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I've been to the vet twice in the last month dog's sudden…

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I've been to the vet...
I've been to the vet twice in the last month for my dog's sudden onset of itching. No fleas. Started on prednisone 5mg daily and still not better. Have also started a skin supplement which doesn't help either and frequent bath with allergy shampoo vet gave us. Now has rash on belly. Also notice bumps on skin, used to have just one that I considered to be like a large raised mole and now has several. Still eating, drinking, acting normal just itching quiet a bit.
Submitted: 3 years ago.Category: Dog
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Answered in 7 hours by:
6/9/2015
Dog Specialist: VetTechErin, Licensed Vet Tech replied 3 years ago
VetTechErin
VetTechErin, Licensed Vet Tech
Category: Dog
Satisfied Customers: 681
Experience: Published author in veterinary medical journals and on the Veterinary Information Network with a focus in toxicology
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My name is ***** ***** I would be happy to help you with your question about your dog. Sorry it has taken someone so long to get back with you.
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Customer reply replied 3 years ago
Yes
Dog Specialist: VetTechErin, Licensed Vet Tech replied 3 years ago
I have a few questions about the onset what's been done at the vet, then if you don't mind!
When did you start to see the itching occur?
Before the bumps appeared, did it seem like he was scratching at his "normal" skin, or was there redness/flakiness, anything like that?
Where are the mole-like bumps? Did the vet do a fine-needle aspirate on the first one?
At the vet, did they do testing like skin scrapings, food trials, looking at areas with a Wood's lamp (a little bit like a blacklight), or test for ringworm? Or was he just diagnosed with allergies?
Are you seeing any hair loss?
Was the skin supplement fish oil?
Is he on a flea/tick formula and does he go outside at all?
Has Benadryl been tried?
Sorry for all the questions, skin issues can be complicated!
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Customer reply replied 3 years ago
Itching started 6-8 weeks ago approximately. I was worried at first it was fleas as it was right before we put his first frontline on for the year/spring. The skin was "normal" from what I could tell until this week. Noticed the rash right after he got groomed and then bathed him in his "allergy" shampoo. The mole like bumps are on his back, that is also new. He used to have just one now he probably has like 4-5. No none of that testing at the vet. I did switch him to an all natural Hills brand dog food this week. They just diagnosed him with allergies put him on prednisone 5mg and a fish oil supplement. I am currently doing prednisone 5mg every other day yet I don't think that is helping either and 2 tabs of fish oil supplement. Starting to see some hair loss at inner sides of his eyes from scratching. He is on frontline and goes outside mainly to go to the bathroom and back in. Have not tried Benadryl.
Dog Specialist: VetTechErin, Licensed Vet Tech replied 3 years ago
Allergies would certainly be the most common cause of generalized "itchiness" in dogs. It can cause all of the things you've described above, including itchiness, redness, rash, bumps. I'm going to start off by giving you a brief description of the different causes of allergies that we see in dogs, so you get a little bit of an idea as to why itchy skin can be so hard to diagnose and treat. Typing about skin issues can sometimes take a while, so I'm going to start with the allergies, then I'll follow up with other possible causes and testing that can be done.
Since back-and-forth discussion is important, if you have follow-up questions, please get back via "reply", and I'd be happy to address them!
On allergies, these are the main types that cause skin issues (though we can see other types that cause the classic respiratory issues in humans)
Flea allergies - Dogs can be allergic to fleas, and you will notice inflammation, rashes, and bumps in areas which fleas like to hide, such as bellies, neck and facial areas, along the back, and around the rump. The best way to treat flea allergies is via strict flea prevention (Frontline or Advantage should be applied every 30 days). Year-round treatment for fleas is recommended, as it takes a cold snap of below zero weather for thirty days to completely eradicate the flea population. They can also lie dormant in your carpet or cracks in your flooring, so it may be necessary to flea-bomb if an infestation gets bad.
Your pet does not have to have an infestation of fleas in order to display flea allergies. The allergic response caused by fleas occurs after the flea bites your pet. Since flea preventatives also typically work AFTER a flea bites your pet, then there is that opportunity for a flea to jump on your pet and bite before the flea dies, and that can trigger the allergy. Because of this, it is often good to have a secondary medication on board to help with the itch. Allergy shots, Atopica (which is a slight immune depressor to help modulate the response), plain Benadryl at 1 mg per pound for itchiness can help a lot of dogs, hydroxyzine can be prescribed for animals that are still struggling, even on the Benadryl. All the secondary drugs are designed to ease the itch, not cure it, so the flea preventatives are still important.
Food allergies - This is a fairly common cause of allergies in dogs, can cause many skin issues in a dog similar to what you are seeing, and they can be seen all over the body, though areas around the face, ears, back, and rump tend to be the most common areas to see inflammation. A good hint that your dog is suffering from food allergies is frequent ear infections. Studies have linked frequent yeast and bacterial infections to food allergies, and when the allergy symptoms are treated, the frequency of ear infections also fade. Food trials can be done to help identify which food ingredients cause your dog the most issue.
With food trials, your vet will help introduce your dog to a "hypoallergenic" diet which you should keep to very strictly (no treats or human food should be given while on a food trial) for around 12 weeks to determine if there is any improvement from symptoms while on the diet. You can also try switching foods at home to a diet with ingredients vastly different from the one you are currently feeding (IE, if you are on a chicken and corn diet, try a lamb and rice). Many vets carry prescription diets that have fun ingredients such as kangaroo or venison and green pea to help people find a diet with different protein and grain ingredients for dogs with food allergies. Any time a food is switched, it should be done gradually, mixing the old food in with the new food over a period of nine days (3 days of 75% old/25% new, 3 days of 50/50, and three days of 25% old/50% new) to help prevent against gastric distress that comes with a sudden food change.
While switching to a grain-free diet CAN help, and a lot of people will tout them as a cure-all for skin issues, many dogs are actually allergic to the protein like the chicken, beef, or fish. Finding a novel protein like venison may be the better solution in these cases.
The same secondary medications as above can also be used at home to help control the itching until the skin clears up after the right food is found.
Contact allergies - These are the things a dog touches that cause allergic reactions. They can be a wide variety of things, like carpet, grass, nylon, certain plastics, etc. The best way to treat against this is by identifying the cause of the problem, and then getting rid of it in your dog's environment, (Obviously difficult to do with grass). This is the least common of the allergies. allergy tests can be requested from your vet to give you a specific answer about what your pet is allergic to, though these can be expensive.
The secondary medications are also helpful to control the itch here, especially if it is something your animal has to come into contact with, like grass.
There are many things that an cause allergies, and identifying the cause can be time-consuming and costly going through trial and error. However, if you are having trouble with the medications you are giving at home, sometimes allergy testing can end up being cheaper in the long run.
Some things you can do for your dog with allergies when your meds aren't working:
Talk to your vet about a prescription shampoo. There are shampoos that have hydrocortisone as an ingredient that can help with skin inflammation. There are also shampoos that have fungal medications, shampoos to help with mild skin infections, and playing with a variety of these may help pinpoint the issue too. You can also buy shampoos at the pet stores that contain oatmeal, which can help absorb and rinse any airborne allergens from your dog's fur when you bathe.
Add omega-3 fatty acid supplements to your dog's food. You can get these from a vet, or buy the fish oil pills from a pet store or local grocery store, and puncture and squeeze a pill over your dog's food. Sometimes this can help your dog's allergies, and it's certainly good for their skin. If the current fish oil you've got isn't working, let your vet know, and they may have a different brand they'd like to try.
Sometimes dogs can scratch at areas so much that they develop secondary bacterial infections. You'll notice that these areas become really inflamed, sometimes crusty, and sometimes look "oozy". In cases like this, you will want an antibiotic from your vet to help get rid of the bacterial infection, rather than just treating the allergy itself.
Since your vet thinks this is allergy-related, the above information is probably where you want to start. I am going to go ahead and submit this part of the answer so you can read it while I start going into things aside from allergies that we can see in dogs.
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Dog Specialist: VetTechErin, Licensed Vet Tech replied 3 years ago
Now, taking allergies out of the equation, there are a WHOLE LOT of things that can cause a dog to itch. There are really too many to actually name without writing a book. But what I'm going into next are some of the more common things we can see aside from allergies, and the things it is good to speak to your vet about testing for to see if perhaps something other than allergies could be the problem. If they are able to rule out below and you are still struggling with the normal treatments for allergies, then it is time to get your pet in to see a vet dermatologist.
Things other than allergies:
Fungal infections - Ringworm is the most common, but there are several fungal infections that can cause scaly skin issues and itching. These are typically diagnosed via fungal culture, and can be easily treated with a topical or oral antifungal medication (often the dogs will lick the cream off, which makes the areas moist. As this is problematic for getting the areas to clear up, oral medications tend to be far more effective). Your vet may utilize a Wood's lamp to look at areas where you're seeing inflammation or flaky skin, as some tend to "glow" apple green under the lamp.
Folliculitis - This is an infection of the hair follicles. They typically present with pustules that look like a target, with the crustiness in the center, and redness surrounding it. This can also just look like skin bumps. A vet can diagnose with a skin scraping or a biopsy, and is treated with long-term antibiotics.
Folliculitis is usually a secondary condition to something else like allergies, other skin infections, etc. So even after treating the folliculitis, if the other issues aren't addressed, it may just come back.
Mites - Your vet will want to do a skin scraping to diagnose for this! They can then take a look under the microscope to identify any mites that might be in your dog's skin. Treatments for this are usually either insecticidal medications or mite dips (Mitaban) to kill the mites.
Demodex is the most common and it can be seen with general loss of fur. Demodex lives in skin of a dog naturally, so seeing these mites does not indicate poor care or contact with an infested dog so much as it is the natural mites in the skin overcoming a dog's immune system. Short-haired breeds like pit bulls tend to be really prone to stuff like this.
Hormone changes: Pet with Cushing's or thyroid issues can present with skin issues, hair loss, or skin discoloration. The treatments vary, but the best way to diagnose either of those problems is through a blood test for the thyroid or an ACTH Stim test for Cushing's so your vet can get your pet on proper medications for treatment.
Tick borne diseases: Some skin issues can be caused by diseases transmitted by ticks. A tick disease blood panel can be used to diagnose diseases caused by ticks, and can be done through your vet. Doxycyclene (which is a type of antibiotics) is usually the drug of choice for diseases caused by ticks.
I know this list is long and daunting. Dealing with skin issues can be frustrating, even when working very closely with your vet, because so much of the diagnosis process is trial and error to see what works, as specific skin testing can be very expensive.
However, given the long list of testing to rule out other causes, it may just be cheaper in the long run to start out at the dermatologist and have them do testing and treatment there to cut out the time in the middle. While this will be more expensive at the get-go, it will also spare the intermediate cost of trying different things until you find one that works, or not finding anything that works and ending up at the dermatologist anyway.
Hopefully I have not overwhelmed you with this list, but if you have any questions about anything or have any further concerns, please feel free to get back with me via "reply" so we can chat further.
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