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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 30288
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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Small dog, age 3, continuously scratching with weeping sores

Customer Question

Small dog, age 3, continuously scratching with weeping sores under tail and on tummy, bald patches on underside. Definitely no fleas (up to date with Advantage) also chews feet and knees; no recent diet change.
Submitted: 2 years ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 2 years ago.
I'm sorry to hear of this with Luna. When pruritic (itchy) extremities (feet, knees, e.g.) are seen both atopy (allergies to environmental allergens such as pollens, molds, dust, and dust mites) and a food intolerance should be considered. Jack Russels are greatly over-represented with atopy which can be addressed with corticosteroids such as prednisone and, preferably, with the new cytokine antagonist oclacitinib (Apoquel) which works as well as a steroid without the steroid's adverse effects. Please discuss oclacitinib with Luna's vet. Antihistamines such as Piriton aren't reliably effective in atopic dogs. Adding essential fatty acids - there are numerous such fatty acid supplements available over the counter or from Luna's vet - appear to synergize with antihistamines but still aren't reliably effective. In one large scale study less than 10% of dogs benefited from the combination of antihistamines and fatty acids. Although less likely, food intolerance is a consideration and so I'm going to post my synopsis of food intolerance for you: 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 Luna'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 hydrolyzed protein diet is my preference). 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. Please respond with further questions or concerns if you wish.
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Expert:  Dr. Michael Salkin replied 2 years ago.
Thank you for your kind accept. I appreciate it.
I can't set a follow up in this venue and so would appreciate your returning to our conversation with an update at your convenience.
Customer: replied 2 years ago.

Thank you very much for your reply to my query. However, I do not wish to continue with this service beyond my 7-day free trial. I cannot afford to pay the monthly fee and feel it would be better to simply go to my vet, which is expensive enough. Once again, thank you for your attention.

Michele

Expert:  Dr. Michael Salkin replied 2 years ago.
You're quite welcome. Please contact***@******.*** for any concerns you have outside of Luna's medical problems.