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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/



Dogs

Need Some Dog Advice? Read This Article




A dog is a man's best friend, but how do you know that you are properly taking care of your dog if your dog doesn't speak the same language? Learning how to take care of your pet is very important. You need to consider the following helpful advice for taking care of 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.

Avoid insisting that your dog socialize nicely with every other passing dog. Experts recommend that your dog be able to tolerate introductions through sniffing and eying with another animal, but say forcing the issue can create problems. Accept your dog's lead when meeting and greeting other animals and allow for natural interaction.

Never hit your dog. There are better ways to train a dog without having to resort to violence. The best way to train a dog is to reinforce positive behaviors with treats and attention. Negative behavior should be handled with a stern and disapproving voice as opposed to striking the animal.

Dogs love to eat grass and other plants. When you're outside, this may not be much of a problem, but if you maintain houseplants indoors, chances are they are poisonous to dogs. Before bringing a dog into the home, make sure all your houseplants are well out of reach of a dog who may be tempted by a green tasty treat.

Remember that dogs are creatures of habit and anything you start with him will be expected in the future. If you're not keen on him sleeping with you, don't let him do it only on occasion. Likewise, if you don't want him begging at the table, never offer him a bite of people food. He will learn and accept things if you are consistent.

Positive reinforcement is the best way to train your dog. miniature labrador size should congratulate your dog when it displays a good behavior, for instance by giving it a treat or petting it. Talk to your dog in a soft voice and make sure you praise it every time the good behavior is displayed.

Accept the aging process in your dog and know how to meet his changing needs. Your older dog may require dietary changes, more rest and not be as playful as he once was. This doesn't mean he should be left to grow old in a corner. Adapt to his needs and make his golden years enjoyable!

Make sure that your dog is not kept outside your home all day long. Yes, people do this too often, but dogs require interactions with people and other dogs for their well-being. When your dog is the only one you have, leaving him alone will make him sad. It's especially important that your dog be inside if the weather outside is nasty.

When training your dog, consistency is everything. You must be consistent at all times. If your dog is not allowed to jump on people as they walk in, don't allow your dog to do it even if a person says they don't mind being jumped on. You should also make sure that everyone that's around your dog understands your rules and are consistent with them.

Attention exercises must be practiced daily. These exercises will help you gain your dog's attention when they are barking or being disruptive or destructive. Once you can gain your dog's attention, you will have less to worry about when you have him out of the house or when there is company over.

You shouldn't use a chilly, wet nose to gauge your pet's health. There are many reasons for your dog's nose to be cold and wet even if the dog is sick. The overall amount of energy your dog has, its eating habits, and its general behavior are what you should watch. These are better signs of how your dog is feeling. Their temperature can be checked via their rectum.

It is natural to want to get your dog trained as quickly as possible. However, remember that there is a limit as to how fast this process is going to go. If you are not realistic, you are much more likely to get frustrated with your pet, which could damage your relationship. Your pet will learn over time, but it may not happen as fast as you would like.

When training your dog, always make sure that you enter a room before allowing the dog to. This is important because it is an obvious form of dominance that your dog will understand. Establishing dominance will help with your ability to train your dog and with its overall behavior patterns.

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.

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.

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.

Dogs will need veterinarian check ups twice a year when they become old. Dogs can age quickly over the course of a year, and older dogs will need more vet examinations in order to catch any changes their bodies may be going through. Additional tests, such as blood, urine, and ultrasound may be needed.


If you do your best to care for your dog's health and happiness, you can enjoy your dog friend for years to come. Take the tips in this article, and use them in your life. You will discover that you can take care of your dog well and be happy in the process.
Dogs
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