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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 29808
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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My poor little Maltese is tearing s coat out with scratching

Customer Question

My poor little Maltese is tearing his coat out with scratching himself he is on antihistamine but this doesn't seem to be helping. We believe it is from an allergy to Bottlebrush. What else is available, some sort of wash?
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Jo replied 1 year ago.

Hello,

I'm Dr. Jo and I'm here to answer your question about Harry. I'm so sorry he's having trouble, but glad you're looking for the information you need.

Expert:  Dr. Jo replied 1 year ago.

You may join the conversation at any time by typing in what you want to say, then clicking REPLY or SEND. That way we can chat back and forth until you're satisfied with the information I've provided.

Expert:  Dr. Jo replied 1 year ago.

There are a multitude of treatment options for dogs who suffer from allergic itch, and you can rest assured you are not alone in experiencing no relief with the antihistamine you've tried. That's pretty common.

Because this is a complicated subject with a lot to discuss, I would like to be sure you are online and understand how the website works before I type in a lengthy reply.

Please type in a short response and let me know if you wish to continue. Thank you.

Expert:  Dr. Jo replied 1 year ago.

It appears you are not currently online and available to discuss your question with me. I'm sorry I missed the opportunity to have a live conversation with you. I will OPT OUT now so your question will be available for other experts when you return online.

Thank you for using our website.

Expert:  Dr. Michael Salkin replied 1 year ago.

I'm sorry that your question wasn't answered in a timely manner. I first need to know if Harry's pruritis (itchiness) is seasonal or was seasonal but now is year round or was always year round. I also need to know on which part(s) of his body he scratches or licks most. I'm going to post my synopsis of the pruritic dog for you and ask that you take your time perusing it and then return to our conversation with additional information and further questions or concerns if you wish...

I’m sorry to hear of this with Harry. Pruritic (itchy) dogs are suffering from an allergic dermatitis in the great majority of cases. Allergies to flea saliva, environmental allergens (atopic dermatitis) such as pollens, molds, dust and dust mites, and foods should be considered. (Paw and extremity licking indicates both atopy and a food intolerance and so it behooves vets to distinguish one from another.) In many instances, a concomitant pyoderma (bacterial skin infection), yeast infection (Malassezia), or mange mite (Demodex or Sarcoptes) might be contributory.

Harry's vet can check a sample of Harry's skin surface microscopically (a “cytology”) for abnormal numbers of bacteria and yeast and skin scrapings can be taken in an attempt to find mites. Pyoderma is treated with a minimum of 3-4 weeks of an antibiotic in the cephalosporin class such as cephalexin (Keflex) and yeast is addressed with ketoconazole for at least a month.

Our dermatologists tell us to apply an effective over the counter flea spot-on such as Advantage, a fipronil-containing product such as Frontline or one of the newer prescription products available from Harry's vet even if fleas aren’t seen. Dogs can be such effective groomers so as to eliminate all evidence of flea infestation. Dogs who remain primarily indoors can contract fleas because we walk them in on us and flea eggs and larva can remain viable in your home for months. As the weather warms or you turn on heaters at this time of year, egg hatches are common. In severe cases, an anti-allergenic prescription glucocorticoid such as prednisone will work wonders for dogs allergic to the saliva of the flea. If you have other pets they may have fleas too but may not be allergic to the flea’s saliva.

Environmental allergies 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 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.

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 Harry's 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.) 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. Food intolerance isn't going to cause a seasonal pruritis.

We need to consider seborrhea in such a patient as well. This is skin disorder of keratinization and maturation. It's a diagnosis of exclusion of the above mentioned skin disorders and can be suggested by skin biopsy.