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He has yeast infection and I have changed his food to No…

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He has yeast infection...

He has yeast infection and I have changed his food to No grains and no starches- only meat and broth. will AZO work to help with his itching?

Veterinarian's Assistant: I'll do all I can to help. There are all sorts of infections the dog can pick up. I'll have you talk to the Veterinarian who'll sort out what is wrong and help you decide what to do about it. What is the dog's name and age?

Chewie and he is 6. He has had a terrible time with itchy skin for so long. I have tried everything I could think of to help him. He is slowly getting better but is still having a hard time.

Veterinarian's Assistant: Is there anything else important you think the Veterinarian should know about Chewie?

I have started giving him probiotics with his food.

Submitted: 4 months ago.Category: Dog Veterinary
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Answered in 59 minutes by:
12/9/2017
Dog Veterinarian: Dr. Kara, Veterinarian replied 4 months ago
Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 18,151
Experience: Over 20 years of experience as a veterinarian.
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Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

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Dog Veterinarian: Dr. Kara, Veterinarian replied 4 months ago

I am sorry to hear that Chewie is so miserably itchy.

Please do not give him AZO. AZO (phenazopyridine hydrochloride) tablets are fine for most people, but this drug is not well tolerated in dogs and it can cause gastrointestinal upset, leading to vomiting and diarrhea, and will often cause a change in stool and urine color as well as blood cell destruction, liver disease, painful muscle inflammation and breakdown, lack of tear production (Keratoconjunctivitis sicca or dry eye) and neurologic symptoms.

The lack of tear production can be a real problem in some dogs as it can lead to corneal ulcers, secondary infections, and a dog that needs tear replacement often. Some dogs have it transiently and the tear production comes back but others are affected for life.

It can also cause methemoglobinemia, a change in the pigment in the red blood cells that carry oxygen but this is usually seen with more chronic use.

Skin yeast infections in dogs are often secondary to allergic inflammation the secondary chewing and licking these allergies cause. I'm not sure what else other than diet modifications you have tried, but I can give you some suggestions.

Even if you don't see fleas I do recommend using protection. Flea bite allergy is the most common allergen and it only takes one bite a month to make an allergic dog scratch and lick so I recommend using flea prevention even if you never see one again. Frontline Plus, Advantage II or Advantix are excellent as is the new Seresto Flea collar. I don't normally recommend flea collars, but this one really works and lasts for at least 6-8 months. New prescription products on the market such as Bravecto or Nexgard, which tend to have less flea population resistance because they are new, may be worth trying too. Don’t use over the counter products, especially Hartz or Sargents, as most are ineffective if not toxic. Unfortunately even after the fleas are gone the allergic reaction can continue for weeks and I will discuss controlling that reaction below.

Other allergens can be inhaled (like grass pollen, dust mites or molds).
You can use a combination of antihistamines and high doses of omega-3 fatty acids to help with the symptoms of flea allergy and inhaled allergens. In combination fatty acids and antihistamines work synergistically, much better than either one alone. If his symptoms worsen seasonally I would think that inhaled allergens are a part of his problem.
You can try:
1)Benadryl (diphenhydramine only don't use the combination products with acetaminophen or decongestants as they can be toxic for dogs) at 1mg to 2mg per pound of body weight or one 25mg capsule per 15 to 25 pounds of body weight orally every 8 hours.
OR 2)Claritin (loratidine) at 5mg per 25 pounds of body weight once or twice daily.
OR 3)Hydroxyzine at 1mg per pound of body weight orally every 8 hours.
OR 4) Chlorpheniramine at 4mg to 8mg per dog once or twice daily.
OR 5) Zyrtec (Cetirizine hydrochloride) at 1/2 mg per pound of body weight orally every 24 hours. That would be one 10mg tablet per 20 pounds of body weight. Make sure it is NOT the formulation with a decongestant (such as Zyrtec-D) because dogs cannot tolerate decongestants.
Some dogs do better on one antihistamine rather than another. Give the one you pick a 3-5 day trial and if it isn't working try another. Be aware antihistamines can cause sleepiness or hyperactivity in some dogs. These side effects do wear off with repeated use.
Omega-3 fatty acids are fish oil products. 3V by DVM or Derm Caps ES are good brand name products. Use the high end of the dosing schedule for your pup's weight. I recommend a dose based upon the EPA portion (eicosapentanoic acid) of the supplement as if we do that the rest of the supplement will be properly balanced. Give him 20mg of EPA per pound of body weight per day. For example an 8 pound dog could take 160mg of EPA per day.

Cool water baths with an oatmeal shampoo or chlorhexiderm shampoo (which is antibacterial and antifungal) and a conditioner with an antihistamine may help. The water rinses off allergens and the cool temperature soothes itchy skin. Do not bathe your fellow for 2 to 3 days before or after applying flea control products or the bath will interfere with the product's efficacy.

Food allergy is very possible with him as well if he seems to be itchy all year round. Dogs can develop allergies to any protein or carbohydrate so even if he is only fed one food that can be what he is allergic to. There is a false theory that dogs are more likely to be sensitive to grains and that they will predispose to yeast growth. Dogs fed high amounts of refined, simple sugars may have skin issues, simply because those calories are a poor source of balanced nutrition. Complex carbohydrates and whole grains are good for your dog. They are not more likely to be allergenic, and they do not predispose to yeast growth. Dogs with food allergies tend to lick and scratch their paws, face and ears the most, but any of the "allergy reactive areas" can be affected.
Make sure that the food that you put him on is a true hypoallergenic diet if you are concerned about food allergies. The trouble with "limited ingredient" or "low allergy" pet store brands is that the same machinery is used on multiple lots of food without sterilization cleaning in between. So for example even if a food says it has salmon and rice if the previous batch had beef and corn then you will get traces of those ingredients in your bag of food. Not a big deal if your dog isn't allergic but a waste of money thinking that the food was hypoallergenic and not good for your dog if those happen to be allergens for your dog. The veterinary brand true hypoallergenic foods are more expensive because it isn't cheap to thoroughly remove all traces of a previous food mixture from the machines used to process food.
Generally what I recommend is trying to clear the skin with a prescription hypoallergenic diet and then adding one food item (chicken, beef, corn, wheat etc) every month to see what they react to. Then we can find a regular food to try that does not have any ingredients he is allergic to. As far as permanent diets I do tend to stick with Purina Pro Plan brands or Nature's Recipe as I find those rarely if ever have cross contamination. Purina Pro Plan Turkey and Barley or Nature's Recipe Vegetarian or Venison are pretty good products. I know that this isn't easy from personal experience (my dog is allergic to wheat) and it is time consuming, but worth it.
If you choose to try testing/treating him for a food allergy I recommend that you try a true hypoallergenic diet like Hills z/d or Purina Veterinary Diets HA. No treats, flavored medication or bones while on the diet and it must be used for a least 12 to 16 weeks to see the full effects. You should see some improvement in 6 to 8 weeks.

Cortisone ointment applied to the very itchy places (as long as they aren't raw) twice daily may help as well if needed. Some sprays have alcohol which can be painful on raw skin and lead to more inflammation. I don't like oral steroids, although sometimes a short course is necessary, but a topical directed at the problem areas can be very helpful and are less likely to cause side effects.

Another option if the antihistamines and omega 3's aren't enough is a product called Atopica. It suppresses the immune system a bit so it decreases allergic symptoms but it doesn't have as many harmful side effects as systemic steroids.
Another option is a newer drug called Apoquel (generic name oclacitinib) which interferes with the allergic pathway. It works very quickly to stop the symptoms of an allergy. Most dogs are reported to be much more comfortable in a day or so.
If you are interested discuss these medications with your veterinarian as they are prescription products.
Another option if you are interested, is trying immunotherapy. Your fellow would need to be tested to determine exactly what he is allergic to, and then he is given small amounts of the allergen to build up his tolerance to it, increasing the amount of allergen in the injection incrementally so that his immune system no longer responds to it. This isn't a quick fix, it takes time to slowly build up their tolerance and as he develops new allergens things may need to be added, but it is an option.
There is a new injection out (Cytopoint) that can be given by your veterinarian that can help with allergies for 4-8 weeks. It neutralizes a key allergic pathway inflammatory protein, thus stopping the itch before it starts.

If it's been a while since his last exam parasites like cheyletiella, demodex or sarcoptes mites should be looked for by your veterinarian as well if he isn't improving as they can lead to very itchy skin.

Best of luck with your fellow, please let me know if you have any questions about what I have written.

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Dog Veterinarian: Dr. Kara, Veterinarian replied 4 months ago

Hello, I wanted to make sure that you didn't have any further questions for me, and I'd like to know how things turned out for your pup. If you could give me an update that would be great, thank you, ***** *****

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Dog Veterinarian: Dr. Kara, Veterinarian replied 4 months ago
Hi,

I'm just following up on our conversation about your pet. How is everything going?

Dr. Kara
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