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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  https://domainscene6.tumblr.com/post/659599284799471616/shhhh-listen-do-you-hear-the-sound-of-my-dog  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/

Need Some Dog Advice? Read This Article

Bringing a dog into the home is a decision that should not be taken lightly. If you are considering, or have already extended your family to include a dog, there are things that you should know. Below, you will find a list of quality tips to use to help the transition easier for you and your dog.

Consider teaching your dog hand signals along with verbal commands. Consistency and practice are key to teaching a dog these non-verbal commands. Many owners get frustrated and resort back to verbal commands, but a well-trained dog should understand both. Try using only verbal commands when the dog is out of sight range, but when close up, only use the hand signals.

Keep on top of fleas. Not only can fleas cause infection in your dog, if one is swallowed, your pet can get tapeworms as well. Speak to your veterinarian about the best prevention method, but remember that this is not a one shot deal. You will have to continue your efforts over the life of your pet.

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.

Avoid impersonating a medical professional when it comes to your dog's health. In an attempt to save money, many people try to diagnose their pet's conditions or use human treatments on various elements and that can be very dangerous to the animal. If you can't afford full vet care, tell that to the doctor and ask their advice anyway or if they could arrange a payment plan for you.

When it's time for dog training, you'll want to do it inside your house or in your yard. This will give you security and an area that your dog is comfortable. Distractions occur, making it difficult to get your dog to focus on basic commands.

When it comes to training your dog, you should never have several people in charge. Everyone has their own methods, and experiencing a number of them can leave your pooch confused. Be sure that one individual is in control of the training and keeps others working with the dog on the same page.

When a dog behaves badly, correct him immediately. Ignoring it can help your dog to establish lifelong bad habits. The longer you wait to address the problem, the worse the problem will become. Your dog might hurt someone else, or you, so take steps to control him early on.

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!

If you are in the market for a pedigree pup, you just may find him at the pound. Many pet owners abandon their dogs at the pound when they no longer want to, or are able to, keep them. Call the shelter to find out which dogs they have available. You can save the life of an abandoned dog this way.

If you are having trouble training your dog, see a professional.  breeds that get along with pitbulls  of people wait until their problems are enormous, but if you would see a dog trainer as soon as you start having difficulty, you will find training goes more easily. Not only that, but you will save yourself a major headache.

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.

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.

Never trust the feel of your dog's nose as the sole diagnosis of a health condition. There are many reasons for your dog's nose to be cold and wet even if the dog is sick. Judge a dog's health by demeanor, appetite, and energy levels. They'll all really tell the story of your pet's health. To check a dog's temperature, you need to do it rectally.

Your puppy may be cute when it starts nibbling slippers, but it will not be when it's older and chewing them to bits. The sooner you stop bad habits, the better. If your dog is doing something that it shouldn't, don't ignore it. You will be saved much trouble down the line.

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.

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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