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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. petsroof what dog breeds get along with pit bulls 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/

Some Dog Care Ideas For Both Owners And Buyers.

What is more fun that having a dog? So many dog owners know the special happiness that comes from having a canine in their lives. If you're one of the people who know what it's like to have a dog, you want to do your best to make sure he's with you a long time. Here are some tips to help make sure of that.

Your daily lifestyle should help guide your choice of dog breed. Joggers should get a high energy dog, for example. If you like to stay at home, perhaps you would like a small dog. By selecting dog breeds start with r methods , both you and your dog will be more content.

Don't give table scraps to your dog. That encourages him to beg and makes him not want his own food. Giving your dog table scraps isn't good for his health as it could result in weight gain and digestive problems. Insist that your dog wait away from the table during family meals to avoid temptation on his part - and yours.

If your dog gets lost, it is very unlikely that you will see him again unless he has proper identification. Tags can come off, so the best option is a microchip. It is quick to put in your dog, and it causes minimal discomfort. Simply register the chip ID after it is put in, and your pet will always have his identification with him.

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.

Brushing your dog's teeth is important, but it is not easy. If your dog is resisting, once a day simply lift their lips and use your finger to rub their teeth lightly. Do it quickly at first, and then begin to draw out the time you spend performing this action. This will help them get use to the process. After that, you can begin using an actual brush and toothpaste.

Take your grown dog to the vet at least once a year. The vet will check to see if the dog's vaccines up to date. In addition, the vet will check the dog's teeth and vital signs. If any major health or behavioral issues come up between annual checkups, you should see the vet earlier.

Send your dog to school! He will feel more comfortable knowing exactly what is expected of him and obedience school will help him learn that. It will also boost his self-confidence, and of course, make a more well-behaved pet of him. Call around locally and see if you can sign him up for a trial class and take it from there.

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.

Know the symptoms of dehydration in your dog, as it is a common ailment that can be dangerous. Particularly during hot dry summer months, your dog may pant excessively and experience a loss of the elasticity of his skin. If you see this, encourage him to drink water and add a little Pedialyte to rehydrate him.

Consider puppy training classes for your young pet. Puppies are eager to learn, and a class is a wonderful atmosphere to let them do so in. Classes are also often cheaper than individual lessons. This will teach your pup essential behavioral skills and allow the two of you bonding time too.

Always use a leash when your dog or puppy is out in public. This helps you make sure your dog always stays by you and prevents them from wandering off or getting into trouble. This can also help you restrain your dog if something upsets them so that they don't hurt another animal or person.

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.

If you pick up a dog from a shelter, make sure that he has been seen by a medical professional. You don't want to bring home a sick dog unless you are aware of it, particularly if you have other dogs at home. Make sure to ask if the dog you have chosen has been around sick dogs in the past few weeks as well.

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.

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.

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.

The truth is that no advice will be perfect either. Every single situation calls for different reactions, be it what to feed a dog or whether or not to take the dog to the vet. Your dog will be happy as long as you love them, and thankfully, that is the easiest part of the job!
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