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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. constant licking lips in dogs 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). actual dog breeds start with r 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/
Here Are A Few Barking Good Dog Tips.
What is more fun that having a dog? So many dog owners know the special happiness that comes from having a canine in their lives. If you're one of the people who know what it's like to have a dog, you want to do your best to make sure he's with you a long time. Here are some tips to help make sure of that.
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.
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!
Offer rawhide rather than actual meat bones. Bones can lodge in the mouth or throat, causing devastating injuries. Also, rawhide is better for the health of your dog's teeth.
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.
Teach your dog to be trained, even if you don't plan on devoting a lot of time to special tricks. A dog needs to understand the basic hierarchy of the home and should be prepared to listen and learn throughout his life. Practice the basics like "sit" and "down" in the beginning and introduce something new every once in a while.
Do not make training your dog seem like a chore. Dogs pick up on this negative energy and will have a difficult time learning if you are not in the right mind frame. Make it fun and try to look at it as a bonding experience with your pet. When your dog is having fun, they will learn their training quicker.
If you already own a dog and are getting another one, have the two meet before bringing the new one home. Dogs can be quite social, but some are more effective at socializing than others. Finding the right dog for you will save you lots of trouble in the end.
Know that an animal doesn't need too many people telling it what to do when it's being trained. Everyone will have a different way of trying to teach the dog something, and that can make things confusing for the animal. Have a single person focus on training your dog, and have anyone else work to reinforce what the dog is learning. No matter what their opinions are, they should stick to the rules set by the trainer.
If your dog seems lonely or seems to have separation anxiety, leave the radio or a CD on when you leave the house. The sounds of the music will provide a sense of security and company for your dog. This little touch can help your dog feel less anxious as he awaits your return.
If you live with other people, make sure they are aware of your training "rules." It is important that everyone redirects the dog off of the furniture, for example, and that they use the same language when doing so. If everyone's rules are different, your dog is just going to get confused, which will make the training process much longer and more difficult.
Always use a leash when your dog or puppy is out in public. This helps you make sure your dog always stays by you and prevents them from wandering off or getting into trouble. This can also help you restrain your dog if something upsets them so that they don't hurt another animal or person.
Be strong when the time comes to say goodby to your beloved dog. Many owners keep the animal suffering to keep them in their lives and that's not fair to the dog. Consult with your vet, then talk it over with family. If it's time to part ways with your dog, do what's best for him.
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.
You need to teach your dog a few simple commands at a very young age for its own safety. Your dog should always come when you call its name and a command such as 'give' should be used to get your dog to stop gnawing at a potentially dangerous object.
Do you feel stressed out a lot? Dogs have been proven to help lower your blood pressure and help you to feel calm. People who own dogs often live longer than those who do not. Dogs can also bring you happiness and comfort if you are suffering from an illness.
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.
Your dog loves you unconditionally, and you want to make sure you provide the most for him. Therefore, it's imperative that you utilize the information you've been given so that you can work towards taking good care of your pet. Your pet deserves proper care, and you can now provide that to him.
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