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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 25258
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My dog has been breaking out with purulent bumps all over s

Customer Question

Hello,
My dog has been breaking out with green purulent bumps all over his body. Took him to the vet and they didn't know what was wrong with him. Tried oral corticosteroids and antibiotics, shampoo, blood work comng back negative, skin biopsy coming back and inflammation only, and allergy test coming back as dust allergy. Is this what is typically seen with allergies for dogs? He is 10 jack russel, dashhnd, chihuahua mix
Submitted: 1 year ago.
Category: Dog Veterinary
Customer: replied 1 year ago.
All over back and on legs
Customer: replied 1 year ago.
Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call. Let me know if you need more information, or send me the service offer(s) so we can proceed.
Expert:  Dr. Michael Salkin replied 1 year ago.

I regret that I'm not allowed to communicate with customers by phone. Please stay in this conversation. Can you tell me if a pustule were cultured and, if so, what was found? You're describing a superficial spreading pyoderma (bacterial skin infection - usually Staphylococcus) which can arise secondary to allergic skin disease but such allergy isn't necessary for pyodermas to arise. The biggest mistakes in treating a pyoderma is stopping antibiotic therapy too soon or administering corticosteroids concomitantly with the antibiotic.

Customer: replied 1 year ago.
cultured and nothing found expect increased WBC count.
Customer: replied 1 year ago.
He had been on medication for 2 months and no change
Expert:  Dr. Michael Salkin replied 1 year ago.

Thank you. An autoimmune skin disorder - the pemphigus complex, subcorneal pustular dermatosis, e.g., then, should be considered. It's not unusual for false negative biopsies in these cases. At this point I would see how an immunosuppressive dose (0.5-1.5 mg/lb every 12-24 hours) of prednisone affects Prince. Alternatively, considering the extensive workup that has already been performed, referral to a specialist veterinary dermatologist (please see here: www.acvd.org) should be considered. Please continue our conversation if you wish.

Customer: replied 1 year ago.
continue the corticosteroid. Should the antibiotic be continued as well
Expert:  Dr. Michael Salkin replied 1 year ago.

...at an immunosuppressive dose. Failure to see a positive response to such a dose in 2 weeks - it can take 2-8 weeks for lesions to resolve completely when pemphigus is present - should prompt re-evaluation of the diagnosis or a switch to another immunosuppressive drug such as cyclosporin, azathioprine, chlorambucil, or dapsone. Yes, it's prudent to "cover" such a patient with a broad spectrum antibiotic in the cephalosporin class such as cephalexin or potentiated amoxicillin (Clavamox). Please continue our conversation if you wish.

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