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Dr. Kara
Dr. Kara, Board Certified Veterinarian
Category: Vet
Satisfied Customers: 15160
Experience:  Over 20 years of experience as a veterinarian.
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Hi, we have a 19 month Boxer girl who has a very itchy rash

Resolved Question:

Hi, we have a 19 month Boxer girl who has a very itchy rash around her stomach and rear end, feet and lower jaw.
Our vet has given various courses of antibiotics and steroid injections over the last year or so since these problems have begun.
She has had a couple of courses of Apoquel which worked initially but got less and less effective and is not available in the UK at the moment anyway.
She is now nearing the end of the two month course of Atopica and there is no real improvement although I can't be sure it wouldn't be worse without it.
She also has very itchy ears which are very sore and painful for which she has had Canaural and Surolan prescribed at various times which also give very short term relief but have no lasting effect.
We are due a return visit to our vet to discuss the next course of action as the Atopica has not been particularly effective.
I would really appreciate any alternative advice you could give that may provide her with lasting relief as it is very sad to see her scratching and knawing at herself.
Hope you can help
Ian (and Kizzy the boxer)
Submitted: 2 years ago.
Category: Vet
Expert:  Dr. Kara replied 2 years ago.
Hello, my name is***** and I have over 20 years of experience as a veterinarian. I'd like to help with your concerns about Kizzy and her horribly itchy skin that seems less responsive to the various treatments that have been tried.
Given her pattern of itchiness, which include her ears and feet as well as her rear end, her lack of a great response to Atopica and her loss of response to Apoquel, I would be highly suspicious that your girl has food allergies. She may have inhaled allergies too (atopy) as dogs with one allergy often develop several, but food allergic dogs often aren't helped with Apoquel or Atopica.
Food allergies are the most common allergies seen in young (less than 2 years of age) dogs.
Dogs can develop allergies to any protein or carbohydrate so even if she is only fed one thing that can be what she 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, and sometimes the only symptom can be repeated ear infections. 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. Most clients do report some improvement in 4 to 6 weeks.
I do not recommend pet store hypoallergenic or low allergen foods. Over the counter foods may be labeled hypoallergenic but they are unlikely to truly be so.
The trouble with "limited ingredient", "hypoallergenic" 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 to those ingredients 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 or to hydrolyze the proteins in the food. And the only ingredients in that food, even at a trace level, are what is listed on the bag.
There are no magic ingredients to make a hypoallergenic food but prescription foods are hydrolyzed, or broken down so the body cannot recognize the allergen, or use very unusual ingredients that the dog cannot have been exposed to in the past. They cannot develop an allergy to something they have never been exposed to.
It also is quite possible that your girl has traumatized her skin enough to create a secondary yeast infection in her skin, which antibiotics won't help, and will make her even itchier. I recommend taking a sample from the very itchy areas and looking for high levels of yeast and if they are present she should benefit from antifungal shampoos and possibly oral medications like ketoconazole or itraconazole.
Best of luck with your girl, please let me know if you have any further questions.
Dr. Kara, Board Certified Veterinarian
Category: Vet
Satisfied Customers: 15160
Experience: Over 20 years of experience as a veterinarian.
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