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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 52406
Experience:  University of California at Davis graduate veterinarian with 48 years of experience.
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She has an itch and keeps scratching what can i do for her,

Customer Question

she has an itch and keeps scratching what can i do for her
JA: I'll do all I can to help. What is the dog's name and age?
Customer: Rosie and she is 5
JA: Is there anything else important you think the Veterinarian should know about Rosie?
Customer: I don't think so she hasn't got fleas
Submitted: 19 days ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 19 days ago.

Dr. Michael Salkin is typing. Please be patient.

Expert:  Dr. Michael Salkin replied 19 days ago.

I'm sorry to hear about this with Rosie. Where on her body does she scratch mostly, please?

Customer: replied 19 days ago.
around her front armpits and back legs
Expert:  Dr. Michael Salkin replied 19 days ago.

Thank you. Can you upload photos of representative skin in those areas to our conversation? You can upload photos by texting them, or by using the paperclip or add file icons above your message box...if you can see those icons on your device. You can also use an external app such as dropbox or navigate to justanswer.com/help/using-justanswer and scroll down to "other".

Customer: replied 19 days ago.
sorry i cannot send photos as i am not up to date with all modern things (i am 90 years old)
Expert:  Dr. Michael Salkin replied 19 days ago.

Ah! The areas you've mentioned are often heavily colonized by yeast. The underlying reason for this is usually allergic dermatitis - atopy or food intolerance and so I'll post my synopsis of both for you.

Environmental allergies (atopy) are usually initially addressed with a steroid such as prednisone. In some dogs an over the counter antihistamine such as chlorpheniramine (many generics) at a dose of 0.1 - 0.25 mg/lb (maximum) every 8-12 hours or diphenhydramine (Benadryl) dosed at 1-2 mg/lb every 8-12 hours (maximum dose of 50 mg at any one time) may be effective. Antihistamines, however, aren’t reliably effective. Adding fish oil to the diet at a dose of 20 mg/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 anti-inflammatory but may take 8-12 weeks to kick in. The cytokine antagonist oclacitinib (Apoquel) is likely to revolutionize how we address atopic dogs and should be discussed with Rosie's vet. Oclacitinib works as well as a steroid but without a steroid's adverse effects. The injectable Cytopoint is another good immune mediator to consider. Bathing twice weekly in a noninsecticidal shampoo can rid her skin of offending allergens and thus hasten remission of Rosie's atopy.

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 **immune system doesn't "see" anything to be allergic to. 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 Rosie's vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d (I prefer the hydrolyzed protein diets because they lessen 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 had been eating the same food for quite some time.

It's important that Rosie's vet performs cytology (microscopic exam of a small sample of affected skin surface looking for abnormal numbers of both bacteria and yeast). These infectious agents will need to be eliminated before treatment for allergic dermatitis can be completely effective.

Please continue in this conversation if you wish.

Customer: replied 19 days ago.
Thank you for this information i will try it and see what happens
Expert:  Dr. Michael Salkin replied 19 days ago.

You're quite welcome. I can't set a follow up in this venue and so please return to our conversation with an update at your convenience.