Fluffy and fit

Tags

allergies, hot spots, lick granulomas, pododermatitis, skin care, weight

I managed to get Bowdu onto a scale this week, and was shocked to find that he weighed in at…

28 August 2011

… 28.7 pounds. In other words, about 4 pounds less than his peak plumpness last year (33 pounds), and right at what I consider his ideal weight of 29 pounds, +/- 1 pound. I thought he’d been looking pretty good lately, but damn, I hadn’t realized just how fit he is. Fluffiness can be deceptive; I was still figuring his weight at over 30 pounds. In the above picture, I scrunched up a handful of fur on his hindquarters to indicate the thickness of his coat. You can also see his hotspot/lick granuloma on his front left leg, which is the worst it’s gotten all summer.

1 September 2011

12 September 2011. Flared up a little and got worse, but it’s going away again.

Compared to this time last year, the difference is pretty stark.

21 August 2010. His feet are oozy and bloody in a few places.

And again, another one from last year:

27 August 2010. His head is in a cone to keep him from mutilating himself.

It’s not just the effect of a better camera. It’s the result of better diet, better grooming, and more careful (and limited) medicine.

Allow me this moment to bask in feeling like a pretty good dog owner, as I haven’t always known what I’m doing in this regard. Right now, both Bows are in great shape, and I am flush with pride. And relief!

2 September 2011

Far from summer

Tags

allergies, canine atopic dermatitis, canine hypothyroidism, foot licking, pododermatitis

Old habits are hard to break. Bowdu still licks his feet occasionally, and I swear he’s learned to do it extra surreptitiously because he knows I don’t like it. But despite it all, his feet are looking really good now. Normal, I’d even say.

Photo taken 19 December 2010

And a front paw…

Compare this to just three months ago, when the briefest bout of licking would cause his pads to swell immediately:

Photo taken 25 September 2010. Back foot (don’t remember which one).

And just before he began his summer of imprisonment in the cone:

Photo taken 12 July 2010. After a longer bout of unapproved, furtive foot-licking.

Tonight, we are the furthest from summer that we can possibly be, and I’m actually grateful. The changing seasons have brought us reprieve, and we can finally sleep peacefully during these long, dark nights.

I hope this recovery is due to more than just changes in weather. I hope that everything we’ve done for his diet and dermal health and stabilizing his thyroid levels is contributing to a stronger overall immune system, because I’m afraid that eight months from now, this blog is going to turn once again into the chronicles of daily frustration that it was this preceding summer.

REVIEW: Various medicated shampoos and Bowdu’s feet

Tags

allergies, baths, canine atopic dermatitis, canine hypothyroidism, chattem, chlorhexidine, comfortis, dechra, dermapet, earthbath, eqyss, fleas, foot licking, greentree, grooming, ivermectin, ketoconozale, mal-a-ket, medicated shampoo, pododermatitis, selsun blue, septiderm-v, shampoo, space dogs, trichlocarban, triclocarban

Hey, I haven’t posted any updates on Bowdu’s feet in nearly a month! In this case, no news is good news.

Photos taken 31 October 2010

Yes, his feet are still blackened and calloused. The patch of fur on his thigh that was shaved for his blood draw (see above left picture), over three weeks ago, has barely grown back. I suppose I can blame his hypothyroidism for his prolonged healing times, but in other respects, he’s doing really well.

For the first time in months, Bowdu’s been sleeping cone-free. He’s been continuously cone-free for at least one week now, which is really monumental considering we started with this cone nonsense all the way back in July. We are so proud of him!

Both Bowdu and Bowpi are also now on Comfortis (spinosad), the oral flea medication recommended by our new vet. Despite my desire to find more natural flea preventatives, it was evident that we had too much to manage in our environment and lifestyle to risk even a few flea bites which would set Bowdu off. I double and triple-checked that it was safe to use with Ivermectin, since they’re both also on Heartgard. Assured in triplicate that both medications were safe to use together provided we remained well within proper dosing limits, we gave both dogs their flea meds two Sundays ago, and we haven’t seen a single flea on them after the second day of taking the medication.

Bowdu’s gnawing and itching hasn’t been completely eliminated yet, but I’d say he’s 90% there. In particular, his back thighs, his groin, and his muzzle still cause him to itch — I think from remnant flea bites and habit. The most important thing to me is that he is not fixating on his paws, and has more or less learned to leave them alone. I’m very paranoid about the possibility of a recurring infection, so we’re continuing to do what we can to manage his bacterial and fungal activity in the meantime.

One reason we switched to Comfortis was because it allowed us to bathe Bowdu more regularly, specifically his feet, as recommended by the vet. This is supposed to wash away any accumulated allergens and to prevent his natural flora from growing out of control, since his own immune system is unable to regulate efficiently. As I recalled from the article “Clinical Practice Guidelines from the International Task Force on Canine Atopic Dermatitis,” “There is currently no evidence of any benefit from using other shampoos or conditioners containing ingredients such as oatmeal, pramoxine, antihistamine, lipids or glucosteroids… Taken as a whole, these findings suggest that the benefit from bathing might lie primarily with the action of washing the pet.” To me, that meant It doesn’t really matter which shampoo you use, just as long as you regularly wash affected areas as recommended.

So we started Bowdu’s foot-washing regimen with some shampoos billed as natural or recommended by holistic pet stores — specifically Earthbath Green Tea Leaf and EQyss Micro-Tek Pet Shampoo.

Well, both of these aforementioned shampoos smelled lovely, but during the weeks that we were using these “gentle” shampoos, Bowdu still could not be trusted outside of his cone. I think I chose the wrong Earthbath product, since Green Tea Leaf was billed as being for preventative maintenance, not medication. Mediterranean Magic, with rosemary oil, is the one billed as having anti-fungal and anti-bacterial properties. At any rate, this goes to show that selection of shampoo does matter. I believe I misunderstood the initial “Clinical Guidelines,” which probably make a distinction between medicated shampoos as treatment for known conditions and preventative shampoos.

As for the EQyss Micro Tek pet shampoo, we didn’t give it much of a chance to prove itself. The active ingredient, Trichlocarban (sic) or rather Triclocarban 0.20%, has been reported in recent years to disrupt endocrine activity. Since Bowdu’s endocrine system is precisely what is the problem here (thyroxine, not testosterone, being the hormone of concern), we decided to discontinue use of this shampoo immediately. Too bad if their patent-pending formula is “developed from NASA research on the decontamination of astronauts,” as it claims on the packaging. We already know that many dog lives were lost in the name of the space race, so this association with spaceman technology does not impress me.

So we returned to Septiderm-V (original review here) for one bath, before turning to Selsun Blue (Selenium sulfide) for humans. This is apparently a classic recommendation for canine yeast infections, according to various online sources.

Only after the bath with Selsun Blue did Bowdu’s paws feel noticeably less crusty, and his desire to lick his paws almost immediately went away. Little did I know that the best solution was lurking at the human drugstore all along…

But for all its efficacy, Selsun Blue is still a human shampoo, with sulfates that I worry will overdry Bowdu’s paws (even though I got the moisturizing aloe formula). So for one final measure, I picked up a bottle of DermaPet’s Mal-A-Ket shampoo (with 1% ketoconazole, 2% chlorhexidene, 2% acetic acid). It seemed as successful as Selsun Blue in controlling Bowdu’s itchiness, though his skin felt smoother only with Selsun Blue. We’ll keep Mal-A-Ket on hand (and try to forgive them for bad product naming) as our alternate medicated shampoo as we continue on our twice-weekly foot bathing regimen.

---

In summary…

PRODUCT: Earthbath Green Tea Leaf shampoo
Volume: 16 fl. oz (472 mL)
Price paid: $16.99 from local Pet Store A
Packaging description: Preventative maintenance for healthy skin & coat
Ingredients: Purified water, renewable coconut-based natural cleansers, extracts of green tea leaf, ginger & Hawaiian awapuhi, aloe vera, vitamin E, olive oil squalene (preservative). All ingredients are natural, 100% biodegradable, and gentle on your pet & you. [Also designated animal cruelty free]
Company information: Earthbath, P.O. Box 411050, San Francisco, CA 94141
Final Grade: W [Withdrawn from review, not considered a "medicated" shampoo]

PRODUCT: EQyss Micro-Tek Pet Shampoo, Maximum Strength
Volume: 16 fl. oz (473 mL)
Price paid: $16.99 from local Pet Store D
Packaging description: “The fastest acting skin problem shampoo ever developed! May on contact neutralize any skin problems. MICRO-TEK Pet Shampoo contains our patent pending formula developed from NASA research on the decontamination of astronauts. Combines ingredients to create the healthiest environment for healing. [...] Stops biting, licking, and scratching; Neutralizes contact allergies; Neutralizes dry flaky skin conditions; Contains no soap or harsh detergents; Will not burn or hurt open wounds; Safe for puppies and kittens; Non-steroidal, Alcohol free; Reduces skin redness caused by irritation; Non-toxic – environmentally friendly”
Ingredients: Active ingredients – Trichlocarban 0.20%, Inactive ingredients: Deionized water, sodium laureth sulfate, cocamidopropyl betaine, cocamide DEA, polysorbate 20, Polysorbate 80, Polyquaternium 10, Allantoin, Sodium PCA, Glycosamino-glycans, Trichlocarban [again?], Aloe Vera, Extract of Clove, Thyme and Lavendar, DM Dm Hydantoin, Methylparaben, Tetrasodium EDTA, Citric Acid, Salt, Fragrance
Company information: EQyss Grooming Products, Inc., Carlsbad, CA 92013
Final Grade: C

PRODUCT: GreenTree Septiderm-V Skin Care Bath
Volume: 8 FL. OZ. (240 ml)
Price paid: $9.99 from local Pet Store B
Packaging description and ingredients: See original review from 18 August 2010
Final grade: B

PRODUCT: Mal-A-Ket shampoo
Volume: 8 Fl. Oz (237 mL)
Price Paid: $16.99 at local Pet Store E
Packaging description: Antiseptic, cleansing, medicated shampoo formulated for dogs, cats, and horses
Ingredients: Chlorhexidine Gluconate 2% w/w, Ketoconazole 1% w/w, 2% Acetic Acid in a shampoo base
Company information: DermaPet Inc., located in Potomac, MD, recently acquired by Dechra Veterinary Products (UK)
Final Grade: A-

PRODUCT: Selsun Blue Moisturizing Formula with Aloe
Volume: 11 Fl. Oz. (325 mL)
Price paid: $9.99 from Walgreen’s
Packaging description: For relief of flaking and itching due to dandruff and seborrheic dermatitis, and to help prevent their recurrence
Ingredients: Active ingredient – Selenium sulfide 1%, Inactive ingredients: water, ammonium lauryl sulfate, ammonium laureth sulfate, dihydrogenated tallow phthalic acid amide, sodium chloride, cocamide DEA, dimethicone, aloe barbadensis leaf juice, titanium dioxide, hydroxypropyl methylcellulose, sodium isostearoyl lactylate, DMDM hydantoin, fragrance, citric acid, sodium citrate, FD&C blue no. 1
Company information: Chattem, Inc.; P.O. Box 2219; Chattanooga, TN 37409
Final Grade: A

Pododermatitis

Tags

allergies, canine hypothyroidism, epsom salt, foot licking, foot soak, pododermatitis, soloxine

Two pictures above of Bowdu’s front left paw, post Epsom salt foot soak, after he was caught having chewed vigorously on them in the absence of human company and despite the cone. I kept the pictures small so as not to totally gross anyone out. It’s pretty distressing to me. It’s also bad enough that he’s limping and raising his foot when standing.

Above is the back left foot, which was holding steady and even decreasing in swelling some days. I noticed a recent abrasion on the pad, as of yesterday. At some point he did manage to reach his back feet, so I guess he did that to himself?

“Pododermatitis due to hypothyroidism may take a minimum of 6 weeks to show clinical improvement,” writes Stephen D. White, in a graphically illustrated article, “Pododermatitis” (Veterinary Dermatology 1989; 1: 9). There are some other recommendations about controlling pododermatitis if the cause is due to allergies, but nothing sounds very new or very promising. Keep in mind, also, that this article was written two decades ago and some recommendations may have changed (I have omitted some information, for example drugs which are not currently pushed, but some has been kept intact to remind me of what may have changed):

While prednisone or prednisolone (1 mg/kg once daily, then tapered to the lowest every other day dosage needed) is usually effective, occasionally antihistamines will give relief from clinical signs. The author uses diphenhydramine [Benadryl] (2.2 mg/kg three times daily), hydroxyzine hydrochloride [Atarax] (2.2 mg/kg three times daily), chlorpheniramine [Chlor-Trimeton] (0.2 to 0.8 mg/kg twice to three times daily) [...]

Recently, products containing essential fatty acids (EFA) (DermCaps: DVM; EfaVet: Efamol Vet [available in the UK]) have been used as non-steroidal antipruritics. These drugs apparently interfere with the production and metabolisation of arachidonic acid (a precursor of prostagladin E₂) and other “pro-inflammatory” substances.

In the author’s experience, approximately 20% of dogs with inhalant allergies show clinical improvement with antihistamine and/or EFA supplementation.

Cats and dogs with food allergies may be diagnosed by being placed on a “hypoallergenic” or limited allergen diet. [...] Alternately, the diet may be changed to some of the prescription diets available through veterinarians such as D/D or C/D (Hills Pet Products). However, the author has not found these prepared diets to be effective initial “hypoallergenic” diets. There are some pets which only tolerate a home-prepared protein and starch diet; in these cases a vitamin-mineral supplement should be added [...]

Contact allergy is probably uncommon as a cause of pedal dermatoses. [...] As a last resort, corticosteroids may be given to control pruritis if the allergen cannot be determined. (5-7)

As unwell as Bowdu’s feet appear, I take small comfort in the knowledge that it could be much, much worse, as documented in this source.

This is his sixth week on 0.2 mg of Soloxine, stuffed in a mini marshmallow and usually administered 1 hour before his breakfast and 3 hours after his dinner. Tomorrow, we get to find out how this little pink pill’s been doing its job. And we’ll see what the new vet can do for his feet…

So frustrated… !!!

Tags

allergies, canine hypothyroidism, drugs, foot licking, pododermatitis, temaril-p

I am so frustrated… SO FRUSTRATED!

I need to be more reserved in my cheery assessments of Bowdu’s progress. As soon as I think he’s getting better, everything turns again for the worse. For reference, here’s how he was doing a mere four days ago.

Here’s how he’s doing today:

He’s managed to get around his cone through sheer force. He chewed his foot bloody (the same one that I was saying looked sooo good) while I was lazily drinking my coffee in the front room and my boyfriend was in the shower. And now that his cone is slightly warped, it just makes it easier for him to reach his feet.

I dragged him into the tub for an Epsom salt foot soak and a half-bath with the medicated GreenTree shampoo (I just washed his paws, his neck, his pits, and his undersides, where he seems to be the most irritated). I took him out and dried him and massaged some lotion onto his sensitive parts and replaced the cone and he STILL wants to self-mutilate.

No more beef liver treats. No more beef at all, processed or raw.

Today, he took his last available dose of Temaril-P. He has taken 150 pills in total. Enough is enough. I really, really don’t want to give him anymore of those drugs.

We are going back to the vet. This will make the fifth visit for these ongoing problems. I am asking for a full thyroid test, because I want to rule out hypothyroidism once and for all. Not a single vet has raised this as a possible issue, but I want it done so I can stop wondering about it. I think I should ask for an allergy test too, something like the VARL Liquid Gold serum test. We’ve been discouraged from pursuing the full range of allergy tests the last couple times because the results could be, as I was told, “disappointing” since it’d most likely exhibit reactions to common household allergens like dust mites, pollen, and human dander. I think the vet was trying to be pragmatic. But putting Bowdu — and myself — out of misery with some kind of CONCRETE answers is worth a few hundred dollars to me.

I mean, if we’d just done this in the first place, we’d probably have saved the hundreds of dollars in mere consultation fees that we’ve already sunk into this ongoing problem.

It puts the lotion on its skin…

Tags

allergies, canine hypothyroidism, grooming, pet store B, pododermatitis, septiderm-v

Photos taken 23 July 2010

Some noticeable improvement in the dark spots on his front legs, the areas right underneath his muzzle, since we started making Bowdu wear the cone. We’re also letting him spend more and more time outside of his plastic prison, since it appears to be chafing his neck. We keep it on him very loosely — we don’t even have the collar buckled. But he was developing a distinctive funky odor about his head and large patches of fur have gone missing.

It’s not actually as noticeable as the picture above suggests, because Bowdu has a lot of fur. And this does coincide with his biannual coat blowing, so I’m thinking the heavy plastic collar just exacerbated his condition. I tossed him into the bath today for a rubdown with GreenTree Septiderm-V Skin Care Bath shampoo ($9.99 a bottle from Pet Store B), massaging it gently into his skin with my fingertips and knuckles. The stuff doesn’t seem to lather up nicely like human shampoo, but maybe that makes it easier to wash out — I just felt like I had to use a lot. It’s slightly medicated, and smells like it too, though it’s not altogether unpleasant. And it got rid of Bowdu’s neck odor and seemed to alleviate his itching for a bit, as intended.

I thought I did a good job bathing him on my own — normally my boyfriend handles the doggybaths. With Bowpi, we enjoyed a collective reward at the off-leash dog park. Then I swung by the pet store to pick up a small bottle of lotion from the same company ($5.99 at Store B) since the shampoo seemed to have helped so much.