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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/
Have Dog Questions? Read This Helpful Piece
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.
Keep on top of fleas. Not only can fleas cause infection in your dog, if one is swallowed, your pet can get tapeworms as well. Speak to your veterinarian about the best prevention method, but remember that this is not a one shot deal. You will have to continue your efforts over the life of your pet.
Take care to keep your dog cool while traveling during the summer by car. Even with your air-conditioning on, the dog may become over-heated in his pet carrier. A simple and low-cost countermeasure is freezing a few gallon jugs of water and placing them near him where he can curl up and cool off.
Never give your dog milk! It's not necessary for his body and he doesn't have the proper enzymes to digest it anyway. Feeding your dog cow's milk can lead to chronic diarrhea and leave him with an upset stomach, among other health problems. Stick with plain old water for a healthy and hydrated dog.
Be a good neighbor and discourage your dog from barking, unless he is alerting you to danger. Most people get used to the sound of their dog yelping, but others find it a constant annoyance. If your dog barks often, consider talking to your vet about what could be causing it and how you can put a stop to it, for everyone's sake.
Take your grown dog to the vet at least once a year. The vet will check to see if the dog's vaccines up to date. In addition, the vet will check the dog's teeth and vital signs. If any major health or behavioral issues come up between annual checkups, you should see the vet earlier.
Do not make training your dog seem like a chore. Dogs pick up on this negative energy and will have a difficult time learning if you are not in the right mind frame. Make it fun and try to look at it as a bonding experience with your pet. When your dog is having fun, they will learn their training quicker.
Lift your dog properly. If you have a little dog or puppy, place your one hand under their chest and use your other hand for supporting their rump and hind legs. If fixing dog aggression lifting a big dog, lift them from their underside supporting their chest using your one arm and using your other arm to support their rear end. Never lift a dog by their back legs, tail, or the nape of their neck.
Always be the boss with your dog. A dog is not only much more apt to be obedient when you are in command, he'll also be much happier. Dogs need to know what's expected of them and that they are being led. This gives them a sense of security and you a more peaceful household.
If you are having trouble training your dog, see a professional. A lot of people wait until their problems are enormous, but if you would see a dog trainer as soon as you start having difficulty, you will find training goes more easily. Not only that, but you will save yourself a major headache.
When crate training a dog, be sure to allow it to stop making noise (barking, whining, crying) for at least 30 seconds before opening the crate up. This is important because otherwise the dog will believe that as long as it keeps making noise, you will come and open the crate. It can be hard to do this, but is necessary. Of course, always be sure that the dog is safe and not making noise for some other reason.
If your dog is prone to getting burs in his coat, keep a can of Crisco in your kitchen cupboard. Next time you notice a bur, put gloves on to protect yourself and work the Crisco around until you can pry the bur out. Give him a nice shampoo to get the shortening out later.
If you have a smaller breed dog, make sure everyone who touches him knows the proper way to hold him. Small dogs can be easily injured by inappropriate handling and many owners find this out the hard way. Gently lift at the belly from under his front legs and secure him with both hands.
Yelling at your dog or displaying any other violent behaviors are not good options. Your dog will fear you and establishing a bond with your pet will be very hard. The best way to train your dog is to use positive reinforcement and simply say no in a firm voice when you catch your dog misbehaving.
Although some dogs do well on the recommended amount of food to be given each day, some dogs need more or less. Instead of just going by what your food says to feed your dog, try to keep an eye on your dog's body. If you notice that your dog is gaining a bit of weight, cut the food intake back a bit.
In order to potty train a puppy, it is of utmost importance to take the dog outside frequently. Doing this will familiarize your puppy with the association between outside and going to the bathroom. Failure to do this will result in a harder time breaking your new family member of his/ her bad habits.
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.
Knowing the background of different dog breeds can help you in selecting the type of dog that will fit your lifestyle. Whether you are looking for a lapdog or a hunting partner, this article provides some valuable information. Remember the tips you have learned here when you visit breeders and pick out a puppy.
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