What can I do to alleviate my dog’s severe skin and paw irritations?

Original Question: I initially want to say that my family looks forward with great interest to your Saturday morning show, which we find most medically informative and balanced with insight and common sense. I realize you have dealt with allergies ‘on air’ but I wanted to supply the kind of detail to you in writing that would be somewhat boring to listeners. The following will help identify Brody and his condition: Born June 15, 2011, he has always been a playful well adjusted affectionate Shetland Sheep Dog (Sheltie) who has been healthy in every respect except for this allergy. We became aware of problems following the summer of 2015 when we observed him excessively biting his front paws at one point breaking the skin while chewing...at which time he wore a cone during the healing process. Since that time (while being treated with the drugs listed below) he has scratched himself on his side and belly in a limited but consistent manner...he does not appear to be in significant discomfort. He has continued to have inflamed spots (varying in size from a dime to a 50 cent piece) predominantly on his stomach, chest, sides and back. These red spots are warm to the touch and seem to scab over and then release flakes to his fur which we gently brush out. To date his condition has been treated with: Antibiotics prescribed in Feb June and August of 2016 (Apo Cephalex 250 mg tablets 2x daily for 14 days on each occasion) because of extensive inflammation spots on stomach abdomen and sides...antibiotics cleared him up 100% Pro Hex Shampoo with 2% w/w Chlorhexidine Gluconate followed by Pro Rinse Cream Rinse & Conditioner up to 2X/week since Feb 2016 to present Isaderm Gel (topical antibiotic/Corticosteroid) applied to affected spots several times per week up to present Starting in August 2016 1/2 Vanectyl-P tablet every other day up to present Starting in March of 2016 we experimented with Benadryl Chlortripolon Claritin & Reactine to no observable improvement and discontinued One wild fish oil blend capsule per day (EPA 180 mg/DHA 120mg) up to present p until November 2016 fed Acana Grasslands [70% meat (lamb duck fish eggs & turkey) 30% vegetables fruit and botanicals] Since December 2016 fed Acana Pacifica [70% fish( Pacific herring Pacific pilchard Arrowtooth flounder Silver hake Redstripe rockfish) 30% vegetables fruit and botanicals] up to present As of 1 month ago his only treats are comprised of the above mentioned dog food with NO leftovers • he has had annual blood collections Wellness 1A PLUS (WIA+T4) W1AT Urine collection and Urinalysis Complete Fecal OP Idexx add on to Profile OPA 4Dx /HWT Screen - Canine Add-on 4DXa Duramune 4 Lepto DAP Recombitek 3 1 Thyroid Sick DogPanel TSDP (NOT 4) June 2016 None of the above tests gave results that raised concerns We are considering changing his dog food to: Royal Canin Anallergenic (apparently feather based) or Acana Singles Free Run Duck or Store bought venison and turnips (organic if I can find) or Raw meat Brody continues to be a lean, happy, frisky, unstressed and wonderful almost-6-year-old with a great disposition. We want to improve his condition and try to the best of our ability to understand and alleviate his allergy. Any suggestions and advice would be most appreciated. - Doug & Cheryl

What can I do to alleviate my dog’s severe skin and paw irritations? Apr 14, 2018

Hi Doug and Cheryl,

Thanks for your question. Brody is very lucky to have such a loving mother that is working so hard to make him comfortable.

The very first thing that we need to do is figure out what infections are at play here. You mentioned all these treatments but you don’t mention many diagnostics that are related to skin infection. The first thing I want you to do is ask your veterinarian to perform a skin scraping. This is an inexpensive and simple test that will check for bacteria, mites and yeast. It’s so important to first determine if yeasts are present or not. Yeast can cause itchiness of the paws, which is where you say this started. If in fact this is a yeast infection, it’s been treated completely wrong, and it would be great if it were because you’ll be able to get rid of it with the correct treatment.

The next thing I would recommend you do after the skin scraping is a skin culture test. This is where you swap the skin with a Q-tip, send it to the lab and it will grow whichever bacteria is present on the skin and expose it to different antibiotics to figure out which one will kill it.

I can’t overstate how important these tests are. We need to figure out what the infectious agent is and remove it from the situation.

Once you have eliminated the infectious agents, you’re then left with allergies to deal with. It could be that this was all caused by an infection, however, if you are left with allergies then you’re certainly on the right track and you might find that the treatments that you’re currently utilizing may work better once the infectious agents are gone. You could consider other medications such as Apoquel or Atopica to control the itchiness. You can also look at omega-3 fatty acid products that you apply directly to the skin as well as antihistamines. These types of treatments are outlined in my article on allergies on this website. I encourage you to watch our video on antihistamine use in pets and check out the antihistamine therapy chart for dogs.

It’s my great hope and expectation that once you get the infection under control, you’ll have better success with treating the overall condition. I strongly recommend that you have a serious discussion with your veterinarian to ensure that the right diagnostic testing are completed.

Good luck.

Dr. Clayton Greenway

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