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chow: is lethargic, not eating, not drinking..treat..2 tablets..muzzle…

HI, my 3-1/2 yr old...
HI, my 3-1/2 yr old chow is lethargic, not eating, not drinking for 2 days now. His medication to treat his hot spots started on June 17,for novo-lexin, 500 mg, twice a day for 14 days, and vanectyl P tablet, 2 tablets a day for the first 5 days, and 1 tablet once a day after that. He has had a crusty muzzle from his hot spots and a dry nose for almost 48 hours. Managed to give him 1/4 c of cottage cheese 2 T of oatmeal in 1/2 c water and 1/2 c milk at 10 am, then 2 T of oatmeal, 1/4 c of organic raw beef (dog food grade) in 1 c water at 4pm. Help!
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Answered in 10 minutes by:
6/28/2010
Dr. Scott
Dr. Scott, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 15,168
Experience: 15 years of small animal, equine and pocket pet medicine and surgery.
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Hello there,

Have the hot spots resolved?

Is there any vomiting or diarrhea?

Where were the hot spots?
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Customer reply replied 8 years ago
Hi, Dr. Scott,

Thank you for your response. Had guests come over for dinner at around 7pm and left at 9:30. The time now is 11:40pm. Email will be detailed, maybe will help you more in diagnosis because I want to know if he has something else going on besides his hot spots. We live in the west coast of British Columbia, Canada, about a mile away from the ocean. Should I still give him Revolution when he is this sick?

Chest area hot spot has resolved.

Hot spot at the base of his tail came back, crusty hot spot(?) on his snout has been there for 8 days, left ear around 5 days. Still not resolved.

No vomitting or diarrhea yet.

Location of hot spots:

1 large hot spot at the lower back/where his tail starts), about 8 inches across and 5 inches wide (came back, now it is crusty at the base of his tail, about 4 inches across and 3 inches wide).

One on his chest/neck area, where his collar was, 10 inches across and 7 inches wide now just bare skin, seems to be healed).

on his snout (?) starting from his nose and an inch or so of crust (?) scabs (?). Nose is dry, gums tacky - dehydrated.

Inside his left ear, using ear drops from his vet, once a day.

Did not have appetite for food for since Tuesday. No desire to drink since Friday.
Coaxed him to drink some water last night at around 11pm.

Got him to drink a mixture of 1/2 c milk, 1/2 c water, 2 T oatmeal, 1/4 c cottage cheese at 12 pm today.

At 4pm, he had 1/2 c milk, 1/2 hot water, 2 T oatmeal, 1/4 c organic fine minced raw beef with organs (the hot water cooks it), 1/4 c cottage cheese, once at 4 pm, once at 8pm, when he came to the table and sat at our feet. Happy that he is starting to move.

1/4 c cooked turkey from dinner at 9pm.

At around 9:30 pm, he followed us outside and had a long pee (a very good sign bec. I haven't seen him wanting to move for the past 36 hours. He just laid down, his head between his paws, no desire to drink or eat or go potty) maybe lasting more than 30 seconds. Then had a BM, looks normal on one end but turned mushy on the other end (not holding its shape).

He is now outside, too dark to see what he's doing.

Stopped giving him novo-lexin for tonight and gave him a teaspoon of organic pro-biotic yogurt. Will try to give him same mixture but with 1 T peas and 2 T yogurt mixed in. Maybe in a few hours or at 7 am tomorrow morning.

I will be feeding his the same above mixture until he recovers.

Will he be okay? Am I doing the right thing for him? Is there anything else I can do?

Thank you for your help and have a good evening.

Mojo's Mom
It is very uncommon for more than one hot spot to occur at a time. They also do not take this long to heal once treatment starts. Hot spots are caused by an inhaled allergen. I am very suspicious there is something more severe going on. An immune mediated skin disease sounds more likely. A skin biopsy is needed to get a specific diagnosis. Dogs with hot spots don't go off their food. The antibiotic may have caused stomach upset. The Vanectyl can cause stomach problems if not taken with food. The only thing to try at home is a stomach protectant to see if that is why he is not eating. Pepcid AC or Prilosec OTC can be used at 5 mg per 20 pounds body weight every 24 hours to coat the stomach. If the dog continues to not drink, he needs IV fluids from your vet to correct the dehydration. A dog this size needs 1300 ml of fluids every 24 hours to stay hydrated. Pedialyte would be better to force feed than milk. Milk can cause diarrhea in dogs, which will make things worse. I would not apply the Revolution until the appetite has returned to normal.
Dr. Scott
Dr. Scott, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 15,168
Experience: 15 years of small animal, equine and pocket pet medicine and surgery.
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Customer reply replied 8 years ago
Hi, Dr. Scott,

Thank you. Your answer helped a lot.

I clicked on "accept answer" but am always directed to a screen with the following message:

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I have tried it several times yesterday and today but it is always the same message. Is there another way for payment? Not quite sure why.

Mojo is still not better. Took him to the vet late yesterday afternoon for a blood test. It checked out okay, nothing wrong with organs. white blood cell count is quite high. Red cell count is normal. Will eat in very small quantities and only if hand fed. When he has had enough, he will turn away. Same behaviour with water. Has not gone potty today that I know of. Had 1/2 c turkey in the morning, 1/3 c beef in the evening, drank about 2 - 3 cups water after beef. Still lethargic. Stopped giving him novo-lexin tonight. What other medication can you recommend?

You were right about Mojo having something more serious than hot spots and your suggestion that he might have an auto immune skin disease. What is the treatment for this? Will he die in a short time? Will he recover? What can I do to ensure his recovery? Thank you again.
Customer reply replied 8 years ago
Mojo is still not better. Took him to the vet late yesterday afternoon for a blood test. It checked out okay, nothing wrong with organs. white blood cell count is quite high. Red cell count is normal. Will eat in very small quantities and only if hand fed. When he has had enough, he will turn away. Same behaviour with water. Has not gone potty today that I know of. Had 1/2 c turkey in the morning, 1/3 c beef in the evening, drank about 2 - 3 cups water after beef. Still lethargic. Stopped giving him novo-lexin tonight. What other medication can you recommend?

You were right about Mojo having something more serious than hot spots and your suggestion that he might have an auto immune skin disease. What is the treatment for this? Will he die in a short time? Will he recover? What can I do to ensure his recovery? Thank you again.
If the internal organs are healthy, that is a positive sign. The elevated white blood cells can be due to inflammation or infection. Counts above 30,000 usually indicate serious infection. As long as the white count is high, he will not likely want to eat anything. There are several antibiotics he can have for secondary skin infection other than novo-lexin. Even regular amoxicillin works well in many dogs. If there is an immune problem, cases can be managed but not cured. Oral prednisone is typically used in high doses for several weeks initially. If that fails, a skin biopsy is done to get a specific diagnosis. Cyclosporine or azothioprine are used when prednisone fails. The goal of all is to suppress the immune systems attack on the skin. If the immune system is found to be deficient, there are several supplements on the market to help the skin and immunity. Your vet needs to get a specific diagnosis for the skin problem before you'll know which direction to go. Most skin problems are not fatal, but the loss of appetite is not common. I would get either the Pepcid or Prilosec into him to see if the stomach feels better. I suspect he will not eat until the white cell count starts coming down.
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Customer reply replied 8 years ago
Hi, Dr. Scott,

Thank you again for taking the time to deal with Mojo's issue/s. Were you able to receive payment? I accept all your answers. Mojo can move around now when he wants to. He just went #1 for quite a while. I will try and give him pepcid ac for his upset stomach and feed him more meat. He is quite picky - no kibble but will eat (hand fed) cooked meat in small quantities. Will try to give him Pedialyte with a syringe if he will let me.

I have an issue with his vet here bec. when I took Mojo in on Monday for a blood test, his vet scheduled a biopsy the following morning (yesterday) and to continue the meds (novo-lexin). Cancelled his biopsy after blood test results were in (Monday evening).

Mojo's fur is dull and dry and hubby said he is giving off a funky smell (not normal at all). His vet has not prescribed prednisone yet. Will this med affect biopsy results if we decide to have one? The cost for a biopsy here is $500 - $650 plus 12% tax. Is this normal for a biopsy? Included in the cost is the lab fee, anaesthetic and suturing.

Thought he was going to die last night, so scheduled a visit this morning with the senior vet who told me to stop giving meds to Mojo for a week bec. all biopsies should be done when dogs are off any meds for at least a week. Don't know why he needs to see Mojo in a couple of hours and confused about conflicting instructions about his biopsy. What is your opinion on this?

What kind of food and supplements do you recommend for him? Thank you again.

Mojo's Mom
The prednisone can affect the biopsy results if it is something that responds to it. Price varies by location and from clinic to clinic. The labs usually charge $100-150 to analyze a biopsy so $500 i not terrible. It would be a little high in my area, but not outrageous. Since blood tests have been done and the dog has antibiotics already, I would say it is a little high. It is best to biopsy when the dog is not on any medication, but not critical. I would have him on a limited ingredient dog food for 6-8 weeks to rule out a food allergy. I would not add supplements until you find out what you are dealing with. If there is a hyperactive immune system problem, giving immune stimulants could make things worse. Derm Caps would not interfere with anything. They basically contain omega fatty acids and vitamin E. There are several brands on the market. You accepted answer came through fine on my end.
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