Multiple Issues this Summer: Allergies?

[Nicole and Teddy]

Hi all! I've been following all the posts about allergies this summer with intense interest. This has been a really challenging summer for Teddy and I'm hoping for some advice on next steps. It seemed to start in May after a week long beach trip in Florida. Teddy ended up with hot spots, yeast between the toes, etc. The vet put him on a course of metronidazole as one of the spots was infected. Since then it's just been downhill. We live in South Carolina and Teddy has battled itching, licking, hot spots for the whole summer. I've tried fish oil, Benadryl, and vet prescribed Hydroxizine. In addition he's had one bacterial ear infection - for which the vet prescribed another course of metronidazole. Amazingly during the antibiotic rounds he hasn't really suffered from stomach issues. I've sporadically supplemented with Klaire probiotic powder. Teddy eats a homemade diet of mostly beef, rice, beans, veggies, and multiple vitamin supplements. Through all of the posts on here, I am fairly certain this isn't a food allergy issue because he's had good luck with this diet until this summer (he's 4 years old). However, about a week ago he did have a bout with diarrhea - for which, you guessed it, the vet prescribed another round of metronidazole. I only gave him 2 days worth of pills and took him off of it. This past week, he's vomited 3 times - mostly undigested food about 10 hours after eating.Normal energy level, eating, playful, drinking water, no diarrhea with the vomiting. And finally, he has anal gland issues. I don't know how it happened but, thinking I was helping, we began getting them expressed when he was a puppy and he's been pretty regularly getting them expressed once a month. Well, last month when he went in to get expressed, they ended up inflamed and on the verge of infection - for which, the vet prescribed metronidazole! He's had a normal expression between that bout and this week- 2 weeks later...and now he's back to incessant licking in that area - which tells me they are bothering him again. I just don't know what to do - i don't want to have them expressed because i know that can (and probably has) lead to all sorts of issues but we're headed into the weekend and I'm at a loss. I don't want him to be uncomfortable and I'm kind of losing confidence in my vet because her answer seems to be antibiotics for everything. However, I did call her for a referral to a dermatologist and am waiting to hear back. I also am speaking with a more holistic vet who agrees it may all be a case of allergies, but she's already mentioned starting with the M word for his anal gland issues. I've heard how expensive allergy testing can be so am also looking into this product: https://market.dogsnaturallymagazine.com/products/pet-wellness-pet-...

If anyone has any advice/experience, I sure would appreciate it. Thank you!

Nicole

[Karen, Jasper and Jackdoodle]

I cannot state strongly enough what a huge waste of time and money it would be to purchase the product you linked. It is 100% useless. There is no saliva, hair, or blood test that is at all accurate for diagnosing allergies. That's a proven fact. A veterinary dermatology specialist is absolutely your best bet. 
I would find a different GP vet as well. Metronidazole is a ridiculous and inappropriate choice of antibiotic to treat an ear infection!!! It shouldn;t even ever be used to treat diarrhea unless there is a reliable diagnosis of a particular digestive disease. I'm also shocked that a so-called "holistic" vet would prescribe it for the anal gland issues. Totally inappropriate.
Repeated and/or long term use of metronidazole will lead to a bacterial imbalance in the gut, chronic diarrhea, and often, neurological side effects. 
Who has been expressing his anal glands and how are they doing it? If they are not doing it internally, that's what is causing the problem. The anal glands must never be expressed from the outside. 
And chronic loose or soft stools contribute to the anal gland problem, because the soft stool is not putting enough pressure against the glands to empty them naturally when he defecates, which is the way it's supposed to happen. You need to clear up the loose stool with a different diet, and/or a better probiotic, and possibly some fiber supplements. 
I agree with you on this not being food related, but I'm wondering what the macronutrient percentages in his diet are? What percentage of his food is meat versus starch (rice) or vegetables? 
This diet also doesn;t contain any Omega 3 fatty acids, which are crucial for skin, coat and digestive issues. Fish oil is fine, but it must be given consistently. 
The most common age for allergies to show up in dogs is three years old, so this very well could be allergies. I think the dermatologist should be your first step in figuring all of this out. 

[Nicole and Teddy]

Thanks, Karen! I did a little research on that product and totally agree. Thought it would be the less expensive, easy route but I see there's a reason why it's less expensive! :) My normal vet gave me a referral for a derm so I'll be making an appointment asap. Teddy has always had his glands expressed internally and, turns out, today's episode had to do with more skin issues rather than the glands. I brought him in and they weren't very full but he has the makings of another hot spot near his tail. I am also hopeful that a good grooming (last one got cancelled due to hurricane evacuation - fun times!) will help out. I did get his diet through a former vet who is not a dietitian but has had her recipe vetted by a dietitian. He gets 2 Omega 3 supplements daily for a total of 600 g. However, I order them online and they sat in the sun for a while this last go around. I am now concerned they went bad and that's the reason behind this week's vomiting episodes.  His stool is usually on the firmer side- except for the diarrhea episode 2 weeks ago (Grandma giving too many treats is my hypothesis!). He does take a fiber supplement and I'm going to start being more consistent with pumpkin as well. I'm hopeful that with the grooming and the derm appt, we can get this under control. If they do find an allergy they treat with immunotherapy. Is this the only recourse and has anyone had experience with this or any other remedies?

[Karen, Jasper and Jackdoodle]

If you use a good fiber supplement (try Konsyl, or the generic version), you don;t need pumpkin. :)
Jack was on immunotherapy for allergies for many years, with excellent results. We have several others here whose dogs have also undergone allergy testing and are on immunotherapy, with varying results. The testing can help predict how successful immunotherapy will be for your individual dog, since certain types of allergies (those to mites, for example) respond better than other types; molds seem to be the worst in terms of successful immunotherapy response. Immunotherapy is by far the very safest treatment. All of the other effective treatments involve immunosuppressant drugs, like Atopica & Apoquel, which carry their own risks. Immunotherapy has no side effects, long term.

Compliemntary treatments include finding the right antihistamine, using a good Omega 3 supplement, and proper grooming. (Linda mentions Douxo shampoo below, which is excellent.) I have some tips in this discussion: https://doodlekisses.com/forum/topics/some-basic-facts-about?groupU...

From above discussion:

For temporary relief of inhalant allergies, here are some things that you can do:

Give Omega 3 fatty acid supplements. You want the Omega 3 fatty acids DHA & EPA, which are only found in fish. You can also give GLA in the form of evening primrose oil supplements. In both cases, use human softgel supplements. 

If you feed dry dog food, check the Omega 6:3 ratio. You want a ratio of 5:1 or less, the lower the better, and the Omega 3 content should come from fish.

Give antihistamines. Different antihistamines are more effective for different dogs. Typically, you want second generation antihistamines that do not cause drowsiness, like Claritin, Zyrtec, Atarax, etc. rather than Benadryl.

Use OTC anti-itch sprays on the affected areas. These are available at most pet supply stores.

Wipe the dog down every time he comes in from outside, paying particular attention to the feet. Brush the dog daily.

Keep the indoor areas where the dog spends the most time as clean and dust free as possible. Wash bedding weekly, wash food & water bowls daily. Vacuum as often as possible.

Keep dry foods in air-tight storage containers and don't buy more than you can use in a month unless you can freeze it. Discard the bags the food came in and use ziplock freezer bags. 

If the feet are affected, you can soak them in tepid water with epsom salts. Be sure to dry thoroughly afterwards.

Bathe the dog often, weekly if possible, with a shampoo formulated for allergic dogs. (I like Douxo Calm). Do NOT use leave-in conditioners or other grooming products. Use a cool dryer setting or air-dry. 

As much as I hate doing it, keeping windows closed really helps with pollen allergies. Run the A/C in warm weather especially, the allergy symptoms are exacerbated by humidity. Use a furnace filter with a high allergen rating and change it monthly. 

[Karen, Jasper and Jackdoodle]

Oh, and I have a private group here for dogs who have been diagnosed with Atopic Dermatitis. Ask to join and I'll approve your membership. We have a couple of members who are currently in the beginning stages of immunotherapy and reading their experiences might be helpful to you.
https://doodlekisses.com/group/atopicdermatitissupportgroup

[Karen, Jasper and Jackdoodle]

One more thing: They are not going to find "an allergy." If there are allergies, they are almost always multiple. We've never yet seen one dog who tested positive to just one thing. :) 

[Linda Yingling]

We have started seeing a dermatologist recently for the same issues.  She changed our food to a sensitive skin food, she feels it is not a food allergy.  She also recommended using duox brand shampoo on his hot spot prone legs 2 x a week to start. She uses topical antibiotics first. Our previous vet only prescribed metrodiazole for stomach issues. We will decide on skin testing in the near future, it is the most reliable. Since the change in food Cooper has had the most consistent stools of his life. Good luck and happy to hear about your dermatology appt. 

Linda

[Nancy, Ned, Clancy, and Charlie]

I am certainly impressed with the information you got here.  I don't think they've left anything out.  A friend has a doodle who  gets hot spots that need treatment.  She purchased doggie 'pajamas' that cover the areas her dog gets his hotspots. She has begun to put them on him when he needs NOT to chew himself so that the spot can heal.  He can still go potty while wearing them.

[Karen, Jasper and Jackdoodle]

Hopefully, your friend is also doing something to treat the hotspot and relieve the itching. Just preventing the dog from getting at the spot is not enough, and so unfair to the dog. Imagine having the worst, most intense itch you've ever had and someone ties your hands behide your back to prevent you from scratching it. No medication, no treatment, just preventing you from getting some relief from the itching. That's what I've seen some people do to their dogs. First priority is get the dog some relief. 

[Nancy, Ned, Clancy, and Charlie]

Of course, she has vet prescribed meds. The ‘pajamas’ are something relatively new in her bag of tricks, rather than a cone. She said her dog is so much more comfortable. She tells him if he wouldn’t chew, he’d be fine with no cone or pjs, but he doesn’t listen. LOL

[Nicole and Teddy]

Thanks so much for the advice and support, everyone! I will keep you posted. He threw up again this morning, so that's my main focus right now - figuring out what's causing that. Have I mentioned this summer has been a bear? :) Glad to have this site as a support/resource though, that's for sure!

[Karen, Jasper and Jackdoodle]

Nicole, if he's bringing up bile in the early morning, that's pretty common, and can be corrected by giving a small snack about an hour before bed. It can be a small portion of his dinner reserved for this, or a couple of biscuits, or some plain yogurt (I add berries, Jasper loves it!), or whatever you choose. 
The main thing that would be concerning would be if he is bringing up undigested food.

[Nicole and Teddy]

Yikes! Well, this morning was just bile but he's vomited 3-4 times this week, starting last Sunday afternoon. All times except this morning have been undigested. Except for last Sunday, all episodes have been early in the morning. I did some research and from what I understand it could be a reaction to something he's ingested. I don't think it's an obstruction as he's only throwing up in the morning and it's only been a few times this week, not everyday. Plus other than the throwing up (well, and itching, of course) he's totally himself- active, eating normally, etc. My plan was to feed him a bland diet for a few days and see how he does. If it continues, I'll bring him back to the vet. Also, during his diarrhea episode a few weeks ago she did do blood work and ruled out pancreatitis. Do you have other suggestions/concerns? Thank you!