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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 A Happy Puppy Or Dog With These Ideas.

There is not another pet in the world like a dog. A dog can give you the loyalty and friendship that you can't get with another animal. That's why they deserve special attention. Here are some suggestions to assist you in making sure your dog can live the good life.

Never allow your dog to ride in a car unsecured. Sitting on your lap or in the front seat is dangerous both to him and your ability to drive. Always place him in an appropriately sized pet carrier or invest in a pet seat belt that will keep him snug and safe in the middle of the back seat.

Consult with your vet about the types of foods that are good for your dog. Puppies may lack the development needed to tolerate certain kinds of food without getting sick. You should be careful when you are feeding 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 issues of jealously if you have more than one animal. Particularly if you bring a young dog into the home of an older dog, problems can arise. Be considerate of the patience and energy levels of your senior dog and make sure his feelings aren't hurt by giving the new guy all the attention.

Rather than merely using verbal commands, it is wise to utilize hand signals when training your dog. These signals will help you keep your dog under control in a noisy environment. Look at both options and see if one particular way works best.

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 cautious with female dogs in the heat. If you aren't, you may have to deal with an unwanted pregnancy. Male dogs can pick up the scent of a female dog in full heat up to five miles away. This may cause a fight or impregnation if a male dog spots her.

If you've got the most well-behaved and lovable dog around, share his good nature with those less fortunate. You could bring him to visit the elderly in nursing homes or sick children in hospitals. Not only will you be improving the quality of life for those people, but your dog will love being a super-star wherever he goes!

In order to make sure that your dog is healthy, be sure to allow it to have access to clean water at all times during the day. Just like with all living beings, water is one of the most important components. The only exception would be that you would want to keep water from a puppy for three hours before bedtime.

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.

To discourage your dog from chewing everything in the house, combine equal parts of water, white vinegar and apple-cider vinegar in a spray bottle. Gently mist things like shoes and umbrella handles and this should repel your dog. If not, dab a little minty muscle ointment on the things he's prone to chomping and that should work for sure.

Be a responsible dog owner, to represent the species well. For example, Pit Bulls are feared and often even hated in most places these days, due to irresponsible ownership. People tend to blame the animals when in fact it's the human factor influencing the dog's behavior. Train your dog well and leave a good impression on others!

If dog breeds that get along with pit bulls suffers from constipation or diarrhea, you can try feeding the pet canned pumpkin. what dog breeds get along with pit bulls is not same as pumpkin pie filling. Pumpkin contains fiber which helps with constipation. In addition, it also absorbs water which helps with diarrhea. Don't give the dog much, just a teaspoon or two with the dog's regular meal.

Keep your dog safe from dangerous chemicals. Similar to kids, cleaning chemicals and any car maintenance substances are harmful to them. These substances are poisonous, so if a dog gets any on them or ingests any, they could get burned, become very sick, or die. Store your hazardous chemicals in a place that your dog can't get to, or keep them in a closed area using a child-proof lock.

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.

Do you feel stressed out a lot? Dogs have been proven to help lower your blood pressure and help you to feel calm. People who own dogs often live longer than those who do not. Dogs can also bring you happiness and comfort if you are suffering from an illness.

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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