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My dog is a small breed and she is a Maltese cross rosell.

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My dog is a...

My dog is a small breed and she is a Maltese cross Jack rosell. She is about 15 months old and since 4 months ago she started to scratch herself more than usual. She had ears scratched marks and then it got all around her body. Her Vet said it’s an allergy and she used antihistamines since then. We used eliminating diet for her and nothing changed so far. She recently has got dark circles around her eyes, like really dark and I realized it bleeded. I saw small dried blood spots around her eyes. It’s very scary. What has caused this I am not sure. We are feeding her with allergy dry food and use allergy shampoo and conditioner.

Veterinarian's Assistant: I'll do all I can to help. What is the dog's name?

What can we do more to keep her healthy?

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

Thanks

Submitted: 6 months ago.Category: Dog Veterinary
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Answered in 8 hours by:
1/1/2018
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 6 months ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 34,829
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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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.

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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 6 months ago

I'm sorry that your question wasn't answered in a timely manner. Can you upload a photo(s) of her eyes to our conversation? You can upload photos by using the paperclip or add file icon in the toolbar above your message box (if you can see those icons on your particular device) or you can use an external app such as dropbox.com/ Please check that the photo(s) is in focus prior to uploading it.

I'm going to post my entire synopsis of the itchy dog for you. You'll read that antihistamines aren't reliably effective for these dog. Please take your time perusing the synopsis. There's a lot of information and so please return to our conversation with additional questions or concerns if you wish.

I’m sorry to hear of this with your dog. 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.

Your vet can check a sample of your dog'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. Mites are addressed topically, orally, and by injection.

Our dermatologists tell us to apply an over the counter flea spot-on such as Advantage/Advocate, a fipronil-containing product such as Frontline or, preferably, one of the newer prescription products available from your vet to which fleas are less likely to have become resistant 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. If the area between the edge of your dog's rib cage and tail (the “saddle” area) is particularly excoriated, a flea saliva allergy should be the most important differential diagnosis. In severe cases, an anti-allergenic prescription glucocorticoid (steroid) 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 (atopy) 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 (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 her vet. Oclacitinib works as well as a steroid without a steroid's adverse effects. The new injectable immunomodulary drug IL-31 (Cytopoint) should also be considered. 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 your dog'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.) 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.

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.

You also have the option of having a specialist veterinary dermatologist (please see here: www.acvd.org) attend to your dog. You can expect some combination of skin scrapings, cytology, bacterial culture and sensitivity, fungal culture, skin biopsy, intradermal or blood allergy testing, or presumptive hypoallergenic diet trials to be performed.

Please respond with further questions or concerns if you wish.

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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 6 months ago
Hi,

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

Dr. Michael Salkin
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