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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. labrador coat care 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/


Dogs

Need Some Dog Advice? Read This Article




Are you looking to become a dog owner? Or do you already have a dog? Anyone with an interst in dogs should know what it takes to be a responsible owner. The following information can help you when it comes to man's best friend. Keep reading to learn more about dogs as pets.

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.

Groom your dog regularly. A dog requires constant grooming to keep his coat in tip top condition. Make sure that your dog is completely relaxed before you start the grooming session; this is especially important if he is excitable. Keep the session quite short (5 to 10 minutes at most) until he is comfortable with the idea of being groomed. Most importantly - be sure to praise him and offer a treat after a successful grooming session!

Offer rawhide rather than actual meat bones. Bones can lodge in the mouth or throat, causing devastating injuries. Also, rawhide is better for the health of your dog's teeth.

Resist the urge to give your dog table scraps. This will encourage constant begging and reduce their appetite towards their own food. Table scraps can actually lead to obesity and other health concerns. Train your dog to sit far away from your dining room so that you and your family won't be tempted to feed it table scraps.


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.

There are many ways to show your dog how cherished he is. Do not focus on just the negatives with your dog. If you focus on the negatives, they will not maximize their potential. Try praising them at least 5 times more than when you scold them. When you do this, you will probably end up with a better behaved dog.

If your vet gives you medication to take home and administer to your dog, be sure and ask for ideas on getting him to swallow it. Dogs differ in their tolerance of pills and badly-flavored liquids, so have a few tricks up your sleeve in case he resists. Getting a dog to take medicine is important, but often challenging.

Your dog should not be left alone outside all day. While this happens quite often, a dog needs interaction during the day. When your dog is the only one you have, leaving him alone will make him sad. Plan on bringing your dog inside when the weather is rainy, snowy, very hot, or very cold.

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.

Never judge a dog's health simply by how cold or wet its nose is. A cold and wet nose could be due to many reasons, and it does not preclude illness. Judge your dog's health by energy levels, appetite and demeanor. These are the best ways to know how the dog is. If you need to take a temperature, you can do so rectally.

Be sure your dog sees the vet once a year. It's important that the dog sees a vet every so often to make sure there aren't any shots that they might need. Puppies have to go to the vet more often than older dogs. This will help your vet diagnose any physical issues with your dog.

If you're on a tight budget at home, think carefully before getting a dog. They actually cost hundreds of dollars annually, but many people don't realize this until they've actually forked over the money. Depending on the size and regular maintenance requirements of your new dog, you could be getting in way over your head and forced to part with him later so make sure beforehand.

Be sure to keep your dog's nails clipped in order to prevent injury. This can occur both from the dog scratching itself or also from having its nails get caught in things such as carpet. In order to be sure you are cutting the nails correctly, be sure to check with the veterinarian or groomer.

Always try to do your training in an area where the dog has some distractions around them. Rarely are you going to be in a situation where you need your dog to obey and it is completely quiet. It is best for you to practice your training with the television on, kids running wild and maybe some music playing.

You need to teach your dog a few simple commands at a very young age for its own safety. Your dog should always come when you call its name and a command such as 'give' should be used to get your dog to stop gnawing at a potentially dangerous object.

No matter what kind or length of fur your dog has, it is important that they are brushed regularly. Without regular brushing, your dog's fur may become matted. Matted fur can cause inflammation on your dog's skin and is very difficult to remove. Also, brushing their fur regularly gets rid of dead hair and helps distribute oils.

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.

A dog can be a faithful companion, but you must know what it takes to be a responsible owner. The article here shared tips any dog owner can use to help make sure their time with their pet is enjoyable. Use what you learned to have the best relationship possible.
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