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Dr. B.
Dr. B., Veterinarian
Category: Dog
Satisfied Customers: 16316
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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My puppy was put on cephalexin rash by my vet and she's

Customer Question

My puppy was put on cephalexin for a rash by my vet and she's taken all the pills yet still has the rash and itching. What would be the next line of TX
Submitted: 1 year ago.
Category: Dog
Expert:  Dr. B. replied 1 year 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 aboutyour situation, and wanted to help.

Again I do apologize that my colleagues could not aid you sooner. If you would still like assistance, can you tell me:

What does the rash look like?

Any pimples or pustules on the skin? Any crusting or scaling?

Customer: replied 1 year ago.
The vet I saw dx it as puppy puppy pyoderma. I've had 3 labs and never a puppy rash. It has gotten a little better but still remains irritating to her as she scratches . It looks like small pimples or dots on her belly and primarily underneath. It is a little dry which I would say scaley appearance. My only thought is bc she is crate trained that possibly bc of the heat and humidity it didn't clear or well, that's your area. I appreciate your prompt reply as I've been waiting. Typically, I'd go to Dr Mary but I'm moving tomorrow and she's an hour away so if a script Is required that's fine. I'd just like to see this clear up. Again , thank you
Customer: replied 1 year ago.
Just took a quick photo
Expert:  Dr. B. replied 1 year ago.

Thank you,

Now the photo is great since it lets me see what you are seeing. And I have to say that I am quite concerned to see such inflammation and diffuse pyoderma present despite treatment with Cephalexin. Especially as this is often our first choice in these types of skin infection. Now if we are seeing pimples and scaling, then bacterial infection is our top suspect (ringworm would be a concern with the crusting but if that was present we'd usually expect more then one pup affected and not to see those bacterial signs). And while being on the crate substrate would lead to moisture build up on the skin, I'd be more worried about it if she were in the crate all the time and especially if she were lying in urine. So, hopefully not an issue here.

Now in regards ***** ***** to do at this stage, it would be best to ring your vet. If they have just seen her for this, they may be fine to just dispense further treatment or call it into a pharmacy or vets closer to you. In this case, she will likely need a second antibiotic (or taking a swab of the pustule contents for culture would be ideal) to address this infection. Furthermore, I do think she'd benefit from use of a anti-bacterial/fungal shampoo like Malaseb (example). Your vet will have the high strength version, but as you can see the regular strength is available over the counter. Otherwise, the itching needs to be addressed for her. Especially since self-trauma often prevents these issues from settling. Since she is young, I do suspect her vet was trying to avoid steroid use to allay her irritation. Still if this is not settling, a low dose needs to be considered. Otherwise, you could try her with an antihistamine to at least reduce that drive to scratch. Most commonly we use Benadryl/Diphenhydramine (More Info/Dose @http://www.petplace.com/article/drug-library/library/over-the-counter/diphenhydramine-benadryl). A low dose (ie. 0.5-2 mg per pound of their body weight twice daily) can just be enough to reduce that allergic irritation. We like to keep the dose low, as it can cause drowsiness (just like people). And of course, this medication shouldn't be used if your wee one has any pre-existing conditions or is on any other medication without speaking to your vet first.

Overall, her signs do look like a bacterial pyoderma, so their treatment was very reasonable. Still, if she isn't settling and looks this severe at this point, then we'd need to think about an alternative antibiotic, an anti-inflammatory (or at least antihistamine), and possible topical treatment with Malaseb +/- culturing the bacteria present to find what it is vulnerable to and clear this for your lass.

I hope this information is helpful.

If you need any additional information, do not hesitate to ask!

All the best,

Dr. B.

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