Is it allergies

[lori]

Not sure if we are dealing with allergies..My food will be 3 this month and has been licking biting at his butt/ tail for 1year. When it first started we told him to leave it and would stop him when we saw it, so it only occurs when we are not around. At night he sleeps in room with us and is fine. Problem occurs when we are not home or watching and then butt and underside of tail are soaked. Just finished a food trial and new flea med. with dermatologist but no change, so it doesn’t appear to be food or flea allergy. She is now recommending skin testing for environmental allergies. We have tried bitter apple spray and cones but even with that he still licks. Also using a medicated bath on that area from the dermatologist as it gets bumpy, scaly and red. She also said could do prednisone or Atopica. The skin testing is very costly and we would do it if  it would help, but not sure what to do. 

[Karen, Jasper and Jackdoodle]

Lori, if a veterinary dermatologist is recommending skin testing, I would follow that recommendation. 

Jack was tested in 2008 and diagnosed with Atopic Dermatitis, which is environmental allergies, also called seasonal or inhalant allergies, and is the 2nd most common type of allergy in dogs after flea allergies.  He tested positive for 13 different allergens. We started immunotherapy in January 2009 and I can tell you that it has been worth every penny. You would never know that he had allergies of any kind, I truly believe that he scratches less than most normal dogs, and this was a dog who did such damage to himself during a flare that his paws looked like pickled pig's feet: raw, red, infected, and completely stripped of all fur. He itched so bad that he couldn't stop moving: rubbing, licking, biting, scratching, it was heartbreaking to watch him. That never happens any more, ever.

Prednisone cannot be used for more than 4 months of the year without serious side effects, and Atopica is a very powerful immunosuppressant drug (cyclosporine is the generic) with some serious side effects, including an increased risk of cancer. The immunotherapy treatment on the other hand has few if any side effects. For me, there was no question that it was the best way to go.

We have a support group here on DK for owners of dogs with Atopic Dermatitis. Please join us, you can read about others experience with skin testing, too.

Has your dermatologist recommended any fatty acids or antihistamines? Those help some, but will not stop the itching when it's bad. 

I would follow the derm vet's advice, and I hope that you can find as much relief for your dog as I found for Jack.

I can also tell you that the cost of Atopica over the length of the treatment can easily be more than the cost for the testing. For a dog Jack's size, it would have run about $180/month. 

 

[lori]

Thanks for the information Karen. We have tried fatty acids and antihistamines but unfortunately they did not help. I sometimes wonder if it is allergies since he doesn't scratch when we are around but I guess the only way to know would be skin testing and then hopefully see some relief. I did not know that Atopica had such serious side effects. I appreciate your input and will look to join the support group.

[Karen, Jasper and Jackdoodle]

Yes, it's a biologic medication like the ones you see in those TV commercials for people with immune-mediated diseases like Crohn's disease and psoriatic or rheumatoid arthritis, and also used in organ transplant recipients to prevent organ rejection; it does that by suppressing the immune system. In about 30% of Atopic dogs, the immunotherapy is not successful enough and you do end up having to use immunosuppressant drugs, but Jack was in the 70% that do respond well and I hope your dog does too. 

I'll be honest, your dog's symptoms don't sound like Atopy to me, either, but if your dermatologist thinks otherwise, I would follow her advice. 

[lori]

 Do you think that trying the prednisone first might might make sense...to see if the butt/ tail licking stopped during that time? If it were itch, I would think the prednisone would help and he would go at it less where as if it were behavioral it would stay the same?  The problem is that the licking leads to infections and more itchiness so it is like a vicious cycle. I was thinking that maybe if there was a way to break the cycle. 

I was also thinking of getting an even bigger size cone. The one we are using is the right size but somehow he has figured a way to push it back just enough. 

[Karen, Jasper and Jackdoodle]

To me, using a cone to prevent an Atopic dog from licking or biting is cruel; it would be like tying the hands of a child with chicken pox to keep them from scratching. You're doing it for a good reason, to try to prevent the dog (child) from damaging his skin, but you must help stop the itching itself first. 

Prednisone would stop the itching very quickly if it's due to Atopy; but it won't cure anything, and as soon as you stop the prednisone, the itching and licking/biting will come right back. If will not break the cycle. It works by suppressing the immune system; no immune response, no itching. But once you discontinue the drug, the immune response comes right back, unless you're dealing with a seasonal flare, where by the time you stop the drug, the allergens (usually pollens) will be gone. It's typically used to get a dog through a flare which generally doesn't last more than a few weeks. You could talk to the dermatologist about using it as a test to see if it is behavioral, because if it is, the prednisone will not help at all. 

[lori]

Our reg vet did give him a shot once earlier last year and he did stop the licking temporarily for around 2 weeks. Will discuss your idea with the dermatologist to see if trying prednisone will help, or to see if it continues and is behavioral.

[Karen, Jasper and Jackdoodle]

For what it's worth, my vet once gave Jack a steroid shot when he was flaring and my dermatologist was out of town. It seemed to work great, but when we saw the dermatologist afterwards, she winced when I told her about the shot. She said to never, ever allow anyone to give him a steroid shot again unless it was an emergency. That shot is usually dexamethasone, which is almost 10 times more potent than prednisone and stays in the body much, much longer. You always want to use oral tablets and a tapered regimen (so much per day for x days, then reduce the dosage, then so much every other day for x days, etc)  if you need to use steroids.

[Lucy & AnnaBelle's Mom]

Karen is the resident expert, but a couple things that came to mind when I read your story was that I know when my Lucy is flaring no amount of my telling her to stop gets her to stop.  She will leave the room and go right back at it.  Also, have they checked his Anal glands?

[Ginny Nightingale]

That is what I was thinking--I have a doodle who licks her tail end quite a bit and it is her anal glands bothering her--it never gets to the point where she has any skin issues, but she does it quite often for about 10 minutes. 

[lori]

Yes..his glands have been checked by our reg vet and the dermatologist and no issues.