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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 29058
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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I'm trying to figure out the next step for my 11 year old

Customer Question

Hello, I'm trying to figure out the next step for my 11 year old dog. Always: licking herself, a couple of times to the point of sores on her front legs. Then: snorting and reverse sneezing. Then: reverse sneezing and nasal discharge. Vet 1 gave an antibiotic, suggested benadryl. Went on, more or less, for months. Vet 2 gave a prescribed antihistamine. No real effect. Months later, Vet 3 antihistamine with steroid. Some effect but not fixed. Now she says rhinoscopy with mild sedation. After that, if she found no foreign body or found a polyp, referral to a specialist. Should I go to one now? This looks like it's going to be terribly expensive, and I understand treatment for polyps or cancer are not very effective. Is there another step to take first?
JA: I'm sorry to hear that. This sounds like it might be serious. I'll let the Veterinarian know what's going on ASAP. Is there anything else the Veterinarian should be aware of about the dog?
Customer: She coughs as if she has post-nasal drip. She's had no fever, has good appetite, seems happy otherwise.
Submitted: 1 year ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 1 year ago.

I"m sorry to hear of this with your dog. Because her licking her extremities most often indicates an allergic dermatitis and reverse sneezing arises secondary to inflammation in the oropharynx or nasopharynx which is also consistent with allergy, I would see how a high dose of a glucocorticosteroid such as prednisone affects her before resorting to anesthesia, scoping and biopsy. Dosing at 0.5 mg/lb once daily with the antiinflammatory and antihistaminic prednisone should address an allergy nicely. If you saw a very positive response to such a drug, you could then taper it to the lowest effect dose. If you didn't see a very positive response, you then have more reason to go ahead with the invasive scoping. Note that you have already seen a reponse to a steroid - that combination antihistamine/steroid was Temeril-P but that has a very small dose of prednisolone in it.

Please respond with further questions or concerns if you wish.