Hi everyone, I have a Westie who is 9 years old and this summer has been the worst for her. We moved from the East Coast to the West Coast over 5 years ago. In May 2013, she had her first ear infection in her left ear, which turned out to be an inner ear infection. This summer (starting in May) she has been having mild bacteria/yeast infections in her left ear which my vet says are a secondary infection from environmental allergies (theorized, never went to a dermatologist).
Last Saturday, her left ear was inflammed (narrow canal, thick skin, yellow golden flakes, smelly). Thursday, my vet prescribed Apoquel (3.6mg pills) and suggested to lightly apply a cortisone cream for 5 days. She has never tried using Claritin or any antihistimine for this. Today we started the Apoquel because I wanted to read more about it. I’m planning to only do 10 days (1/2 pill twice a day) instead of the full 30 days (asked the vet if it was okay and they said yes). Her left ear at this moment is no longer red but still has yellow golden flakes and is a bit smelly.
I’m hoping someone can help me since my vet (and others) only believes in steroids, antibiotics, and Apoquel for long term use. When my Westie’s flare up calms down, what can I do to minimize the use of Apoquel and steroid creams? Right now, I am bathing her once a week with Malaseb and rinsing with apple cider vinegar (will do twice a week now), wiping her down with a wet paper towel (sometimes apple cider vinegar), doing foot soaks at the end of the night with warm water, and I’m currently trying an 8 week diet of only Acana Pork & Squash with no treats. I have noticed that her poop from Acana (since Thursday) is fairly soft versus when I had half Acana and half homecooked food plus Ark Naturals Probiotic added. Should I add a probiotic to help with the soft poop as well as the suppressing of the immune system due to Apoqeul? I greatly appreciate any help since this is my first dog and the vets near me don’t seem to know anything outside of steroids and antibiotics. Thank you.
If the symptoms have been going on for more than 1 year/4 seasons and have not responded in a significant way to treatment by a veterinarian. Consider making an appointment with a dermatologist.
This subject comes at least once a week. People are reluctant to go to a specialist because they are concerned about the cost, and yet they end up spending much more going back and forth to the regular vet and trying all kinds of gobbledygook remedies.
excerpt below from: http://www.2ndchance.info/Apoquel.htm
“Food Allergies are probably over-diagnosed in dogs (they account for, perhaps 5-10%). Hypoallergenic diets are occasionally, but not frequently, helpful in canine atopy cases but you should always give them a try. Food intolerances are more common – but considerably more likely to result in digestive disturbances and diarrhea than in itching problems”.
Mail-in hair and saliva tests do not test for allergies and tend to be inaccurate. Food sensitivities fluctuate. Food allergies are rare.
Per the search engine here:
Hope this helps:
By Klaus Loft, DVM
Angell Dermatology Service
Anyone who suffers debilitating environmental allergies tied to changing seasons, pet dander or household dust mites knows first-hand the misery of a scratchy throat, itchy eyes or painful rashes.
Not everyone knows, however, that our pets can experience similar allergic reactions — and other very bothersome dermatological issues. But our pets need not suffer in silence. Modern veterinary science has evolved such that advanced, comprehensive treatments are now available to treat a range of skin conditions.
Top pet dermatological issues
Our four-legged friends suffer from some of the same skin issues as we do — and several that we do not. The most common conditions we see at Angell include:
•Parasites, such as mites, fleas and mange (scabies)
•Infectious diseases, such as Staphylococcal pyoderma (“Staph”) skin infections, yeast and fungal infections and skin fold infections
•Systemic diseases, such as autoimmune diseases
•Skin cancer, such as Squamous cell carcinoma, cutaneous lymphoma, Mast cell tumors
•Allergies, such as flea allergy dermatitis, adverse food reactions, environmental allergies, etc.
All of these conditions can become serious and, if untreated, dramatically reduce quality of life. But the tremendous strides made in veterinary innovation, however, is very good news for our pets. Specifically, the testing and treatments for allergies now rivals human healthcare in its sophistication, quality of care and long-term health outcomes.
Unlike humans, dogs and cats cannot tell us about their dermatological health issues. So we as pet owners must look for the signs. The most common indicators that a pet is suffering from some kind of allergy involve frequent episodes of ear infections, red raised or open sores on the skin, constant licking or biting of paws or groin — sometimes causing wounds that will not go away.
Allergies present a particular challenge because there can be hundreds (even thousands) of potential allergens that impact pet health, from foods to pollen from grasses, weeds, trees, dust mites and more. Today’s specialty veterinary hospitals have access to the very latest diagnostic tests to get to the bottom of what’s ailing our pet. Among these tests is the Intra Dermal Test (IDT).
IDT is generally considered the gold standard of testing for identifying allergens that cause pets to suffer from chronic skin and/or ear diseases. IDT involves injections of a series of concentrated allergens into the skin to determine which of them generate allergic reactions in a given animal. The use of fluorescein — a chemical that illuminates the inflammation caused by the injected allergens in order to visualize the strength of individual reactions — is key to accurately diagnosing pet allergies, and is just one of the many ways veterinarians use new technologies to improve care and diagnostics.
The results of IDT (as well as a review of the pet’s medical history) can then inform comprehensive immunotherapy treatments to relieve suffering. Veterinary dermatologists rely on IDT to build customized treatment plans for patients called Allergen Specific Immuno Therapy or “ASIT” for short.
ASIT involves a series of injections specifically created for the allergic animal’s skin. These injections, of diluted allergens, are designed to make a pet less sensitive to their allergens over time. In most cases these injections must be continued for life to reduce symptoms, but they are highly effective. Seventy to 90 percent of pets experience a reduction in symptoms as a result of ASIT treatment. These treatments can be delivered even more easily via droplets under the tongue, perfect for pet owners who are squeamish about giving injections to their pet.
This treatment is very new to the North American field of medicine (both human and veterinary) and underscores just how far innovation in veterinary medicine has come.
When it’s time to see the vet
Many pet owners are understandably concerned about taking their animals to the veterinarian because the cost (to say nothing of the fear some animals experience when going do the doctor) may outweigh any perceived reduction in suffering. To help pet owners know when it’s time to bring Fido to the doctor I’ve compiled my “Top Ten” list of dermatological symptoms that should never be ignored:
•Intense itching of the skin (head shaking, running the face into the carpet, furniture, etc.)
•Biting at the skin that creates red, raw crusting areas of the skin
•Multiple ear infections (head shaking, odor from ears, scratching at the ears with hind legs)
•Paw licking or chewing and frequent infections of the skin in the webbed skin of the paws
•Staining of the fur of the paws and nails on multiple feet
•Reoccurring skin infections in the groin, under the shoulders, perianal areas (on or under the tail)
•Greasy scaling skin and/or fur with odorous skin
•Hair loss, or thinning of the fur
•Dark pigmentation of the skin that is chronically infected
•Sudden depigmentation of skin
Allergies and other dermatological issues can be as frustrating for pet owners and their veterinarians as they can be for pets. I encourage any pet owner whose animal is experiencing any of these symptoms to consult with their veterinarian.
Thanks anonymous. I had read what you have posted here in other people’s posts and it’s very helpful. I wanted to know how I could help my dog unrelated to drugs to maintain allergies as best as possible. I will take her to a dermatologist but in the mean time, instead of using Cortisone cream is there another natural anti-itch cream that can be used? Do people supplement with probiotics and salmon oil? Do people use those spot on treatments to help with the skin barrier? I’m hoping to find some natural alternatives to help her while we find a dermatologist and get to the bottom of this.
I believe most supplements and “natural” remedies are a scam. I tried various things…nothing worked. Do you really think I wanted to go to a specialist? I am glad I did, as nothing else worked for my dog.
BTW: ASIT (allergen specific immunotherapy) is the most natural treatment available for environmental allergies. No drugs involved. Of course steroids and antihistamine medications and frequent bathing with Malaseb (sometimes twice a week for my dog, even now) may be necessary from time to time to stop the suffering until the ASIT takes effect.
PS: I would not put anything topically on the dog unless prescribed by a veterinarian that has examined her/him, it could make things worse. We ended up at the emergency vet after I applied witch hazel to a rash.
Do not give over the counter meds to a dog unless approved by a veterinarian that has examined the dog.
Thank you so much, you’ve been really helpful anonymous. I’m just a bit cautious because I thought that my vet would suggest for my dog to take an antihistamine like Claritin or Benadryl first. Instead he prescribed Apoquel immediately so I feel that we didn’t try anything else to see what would have helped. I’ll make sure to talk to the dermatologist about ASIT.
Also, my dog went deaf after being prescribed Tri-Otic for her mild left ear infection back at the end of April so that’s why I’m so cautious. It took a few weeks for her hearing to return but thankfully it did return.
The over the counter stuff (Benadryl, Claritin) has a minimal effect (if any).
Obviously your dog’s condition is more serious, so the vet has to go with a prescription drug like Apoquel, some dogs do well on it, but long term I might be concerned about side effects, the same thing with steroids.
Without testing and identification of the allergens by a dermatologist, a veterinarian has no choice but to try band aid treatments to stop the symptoms in an attempt to keep the dog comfortable.
I would ask the vet for a referral to a specialist in your area.
Addendum: It must have been a severe ear infection for what you described to have happened.
I have used prescription ear drops (Tresaderm) on my dog for ear infection X 2 with good results and without any adverse effects.
The dog has not had an ear infection since starting ASIT 4 years ago.
I’ll give my vet a call and see who he recommends we see for a dermatologist. I also agree with you about not keeping dogs on Apoquel or steriods long term. My vet said he had his terrier on Apoquel for over 2 years… I’d rather not do that unless her allergies are really that severe. So far, her allergies don’t seem as bad as what I have read on this site.
Actually, my dog’s ear infection wasn’t severe at all. It was a fairly mild yeast/bacterial infection but another vet (my vet was on vacation) at the clinic prescribed Tri-Otic. My vet believes my dog was sensitive to that ingredient since they had other cases where dogs have gone deaf. The only thing that made me angry and so cautious was that they didn’t inform me of this side effect when putting the ear drops in. They also gave my dog a booster shot which was probably the worst thing they could do when the allergy season just started 🙁
I do a gentle ear cleaning with a mild solution once a week, that seems to help.
PS: I might try to avoid vaccinations for a dog that has a medical condition, especially if they are a senior.
Thanks for replying anonymous. Just curious which ear cleaning solution you use and if you do a full flush or just clean the pinna? My dog currently has TrizEDTA (the green/white bottle). I was thinking if her ear infection gets worse then I would try out Zymox drops since she seems sensitive to antibiotics with “-mycin” ingredients.
I use an old ear cleaner dispenser bottle and mix 1/2 witch hazel with 1/2 organic apple cider vinegar or water. I apply 1 or 2 drops per ear, I use a Q-tip to gently swab. Just once or twice till the Q-tip looks clean. The vets will advise you not to use a Q-tip as you could cause damage if you do it wrong, they will suggest cotton balls instead. Store leftover in fridg and discard after a few weeks and mix fresh.
This is only for routine weekly cleaning, not intended to treat infection. I would go by what your vet recommends if there is chronic infection. Prescription drops are needed to treat infection and inflammation. Usually antibiotic and steroidal (in my experience)
I would ask your vet what over the counter ear drops he recommends if prescription drops are not necessary. I would not use anything unless the vet approves, sometimes you can make things worse.
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