Yes, please do. You can use the paperclip icon in the toolbar above your message box (if that icon is visible) or you can use an external app such as dropbox.com. I can be more accurate for you if I can see what you're seeing.
thanks. This is him with a 'normal' lip:
and then with the infection a couple of weeks ago:
and then now, today:
Thank you! This is most indicative of mucocutaneous pyoderma which is a bacterial infection of mucocutaneous junctions (such as where the mucous membranes of the oral cavity meet the skin). It's uncommon in dogs; German shepherds and their crosses are possibly predisposed, indicating possible association with the ulcerative syndromes of German shepherds (mucocutaneous pyoderma, perianal fistula, metatarsal ulceration). Lesions are characterized by some combination of mucocutaneous swelling (quite apparent in Bandha), erythema (reddening/quite apparent), and crusting, often bilateral and sometimes symmetrical. Affected areas may be painful or pruritic (itchy), and self-traumatized; they may become exudative, eroded, ulcerated, fissured, and depigmented. The margins of the lips, especially at the commissures, are most frequently affected.
Treatment is as follows:
1) For mild to moderate lesions, affected areas should be clipped and cleaned with shampoo that contains chlorhexidne.
2) Topical prescription mupirocin ointment or cream should be applied every 12-24 hours for 1 week, then every 3-7 days for maintenance therapy, as needed.
3) For severe lesions, in addition to topical therapy, appropriate systemic antibiotics should be administered for 3 weeks.
4) The prognosis is good if an underlying primary disease (allergy, endocrinopathy) can be identified and controlled but lifelong maintenance therapy is often needed. If regularly applied, topical antibiotics may maintain remission.
Feel free to share our conversation with Bandha's vet. The top differentials are superficial pyoderma, lip fold pyoderma, autoimmune skin disorders (unlikely if it has responded nicely to only antibiotics), demodicosis (the Demodex mange mite), dermatophytosis (fungal infection), Malassezia (yeast) dermatitis, candidiasis, and epithliotropic lymphoma (not a consideration because it has responded to antibiotics). Please continue our conversation if you wish.
If he'll let you do so, applying an over the counter topical antibacterial ointment or cream such as one containing fusidic acid or neomycin should be helpful. I don't want your getting bit, however. He'll ingest some of the product but that should be of little consequence. This isn't an emergency situation other than it can abruptly worsen prompting a more protracted therapy.
You're quite welcome. I can't set a follow-up in this venue and so would appreciate your returning to our conversation with an update - even after rating - at a time of your choosing.
hi again. I already rated and thank you so much - the advice was excellent - but I just wanted to check - is the ointment (fusidic acid/ neomycin) a vetinary one or could a human one be used? Thanks again so much - and Happy New Year!!
Those products can be found at your local druggist and are used in both veterinary and human patients. Thank you for your kind accept. I appreciate it.
I can't set a follow up in this venue and so would appreciate your returning to our conversation with an update at your convenience.
Yes, please, I would like to see a photo(s). You can upload photos by using the paperclip icon in the toolbar above your message box (if you can see the icon) or you can use an external app such as dropbox.com/ Pemphigus folicaceus, perhaps, but let me take a look...pemphigus doesn't respond to antibiotics alone; glucocorticoids such as prednisone are most always necessary.
I can't see the second and third posted photos because they aren't specified as you specified the first one. The provided link only brings me to the home page of flickr. Please try again.
Thank you! There's no evidence of pemphigus in those photos. The anatomy of the lip (a large lip flap) predisposes to a skin (lip) fold pyoderma also called lipfold intertrigo. Bacterial and/or Malassezia (yeast) overgrowth is extremely common in these folds and actic acid treatment once to twice daily can be beneficial. Dogs with very deep folds often can't be cleaned well enough. These dogs often need treatments with oral antibiotics and/or oral antifungal products to keep the dermatitis under control. Cheiloplasty (lip reduction) is curative and should be considered in Bandha. Please continue our conversation if you wish.
Julia, those are epidermal collarettes which start as pustules (which I can also see in the photos) and most often represent a superficial spreading pyoderma (a Staph infection, usually) which is best addressed with a systemic antibiotic in the cephalosporin class such as cephalexin for a minimum of 3-4 weeks and 1 week past clinical signs. Shampooing twice weekly in a shampoo containing either chlorhexidine or benzoyl peroxide should hasten resolution of the infection.
Please open up a new question for a new problem lest my moderator become upset with me, rip off my left leg, and beat me to death with it. You need only to type "for Dr. Michael Salkin, only" as the first few words of your new question so my colleagues will know to defer to me.