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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog
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Experience:  Over 20 years of experience as a veterinarian.
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I have a female boxer dog, who is 6 months old. She started

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I have a female boxer dog, who is 6 months old. She started scratching her mouth and ears a few months ago now. She scratches so much that she makes her ears and mouth bleed and they look very red and sore. I took her to the vet and she explained that it could be an allergy to something & advised me to put her on a hypoallergenic food, which i have done so. I was given piriton tablets and also some steroid tablets called prednicare. My dog instantly settled down and stopped the frequent scratching. However as soon as she stopped the steroid tablets it came back again and is very distressing for her and myself. I went to the vet again and she gave me the same again and told me that puppies do often grow out of this. But once again the steroids have finished and she is scratching all over again. Also today she went on along walk and when we returned her paws were driving her mad and she ran around frantic scratching her mouth and nibbling her paws, she appeared very distressed and has only just settled due to tiredness i think! Please could you advice me on what i should do next? She is suffering and i feel desperately sorry for her as she is a beautiful pup who is loved so much!
Thankyou kelly
Submitted: 3 years ago.
Category: Dog
Expert:  Dr. Kara replied 3 years ago.
Hello, my name isXXXXX and I have over 20 years of experience as a veterinarian. I am sorry to hear that Ruby is so miserably itchy.

Allergies are the most common cause of itchy skin and can give her a skin crawling, all over itchy type effect which many dogs find irritating. I'll give you an allergy rundown of likely causes for skin troubles. She may have more than one allergy given how symptomatic she is now and her improvement with the use of steroids.
Though dogs with food allergies tend to have itchy paws and faces they don't usually improve greatly with steroid use. Dogs that have one allergy often develop several with time. The effect of multiple allergies aren't additive, they actually compound one another.

Even if you don't see fleas I do recommend using protection, because they are the most common allergen and it only takes one bite a month to make an allergic dog scratch. I recommend using flea prevention even if you never see one again. Frontline Plus, Advantage II or Advantix are excellent products. Don't use over the counter products, especially Hartz or Sargents, as most are ineffective if not toxic.

Other allergens can be inhaled (like grass pollen, dust mites or molds) and you can use a combination of antihistamines and high doses of omega-3 fatty acids to help with those (they also help with the symptoms of flea allergy). In combination fatty acids and antihistamines work synergistically, much better than either one alone. If in time you notice that her symptoms worsen seasonally I would think that inhaled allergens are a part of her problem.
You can try:
1)Benadryl (diphenhydramine only don't use the combination products with acetaminophen or decongestants as they can be toxic) at 2mg to 4mg per kilogram of body weight or one 25mg capsule per 8 to 12 kilograms of body weight orally every 8 hours.
OR 2)Claritin (loratidine) at 5mg per 12 kilograms of body weight once or twice daily.
OR 3)Hydroxyzine at 2mg per kilogram orally every 8 hours.
OR 4) Chlorpheniramine (piriton) at 4mg to 8mg per dog once or twice daily. I know you've tried this one, but I want to make sure a high enough dose was used.
Some dogs do better on one antihistamine rather than another. You'll have to see which one works. Pick one, give it a week trial and if it isn't working try another. Be aware antihistamines can cause sleepiness or hyperactivity in some dogs. These side effects do wear off with repeated use
Omega-3 fatty acids are fish oil products. 3V by DVM or Derm Caps ES are good brand name products. Use the high end of the dosing schedule for your pup's weight. I recommend a dose based upon the EPA portion (eicosapentanoic acid) of the supplement as if we do that the rest of the supplement will be properly balanced. Give her 20mg to 40mg of EPA per kilogram of body weight per day. For example an 20 kilogram dog could take 400mg to 800mg of EPA per day.

Cool water baths with an oatmeal shampoo or chlorhexiderm shampoo (which is antibacterial and antifungal) and a conditioner with an antihistamine may help. The water rinses off allergens and the cool temperature soothes itchy skin.

Food allergy is very possible with her as food allergic dogs often have very itchy ears and feet and food allergies are the most common allergen in young dogs. Dogs can develop allergies to any protein or carbohydrate so even if she is only fed one thing that can be what she is allergic to. Dogs with food allergies tend to lick and scratch their paws, face and ears the most, but any of the "allergy reactive areas" can be affected. I know that you have changed her diet but it may not have been restrictive enough. You could try a true hypoallergenic diet like Hills z/d or Purina Veterinary Diets HA. No treats, flavored medication or bones while on the diet and it must be used for a least 12 to 16 weeks to see the full effects. You should see some improvement in 6 to 8 weeks though.

Another option if the antihistamines and omega 3's aren't enough is a product called Atopica. It suppresses the immune system a bit so it decreases allergic symptoms but it doesn't have as many harmful side effects as systemic steroids. Another option is a brand new drug called Apoquel (generic name oclacitinib) which interferes with the allergic pathway. It works very quickly to stop the symptoms of an allergy. Most dogs are reported to be much more comfortable in a day or so. If you are interested discuss these medications with your veterinarian as they are prescription products.

If she has never had a skin swab, deep skin scraping or skin biopsy to look for skin mites then your veterinarian should look for parasites like cheyletiella, demodex or sarcoptes as they can lead to very itchy skin and the secondary inflammation they cause can improve with steroid use, thus masking her itchiness.

If your veterinarian seems stumped ask for a referral to a veterinary dermatologist, they specialize only in skin diseases and may be able to get her more comfortable more quickly.

Please let me know if you have any further questions.
Customer: replied 3 years ago.

Hi


Thank you for all your help. She had her flea treatment previous and has never had a flea as i frequently look especially since i noticed the itching. She is due to have her next flea treatment this week, is it possible she could be allergic to the flea treatment? I do feel that her skin should be tested and i will ask the vet to do this.


 


Thank you


Kelly

Expert:  Dr. Kara replied 3 years ago.
It is pretty unlikely that she is allergic/sensitive to her flea medication. If that were the case then I would expect redness at the site of application rather then on her paws and face.

I think testing her skin for parasites is a great idea.

I don't know what diet she was placed on, but if it wasn't a veterinary prescription, true hypoallergenic diet and she was given any additional treats or edible bones while she was on her diet then she hasn't been on a truly hypoallergenic trial.

Another thing you might want to discuss with your veterinarian is blood testing for inhaled allergies. She is young for inhaled allergies (atopy) to be developing already but if she is clear for skin parasites that is another avenue to explore.

Best of luck with your girl, I know how frustrating allergic skin disease can be and how miserable they are until we can get things under control.
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