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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). in a blog post 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

Your dog is always there for you. No matter what, a dog will do what it takes to make sure you are alright. He always looks out for you, always wants your attention, and is always happy with you. Shouldn't you see what you can do for him? Here are some tips to help you be a great owner for your dog.

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.

If your dog spends a lot of time outdoors, he or she may eventually come in contact with a skunk. If he gets sprayed, mix together one teaspoon of dish-washing detergent, a fourth a cup of baking soda and a quart of hydrogen peroxide solution (but make sure it is no more than three percent). Apply the mixture to your dog's coat and allow it to sit for five minutes. Wash your dog off well afterward.

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.

Talk to your vet to learn which foods are appropriate for your particular dog. A puppy's stomach may not be able to handle particular foods, which may cause stomach issues. Always exercise caution when it comes to your animal's food.

If your dog has been playing outside, take the time to inspect its ears and neck for ticks. These parasites are very common and could make your dog sick if you do not take action right away. Take your dog to the vet if you do not know how to remove the ticks yourself.

Teach your dog to be trained, even if you don't plan on devoting a lot of time to special tricks. A dog needs to understand the basic hierarchy of the home and should be prepared to listen and learn throughout his life. Practice the basics like "sit" and "down" in the beginning and introduce something new every once in a while.

If you are thinking about adopting a dog, try taking a couple of weeks off work so you can spend some time with your puppy and teach it a few good habits. Training your puppy and helping it get used to its new environment will be much easier if you are home.

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.

If your dog isn't happy or is lonely, consider buying a second dog. Because dogs typically run in packs, they typically love being around other canines. Match them on energy and temperament for the best selection.

Playing music in your home when you leave for your job may help your dog with separation anxiety. That helps the dog feel like someone is around. This could be the perfect fix to keep him calm until you return.

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.

Before you decide to go get a dog you should think about the individual needs of different breeds of dogs. Some dogs can get enough exercise in the home, while others may need a few hours outside each day. These factors can mean a lot when it comes to meeting the needs of your new family member.

Your dog needs shelter from the sun in the summertime. You should not let your dog outside for too long unless there are a few cool spots in which your dog can be shielded from the sun. You should also make sure your dog always has access to some cool water and.

Some vitamins are not beneficial for dogs. If your dog already has a good diet, avoid giving him supplements. Too many vitamins can damage his body, particularly the bones, joints and blood vessels. Before giving your dog vitamins, speak with your vet.

Never approach a dog you are unfamiliar with. Teach your children the same thing. An unfamiliar dog may look friendly, but he could have a vicious bite. Even if he is not a biter, he might jump on you, potentially causing harm. Always ask his owner for permission before approaching him.

Make sure that you spend adequate time on each thing that you try to teach your dog. Even though your dog might catch on to something, for example the "sit" command, it may not be mastered. You'll want to make sure that the command is done every time that you ask no matter what situation you are in before you move onto a new command.

Make sure that you carry small bags and gloves with you while you are out walking your dog. If he uses the bathroom outside, it is your responsibility to clean up the mess. It is unsanitary for you to leave it there, and it some places you may receive heavy fines for that.

Now that you know more about some great advice for taking care of your dog, you can make sure your loving addition to the family is pleased and satisfied. Your dog is going to do everything he can for you, so you need to make sure you return the favor. Use the information you have read to help you.
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