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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 24459
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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I Have a 1/2 Cheewaha and 1/2 Rat Terrier, she is 15 lbs and

Customer Question

I Have a 1/2 Cheewaha and 1/2 Rat Terrier, she is 15 lbs and 3 yrs old, been to a Vet 3 times for her scratching and biting herself, they gave her 3 different kind of shots and put her on an experimental drug, and I had to use a Medicated shampoo, well she still does it. She been doing this for 2 yrs now, no body seems to know what it is. They say its allergies. I don't think so.
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

I can understand your frustration. It's difficult for me to jump into the middle of such a long-standing case and so I'm going to post my complete synopsis of the itchy dog for you. In summary, a methodical approach to these patients should uncover the etiology of such scratching and biting at herself. If her vet is unable or unwilling to take such an approach, please consider having a specialist veterinary dermatologist (please see here: www.acvd.org) take a look at her.

Pruritic (itchy) dogs are suffering from an allergic dermatitis in the great majority of cases. Allergies to flea saliva, 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 contributory.

Her vet can check a sample of your dog's skin surface microscopically (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 or you turn on heaters at this time of year, egg hatches are common. In severe cases, an anti-allergenic prescription glucocorticoid 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 reliably effective. 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 atopic dogs and should be discussed with her vet. Oclacitinib works as well as a steroid without a steroid's adverse effects. Perhaps this is the "experimental drug" you mentioned?

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 her 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. (I prefer the hydrolyzed protein diets.) 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.

We need to consider seborrhea in such a patient as well. This is skin disorder of keratinization and maturation. It's a diagnosis of exclusion of the above mentioned skin disorders and can be suggested by skin biopsy.

Please respond with further questions or concerns if you wish.

Expert:  Dr. Michael Salkin replied 1 year ago.
Hi Tammy,
I'm just following up on our conversation about Sandie Kae. How is everything going?
Dr. Michael Salkin
Customer: replied 1 year ago.
Giving her a 1/2 Benadryl dailey, calm down some. the dosage is 12 1/2 mg.
Thank you
Tammy
Expert:  Dr. Michael Salkin replied 1 year ago.

Thank you for the update, Tammy. You can repeat the dosing at 12 hour intervals if need be. I can't set another follow-up in this venue and so would appreciate your returning to our conversation with an update - even after rating - at a time of your choosing.

Customer: replied 1 year ago.
Dr Salkin,The Benedryl is not helping, she bites and scratches so hard it scares her into
a Ceasur. What is wrong with my little girl. The Vets her say its allergies.
I cant believe that.
Tammy
Expert:  Dr. Michael Salkin replied 1 year ago.

Tammy, please review my synopsis for the itchy dog I posted earlier. There are quite a few reasons for Sandie Kae's itchiness and they're treated differently from each other. You also have the alternative of having her see a specialist veterinary dermatologist whom can be found here: www.acvd.org