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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 24467
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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He's very listless won't come up on the bed all night. He's

Customer Question

He's very listless won't come up on the bed all night. He's been kicking at his but for a good 2 weeks. Has an appointment wendsday but ...
JA: I'm sorry to hear that. Could be a lot of things that cause lethargy. The Veterinarian will know how to help the dog. What is the dog's name?
Customer: Titan he's an 11lb yorkie
JA: Is there anything else the Veterinarian should be aware of about Titan?
Customer: No I'm just very worried
Submitted: 1 month ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 1 month ago.

You're speaking with Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

Expert:  Dr. Michael Salkin replied 1 month ago.

I'm sorry that your question wasn't answered in a timely manner. Licking the anus is often attributed to anal sac gland impaction/infection and so Titan's vet will check those glands but it's important to note that that behavior is more commonly associated with a systemic allergy such as atopy (allergies to environmental allergens such as pollens, molds, dust, and dust mites, etc.) and food intolerance. For now you can apply a thin film of over the counter hydrocortisone cream to his anus thrice daily. He'll want to promptly lick it off and so rub it in thoroughly and then divert his attention from his anus with food or exercise.

Environmental allergies (atopy) 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 (maximum dose of 50 mg at any one time) 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 his vet. Oclacitinib works as well as a steroid without a steroid's adverse effects. Please note that atopy, at least initially, should have a seasonality to it while a food intolerance should cause pruritis regardless of the season. Chronically atopic dogs may be pruritic year round.

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 his 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 his 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 because it avoids the possibility of my patient being intolerant to even a novel protein.) 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.

Customer: replied 1 month ago.
Hello, I made an appointment for him to goto the vet at 10 am. Thank you tho
Expert:  Dr. Michael Salkin replied 1 month ago.

That's good to hear. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

Expert:  Dr. Michael Salkin replied 1 month ago.
Hi,

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

Dr. Michael Salkin

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