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Ask Dr. Michael Salkin Your Own Question

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 24443
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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My dog has patches all over her back with open skin due

Customer Question

Hi , my dog has patches all over her back with open skin due to her biting her self due to itching ... What can be done to help her ?
Thanks
Nipa
Submitted: 8 months ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 8 months ago.
Nipa, there are quite a few considerations in a dog such as Reva. Her vet will want to examine Reva and discuss diet, whether or not Reva's itching is seasonal, and identify all the areas on Reva's body that appear to be itchy.Pruritic (itchy) dogs are suffering from an allergic dermatitis in the great majority of cases. Allergies to flea saliva, environmental allergens (atopic dermatitis) such as pollens, molds, dust and dust mites, and foods should be considered. (Paw and extremity licking indicates both atopy and a food intolerance and so it behooves vets to distinguish one from another.) In many instances, a concomitant pyoderma (bacterial skin infection), yeast infection (Malassezia), or mange mite (Demodex or Sarcoptes) might be contributory.Reva's vet can check a sample of Reva's skin surface microscopically (a “cytology”) for abnormal numbers of bacteria and yeast and skin scrapings can be taken in an attempt to find mites. Pyoderma is treated with a minimum of 3-4 weeks of an antibiotic in the cephalosporin class such as cephalexin (Keflex) and yeast is addressed with ketoconazole for at least a month.Our dermatologists tell us to apply an effective over the counter flea spot-on such as Advocate, a fipronil-containing product such as Frontline or one of the newer prescription products available from Reva's vet even if fleas aren’t seen. Dogs can be such effective groomers so as to eliminate all evidence of flea infestation. Dogs who remain primarily indoors can contract fleas because we walk them in on us and flea eggs and larva can remain viable in your home for months. As the weather warms or you turn on heaters at this time of year, egg hatches are common. In severe cases, an anti-allergenic prescription glucocorticoid such as prednisone will work wonders for dogs allergic to the saliva of the flea. If the area between the edge of her rib cage and her tail (the "saddle" area) is particularly excoriated, a flea saliva allergy should be the most important differential diagnosis. If you have other pets they may have fleas too but may not be allergic to the flea’s saliva.Environmental allergies are usually initially addressed with prednisone as well. In some dogs an over the counter antihistamine such as clemastine (Tavist) at a dose of 0.025 - 0.75mg/lb twice daily or Piriton (chlorphenamine) dosed at 4- 8 mg/dog twice daily may be effective. Antihistamines, however, aren’t reliably effective. Adding fish oil to the diet at a dose of 20mg/lb daily of the EPA in the fish oil might synergize with antihistamines to provide better anti-pruritic action. The omega-3 fatty acids in fish oil are antiinflammatory but may take 8-12 weeks to kick in. The new cytokine antagonist oclacitinib (Apoquel) is likely to revolutionize how we address atopic dogs and should be discussed with Reva's vet. Oclacitinib works as well as a steroid without a steroid's adverse effects.Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Reva'simmune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from her vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra. (I prefer the hydrolyzed protein diets.) A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time.We need to consider seborrhea in such a patient as well. This is skin disorder of keratinization and maturation. It's a diagnosis of exclusion of the above mentioned skin disorders and can be suggested by skin biopsy.You also have the option of having a specialist veterinary dermatologist (please see here: www.acvd.org) attend to Reva. You can expect some combination of skin scrapings, cytology, bacterial culture and sensitivity, fungal culture, skin biopsy, intradermal or blood allergy testing, or presumptive hypoallergenic diet trials to be performed.Please respond with further questions or concerns if you wish.
Customer: replied 8 months ago.
Hi , can I send you a picture ? It looks like it's Mange ... Reva is in India along with my 3 other dogs ...and not having much with the vets there . The other 3 dogs don't seems to be affected . What s the best treatment ? Sulfurated lime drips ? Is there any other treatment ? Revas immune system is down too , are there any supplements we can give her to boost her immune system ? And can I get medication / lime sulphur in U.K. ?Thanks ,
Nipa
Expert:  Dr. Michael Salkin replied 8 months ago.
Yes, please do send a picture. 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/ I'll answer all of your questions once I get a chance to see what you're seeing. The type of mange (sarcoptic) that causes intense pruritis is also very contagious. Your other dogs would be affected as well.

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