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Is ketoconazole safe?

Species: Dog
Breed: Pappillon
Age: 5-8 years
Hi. My 6 y/o Papillon has suffered fron skin problems his whole life. I've been told they are allergies. Hes had a few Prednisone shots over the years but they dont really help so I asked them to stop giving them to him . Hydroxyzine didnt help.Benadryl gives him some releif. He has always been on a flea preventative first frontline plus, but that doesnt seem to work anymore, so I switched all my dogs to comfortis, and of course a heartworm preventative.
Well recentely he started developing scabs on his back. where he couldnt really reach to scratch. I just happenened to notice one day when i was watching TV and running through his hair, Its long. Took him to the vet, they thought ringworm and said we could treat with lotrimin, over the counter stuff. After a couple weeks no improvement (I know it takes up to a month but you'd think there would have been some improvement), back to the vet.
This time a prescription shampoo used twice a week and ketoconazole 50 mg (they broke them up for us) once a day. She knew I wasnt crazy about putting him on an oral anti-fungal , the liver toxicity and all, so I understand this is a low dose. Ok thats the history. Now my question. Do you feel this is a safe drug? I havent started yet (got it yesturday and did shampoo him last night). And also he seems lethargis and has lost his appetite so I've been giving him boiled chicken and some low sodium beef stock mixed with water. But I found a raw diet on the internet and want your opinion on it.Do you think it would be safe for him, or any dog.
Thank you, sorry this is so long.
Sincerely Tina (diet follows)
■10 lbs. of raw ground beef
■18 hardboiled eggs including the shells-cooled (the egg shells supply digestible calcium to your dog. Yes, studies have proved that the calcium in egg shell is highly absorbable.)
■1 tube of Supromega omega 3 fatty acid Supplement (This supplies important omega 3 fatty acids. It also contains natural source vitamin E.)
■Dinovite daily dog supplement (This supplies a host of vitamins, minerals, digestive enzymes, zinc and live direct fed microbials. Dinovite also has a nutritious plant component in the “Alfalfa Nutrient Concentrate” that replicates the partially digested plant matter of herbivores. All great stuff!)I use 1 tablespoon of Dinovite per cup of dog food.

(Tina's Note)
This is all mixed together and served raw in appropriate serving sizes to the dog. the rest can be refrigerated or frozen.

Online vet, Dr. Marie

Dr. Marie replied:

Hi Tina,

So sorry for the delay in getting back to you! My power went out this afternoon and I lost my internet connection. But things seem to be good now. :) The also thing that you may or may not know is that I now have a young baby and so I am not able to respond as quickly as I once was!

Poppi's situation sounds very frustrating. Chronic skin problems like this are very difficult.

I know that ketoconazole comes with all sorts of scary warnings but it generally is quite safe. There is the odd dog that can experience liver problems on the drug but this is very uncommon.

As you were describing the problem I was thinking that this could be a yeast issue, so it is certainly a good idea to go on the anti-fungal.

If you wanted to be absolutely certain you could ask your vet to do some liver blood tests every couple of weeks but I don't usually do this when I put a pet on ketoconazole.

I am not a fan of raw diets. They tend to be hard to balance and there are some risks involved. I would not recommend changing his diet unless your vet has recommended it. You could potentially do more harm than good. For example, let's say that he had a mild beef allergy. Putting him on a food that is primarily beef based could make skin problems worse. I'm not saying that an allergy is likely, but I just wouldn't switch the food unless the vet advised switching to a prescription hypoallergenic diet. The symptoms you are describing do not sound food related though.

Don't be afraid to try the ketoconazole. It sounds like your vet is doing everything I would. It may take a few weeks to see a noticeable difference though.

I hope things improve soon!

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.

Customer reply:

Thank you so much. You have alleviated my fears somewhat about this medicine and I started him on it today.Crushed it up and added it to some wet dog food I bought for this purpose. The vet also put him on cephalexin for 10 day, and I started him on that yesturday and he already seems better. Drinking water on his own, more active, almost his old self. Now we just have to clear up his skin.

Besides yellowing of his eyes or gums, is there any other side effects I should watch for with the anti-fungal that is a 'trigger' to take him to the vet? SHe has already scheduled a blood test in 2 weeks to make sure his liver is doing ok. Yes they are my babies and sometimes I am a bit paranoid.

Anyways thanks for your reassurance, I'll take your advice and avoid the raw diet.

Congrats on the new addition to your family!!!! I have a 15 month old grandson living here and boy is he a handfull!!!!

Online vet, Dr. Marie

Dr. Marie replied:

*If* the ketoconazole was going to cause problems then it would likely start with a reduction in appetite and maybe vomiting, so if you see those then it's a good idea to talk to your vet.

Hope things are better soon!

Dr. Marie

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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.