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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 66012
Experience:  University of California at Davis graduate veterinarian with 48 years of experience.
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Itchy ears chin and licking paws dry skin on outside of ears

Customer Question

Itchy ears chin and licking paws dry skin on outside of ears always scratching chunks of fur coming off of him and some bald patches
JA: I'll do all I can to help. When did this licking start? Does the dog have any known allergies?
Customer: ages ago yes he has loads of allergies
JA: Does he also have a rash or other skin-related symptoms?
Customer: his ears are often red dry skin on tummy have t noticed a rash
JA: And what's the dog's name and age?
Customer: benny 6 7 in august
JA: Is there anything else the Vet should know about Benny?
Customer: He’s on hypoallergenic dog food
Submitted: 10 days ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 9 days ago.
Dr. Michael Salkin is typing. Please be patient. I have 50 years of experience in canine, feline, avian, rodent, and rabbit medicine and surgery.
Expert:  Dr. Michael Salkin replied 9 days ago.

I'm sorry to hear about this with Benny.  Can you upload photos of representative skin 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".

Expert:  Dr. Michael Salkin replied 9 days ago.

I haven't received a photo.  As you mentioned, two types of allergic dermatitis are important considerations.

Expert:  Dr. Michael Salkin replied 9 days ago.

Atopy (environmental allergens) is usually initially addressed with prednisolone as well. In some dogs, an over the counter antihistamine such as cetirizine (Zyrtec) dosed at 1 mg per pound of bodyweight every 12 hours or diphenhydramine (Benadryl, generics) dosed at 1-2 mg per pound of bodyweight every 8-12 hours (maximum dose of 50 mg at any one time) daily may be effective but is unreliable. Oral oclacitinib (Apoquel) and injectable Cytopoint are additional immunomodulary drugs to consider. Cyclosporin - a chemotherapeutic agent - is another consideration particularly when a steroid is contraindicated by concurrent disease or unacceptable adverse effects. Bathing weekly in a hypoallergenic shampoo such as Allergroom (or generics) can reduce the allergen level on Benny's skin. Atopy usually causes diffuse pruritis - all body areas can be affected with the extremities particularly involved. Atopy is seasonal although some dogs suffer throughout the year.

Expert:  Dr. Michael Salkin replied 9 days ago.

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 Benny'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. There are many prescription novel protein diets and the prototypical hydrolyzed protein diet is Hill’s Prescription Diet z/d (I prefer a hydrolyzed protein diet because it lessens the possibility of my patient being intolerant to even a novel protein diet.). We usually see a positive response to these foods within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can appear at any age and even if our dogs have been eating the same food for quite some time. Food intolerance usually causes pruritis about the head, neck, and belly. Food intolerance isn't seasonal.

Expert:  Dr. Michael Salkin replied 9 days ago.

It's important that Benny's vet performs cytology (microscopic exam of a small sample of affected skin surface looking for abnormal numbers of both bacteria and yeast).  Skin scrapings are needed when looking for mange mites - both sarcoptic which is very itchy - and demodectic.  These infectious agents will need to be eliminated before treatment for allergic dermatitis can be completely effective.

Expert:  Dr. Michael Salkin replied 9 days ago.

If you need clarification on anything I've posted or have additional questions or concerns, please don't hesitate to ask.

Expert:  Dr. Michael Salkin replied 9 days ago.

I hope I was able to answer your question satisfactorily.  If you would like to ask me another question in the future, you can add me as a favorite expert.  You'll have the option to do that on your "My Questions" page if you choose to rate our interaction or you can request me by name if you wish: Dr. Michael Salkin.

Expert:  Dr. Michael Salkin replied 9 days ago.

errata: "Atopy (environmental allergens) is usually initially addressed with a steroid such as prednisolone." is correct