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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://petsroof.com/why-do-cats-eat-their-babies/ 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/
How To Properly Care For A Canine
A dog is a man's best friend, but how do you know that you are properly taking care of your dog if your dog doesn't speak the same language? Learning how to take care of your pet is very important. You need to consider the following helpful advice for taking care of your dog.
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.
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.
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.
When training your puppy or dog, keep the sessions short! Experts say that a dog has the attention span of a small child, sometimes less, and that longer sessions will actually cause him to forget everything you've learned together. Use positive reinforcement and limit your training sessions to no more than 15 minutes.
Keep your dog's teeth clean and healthy with regular brushing. Most canines don't mind you brushing their teeth, provided you introduce them to the process slowly and gently. Use a specially designed dog brush, along with other products made just for him. Remember to provide him with toys and biscuits that will also clean and protect his teeth.
If information online spends a lot of time alone, think seriously about adding a second animal to your family. Dogs are usually in packs by nature and this means they enjoy being around one another. By choosing another dog that matches your pup's energy level and temperament, you'll ensure that your dogs will be great companions for each other.
If you are thinking about adopting a dog, try taking a couple of weeks off work so you can spend some time with your puppy and teach it a few good habits. Training your puppy and helping it get used to its new environment will be much easier if you are home.
If you're considering becoming a dog owner, but are unsure if you're ready to take the step, you can foster one. There are many less than fortunate dogs in shelters that would love to find a forever home. Besides helping you figure out if full-time ownership is right for you, fostering will also do a great deal for the cause of abandoned animals as a whole.
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.
Designate a family member or close friend to be responsible for your dog, should something happen to you. If you are in an accident and unable to get home, your dog will need someone to feed him and address other needs. Perhaps you trust a neighbor with your house keys and they could act for you in a time of need.
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.
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.
Yelling at your dog or displaying any other violent behaviors are not good options. Your dog will fear you and establishing a bond with your pet will be very hard. The best way to train your dog is to use positive reinforcement and simply say no in a firm voice when you catch your dog misbehaving.
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.
Be thoughtful about breeding your dog. Repeated breeding of a female can evetually lead to severe health problems for both the dog and the puppies that is born from her. If you plan to breed be sure to do your research first so that you can be sure that you are doing the right thing for your animals.
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 so many amazing aspects of being a dog owner, and you should be able to appreciate all of them. With these suggestions, you'll be equipped to handle any kind of issue that your dog might throw your way. Keep this advice in mind, and enjoy your wonderful pet.
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