Albert Einstein On cat Butt Scratch
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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 why do cats like their bum scratched 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/
Seeking Knowledge About Dogs? You Need To Read This Article!
A dog is a very loving pet and who makes a great companion for any person. They are great family pets that provide a companionship for everyone. If you want to take better care of your dog, make good use of the following tips.
When you are trying to teach your dog new tricks, you should always be patient. Different dogs will learn things differently. If your dog isn't picking up a new trick right away, give him time. You could also try changing your teaching method. Your dog may respond better to a different approach.
Never lose your temper or punish your dog if you find that they did something wrong. Negative reinforcement will simply make your dog scared, which will make it difficult for you to train them. Use positive reinforcement at all times to get your dog to cooperate when teaching him new things.
If your dog has long hair, make sure to take the time to trim the fur around his feet. If you allow your dog's hair to grow too long, they can get things stuck in their fur. This could lead to injuries between the pads of the feet and around the nails.
Know your dog's behavior and body rhythms well, to keep him at his healthiest. Medical issues often present themselves in slight nuances early on and if you know your dog, you'll see them. Pay attention to input and output, sleep duration, energy levels and so forth to keep on top of important issues that affect his health.
Your pet needs vaccinations, much in the same way that your baby does. Some common vaccinations that dogs require include rabies, hepatitis and distemper. Each pet is different, and each will have a different immunization schedule. Your veterinarian is a great resource when it comes to which vaccinations are right for the age and breed of your pet.
Make sure your dog gets enough exercise. This is vital to the care of a happy dog. Many people don't bother to exercise their dog, thinking that walks are enough. Dogs are active creatures and need to play. Talk to your veterinarian about how much activity your dog needs, and make sure he gets it.
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.
Your dog should not be left outside in the yard by himself for the entire day. Lots of folks do this, but it's bad because dogs need constant attention. A dog left alone outside will get very lonely. Plan on bringing your dog inside when the weather is rainy, snowy, very hot, or very cold.
Positive reinforcement is the best way to train your dog. You should congratulate your dog when it displays a good behavior, for instance by giving it a treat or petting it. Talk to your dog in a soft voice and make sure you praise it every time the good behavior is displayed.
Groom your dog frequently. Keep them clean and reduce the amount of hair they shed by brushing them frequently. When the weather warms up, start checking them for ticks and fleas daily. Dogs generally require a few baths a year. Before you give your dog a bath, make sure to cut or comb out mats and tangles. Rinse their coat thoroughly to avoid dirt sticking to any soap residue.
Does your dog chew a lot? This could be a sign that your dog is bored or anxious. You need to provide your dog with some toys that can be chewed and perhaps leave a shirt with your smell near your dog to avoid separation anxiety, especially if your dog is very young.
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.
Dog training requires you to be consistent. Once you decide you want to establish a rule for your dog, do not make any exceptions. Make sure everyone at home helps you enforce the rule and encourage your guests not to let your dog jump on them or to not acknowledge your dog when it barks.
Don't rely on just a wet and cold nose to determine a dog's health. There are lots of reasons why his nose may be this way, even if he is feeling ill. Using your dog's appetite, attitude, and amount of energy, you can determine its health. These are all good ways to gauge how well your pet is doing. Dogs can have their temperature taken rectally.
Some people think it is cute to give their dog alcohol, but it is dangerous. In high doses, alcohol is toxic to humans and even more so for animals. In addition, it affects co-ordination, causing accidents, and can decrease a dog's respiratory rate. Even small amounts of alcohol can kill a dog.
Pay attention to your dog's breath. Dogs will always have "dog breath,"u009d however, really bad breath is a sign that they need a dental check up. Plaque buildup caused by bacteria could be the culprit and that will need to be treated by a professional. After their treatments, you will need to brush their gums and teeth and feed them food that helps maintain good dental health.
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.
After reading this article, you should have a better understanding of how to take care of your dog. By using this advice on a daily basis, you can enjoy many years of companionship with your furry friend. Keep your dog happy and healthy throughout its life by using these tips.
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