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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.  australian shepherd vs cattle dog  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/

Know These Things If You're A Dog Owner!

Dog ownership is not a responsibility to take lightly. There are actually many parallels with having a baby. Although it's a big task, having patience and knowledge will help make it easier. Keep reading to learn some dog tips.

Groom your dog regularly. A dog requires constant grooming to keep his coat in tip top condition. Make sure that your dog is completely relaxed before you start the grooming session; this is especially important if he is excitable. Keep the session quite short (5 to 10 minutes at most) until he is comfortable with the idea of being groomed. Most importantly - be sure to praise him and offer a treat after a successful grooming session!

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.

Some people think that it is necessary to bath a dog often. The truth is that unless your dog gets into something to get dirty, they only need bathed once every two to four months. Bathing more often could strip their skin of the oils they need for a healthy coat and skin.

Dogs love to eat grass and other plants. When you're outside, this may not be much of a problem, but if you maintain houseplants indoors, chances are they are poisonous to dogs. Before bringing a dog into the home, make sure all your houseplants are well out of reach of a dog who may be tempted by a green tasty treat.

If your dog is very rowdy or easily excitable, experts recommend that you don't bring them along on vacation. Many times the thrill and confusion of a new area filled with strangers is too much for the hyper dog and unpleasant incidents may occur. Find a great kennel to care for your pooch instead.

Be a good neighbor and discourage your dog from barking, unless he is alerting you to danger. Most people get used to the sound of their dog yelping, but others find it a constant annoyance. If your dog barks often, consider talking to your vet about what could be causing it and how you can put a stop to it, for everyone's sake.

Think about your life and then find a dog breed that will fit in well with your habits. For instance, if you like to go running, you're not going to want a little dog that can't keep up with you. On the other hand, a cuddly small dog may be perfect for those who enjoy a quiet evening reading on the couch. Don't get a dog that you don't fit in with if you can avoid that.

Lift your dog properly. If you have a little dog or puppy, place your one hand under their chest and use your other hand for supporting their rump and hind legs. If you're lifting a big dog, lift them from their underside supporting their chest using your one arm and using your other arm to support their rear end. Never lift a dog by their back legs, tail, or the nape of their neck.

In order to make sure that your dog is healthy, be sure to allow it to have access to clean water at all times during the day. Just like with all living beings, water is one of the most important components. The only exception would be that you would want to keep water from a puppy for three hours before bedtime.

Before you have your dog fitted with a microchip, be sure and check the database of the company that will store his information. Not all of them are created equal and you want to know that you'll get a fast response if your dog is lost. Look for a large database that connects to shelters and vets near you.

You need to train the dog by yourself; more than one person might confuse him. People have different ways of doing things, and having multiple commanders can confuse your dog. Be sure that one individual is in control of the training and keeps others working with the dog on the same page.

Consider the placement of your dog house carefully. Think about the way that the winds typically blow and face the door on the opposite side. If you tend to get winds from all directions, consider a house with a door flap. There are some states that require a door flap, so check with your local animal shelter to learn more.

When selecting a new dog to come and live with an existing dog, take your current dog to meet him if at all possible. Most dogs enjoy another dog's company, but some dogs do not get along. If you find a dog that is compatible right away, you'll save yourself some difficulties later.

Every dog needs to have a good amount of exercise in order to stay healthy and fit. It is a good idea for you to take your dog out for a walk at least once a day if you do not have a yard he can use to run around freely.

Socializing your dog with other dogs is essential when you get to bring a puppy into your home. Getting your pet groomed, taking it on play dates with other dogs, or going to the dog park can help your dog to socialize with other animals.

If you want your dog to learn to "sit", start by holding a cookie, or other treat, above his head. This will cause him to look up. When he looks up, gently push his hind end down, and give the command to sit. Give him the treat, and praise him. Soon, he will sit just by hearing the command and seeing your hand go up, and eventually will obey to the "sit" command alone.

Walk your dog at least once daily. You and your dog both need exercise, and a walk is a nice break in routine for man and beast. Walks are very important to your dog's development and will keep it happy and in good shape.

Dog care is something you have to be careful with. Owning a dog is almost like having a child in that you're the one responsible for keeping your dog alive. While it is not an easy task, it is something you can excel at. You have this article to help you if you need it, so take care of your dog.

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