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They are making several great points about Pets overall in the article which follows.

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/

Useful Advice For Raising A Happy, Healthy Canine

Dogs love to jump, run and play. They like to eat, even when it is an item they shouldn't chew on. They also love to give you all the kisses in the world. Your responsibility is to take the best care you can of your dog, and this article will show you how it's done.

Never bring your dog with you while flying during the hot summer months, unless the airline provides a climate-controlled cabin for him. Most of the major carriers use the same area for pets as they do for cargo, meaning your dog will have to endure some pretty high temperatures as you travel to your destination, jeopardizing his safety.

You may know that chocolate is dangerous for dogs, but you may not know the specifics. Chocolate is dangerous because of the stimulants caffeine and theobromine. Baking chocolate is the most dangerous, with a high amount of stimulants. White chocolate contains the least amount of stimulants. Take you dog to vet if he ingests chocolate.

Let your dog chew some rawhide rather than meat bones. Giving them actual bones may cause them to fall apart and become lodged in the digestive tract or oral cavity of your dog. In contrast, rawhide has health benefits for your pet.

If your young dog is teething and gnawing at everything, buy him a fun chew toy and keep it in the fridge. a discussion does this provide him with a good alternative to your furniture, but the cold will help to make his gums feel better. Most younger dogs gnaw out of necessity, not poor manners.

Dog training requires you to be consistent. Once you decide you want to establish a rule for your dog, do not make any exceptions. Make sure everyone at home helps you enforce the rule and encourage your guests not to let your dog jump on them or to not acknowledge your dog when it barks.

If your dog is still getting used to the grooming process, only work with him or her in short bursts. Groom for about five minutes and then stop and move on to another activity. Eventually, start adding on two or three minutes to your total grooming time until your pet is able to handle a full session.

Groom your dog frequently. Keep them clean and reduce the amount of hair they shed by brushing them frequently. When the weather warms up, start checking them for ticks and fleas daily. Dogs generally require a few baths a year. Before you give your dog a bath, make sure to cut or comb out mats and tangles. Rinse their coat thoroughly to avoid dirt sticking to any soap residue.

When preparing to groom your pet, start the session off on the right foot by helping your dog relax. Spend a few minutes simply petting him, starting with the head and then rubbing the back, paws, belly and even tail. Once you feel your dog is happy and content, begin grooming him.

Before you have your dog fitted with a microchip, be sure and check the database of the company that will store his information. Not all of them are created equal and you want to know that you'll get a fast response if your dog is lost. Look for a large database that connects to shelters and vets near you.

If you are looking for a new dog, bring your current pup to check him out. Just like people, dogs can have a personality clash. Having dogs that get along with each other makes your life that much easier.

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.

It is important to train your dog as soon as you get him or her. https://petsroof.com/is-honey-safe-for-cats/ that might seem cute as a puppy, can develop into bad habits as your dog matures. It is essential that your dog understands and obeys simple commands. Not only for your safety, but the safety of your dog as well.

Make sure there is one policy in your home for giving your dog table scraps. While some owners do not give their dog any table food at all, yet others wait until the family meal is done. This causes less confusion on the part of your dog, and makes meals much easier for your family.

Be cautious with female dogs in the heat. If you aren't, you may have to deal with an unwanted pregnancy. A male will be able to smell her from a far distance. She might instigate problems with fellow dogs, as well as getting pregnant with an unknown mate.

Puppies are cute and cuddly, but remember that puppies eventually grow into dogs, and rather quickly. Make sure that you put a lot of thought in your decision to get a dog. Taking a dog into your home is a long-term commitment and comes with certain costs and responsibilities, but is ultimately rewarding.

Put your dog through obedience training. A well-trained dog is a joy to live with for both you and them. Teaching them simple commands like "Come,"u009d "Heel,"u009d "Sit,"u009d and "Stay"u009d can help curb or prevent troublesome behaviors in no time. You can either teach them yourself, or you can find out about obedience courses by contacting the SPCA or the local humane society for class recommendations.

Don't bathe your dog after you have applied a flea or tick medication. Some medications tout that they are waterproo, but they only mean against rain or swimming. They will largely wash away with a dog shampoo, rendering the treatment ineffective. If you must bathe the dog after a treatment, use a soap free shampoo.

Taking care of a dog should be a serious matter. The dog is similar to a child, in that you have to provide it with everything. It can be a huge undertaking but something that can be easily accomplished by just about anyone. Use the information in the article above to help you give your dog the best care you can.
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