged on something. If the collar is too tight, it may restrict the dog's breathing ability. Allow for a two finger space between the dog and the collar.
Dogs need water just as much as humans do. In fact, approximately 70% of their bodies are water! You need to be sure your dog always has fresh, clean water to drink. Keep bottled water on hand in case of emergencies. You want to make sure your pet has something safe to drink no matter what.
Naming a dog can be an absolute blast, but there are several things you should consider. Be sure that your dog's name doesn't rhyme with a word like stop or no, as this can be extremely confusing for your pet. Try and keep the name at one or two syllables in length, so that it's easy for you to call out in a hurry.
It is wise to check your area to find out what the local leash laws are. Many areas require a dog to be leashed at all times if it is not on your property. keeping your dog on a leash is a good idea anyway, as it can be dangerous to let your pet run unattended, where he could be hit by a car, or fight with other dogs.
Having a dog isn't all fun and games. You have to give yourself some time to really think about what you're doing, and to act accordingly. You can use the tips here to help you to know what you need to do. You can always have a happy dog, if you take the time to give it a little thought.
As an avid reader about Dogs, I was thinking sharing that excerpt was a great idea. Sharing is nice. One never knows, you may be helping someone out. I praise you for being here. Come back soon.