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Dr. Kara
Dr. Kara, Board Certified Veterinarian
Category: Vet
Satisfied Customers: 15580
Experience:  Over 20 years of experience as a veterinarian.
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My dog came down with red itchy skin going on 2 years ago now,

Resolved Question:

My dog came down with red itchy skin going on 2 years ago now, we have paid hundreds of pounds to be told he has a allergy to dust and slightly rice, so they put him on steroids. Now I have bought every shampoo, oatmeal, aloe vera, cole tar and the list goes on. and he has an allergy tablet too, we washed him yesterday and his skin has gone really bad and the smell is becoming unbareable, we have used malaseb too, i have actually sheared his hair back today to be able to get to his skin. and he is red red red, we also have him on natural food and supplement his vitamins with a vet gravy. My vet just keeps giving him steroids, what more can i do please?
Submitted: 2 years ago.
Category: Vet
Expert:  Dr. Kara replied 2 years ago.
Hello, my name isXXXXX and I have over 20 years of experience as a veterinarian. I am sorry to hear that your fellow Jennson is so itchy that his skin is turning bright red and that he smells. He may even have a secondary bacterial or yeast infection from all of his scratching and licking and those will make him itchy as well and could definitely cause an odor.

Allergies are the most common cause of itchy skin and can give him 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. He may have more than one allergy given how symptomatic he is now. 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 still see fleas I do recommend using protection, if only during the spring, summer and early fall months in areas where there are deep freezes. If your area doesn't have a deep freeze then you'll need to use them all year round. They are the most common allergen, and it only takes one bite a month to make an allergic dog scratch, so I recommend using flea prevention even if you never see one again. Frontline Plus, Advantage II or Advantix are excellent. 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 his symptoms worsen seasonally I would think that inhaled allergens are a part of his problem.
You can try:
1)Benadryl (diphenhydramine only don't use the combo products as they can be toxic) at 0.5mg to 1mg per kilogram of body weight or one 25mg capsule per 12 kilos of body weight orally every 8 hours. I know that you are using Benadryl now but I want to make sure that you are giving the appropriate dose.
OR 2)Claritin (loratidine) at 5mg per 12 kilograms of body weight once or twice daily.
OR 3)Hydroxyzine at 0.5mg per kilogram of body weight orally every 8 hours.
OR 4) Chlorpheniramine at 4mg to 8mg per dog once or twice daily.
Some dogs do better on one antihistamine rather than another. Give the one you pick 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 him 20mg to 40mg of EPA per kilogram of body weight per day. For example a 30 kilogram dog could take 600mg to 1200mg 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. I know that you have used malaseb shampoo in the past and that is very good for secondary fungal infections, though at this point he may need oral antifungals as well.

It appears he has been diagnosed with food allergy as well. Dogs can develop allergies to any protein or carbohydrate so even if he is only fed one thing that can be what he 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 don't believe that the foods that you have fed 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, though you should see some improvement in 8 weeks or so.
The trouble with "limited ingredient" or "low allergy" pet store brands is that the same machinery is used on multiple lots of food without sterilization cleaning in between. So for example even if a food says it has salmon and rice if the previous batch had beef and corn then you will get traces of those ingredients in your bag of food. Not a big deal if your dog isn't allergic but a waste of money thinking that the food was hypoallergenic and not good for your dog if those happen to be allergens for your dog. The veterinary brand true hypoallergenic foods are more expensive because it isn't cheap to thoroughly remove all traces of a previous food mixture from the machines used to process food.

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 it's been a while since his last exam parasites like cheyletiella, demodex or sarcoptes should be looked for as well if he isn't improving as all lead to very itchy skin.
And even if we can start to control his allergies he may well need oral antibiotics or antifungal medication of he has a secondary infection from all of his scratching.
Please let me know if you have any further questions.
Customer: replied 2 years ago.

Thanks so much, It has been 3 weeks since his last check up, and we were just given more steroids, I treat him regulary with spot on from the vets sorry i forgot to put that, I think we will go along with the secondary infection as i worked out the smell was coming from a yeast infection so i use something called earsolve, in his ears and his paws, i have just panicked more than anything from his reactions this weekend, after using an antibacterial shampoo. I am asthmatic so i constantly have to wet dust everyday and i have my air purifier too, to keep the bad thing at bay, he does roll alot so he could be picking up alot whilst trying to cool off, Thanks again i will book him back into the vets tomorrow.

Expert:  Dr. Kara replied 2 years ago.
No worries on the name as long as he is on flea prevention I am happy.
Depending upon the type he taking some also treat sarcoptes mites so you might want to check with his veterinarian on that.
I do believe that he has some sort of secondary infection and hopefully they can address that tomorrow.
Please let me know how things go for him tomorrow.
Dr. Kara, Board Certified Veterinarian
Category: Vet
Satisfied Customers: 15580
Experience: Over 20 years of experience as a veterinarian.
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