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Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 16293
Experience:  Hello, I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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Skin rash, a few small bumps..Blood test done to rule out

Customer Question

Skin rash, a few small white bumps..Blood test done to rule out Cushings..All blood and lab work came back normal
JA: I'm sorry to hear that. What is the dog's name and age?
Customer: Pebbles; 10 year old shih tzu
JA: Is there anything else the Veterinarian should be aware of about Pebbles?
Customer: 6.6lbs
Submitted: 1 month ago.
Category: Dog Veterinary
Customer: replied 1 month ago.
Vet prescribed Cephalexin 100mg bidx14 days..She started therapy Friday 7, 2016. I wanted a skin scrape, however the vet was adamant about Cushings.
Today they did a follow up call, now they're wanting another visit and possible skin scraping
Expert:  Dr. B. replied 1 month ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today. I do apologize that your question was not answered before. Different experts come online at various times; I just came online, read about your wee one’s situation, and wanted to help.

Where on the body is the rash?

Is he itchy with it?

Can you take a photo of this to let me see what you are seeing? To post a photo, you can use the paper clip on the tool bar. Or if you cannot see that on your phone/computer, then you can post them on any site (ie Flickr, Photobucket, Imgr etc) and paste the web address here for me to have a peek.

Customer: replied 1 month ago.
Thank you for responding.. Attached is a couple of photos. The rash is On her back, a lil below her neck. One photo is where I pointed it out. Her skin is very dry, and you'll notice the dry skin as well. She also has warts (Vet stated this is normal with her age) And yes it itches.
Thanks again!Pam Douglas, RPh
Expert:  Dr. B. replied 1 month ago.

Thank you, Pam.

Your vet is right that warts tend to be commonplace with age and we don't tend to remove them unless they are ulcerating or causing a dog bother. Now based on the photo, this white bump looks like a bacteria pustule. I had been concerned that she may have had firm crusty type lesions (calcinosis cutis) with her vets concerns about Cushings, but that doesn't tend to look like what we are seeing here. Furthermore, the dander does look tight to the skin, so while it could be a side effect of poor skin health (often a deficiency in essential fatty acids) I cannot rule out burrowing mites here.

With this all in mind, the Cephalexin is a good place to start with the bacterial pustules. Otherwise, if there are just a few on her body, a topical shampoo (ie Malaseb) would have been another option. Though it isn't going to address her itchiness. Therefore, you may need to speak to her about treatment for that (ie steroids, Apoquel, Atopica) or even consider trialing her on OTC antihistamines (ie Benadryl/Diphenhydramine (More Info/Dose @ http://www.petplace.com/article/drug-library/library/over-the-counter/diphenhydramine-benadryl). As well, for the dry skin/dander, we can try to soothe that skin with an emollient shampoo (ie Episoothe, oatmeal based one).

Also I do think it would be ideal to also supplement her with essential fatty acids. These can take a few weeks to reach therapeutic levels in the skin but to supplement we can start giving her 1.5-2 ml fish oil (OTC Omega 3 +6) daily. Alternatively, if you prefer, you can feed a small volume of fresh salmon weekly. If she isn't keen on fish, then there are alternatives like Viacutin or Yumega (all are available OTC online, at vets, and most pet stores).

Finally, since mites are a concern, a scrape would be ideal. Though you could plan to treat and monitor for a treatment response as well. To do that, we'd want to use a multi-species anti-parasitic drug (ie Advantage Multi, Stronghold or Revolution). Usually this is used on 2 occasions 2 weeks apart and should counter any mite suspicions here.

Kind regards,

Dr. B.

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Expert:  Dr. B. replied 1 month ago.
Hi,

I'm just following up on our conversation about your pet. How is everything going?

Dr. B.

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