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Sores around vulva.

Species: Dog
Breed: GSD/Boxer mix?
Age: 2-5 years
Hi Dr. Marie,
I would like a second opinion on my dog's health issue. She is a 4 year old spayed female, probable German Shepherd mix - I think she's mixed with Boxer, but our vet thinks she is GSD with Sharpei. (I mention this because he was very specific about Sharpei tending to have skin allergies and I wonder if it's possible this may slant his view a little.)

She had licked her vulva raw and had red oozy raw irritation in the crease where the skin cups down under it. Her records say "mild vaginitis" and "peri-vulvar skin is irritated and raw. Hair has acral staining from self trauma and excessive licking." It resolved with antibiotics plus Temaril-P but came back right away. We just finished another round of Temaril-P and it is cleared up again for now but tonight she is already starting to worry at it.

At the first visit for this he did mention that she had some extra skin folds and urine was getting caught in there, and I should try to keep her clean. Then he told me at the second visit to stop washing her, that washing was irritating it more. He said if it starts up again to give her benadryl but that we will probably have to put her on Atopica (that's when he mentioned that Sharpei are very prone to skin allergies). What concerns me is that she's not an "itchy" dog and I haven't seen any other signs of skin allergies.

A previous vet did point out that her vulva is a little bit recessed and said she might need a surgical lift some day if she had chronic problems. She has had three minor problems with her female parts BUT none of these issues have been chronic:
When we got her at eight months she had puppy vaginitis. At about a year and a half she got a pimply looking skin infection (staph?) further up on her tummy in the folds created by her spay scar. It cleared up with antibiotics and medicated shampoo. At about two years old she had a single urinary tract/bladder infection that cleared up with antibiotics. (The recessed vulva was pointed out at that time.)

So I'm pretty confused. I've read about urine burn causing vulvar dermatitis and this seems like the most likely cause to me, and it even seems like that's what he thought it was too at first. I'm not thrilled about suppressing her immune system if it's not really allergies. I see Atopica is used for chronic atopic dermatitis but can't find any information specifically about vulvar irritation. Have you prescribed it for this purpose or heard of it being used this way?

Are there other options besides either the Atopica or the surgical lift the other vet thought she might need? I certainly wouldn't want to put her through surgery if a pill will fix the problem. Yet, everything I read about Atopica seems like once you start it's going to be for life and there are side effects. And of course it's incredibly expensive!

I guess I need your opinion on whether I should take her for another opinion? She's a big timid girl and I don't want to drag her around to different vet offices if I'm way off base. Thank you for your time!

Online vet, Dr. Marie

Dr. Marie replied:

Sorry to hear that Misha is having these problems!

From what you have described there is a good possibility that the recessed vulva is indeed trapping urine and causing her to have repeated infections.

I had a similar case in my practice. This was a German Shepherd who was constantly dealing with peri-vulvar infections. We ended up doing a reconstructive surgery on her and it worked amazingly well for her! We wished we had done it sooner. It did cost a fair amount. However, when you add up all of the vet visits and medication used for constant infections the surgery probably cost less that long term treatment would.

Any time we have a dog with repeated skin issues we start looking at whether allergies could be a culprit. But, it does seem a little unusual that at this point the skin problems are localized to the vulvar area. This is not normal with allergies.

Some dogs, especially dogs with German Shepherd in them can get nasty skin issues around their vulva or anus sometimes that are very hard to stay on top of. I usually try to treat them with antibiotics and either prednisone or vanectyl-p (temaril-p) but if these drugs are not working then yes, the next step is Atopica.

The Atopica insert talks about many potential side effects but in all of the dogs that I have put on Atopica I find that side effects are not common.

Please remember that an online consult can never take the place of an in person visit with your vet. Being able to see the affected area could make me have a different answer. So, it's not a bad idea to have another vet take a look at Misha and help you decide whether you are on the right track or not.

Dr. Marie.

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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.