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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. https://en.wikipedia.org/wiki/List_of_dog_breeds 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/

You Can Have A Dog In The Home

Owning a dog is no simple task. They require a ton of care, from being bathed to fed to checked over by the vet. With so much to do, how can you keep track? This article will give you some simple tips to help you get the job done right. 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 gets lost, it is very unlikely that you will see him again unless he has proper identification. Tags can come off, so the best option is a microchip. It is quick to put in your dog, and it causes minimal discomfort. Simply register the chip ID after it is put in, and your pet will always have his identification with him. When preparing to groom your pet, start the session off on the right foot by helping your dog relax. Spend a few minutes simply petting him, starting with the head and then rubbing the back, paws, belly and even tail. Once you feel your dog is happy and content, begin grooming him. Be careful around Christmas time with a dog in your home; it's the busiest time of year at 24/7 animal clinics! Things like hanging and tree lights pose a danger to your dog, as they could become tangled or gnaw their way down to raw wires. The loveliest of Christmas plants are also hazardous to a dog's health, so take extra care during holidays. Be sure to praise your dog thoroughly any time it behaves correctly, such as sitting when it is time to put their leash on. Let a dog know that their behavior is what you wish to see. It also reinforces the idea that they will receive attention if they behave as you want them to. 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. If you're trying to break one of your dog's unwanted habits, make sure that you understand that it will not happen overnight. Breaking a habit takes time and patience. Don't get discouraged and give up if it seems like your pup isn't making progress. Keep at it and maybe try changing your approach to the training. Sometimes this can be the boost that your dog needs. 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. 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The article here shared tips any dog owner can use to help make sure their time with their pet is enjoyable. Use what you learned to have the best relationship possible. I am very intrigued by Pets and I'm hoping you liked the blog entry. Those who enjoyed reading our post please make sure you remember to pass it around. We take joy in reading our article about Pets.