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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/
Think Like A Dog. Be A Great Pet Owner.
Raising a dog is a big undertaking and long term commitment. The responsibilities that come along with owning a pet are numerous, however so are the rewards. This article aims to provide you with a few useful tips to help you with the different aspects of owning and caring for a dog.
Always be prepared to pick up after your dog with a scoop and bag. Although most people think that this is simply a polite thing to do so that others don't step in it, your dog's excrement is actually hazardous!rnIt contains a bacterium that can contaminate local supplies when it washes through to ground water.
If your dog is still getting used to the grooming process, only work with him or her in short bursts. Groom for about five minutes and then stop and move on to another activity. Eventually, start adding on two or three minutes to your total grooming time until your pet is able to handle a full session.
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.
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.
Be consistent when giving your dog commands. This is an area where a lot of dog owners have a problem, especially when you won't feed your dog from the table but your spouse will. Make sure that everyone in your home understands what's acceptable so that the dog will receive a clear message. That will make him more likely to obey.
If your dog is a digger, make sure to protect him and your garden. Some plants are poisonous to dogs, not to mention the damage those paws can do to your prized flowers and produce. Put up an appropriately sized fence to keep him out or consider using an electric one.
When choosing a dog for your home, don't forget to estimate the size it will be as a full grown adult. This is especially true if you have small children at home. Although do wild rabbits eat mushrooms will be cute, it may grow into a large, one hundred pound dog. Do some research on the average adult size of the breeds you are considering.
If you choose to adopt a pet, take him or her to the veterinarian as soon as possible. Shelter dogs have likely been exposed to all kinds of viruses, such as parvo and distemper, which are deadly. It's crucial that your pet has all necessary shots before it's brought into your house.
When it comes to your dog, you need to be aware of the laws in your area. Make sure that you know all legislation that may be going through your local system. Some of it may be trying to regulate you as a dog owner. It often results from one bad breed or bad dog. Talk to responsible pet owners all around you by contacting your local officials.
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.
When choosing to introduce a new pooch to a home that already has one, it is best that you bring your current dog along to meet him. This will give them a chance to socialize together. If you find that your dogs are compatible, a lot of anguish and trouble can be saved.
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.
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.
Make can pet rabbits eat mushrooms 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.
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.
It is important to train your dog as soon as you get him or her. Behavior that might seem cute as a puppy, can develop into bad habits as your dog matures. It is essential that your dog understands and obeys simple commands. Not only for your safety, but the safety of your dog as well.
Make sure that you carry small bags and gloves with you while you are out walking your dog. If he uses the bathroom outside, it is your responsibility to clean up the mess. It is unsanitary for you to leave it there, and it some places you may receive heavy fines for that.
Now that you understand the undertaking of owning a dog, you should feel confident in the fact that you can now provide for your pet fully. When he pees on the floor, forgive him. When he barks at the moon, bark with him. And when he gives you a big kiss, return the favor!
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