Isolating allergen

[MrSnappy]

Any input would be helpful here.

 

We have a five year old dog that was surrendered to rescue. The poor thing is in pretty rough shape. He is missing hair on most of his back and sides, stomach, throat and behind his ears. he is incredibly itchy. He also has an ear infection and an ulcerated cornea, but this is besides the point, really. He's just a mess.

 

He also, and I don't know if this is relevent which is why I throw it in here, has incredibly short legs. As in, his head and body are the size of my 21.5 inch, 50 lbs dog, but he is probably just shy of 20" at the shoulder. He looks like he has a mild case of dwarfism.

 

Anyway, his previous owners tell us he has had skin problems since the age of 4 weeks when they brought him home (*shudder*), and that at the time he was covered in small scabs that the breeder claimed was from the other puppies. He from them on was habitually itchy.

 

At about the age of 1.5 years the wife developed asthma and the dog had to be moved outside, which is when his problems began to worsen. He developed hotspots every Spring that last through the summer and healed up in the Fall, though he did remain itchy for the winter months. Last Spring was the first year he developed actual hair loss, the end result being the partially bald fella we have now.

 

He has been through multiple "hypo-allergenic" food changes, steroids and flea collars, to no avail. Every year he gets worse.

 

Now that he is with us, he lives inside. We have put him on a single protein source, no grains, no additives, and he is taking non-steroidal antihistamines that are not helping in the least - he is still evry itchy. We see no fleas but have applied Advantage, and we took his cedar dog bed away and replaced it with a quilt.

 

His skin does not feel moist, but dry and the hair he does have is course and dry.

 

So I am thinking he has a suppressed immune system, and an allergy to something he comes into contact with outside, like pollen or grass, and is probably aggravated by stress. He has chewed his paws quite badly too and he scratches all the time.

 

We are going to give him a few weeks to settle in, and then we'd like to run a blood panel to see if he has an endocrine problem.

 

Is there anything else you can suggest? None of the vets who have seen him think it is a thyroid issue, though we may test for it anyway. But any other observations or suggestions would be greatly appreciated.

 

RDM

[kaos]

Hi RDM

You could be describing my parents dog (two years ago although without the short legs!) She began by just itching and then mutilating herself, she would have huge gashes on her body where she had ripped herself to shreds either with her claws or her teeth, she eventually lost most of her hair (there were a few scaterred bare patches left), was covered in horrible scabs and welts and scars and her personality underwent a huge change, from happy and jolly to surly and snarly.

 

My parents had her on, flea control, mite control, used medicated shampoos, tried many of the vet recomended diets etc but not the all natural home made variety (ie: barf etc) and nothing worked, she lost so much weight and was so miserable that my brother (rather insensitive as he is ) kept asking when they were going to put her out of her misery. She was in this state for atleast a year and a half if not more when she became unable to hold her pee and began passing blood in her urine and a kidney (?) infection was detected.

 

She was placed on Metacam (?) I believe to help with the inflamation and discomfort and on several (I don't remember how many but more than 4 I think) courses of antibiotics. This finally seemed to do the trick, once she was out of pain she was able to begin healing and her personality gradually reverted to her old self (now that she could sleep and not just itch and be in pain all the time) she grew her full coat back and it was lustrous and glossy and was generally a much happier dog.

 

The vet said that in hindsight she believed that it may have been a really deeply burrowing mite infection that did not show up on the skin scrapes, compounded by a massive infection on the already upset skin as well as an allergic reaction to both!

 

I really do feel that the pain management was the first important step in her recovery, My own dog had a bout with it at about the same time as her (mine has seasonal allergies that went haywire that year but she threw it off after three months where as my parents dog went steadily down hill and stayed there)

 

I guess I'm telling you this to say that if the first recomended treatment doesn't work, keep trying, this poor pup doesn't sound like he has had any life at all thus far and deserves a chance, a multi-faceted approach may work as the problem could be compounded by several factors...

I hated seeing her in the condition she was in, so I know its really hard, but i'm sure you will find an answer. (On a sidebar I used to walk daily with a couple of people who had a damation with such severe allergies that he was on steroids year round just to live a normal life, he looked like huge spotted marshamllow due to the swelling and water retention but that dog had a quality of life that was unmatched!)

good luck with the poor guy I hope you can help him!

sara

Eventually, she went on

[AK dog doc]

Hi RDM

Yikes, poor dog. I don't think the endocrine testing is out of line - one of the forms of dwarfism in dogs is related to congenital hypothroidism, so that *might* have something to do not just with the skin, but also with the short stature - although that could also be genetic, developmental or nutritional in origin. Typically endocrine diseases don't cause itchiness by themselves - but they CAN predispose to other skin problems (like infection) which CAN cause itchiness.

 

As far as hypoallergenic diets, food allergy is a slow responder, so the animal may have to be on the diet for a good 8 weeks before you can see if it improves anything. So whatever diet you have him on, I'd stick to it for a while, so you can see if it helps.

 

A skin impression smear might be of value - that's meant to tell what sorts of pathogens are living on the skin (ie, is there a bacterial &/or yeast infection). Certain types of mites are notoriously difficult to find on a skin scrape, especially if the skin is thickend and has that elephant-hide look to it - so if I'm suspicious enough, I'll sometimes treat presumptively.

 

Is his skin oily/flaky or dry/flaky? You said it wasn't moist... that's one mercy, anyway.

 

Antihistamines in dogs can be like in people... sometimes you have to try several different ones before you find one that works well for a given dog. It seems like in my patients, antihistamines may help, but are rarely enough by themselves.

 

You could try the metacam, though I wouldn't mix that with steroids, should he ever be on any... it's possible that it might help if he's ouchy (and he could be, given the description... it sure SOUNDS like it hurts, anyway). But that also might NOT help; no way to know but to try.

 

The other nutritional supplements you might try are some vitamin E and some omega-3 fatty acids, which are usually easily found at health food stores - although some of the omegas are of fish oil origin, so if you're trying to keep fish out of the diet, look for a plant source instead.

[MrSnappy]

Thanks for the advice!

 

His skin is neither flaky nor oily. He is just balding and itchy. No welts or scabs at all, although he does chew his feet quite a bit ... but this could be a stress related behaviour because he was outside and alone so much.

 

He is a little stocky, but not fat, and he is very energetic. Loves to play.

 

According to his previous medical records he has been on Clavamox and Prednisone, neither of which have helped him at all.

 

I was curious about the possibility of mild dwarfism and a connection to his thyroid, so we are going to get that test done. I am not sure if he has had any skin biopsies (waiting for the rest of his medical history to be transferred) but we will check.

 

Right now he is on a raw diet of just chicken and lots of EFAs, no grains and no other protein source. He's just begun this, so we will give him several weeks and see if it makes any difference at all. I would hate to put him on steroids again, they really give me the heebie jeebies.

 

He is such a wonderful dog, with such a wonderful personality and so much enthusiasm, he deserves to be itch free and HAIRY again!

 

Thanks again

 

RDM

[AK dog doc]

Yay for hairy! (although I frequently curse this while vacuuming...)

 

You sound like you have good start... the foot-chewing could certainly be behavioral, but I did have one food-allergic patient for whom that was the cardinal sign, so I'll be interested to hear if he smooths out after a couple of months on good food, limited diet, excersise and TLC. Also curious about the hormone test, though that may be a dead end. And yes, pred is kind of the court of last resort, but steroids sometimes do have their place (and are excellent tools to have, if they are necessary)... I'll X my fingers that their place just isn't with this particular dog!