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Dr.Fiona
Dr.Fiona, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 6273
Experience:  Small animal medicine and surgery - 16 years experience in BC, California and Ontario
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my westie has really bad skin allergy its like scabs and her

Customer Question

my westie has really bad skin allergy its like scabs and her skin colour is pink under her fur and gone black and elephant like in some parts of her underbelly and carriage - we have had blood tests and she has had so many steriod jabs in the three months we have had her since we rescued her from an RSPCA centre.

What can we do?
Submitted: 5 years ago.
Category: Dog Veterinary
Expert:  Dr.Fiona replied 5 years ago.
Hi there,

Welcome to Just Answer! I'd be happy to help you and your Westie but need a bit more information in order to better assist you.

How old is she?

What kind of steroid has she been getting by injection?

Is it called Depo-Medrol?

Has she taken any pills to help to control this?



Fiona
Customer: replied 5 years ago.
Hi there i am afraid i do not know the name of the injections but yes we are always sent home with two weeks worth of pink pills to give her. we know this cannot be good longterm tho - i have been told that west highland terriers are proned to this condition but there must be someone that has some ideas to help?
Expert:  Dr.Fiona replied 5 years ago.
I have (unfortunately) met many many Westies with skin problems. They are very prone to them!

I do have some suggestions...let me just try to understand things a bit better.

She gets an injection, and goes home with pink pills the same day?

Would the pills be Temaril-P?

do you have an invoice from your vet to say what the injection is of? dexamethasone? Vetalog?


Customer: replied 5 years ago.

 

Hi there we take the pills home temaril sound familar and start them 24 hrs after her jab the next day - as for what the jab is sorry she just said it was a steriod shot to ease the discomfort and stop any infection starting (as sometimes she nibbles so hard it bleeds or like now she is bald ont he underside of her tail where she bites the fur out!!

Expert:  Dr.Fiona replied 5 years ago.

Ok, what you have told me has been very helpful!


What you are describing in your Westie certainly sounds like she has allergic dermatitis, which means that allergies are making her itchy.


This could be to something in her food (eg meat, corn, wheat or OTHER things), to insects biting her, or most commonly to atopy, which is an inhalant allergy.

With humans and inhalant allergies we call it hay fever. In ragweed season,lots of people get hayfever - itchy, watery eyes and sneezing. Dogs with inhalant allergies to things like ragweed pollen get ITCHY!



So, dogs with allergic dermatitis can be VERY itchy and often need long term corticosteroids or immuno-suppressants like Atopica in order to relieve the itch. Atopica is a fantastic drug to use in cases like this. It is not cheap, but in a small dog is much more possible than it would be in a 100lb Rottweiler!


Here are some links to further information about allergic skin diseases in dogs:
http://www.petplace.com/dogs/allergic-dermatitis-in-dogs/page1.aspx

You might want to ask your vet about Atopica as a long-term option for your dog. It does not have the side effects of steroids, and apart from the cost, is a very good choice for many dogs with atopy. Dogs usually start at a slightly higher dose and then are weaned down to the minimum needed to control the itchiness.

Here is more:

http://www.petplace.com/drug-library/cyclosporine-atopica-optimmune/page1.aspx




So, before we talk about other treatment options, let me just mention that dogs with atopy can be allergic to not only dust mites, but also to various plants that may be pollinating at various times.


It is often very useful to keep a diary with an "itchy" rating in it to be able to determine what times of year it is worse. I'm not sure what plants you have pollinating now where you are, but it is really helpful to keep a journal.


Here are some links to further information about atopy:

http://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=597

http://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=599

http://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=1535

http://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=652


So, when I diagnose a patient with atopy, I always start by warning people that we CANNOT CURE this! The best we can ever hope for is to control it. Anything that can be done to decrease his allergic tendencies should be done, and lots of little things may start to have a big effect.


What I suggest for dogs with atopy:

1. Bathing

It can be soothing to give your dog a *cool* bath in the tub, and apply a soothing colloidal oatmeal conditioner (I used Aveeno colloidal oatmeal treatment on myself and was suprised how much relief I got from it)


Here is one example of a Conditioner: http://www.calvetsupply.com/index.asp?PageAction=VIEWPROD&ProdID=373

After bathing, towel dry gently, and then keep her in a warm room snuggled in the towel so that you don't need to blow dry her at all


2 Antihistamines

If your Westie were my patient, I would evaluate her for being a candidate for being on antihistamines year round.


They are safe in the majority of patients, and although they don't stop the itching the way the injections or Atopica does, they do "take the edge" off and make future flare-ups less severe.


Adding these in might mean you could decrease the use of prescription medications.

As with humans, some dogs do better on one type of antihistamine, and not on others. Often, we have to try a few different ones, giving each a trial of several weeks before knowing whether it helps, and before moving on to another. Common anti-histamines we use in veterinary medicine are Diphenhydramine (Benadryl here in Canada), chlorpheniramine and hydroxyzine.

Here is more about each, including dose:
http://www.petplace.com/drug-library/diphenhydramine-benadryl/page1.aspx

http://www.petplace.com/drug-library/chlorpheniramine-maleate-chlor-trimeton/page1.aspx

http://www.petplace.com/drug-library/hydroxyzine-atarax-anxanil-vistaril/page1.aspx

With anti-histamine use it is really important to use them at the recommended frequency as they help PREVENT itchiness, but don't do as much at stopping it once it has started.

3.Essential Fatty Acids

Again, if she were my patient, I would put her on a dietary source of essential fatty acids (Omega 3 and Omega 6 fatty acids) daily added to her food.



Your vet would be able to provide these for you - some brands are DermCaps and EFA-Z.


You could make your own using evening primrose oil for the Omega 6 fatty acids. You could then add in a fish oil to provide the Omega 3's. Extra strength fish oil is most useful - it provides approximately 600mg of combined EPA and DHA per capsule. You can find a listing of companies that make such a thing here: www.nasc.cc.


The omega-6/omega-3 ratio should be 5 to 10.

Here are some examples of combined Omega 3 and 6 fatty acids:
http://www.1800petmeds.com/Derm+Caps-prod10062.html
http://www.vetrxdirect.com/product/view/ALLERDERM-EFA-Z-PLUS

4 Air filter

I would also consider getting a HEPA filter for your house. In Canada, you can get these at hardware stores. For $100 - $300 (depending on the amount of space you want to have filtered) it removes tiny dust particles from the air, which is another thing to help your dog a bit.

Make sure that there are no pollutants in her environment. Avoid cigarette smoke, fireplaces, incense, hair sprays, air fresheners and other things with small particles that can be inhaled.


5. Quercetin

This homeopathic remedy works to inhibit mast cell's participation in the manifestation of allergy signs. This is similar to the way antihistamines work in Western medicine. I have not used this myself, but my colleagues have used it and recommend it to "take the edge off" and allow you to reduce the atopica. The vets I know who use it give 1/8 to 1/4 of a human dose in a small dog like a Westie, who has severe signs.

http://en.wikipedia.org/wiki/Quercetin



6. Vitamin E

This can also be helpful when added in. The dose I use is about 5-10 IU per lb daily. So, in a 20lb Westie, that would work out to 100 to 200 IU per day. You can purchase this at any chemist.

7. Probiotics

If your girl were my patient, I would put her on a probiotic.


They are very safe and help a lot of dogs! It just helps to promote the growth of "good" bacteria and reduce the "bad" bacteria in a natural and safe way. This can help to decrease stimulation to the immune system.



You can use FortiFlora products which are available from your veterinarian, or you can use Culturelle which is available at pharmacies in the USA (and perhaps in the UK?). For the Culturelle, a 20 to 30lb dog would get 1 capsules daily sprinkled on her food.

Here are links:
http://www.dogbuffs.com/purina-fortiflora-probiotics-dogs-cats
www.culturelle.com


8. Limited antigen diet

It sounds like you have already done this and found it did not work.


Quite often, allergic dogs can react to things things they are EATING as well as things they are inhaling.


Because it is hard to know WHAT a patient may be allergic to, vets do usually recommend changing the food so she is on some different protein sources. If she has been eating duck, then switching to something that does NOT contain duck is a good idea. This could be fish, seafood, or anything else novel (rabbit, venison, duck, etc).

***In order to know that she cannot be allergic to it, the protein has to be one that she has never had before!***

There is nothing magical about any one protein source, it just has to be something that she has not had before. So, you have to check ALL the foods she has previously eaten and make a list of all the proteins she has been exposed to. Then you have to find a food that has NONE of those in it.

Also, she can have no other sources of food or treats (rawhides, chew toys, not even PB) while she is on the elimination diet. I strongly recommend a home-made diet so you know exactly what it going in to it.

The site, www.balanceit.com , has a section where you can get custom balanced recipes easily for your adult pets. You can put in the promotional code HOMEMADE at checkout and the recipe will be free. Just choose a recipe with a meat that Millie has never had before (goat? rabbit? venison?) and use that to make the food.

When you get to the payment/invoice type window, zero out the bottles of supplements (if you're going to buy them elsewhere), put the promo code in, and hit the "apply" button next to it. Then your invoice will recalculate and go down to zero if you only have one recipe there. You can continue on through the process without entering any payment info from there, and it will take you to the recipe for the pet you entered.

Finally, all home recipes for dogs need supplementation with essential fatty acids, calcium, phosphorus, potassium, vitamins, and minerals. The amounts of these are totally dependent on the animal and the base diet. There is no universal "supplement" that covers everything appropriately.

If you do not feel up to making a home-made food, then another option would be a "hydrolyzed" protein food. These are available only through a vet. The idea with this is that the protein is broken down so that the immune system can no longer recognize it. So, to the immune system it is no longer a protein, and (theoretically) the body cannot become allergic to it. These are fairly new in veterinary medicine (just a few years old) and so far, I have not had dogs become allergic to it, so I am crossing my fingers!

Your vet would have a number of different brands of prescription foods that have these “hypoallergenic” diets containing hydrolyzed protein. You could contact your veterinarian to try one. There are prescription foods that your vet could provide that serve this purpose. One of these is Royal Canin HP food: http://www.medi-cal.ca/diets/diets.php?diet=10


9. Acupuncture

This has been reported to improve immune function in dogs. Your vet could refer you to a veterinarian trained in this modality.


10. Traditional Chinese Medicine (TCM)

My colleagues trained in this area use Tri Snake subsitute from Mayway. **Use the Plum Flower Brand.** Hua She Jie Yang Wan is the Chinese name of the formula from Plum Flower.

Here is a link: http://www.chineseherbsdirect.com/hua-she-jie-yang-wan-p-179.html
and the company's phone number is(NNN) NNN-NNNNfor the company that makes them.

The dose is 3 pills given THREE times daily for a dog that weighs about 30 lbs . Give them a week to work.


11. Herbs

There are veterinarian trained in alternative medicine and the herbs that they recommend are yellow dock, sarsaparilla, Xiao Feng San. These are dosed based on size - so a 30lb dog would get roughly 1/8 to 1/4 the dose of a human.





I hope that these things will help!

Any small thing that decreases your Westie's allergic tendencies is good and with lots of small things we can hope for a big improvement over time! Fingers crossed for you! I would definitely start with the food, the Omega 3's and the Hepa filter as these are quite easy to do.



If this has been helpful, please Accept my answer and leave feedback.

If you have more questions just click on reply and I will still be here to provide further information if you need it!

The above is given for information only. Although I am a licensed veterinarian, I cannot legally prescribe medicines or diagnose your pet's condition without performing a physical exam. If you have concerns about your pet I would strongly advise contacting your regular veterinarian.

Fiona

Expert:  Dr.Fiona replied 5 years ago.
It is almost 11pm here in France, and I am heading off to bed. If you have any further questions, I will be happy to address them in the morning!


Best wishes and good night...

Fiona
Customer: replied 5 years ago.

hi fiona

 

thanks for the listings - should i try all of these or what would recommend i try first - we are putting primrose and omega 3 oil in her foods but recently she has decided not to eat dry food! and for the past three days has even been off her chappie food - is it safe to raise a dog on home cooked chicken and fresh vegetables as someone has suggested to me?

 

and would it be better to keep her coat clippered short at all times i mean does the length of her coat irriate her?

 

the scabs are as if she has had mini explosions around them with bits of scab stuck around the bumps and up into her fur - is this usual and why is her skin on her belly and between her legs turned black? with toughness like an elephants skin? is there life threatening long term ... we have never had a dog and want to be prepared ...

 

thanks so much for your continued help if you can tomorrow

Expert:  Dr.Fiona replied 5 years ago.
Hi again!

Glad to hear that you are doing the Omega 3 and 6 fatty acids. Do be sure to use the correct ratio as outlined previously!



You can definitely make home-cooked food. It needs to be balanced, with supplements added to it to make sure it meets her needs. In part 8 of my answer, I provided a link to a website that is run by veterinary nutritionists (www.balanceit.com ). They can provide you with a balanced recipe for your dog. This usually costs $30. I have given you a code to get it for free.



The length of her coat should not make a difference to her allergies, so do whatever you prefer to keep her comfortable in terms of temperature and need for brushing. If she does not like to be brushed, keep her short.


The scabs may well be due to bacterial skin infections. With allergies, the skin is irritated. The dog scratches. Little tiny cuts are opened up in the skin and can become infected. This is much the same as with us and a mosquito bite. If you scratch too much it can become infected. If she has a lot of these scabs, she may need to have a course of antibiotics to control the infection, as well as perhaps a medicated shampoo. This would require a visit to your vet.


The skin on belly and legs is turning black due to chronic (long term) irritation. It is called hyperpigmentation. The toughness is called "lichenification" and is also due to long term irritation. We can see this with allergies and also with yeast infections (which can also be secondary to allergies, in much the same way as I just explained for the bacterial infections). Yeast infections can be treated with medicated shampoos and with anti-fungal medications from your vet.


So, controlling allergies and also controlling secondary infections (bacteria and/or yeast) are what is needed to help your little Westie girl.


In terms of this being life threatening... well, it is not imminently life threatening, no. We do sometimes see dogs becoming so overwhelmed with the secondary bacterial and yeast infections that they can become seriously ill and even die. These problems are not something to be taXXXXX XXXXXghtly!


I hope that answers your questions more fully?

Let me know if you need more help.

Otherwise, if this has been helpful, please Accept my answer and leave feedback.

If you have more questions just click on reply and I will be back to provide further information if you need it!

The above is given for information only. Although I am a licensed veterinarian, I cannot legally prescribe medicines or diagnose your pet's condition without performing a physical exam. If you have concerns about your pet I would strongly advise contacting your regular veterinarian.

Fiona

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