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Her paws have a rash and she keeps licking them somewhat…

Customer Question
Her paws have a...

Her paws have a rash and she keeps licking them somewhat raw

Veterinarian's Assistant: I'm sorry to hear that. What sort of animal are we talking about?

She is a Red Healer mix dog

Veterinarian's Assistant: OK. What is the dog's name and age?

Lana, 3years

Veterinarian's Assistant: How old is Lana?

3years

Veterinarian's Assistant: Is there anything else the Veterinarian should be aware of about Lana?

I don't think so....she weighs 48 pounds

Submitted: 10 months ago.Category: Veterinary
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Answered in 4 hours by:
9/30/2017
Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 months ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Veterinary
Satisfied Customers: 35,490
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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You're speaking with 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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Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 months ago

I'm sorry that your question wasn't answered in a timely manner. An allergic dermatitis such as atopy and, less commonly, caused by food intolerance are important considerations in dog who excoriate their extremities as you've described in Lana. An underlying demodicosis (mange mite Demodex) and secondary bacterial and yeast infections are commonly found.

Environmental allergies (atopy) - allergies to pollens, molds, dust, and dust mites, etc. are usually initially addressed with a glucocortiocid (steroid) 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 oral immunotherapy using the cytokine antagonist oclacitinib (Apoquel) is likely to revolutionize how we address atopic dogs and should be discussed with *** vet. Oclacitinib works as well as a steroid without a steroid's adverse effects. The new injectable immunotherapy with the monoclonal antibody IL-31 (Cytopoint) should also be discussed with Lana's vet. 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 Lana'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.

Please respond with further questions or concerns if you wish.

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Customer reply replied 10 months ago
I have been giving her Benadryl for 2 weeks or so. It doesn't seem to help. She has always taken fish oil supplements according to her eye Vet. She had this problem last year that was resolved by wiping her feet after she comes in from outdoors. That only helps somewhat this time.I did switch her food then from Nutro to Blue Buffalo grain free chicken recipe. Maybe i should switch again I was wondering if there is a topical cream i could use like spectazole or something steriodal or something different on them. I tried polysporin otc but doesnt help. May have to have a perscription... I tried sending a pic. Dont know if it worked.
Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 months ago

No, as you see antihistamines aren't reliably effective. Please note that grain free isn't necessarily hypoallergenic. Yes, creams can be helpful but you'll need to know what you're treating first - bacterial, yeast infection? - no infection? This can be determined by her vet performing a cytology (microscopic exam of a small sample of affected skin surface) looking for abnormal numbers of both bacteria and yeast. No, a pic didn't upoad. Customer service can help you do that: ww2.justanswer.com/contact-us or 1-***-***-**** for help in that regard. You're going to need your vet's help in getting to the bottom of this. If the vet isn't helpful, consider having a specialist veterinary dermatologist (www.acvd.org) look at Lana. I have to leave my computer for the night. I promise to reply in the morning if need be.

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Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 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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