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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 30779
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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my dog has dermatitis , recurrent spates for 18 months , back

Customer Question

my dog has dermatitis , recurrent spates for 18 months , back and forth to the vets costing a fortune, they have put her on steroids and recently atopica, which helped but didnt solve. She hasnt been spade yet would that help , what other things could i do?
Submitted: 3 years ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 3 years ago.
Aloha! You're speaking with Dr. Michael Salkin
I'm sorry to hear of this with Sandy. We need to ascertain the etiology of her dermatitis (inflamed skin). Our baseline data includes the result of skin scrapings in an attempt to rule out underlying mange mites such as Demodex and a cytology of the skin (a sample of the skin surface is examined microscopically) in an attempt to determine if abnormal numbers of either bacteria or yeast are present on the skin.

If we can rule out mites, bacterial infection (pyoderma) and yeast infection (Malassezia) and there's support for an allergic dermatitis such as pruritis (itchiness) in the areas of the skin usually affected by allergies, we can treat with immunosuppressive drugs such as cyclosporin (Atopica) or steroids (prednisone, e.g.).

To clarify an allergic dermatitis further, however, is the goal for a dog such as Sandy in which drug therapy hasn't been completely effective. The three allergies we see most are a flea saliva allergy, atopy (allergies to environmentals such as pollens, molds, dust, and dust mites, e.g.) and food intolerance. We can blood test our dogs and determine if a flea saliva or environmenmtal allergies are present. A hyposensitizing serum can be produced and you can then give allergy shots over many months.

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 Sandy'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 her vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra. A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen.

Alternatively, Nutriscan (please see here: www.nutriscan.org) is a new diagnostic protocol that can avoid hypoallergenic food trials. I understand your frustration but with a methodical approach we can get to the bottom of skin disease and treat appropriately.

Please respond with further questions or concerns if you wish.
Customer: replied 3 years ago.

Thank you for your reoply , what costs should i be looking for with this blood test or test???


Where are you vbased if i wanted to bring her to you, would getting her spade help???k



Her season was ionly once this year as well , would that be down to the steroids? Would pirton help? how many woukld i give her, sorry about the spelling it wont let me delete to correct lol p

Expert:  Dr. Michael Salkin replied 3 years ago.
You're quite welcome. I can't know what your vet would charge you for allergy testing but I do recommend that you receive a written estimate prior to having anything done.

I divide my time between the big island of Hawaii and California. I suspect that the commute would be prohibitive for you! There's no reason to believe that spaying Sandy would be of benefit unless a sex hormone-related dermatopathy were diagnosed and that's not a common finding. The dose of steroids prescribed for allergic skin disease isn't expected to alter Sandy's heat cycles. Some breeds normally have just one heat cycle yearly.

Piriton - like other antihistamines - may be effective against atopy in just 10-40% of dogs. When combined with essential fatty acid supplements (available in pet/feed stores) we do see a synergism of effect but patience is required as the fatty acids can take 8-12 weeks to kick in.

Please continue our conversation if you wish.