Itchy skin, red bumps, chewing paws

[AmyD]

Hi, Doc! I hope you remember me...my pups Max (25 lb. beagle mix, 7 yrs. old) and Chelsy (40 lb. unknown mix, 15 1/2 yrs. old) used to be your patients until we moved to TN in 2006.



I am trying to find some relief for poor Max's skin condition. I have tried what feels like everything, other than allergy testing, which I am not ruling out at this point.



Age 1 - began licking/chewing feet until raw. Frequent ear infections up until the last year or so...no clue why they are coming on less often, but not complaining. Currently, he still licks/chews his feet and the itch has spread to his basically his entire body. His back has little red bumps that he scratches at until they bleed/scab, and he has rubbed the hair off in a couple of spots on his back by scratching against our box spring. His belly and hind legs are also covered in bright red bumps, some I can tell have puss in them so that suggests to me infection. He just came off a week of Cephalexin about a month ago...skin scrape revealed it had cleared up infection, but given the puss I see on his belly bumps now, I am guessing it is back already.



Things we've tried over the last 5 years or so-



Benadryl - he gets 50 mg at night, sometimes also in morning if he seems more itchy than normal (doesn't seem to make a difference)



Several 6 mos. or more trials of simple protein/carb dry foods. On Natural Balance Duck and Potato dry for at least the last couple years.



Steroid + antibiotic + anti-itch/anxiety meds - this at least seemed to offer some relief and his feet cleared the most they ever have. Also, it's the only time I recall since this began I could rub his back w/out him cringing. At the end of the treatment though, all of his symptoms returned. He also gained weight on the steroids.



Cortaid cream for his itchy back. It seems to help initially, but then it just goes back to itching even when the cream is applied.



I have clearned the bumps on his tummy successfully before w/ Neosporin, but again, they clear up and come right back once the treatment stops.



Fish oil. - No real change.



Stopped giving him raw carrots in case these were allergens



Malaseb shampoo. Seemed to make his feet better somewhat, but the rest of him even more itchy than before.



Oatmeal shampoo. Seems more itchy after any kind of bath really.



Some kind of yucca root liquid stuff that was supposed to do wonders for dry dog skin - no change



Socks on his feet to keep him from licking...worked to some degree, but not easy to keep them on him and doesn't address his full body itch.



Lamp shade collar to keep him from biting at himself. Both pitiful to see, and not effective as he can pop the snaps off. Also cannot leave him unattended b/c he gets his dewclaw caught in the snap holes.



What have I missed? I am told that his options are to (a) see a doggie dermatologist or (b) do the steroids again. I am sure the steroids will bring relief, but if history is an indication, it won't last. How can I make him well for good? What questions should I be asking?

Thanks very much for any help you can give,
Amy

[Doc]

Hello Amy,

If you're trying to avoid steroids you should consider allergy testing. Your vet can do a blood test or refer you to a dermatologist for skin testing. Some dogs respond well to hyposensitization but you have to determine what the offending antigens are by testing or trial and error. Ask your vet about testing or a referral. Otherwise steroids can really reduce the symptoms and with judicious use, the side effects can be minimal.

Hope this helps,
Doc

[AmyD]

Thanks very much for the input...we ended up trying another round of the prednisone...25 mg for 5 days then one every other day. The first day on, could touch his back w/out his skin curling up, but the very first "off" day, that was back. He's completely off of the meds now so that he may be evaluated by a specialist...and has a huge bald spot on one side where he has rubbed the hair off trying to satisfy the itch. Poor dog. Headed to the University of Tennessee to see if they can figure it out.

Thanks again!
Amy

[AmyD]

Made it through the first visit at UT...the vet thinks maybe he never really had a long enough course of antibiotics to really clear the infection. Culturing several scrapes to find best antibiotic for him. Found no mites.

She also thinks maybe he has a flea allergy on top of his initial underlying condition, since his body didn't really start with the bumps until the last couple of years...our son is 2 1/2 and has multiple food/environmental allergies...we stopped with the Frontline a couple of years ago for fear of it hurting our other little guy, so this makes some sense. Though neither dog seems to have fleas...I check fairly often w/ a flea comb. According to the UT vet, though, if you live in TN, your dog has fleas.

So far we have ChlorHex 2X 4% spray for paws and some skin folds around his mouth twice a day, Etiderm shampoo twice per week for 10 minutes, Capstar 57 mg every other day, and Frontline Plus every 3 weeks. When they have the culture results, we'll add antibiotic on top of thiese other steps for several weeks.

Wow, I hope we can get some relief for this poor dog...I hate the thought that taking him off flea control could have contributed to his discomfort, but if the fix is that simple I will take it!

[RoushZ06]

I feel for you and the dog. Not a pleasant thing to constantly go through for either of you I am sure. Good luck.