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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 29730
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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Red inside of ear - Zoe 4 years, she has been laying on her

Customer Question

red inside of ear -
JA: I'm sorry to hear that. What is the dog's name and age?
Customer: Zoe 4 years
JA: Is there anything else important you think the Veterinarian should know about Zoe?
Customer: she has been laying on her back and rolling around like she is scratching her back - no fleas
Submitted: 10 months ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 10 months ago.

You're speaking to 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 10 months ago.

The erythema (redness) you're seeing in that area concomitant with her pruritis (itchiness) as evidenced by her behavior is consistent with both atopy and less commonly, food intolerance. These ears are termed "reactive" rather than "infective" although secondary bacterial and yeast (Malassezia) infections are common.

Environmental allergies (atopy) are usually initially addressed with a glucocorticosteroid such as prednisone. 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 Zoe's 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 Zoe'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 her 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.)

Please respond with further questions or concerns if you wish.

Expert:  Dr. Michael Salkin replied 10 months ago.
Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Michael Salkin
Customer: replied 10 months ago.
I did take Zoe to the vet. She has an ear infection.
Expert:  Dr. Michael Salkin replied 10 months ago.

Thank you for the update. I'll think good thoughts for her quick recovery.