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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 14884
Experience:  Over 20 years of experience as a veterinarian.
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My name is ***** *****. My dog is scratching her neck raw.

Customer Question

Customer: Hi my name is ***** *****. My dog is scratching her neck raw. She is on Frontline. I'm not sure what to do
JA: Thanks. Can you give me any more details about your issue?
Customer: She is using her left foot to scratch under her neck. There is now a bald spot. She keeps whinning.
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Submitted: 11 months ago.
Category: Dog Veterinary
Expert:  Dr. Kara replied 11 months ago.

Hello, my name is***** and I have over 20 years of experience as a veterinarian. I'm sorry to hear that your pup has an areas on her neck that is raw, red, hairless, itchy and is painful for her. This is probably a hot spots or superficial pyoderma lesion.

Hot spots are caused by the skin getting wet, sometimes from swimming or bathing and not getting dried off properly but most of the time they come from a dog licking, chewing or scratching an itchy area and breaking the skin barrier due to an allergic reaction of some type, allowing bacteria that normally live on the skin to get in the skin and thrive. Folds of skin in the neck and drool may be contributing factors as well.

We need to get her to stop scratching and allow the skin to heal. Depending upon location on her neck this may involve placing an elizabethan collar so she cannot reach the spot with her foot and treating the underlying allergy.

Allergies are the most common cause of itchy skin. I'll give you an allergy rundown of likely causes for skin troubles. She may have more than one allergy given how symptomatic she is now. Dogs that have one allergy often develop several with time. The effect of multiple allergies aren't additive, they actually compound one another.

Allergies are not something that we cure, we can only control them so they can be quite frustrating.

Even if you don't see fleas I do recommend using protection, so I am glad she in on Frontline. They are the most common allergen and it only takes one bite a month to make an allergic dog scratch so I recommend using flea prevention even if you never see one again. Frontline Plus, Advantage II or Advantix are excellent topicals, and another option is the new Seresto flea and tick collar that works for 6-8 months continuously. I don't normally recommend collars but this one works very well without toxic side effects for most dogs. Don't use over the counter products, especially Hartz or Sargents, as most are ineffective if not toxic.

Other allergens can be inhaled (like grass pollen, dust mites or molds) and you can use a combination of antihistamines and high doses of omega-3 fatty acids to help with those (they also help with the symptoms of flea allergy). In combination fatty acids and antihistamines work synergistically, much better than either one alone. If her symptoms worsen seasonally I would think that inhaled allergens are a part of her problem.

You can try:

1)Benadryl (diphenhydramine only don't use the combo products as they can be toxic) at a dose of 1mg to 2mg per pound of body weight or one 25mg capsule per 15-25 pounds of body weight orally every 8 hours. Dogs take a much higher dose per pound of body weight compared to people so don't let the size of the dose he would need concern you.

OR 2)Claritin (loratidine) at a dose of 5mg per 25 pounds of body weight once or twice daily.

OR 3)Hydroxyzine at a dose of 1mg per pound of body weight orally every 8 hours.

OR 4) Chlorpheniramine at a dose of 4mg to 8mg per dog once or twice daily.

OR 5) Zyrtec (Cetirizine hydrochloride) at a dose of 1/2 mg per pound of body weight orally every 24 hours. That would be one 10mg tablet per 20 pounds of body weight. Make sure it is NOT the formulation with a decongestant (such as Zyrtec-D) because dogs cannot tolerate decongestants.

Some dogs do better on one antihistamine rather than another. Give the one you pick a 5-7 day trial and if it isn't working try another. Be aware antihistamines can cause sleepiness or hyperactivity in some dogs. These side effects do wear off with repeated use.

Omega-3 fatty acids are fish oil products. 3V by DVM or Derm Caps ES are good brand name products. Use the high end of the dosing schedule for your pup's weight, which means if she is between doses work up to the higher one. I recommend a dose based upon the EPA portion (eicosapentanoic acid) of the supplement as if we do that the rest of the supplement will be properly balanced. Give her 20mg of EPA per pound of body weight per day. For example an 80 pound dog could take 1600mg of EPA per day.

Clip/shave the hair in the area around and over the hot spot lesion very short and use a solution mix of Betadine solution (povidine iodine solution) and warm water, mixed so it looks like weak tea. Clean the affected area twice daily. Make sure you get the solution, not the scrub. This is an antibacterial and will dry the lesion out to allow it to heal. No need to rinse this, let it dry on her skin. It does stain horribly though so you probably want to do this outside. Or if you don't want to use Betadine you can clean the affected area with an antibacterial cleanser called Hibiclens (found over the counter at the drug store), then rinse and pat dry.

Clipping the hair stops bacteria from wicking into the site and allows the skin to breathe and dry.

In cases where the infection gets deeper than the surface of the skin oral antibiotics may be needed to treat deeper infection. If she isn't significantly better in 3-4 days she should see her family veterinarian.

Please let me know if you have any further questions.

Expert:  Dr. Kara replied 10 months ago.

Hello, I wanted to make sure that you didn't have any further questions for me, and I'd like to know how things turned out for your pup. If you found my response helpful, please don't forget to rate it so I may receive credit for it, thank you, ***** *****