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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 28543
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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I have had dogs but need help with my 3 Poodles continually

Customer Question

I have had dogs for years but need help with my 3 Poodles continually scratching. I have sprayed them with Frontline, although no flees or ticks could be found. Also have treated them with Spot on. One Poodle continually scratches at the side of his mouth and has made it bleed, also he has now started licking and chewing his front paw. The other small poodle is always scratching round her left ear, haven't found any sore spots yet but keep looking. The larger Poodle has just started chewing the top of his leg. My husband thinks perhaps it might be their food. They have been on Royal Cannin mini while small puppies and ever since on the junior Royal Cannin. I might add they are not keen on this food and wondered you think a change of complete food may be the answer to the irritating skin and the lack of enthusiasm for their present food. Any ideas would be gratefully received. Thank you in advance Judy Kulczyk
Submitted: 1 year ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 1 year ago.

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Expert:  Dr. Michael Salkin replied 1 year ago.

I'm sorry to hear of this, Judy. I'm going to post my complete synopsis of the itchy dog for you so you can see what we need to consider in your dogs. Your husband may be correct but I would find it unusual for three out of three dogs in a household to suffer from a food intolerance. The symptoms of atopy are identical to those of a food intolerance and so please pay particular attention to my discussion of atopy below.

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 and facial pruritis as you've described above 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.

Your vet can check a sample of your dogs' 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 Advantage/Advocate, a fipronil-containing product such as Frontline or one of the newer prescription products available from their 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 at this time of year, egg hatches are common. If the area between the edge of a dog's rib cage and tail (the “saddle” area) is particularly excoriated, a flea saliva allergy should be the most important differential diagnosis. In severe cases, an anti-allergenic prescription glucocorticoid such as prednisone will work wonders for dogs allergic to the saliva of the flea. If you have other pets they may have fleas too but may not be allergic to the flea’s saliva. (A flea saliva allergy isn't an important differential diagnosis in your dogs but fleas might still be contributory to their pruritis. We've identified populations of fleas resistant to the fipronil in Frontline. Consider one of the newer prescription products instead - Bravecto (fluralaner) or NexGard (afoxolaner).

Environmental allergies (atopy) 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 diphenhydramine (Benadryl) dosed at 1-2mg/lb 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 their vet. Oclacitinib works as well as a steroid without a steroid's adverse effects. Please note that atopy, at least initially, should have a seasonality to it while a food intolerance should cause pruritis regardless of the season. Chronically atopic dogs may be pruritic year round.

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 a dog's immune 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 their 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 because it avoids the possibility of my patient being intolerant to even a novel protein.) 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.

You also have the option of having a specialist veterinary dermatologist (please see here: www.acvd.org) attend to your dogs. 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.

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