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Severe skin problems.

Species: Dog
Breed: jack russel/ pit bul
Age: 5-8 years
My dog Leila started licking on 8/1/12. Her spots looked like hot spots on elbows and she consantly chewed her nails. Ears smelly and crusty.She also was licking her perianal area, and she had some straining during BM. Nails were very irritated, took her to vet, vet presecribed steriods and antibiotics. Expressed anal glands, vet said it was infected and gave her a shot ClinzGard 1.0,(8-2-12)
She got worse, smelled terrible, paws became crusty and inflammed.Perinanal area has dark colored raised area. Brought back to vet,
(8-9-12) they put her on Ketoconazole 200 mg 1 a day for 14 days-some improvement in skin
but started researching and it seems to me she has systemic yeast infection (had thyroid levels done) was a little low but vet said thats to be expected since she is fighting infection. Multile skin scrappings done, Vet never really gave us a firm diagnosis, never called to check on Leila and we already spent $1200 on x ray, tests , bloodwork etc.
and no real diagnosis. (She said possibly auto immune disease) what is that?
Well I ended the antibiotics and steroids after 14 days- took Leila off all foods and fed her just one protein source (turkey) and sprayed her with RAW apple cider vinegar, bathed her in tea tree oil and masaleb shampoo. BIG improvement, but still paws look terrible and seem painful. Negative for Lyme,ringworm,heartworm etc. Skin scrappings did show Leclercia (Escherichia) adecarboxylato
Staphylococcus, pseudinermedius, Pantoea,
her nose stared running, , limping on paws, breath terrible, called vet- she's away-they cannot see Leila , called our old vet and made an appointment for Thursday. ( we moved last year)Woke up yesterday, Leila's right leg very swollen, perianal area looks swollen as well. At a complete loss as to what is wrong with my dog, need a second opinion. (x ray showed no degenerative joint disease) she was negative for mites had been very health before the initial epsiode began with the so called "Hot spots" she did seem depressed and a little more lethargic then usual, but appetite has remained enormous. She is 40 pounds medium sized female spayed, adopted at 1 year from shelter. She had anal glands expressed in 2007, and skin infection when we adopted her (was given biotin, masaleb) cleared up (2006) other then that totally healthy. We have 2 other healthy dogs, walks several times a day, (no dog parks) Her fur is course, falling out in spots where "Fungus" or yeast is. Skin turned balckish color at those spots. She has annual vaccinations (2010 Sep) for lyme.Always kept up with her heartworm meds, flea and tick preventative (k-9) advantage 2, I feel so exhausted, and am researching everything from Thyroid issues, to flesh eating bacteria, I just don't know. Please can you offer an expert opinion?

Online vet, Dr. Marie

Dr. Marie replied:

Oh wow. You must be so frustrated. I have had a few cases like this and believe me, your vet is probably frustrated as well. While I won't be able to give you a diagnosis I'll give you some thoughts on what you have written and perhaps give you some things that you can ask your vet about.

You mentioned a few bacteria above. I'm assuming this was not on a scraping, but rather on a culture. This is where we send a swab to the lab to determine what type of bacteria is growing. The lab usually gives us a report back that says not only what is growing, but also which type of antibiotic is necessary to get rid of the problem. There are some cases where a combo of antibiotics may be necessary in order to get rid of bacteria. However, I'm thinking that if this were the case the vet would have mentioned it.

I, too, am worried about an autoimmune disease. Having problems with the nose, feet and ears can often be a sign of an autoimmune disease. Some examples include pemphigus and lupus. The only way to know for sure if this is an autoimmune disease is to have skin biopsies done. In most cases we can do this with a local anesthetic but sometimes we do need a general anesthetic. The vet will remove tiny pieces of skin and the tissue below and send it to the lab to have a pathologist look at it.

In most cases, if this is an autoimmune disease, the treatment is steroids, but they would be given at much higher doses than what your vet likely prescribed at first. Unfortunately autoimmune diseases tend to be lifelong and some can be very difficult to control.

One other thing that I might consider trying, although it is a long shot is actually treating for sarcoptic mange. The skin scrapings were negative but often it can be really difficult to find sarcoptic mange. One easy treatment is to switch the heartworm meds to Revolution which kills mange. But, I think that from what you have described an autoimmune disease is more likely than mange.

I think it's a good idea to get a second opinion. I would highly recommend the biopsy. I know the costs have added up, but often doing biopsies can get down to the diagnosis much quicker and can be less expensive that trials of medications. One other option you have is to ask for a referral to a veterinary dermatologist. These vets are the ones who see all of the really unusual skin problems that we can't figure out.

I really hope you get some answers soon, and that Leila gets some relief!

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.