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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 28538
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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He wakes in the morning fine when he gets up stretches or

Customer Question

He wakes in the morning fine when he gets up stretches or becomes excited he begins to bleed in 2 small spots on his head 2 larger spots behind his jowls
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 and age?
Customer: Names Milo 2 1/2 a
JA: Is there anything else the Veterinarian should be aware of about the dog?
Customer: American staffotdshire, he has allergies and is prone to like a costs like boils? Takes allergy medicine everyday
JA: I'm sending you to a secure page on JustAnswer so you can place the $5 fully refundable deposit now. While you're filling out that form, I'll tell the Veterinarian about your situation and connect you two.
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

That's a curious history. Is the bleeding spontaneous or has Milo scratched those areas to the point of bleeding? Can you upload a close-up photo(s) of these areas to our conversation? You can use the paperclip icon in the toolbar above your message box (if you can see the icon) or you can use an external app such as I can be more accurate if I can see what you're seeing. Please clarify " a costs like boils". What is the allergy medicine he's taking everyday, please?

Customer: replied 1 year ago.
I'm sorry I am not not good on computers don't get the whole paper clip. Not cost cyst like boils vet gave antibiotics , cream (ente derm) and allergy pills (hydroxine)
Customer: replied 1 year ago.
No he hasn't scratched at the spot they just show up
Expert:  Dr. Michael Salkin replied 1 year ago.

Thank you for the additional information. I can understand prescribing antibiotics - an antibiotic in the cephalosporin class such as cephalexin prescribed for a minimum of 3-4 weeks and 1 week past clinical signs would be appropriate if those "cyst/boils" indicated pyoderma (bacterial skin infection - often Staph). The use of hydroxyzine, however, should be circumspect because studies have shown that such an antihistamine is effective in less than 10% of dogs suffering from an allergic dermatitis. A dog who isn't scratching at those areas, however, is unlikely to suffer from an allergic dermatitis. If those spots are spontaneously appearing, pyoderma as mentioned above and, less commonly, autoimmune skin disease such as the pemphigus complex need to be considered. Biopsy of the affected skin would be necessary to distinguish one disorder from the other.

I would continue the appropriate antibiotic for the length of time I mentioned but if you didn't see a positive change, diagnostics in the form of a cytology - microscopic exam of a small sample of his affected skin surface looking for abnormal numbers of bacteria or yeast, skin scrapings looking for underlying demodectic mange, bacterial culture of the insides of one of those cysts/boils, and even skin biopsy need to be considered.

Please continue our conversation if you wish.