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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/
What Any Dog Lover Needs To Know
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.
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.
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.
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.
You need to ask your vet to make sure the food you are feeding them is good. Some foods can cause sickness or an upset stomach. Be cautious about what types of foods you feed your dog.
Be prepared to have a lot of patience with your dog during potty-training. Much like children, dogs learn at different speeds and ages and your canine may be slow or stubborn. Have good resources at your fingertips to assist your efforts and remember not to get angry when your dog has "accidents" as that will only impede his progress.
Don't assume your toy-sized dog's bite isn't dangerous, just because he's little. A lot of owners brush-off training, thinking that the smaller breed dog can get away with a little bad behavior and this isn't true. As a responsible canine master, you've got to make certain your dog does not pose a threat to anyone by having him well trained.
Don't be upset if your dog does not want to get dressed up. It's becoming more popular to dress your dog in dog clothes, but some dogs just don't like the feeling of having clothes on. If your dog does not relax after the clothing is on, you should remove the clothing to avoid your dog trying to remove it by itself.
To ensure that your dog is safe, you should try to make your home as dog-proof as possibly. This includes making sure that only safe play toys are within your dogs reach. If you have a problem with your dog getting into your kitchen trash or the things on your counter, you could consider getting a baby gate to prevent your pup from entering the kitchen.
Respect your pet. When out on a walk, do not force your dog to interact with other people or animals if he does not want to. There is a reason why your dog may not want to get too close, and it is important that you listen to him. If you try and make him interact, your dog may begin to act out over time.
Getting a dog on a whim is rarely a good idea. You need to make sure you can afford to feed a dog and cover medical expenses before getting a pet. Research different breeds to figure out which dog would be best for your family, your lifestyle and the size of your home.
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.
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.
Even if your dog does not spend the majority of his time outside, it is still important that you bring him or her to the vet for their yearly shots. Your dog could come in contact with other dogs at the dog park or at your home. If the other dog is sick, it could pass on to your dog. This is why it is important that they are vaccinated every year.
Never approach a dog you are unfamiliar with. Teach your children the same thing. An unfamiliar dog may look friendly, but he could have a vicious bite. Even if how to keep cats out of your sandbox is not a biter, he might jump on you, potentially causing harm. Always ask his owner for permission before approaching him.
You should be giving your dog clean water regularly. Even if your dog does not drink too much water, you should still change his bowl twice a day. Also, if the tap water in your area isn't great, give him or her bottled water. When it comes to drinking water, your dog should have the same quality as you have.
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.
There are few greater joys in life than the love you can share with your loyal companion. It won't always be a walk in the park but the rewards are more than worth it. Enjoy your pup and continue to learn more to help keep your lives happy and healthy.
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