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Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 21257
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 dog has skin problems. Tonight there were pearl like cysts

Customer Question

My dog has skin problems. Tonight there were pearl like cysts in the skin folds that wiped away easily. Do you know what this is? She is a 6 yo dachshund
Submitted: 2 years ago.
Category: Dog Veterinary
Customer: replied 2 years ago.
I work as a vet tech in nyc. Please advise on what you suggest I do. She had MRSA in July of 2014, was treated and cleared of it. Saw dermatologist at specialty center. She currently takes chlorpheneramine 4mg BID & pet alive skin & coat tonic capsules 1 BID. We are trying everything- She constantly bites, scratches and licks areas she can reach, some areas look like elephant skin but derm doc said it wasnt
Expert:  Dr. B. replied 2 years 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.
Again I do apologize that my colleagues could not aid you sooner. If you would still like assistance, can you tell me:
Since you have called them cysts, do they appear attacked before wiped away?
Do they look like the heads of pimples/pustules?
Or free material that is being secreted from the skin?
What treatments have you tried besides those you reported?
Has she had any diet trials? Any allergy testing? Immunovaccines? Other medication?
Can you take a photo of this material? If you can do so and post them online, this will let me see what you are seeing. To post them, you can either use the wee paper clip on the tool bar above your text box. Or if you cannot see that on your computer/phone, then you can post them on an alternative site (ie Flickr, Photobucket, imgur, etc) and paste the web link here for me to check.
Customer: replied 2 years ago.
Hi, I am currently at work and was told by my mom who was at home with Scout at the time. Fom what she told me it seemed like free material (she said looked like lice eggs). She currently gets bathed once weekly with phyto vet shampoo. Was on benadryl for months (didn't help), on 1 month of cephalexin (before we knew it was MRSA back in July), now shes on pulse AB therapy for resistant proteus in her urinary tract. She also gets a digestive probiotic called Vetri science vetri mega probiotic. She is curently on Royal cann urinary so moderate calorie-they told me part of her issue with her skin, was she was overweight. She has lost about 10 lbs on the diet and skin has not improved. I will get more details when I get home and will try to take a picture and send it to you.
Customer: replied 2 years ago.
She has not been allergy tested (cost reasons) and I can not bring her to my vet to be treated due to a balance I have and they refuse to see my pets
Expert:  Dr. B. replied 2 years ago.
Thank you,
If you can post photos once you are home, that would be grand as we can work together to determine what this material is and how we can tackle it.
Speak to you this evening,
Dr. B.
Customer: replied 2 years ago.
Below are some photos of her front and rear legs/feet. The closest spot that is similar as described would be pic marked 090012. Please help and advise. Thank you
Expert:  Dr. B. replied 2 years ago.
Thank you,
Is there any chance of getting a more focused or macro shot of the cyst/material (as its blurred in 090012)?
Otherwise, I do see why you were asking about elephant skin since she has severe thickening/lichenification of the skin and quite dramatic hyperpigmentation (both being signs of chronic skin irritation).
As well, do you find that she responds to the Chlorphenamine? Any drowsiness?
Customer: replied 2 years ago.
No drowsiness, not sure if its helping.
Expert:  Dr. B. replied 2 years ago.
Hi again,
Where you able to post a clearer photo (just so I can see what you are seeing)?
Otherwise, if you aren't seeing drowsiness and it may be helping, I would note that you can actually give up to 8mg of chlorphenamine up to TID. So, you could consider increasing that to see if you can get her more comfortable. Otherwise, we could potentially try an alternative antihistamine (ie Loratidine, Cetirizine) to see if that would be more effective for her. And of course, if you can tap into local vet resources (even if it meant seeing an alternative vet), she would be a good candidate for Apoquel or possibly Atopica, even if allergy testing wasn't practical.
I will keep my eyes peeled for your additional photos,
Dr. B.
Customer: replied 2 years ago.
Hi . I was unable to get additional pics. I tried a foot soak then followed it with vetiricyn spray. The feet looked better last night. I read vetiricyn spray is very safe and can be licked by pet. I noticed in her skin folds there was moist whitish color liquid which im assuming could be moist dermatitis? Those pearl balls never appeared again when i looked at her. Do you think this regimen will help her?
Customer: replied 2 years ago.
I also heard cetirizine long term damages the liver-is that true? Have you had any experience using doxepin? I dont want additional problems with drug interactions. I just want to help her in the safest possible way
Expert:  Dr. B. replied 2 years ago.
Hi again,
That is a shame, since with your knowledge as a vet tech, I did suspect it would be something particularly strange (since I have no doubt that you'd know your cysts, pustules, and our more common skin changes).
Otherwise, I have to say I have not been overly impressed with vetiricyn spray (ingredients: Hypochlorous Acid (HOCl) Inactive: Electrolyzed Water (H2O), Sodium Chloride (NaCl), Sodium Hypochlorite (NaOCl)). I find dilute chlorohexidine better for cleaning wounds/inflamed skin (and its not a worry if licked either). As well, I prefer Malaseb (which you can get the lower strength version on Amazon now) for dogs with chronic skin issues. So, if the vetiricyn is working for you, I'd not argue with that, but otherwise its worth using the above if you are struggling.
Now in regards ***** ***** moist white material, the skin is likely overly moist and we may be seeing a collection of sebaceous material or pus. And in regards ***** ***** former, it could potentially appear as pearl like discharge, so we'd have to assume for the moment that was what was being seen. But in either case, regular cleaning followed by thorough drying and airing out the areas should help reduce that for her.
Finally, all drugs can negative effects if used improperly or in the wrong patients. We don't tend to see liver damage because of Cetirizine, but due to liver excretion we wouldn't use it in a dog with liver compromise. So, it is safe to use when used properly (at a low dose of 5 mg, given once daily) in healthy dogs; but we see issues when used in animals that already have liver compromise and cannot metabolize it properly. And I would say that we use this drug in dogs and have a better understanding of its use for skin issues then we do for Doxepin.
Take care,
Dr. B.