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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 24467
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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Denise! My 11 year old Cocker has developed a dry skin

Customer Question

Hi, Denise! My 11 year old Cocker has developed a dry skin issue on her back. She has dandruff and is itching like crazy. In the affected area, her skin has been running warmer than her normal skin. Any thoughts or sugguestions?
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.
Aloha! You're speaking to Dr. Michael Salkin
I’m sorry to hear of this with Alix. Pruritic (itchy) dogs are suffering from an allergic dermatitis the great majority of the time. Allergies to flea saliva - particularly when the "saddle area" of a dog is affected, environmental allergens (atopic dermatitis) such as pollens, molds, dust and dust mites, and foods should be considered. (Paw and extremity licking indicates both atopy and a food intolerance and so it behooves vets to distinguish one from another.) In many instances, a concomitant pyoderma (bacterial skin infection), yeast infection (Malassezia), or mange mite (Demodex or Sarcoptes) might be responsible.
Alix's vet can microscopically check a sample of Alix's skin surface (a “cytology”) for abnormal numbers of bacteria and yeast and skin scrapings can be taken in an attempt to find mites. Pyoderma is treated with a minimum of 3-4 weeks of an antibiotic in the cephalosporin class such as cephalexin (Keflex) and yeast is addressed with ketoconazole for at least a month.
Our dermatologists tell us to apply an effective over the counter flea spot-on such as Advantage, a fipronil-containing product such as Frontline or one of the newer prescription products available from her vet even if fleas aren’t seen. Dogs can be such effective groomers so as to eliminate all evidence of flea infestation. Dogs who remain primarily indoors can contract fleas because we walk them in on us and flea eggs and larva can remain viable in your home for months. As the weather warms at this time of year, egg hatches are common. In severe cases, an anti-allergenic prescription glucocorticosteroid such as prednisone will work wonders for dogs allergic to the saliva of the flea. If you have other pets they may have fleas too but may not be allergic to the flea’s saliva.
Environmental allergies are usually initially addressed with prednisone as well. In some dogs an over the counter antihistamine such as clemastine (Tavist) at a dose of 0.025 - 0.75mg/lb twice daily or diphenhydramine (Benadryl) dosed at 1-2mg/lb twice daily may be effective. Antihistamines, however, aren’t reliable. Adding fish oil to the diet at a dose of 20mg/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 antiinflammatory but may take 8-12 weeks to kick in. The new cytokine antagonist oclacitinib (Apoquel) is likely to revolutionize how we address dogs such as Alix. Oclacitinib is as effective as the steroids but doesn't cause their adverse effects.
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 Alix'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 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.
Can you upload a photo of Alix's affected skin area to our conversation? You can use the paperclip icon in the toolbar above your message box (not if you're using the chrome browser) or you can use an external app such as imgur.com or dropbox.com. I can be more accurate for you if I can see what you're seeing. Cockers are overrepresented with seborrhea - a disorder of keratinization/skin maturation and seborrhea can mimic all of the skin disorders I mentioned above.