Mr. Max's Issue(s)

Posted by: vio79

Mr. Max's Issue(s) - 02/17/10 10:01 PM

I know I promised I wouldn't start a thread until I had an update. But on the other board, someone mentioned in another person's "itchy dog" thread that maybe it could be change in climate. And I got to thinking - Max was shipped up here from Kentucky and the bad itching started in October.

Could there be any way his itchies are somewhat related to the cold, dry climate up here? I know that I'm super dry and somewhat itchy as a result, unless I slather myself in lotion. Anyway, a thought. Something to look out for as the weather gets warmer and muggier...

This is assuming he's no better by late spring on his current program.

thinking
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 02/18/10 01:17 AM

It's always possible.
Posted by: Braverhund

Re: Mr. Max's Issue(s) - 02/18/10 01:38 AM

Tracy, perhaps. I am sorry that I don't know all of your dear Max's story. I know itchyness is such a frustrating condition for us and for our GSDs. The worst I have dealt with was horrible frantic itching in my last GSD. It turned out to be the human joint supplements from Walmart that I gave my dog. The vet said those made for humans can make dogs terribly itchy sometimes, as the fillers needed to make them easy to swallo and hold their shape for people , well, those fillers can cause itchyness. Some dogs tolerate those fillers fine. Many others don't. Any chance he is on any human-type joint supplements or vitamins? Sending good thoughts for your Max!
Posted by: vio79

Re: Mr. Max's Issue(s) - 02/18/10 10:25 AM

Patti - I will try and summarize all 20+ pages from the other board:

The Problem - Max has been itchy since the beginning of October. (This, after a string of other issues since we adopted him last May plus elbow dysplasia in both front legs and arthritis in both knees.)

What we have tried:
- Ivermectin
- Temaril-P and Prednisone
- Hypoallergenic diet (Prescription Z/D)
- Raw diet
- Dermatologist
- Two weeks at the vet (Atopica, "sterile" environment, etc.)
- Thyroid panel and blood serum panel
- Comfortis
- Metacam
- Holistic vet

Now we're on prednisolone, adequan and the Natural Balance LID (venison & sweet potato) and plan to stick with it for next few weeks. If that doesn't work, we'll see. To answer your comment, we used to have him on a human Glucosamine supplement but stopped that since we're using Adequan.

Suggestions/Comments given over the past couple of months:
- Stem cell therapy
- Autoimmune issue?
- Vitamin E, Ester C, salmon oil
- Infamazyme
- Raw diet
- Preventic collar

That's just a really abbreviated summary and list of everything! I am not really giving enough credit to the people who have posted over and over to try and help me with my Max issues. They know how much I appreciate it! thanks
Posted by: kaisersmom

Re: Mr. Max's Issue(s) - 02/18/10 04:30 PM

This is going to sound really simple, but maybe it's worth a shot after all you've been through!!

Kaiser used to get itchy in the winter - not as bad as Max, but still itchy.

He sleeps in our bedroom and I had a cold last month and I've been using a humidifier/vaporizer at night. We also started putting a teaspoon of olive oil in his food back in November or December, and this year he has not had any troubles with itching at all!

So maybe getting a humidifier and/or a vaporizer and putting it in the room he spends the most time in might be something to try. And if he's not allergic to it, the olive oil might be helpful too - just a teaspoon is all we use.
Posted by: vio79

Re: Mr. Max's Issue(s) - 02/18/10 06:47 PM

Originally Posted By: kaisersmom
This is going to sound really simple, but maybe it's worth a shot after all you've been through!!

Kaiser used to get itchy in the winter - not as bad as Max, but still itchy.

He sleeps in our bedroom and I had a cold last month and I've been using a humidifier/vaporizer at night. We also started putting a teaspoon of olive oil in his food back in November or December, and this year he has not had any troubles with itching at all!

So maybe getting a humidifier and/or a vaporizer and putting it in the room he spends the most time in might be something to try. And if he's not allergic to it, the olive oil might be helpful too - just a teaspoon is all we use.


We have thought about that. The only issue is that our whole house is open concept, so there is no "room" he spends all his time in. We could try using one in our bedroom at night, like you do. Do you have one of those really fancy humidifiers? Because we have one already, but it's just one of the $20 Vicks ones from CVS. Not sure I want to invest hundreds in one of those fancy ones.

Could also try olive oil, though will probably hold off until we've kept him on this diet for a while. Though I read somewhere (maybe Give Your Dog a Bone?) that using opened oils, like what we use for cooking, isn't good for dogs because the oil has been exposed to air, or whatever. I also heard someone mention oregano oil.

Wouldn't it be nice if this all turns out to be a winter itchy thing??
Posted by: kaisersmom

Re: Mr. Max's Issue(s) - 02/19/10 09:28 AM

Quote:
Do you have one of those really fancy humidifiers?


Nope! Ours is one of those $20 Vicks-type things also! We do have a humidifier built into our furnace, but I don't think the thing has worked coorectly since we built the house 12 yrs ago and we might as well not even have it. Our house is pretty much an open concept also, so I understand how it would be difficult to pick a room to put it in - but if he sleeps in your bedroom most of the night like Kaiser does, it might work!

I had read in a magazine somehwere about the olive oil so we gave it a try - we use EVOO (Extra Virgin Olive Oil) - if it's good enough for Rachel Ray, it's good enough for Kaiser! smile I hadn't heard that about the open oils, but it seems to be working for us.

That would be great if Max's issues were just due to the winter itchies!!
Posted by: Woodreb

Re: Mr. Max's Issue(s) - 02/19/10 02:16 PM

Olive oil is mostly a mono-unsaturated oil so it is not very reactive and, therefore, much more stable after opening.

On the other hand, vegetable oil and most other oils have more poly-unsaturated oils in them (like omega-6 and omega-3 fatty acids). These are more reactive when exposed to air and/or heat.

I'm not sure about oregano oil.
Posted by: bjdimock

Re: Mr. Max's Issue(s) - 02/20/10 01:04 AM

Have you looked towards a behavioral problem? Could Max be having an anxiety problem?
I have 2 dogs in my house right now that present with odd behaviors.
Sika will sneeze when she is feeling stressed. (Sika is my 4th Fidelco foster pup who is trained to work in harness, but couldn't quite get over leaving home.) It's interesting to work with her now. She has learned how to guide a blind person with great skill, so walking with me can stress her out. If we come to a curb and I don't stop, she will. And then the sneezing starts.....
Fenna is my 5th foster and now a breed dog for Fidelco. Starting from week one when she is bred, she starts scratching. Her skin is beautiful, her coat is fantastic, and if I ever saw a flea in this house, I would drop dead.
It really seems to be connected to pregnancy only...
Have you tried a calming remedy yet?
Have your exercise, walk times, or general house behavior changed because of the cooler weather?
Posted by: vio79

Re: Mr. Max's Issue(s) - 02/27/10 03:08 PM

@bjdimock: Max could be suffering from anxiety, which is why we're trying to de-stress his life.



Anyway, Max has a UTI now. So he needs to be on Amoxicillin for the next three weeks. Poor dog can't get a break - it's one thing after another! And of course he showed no signs. We only found out because we saw blood in his urine today. But his urine has smelled weird for weeks now, so I really hope he hasn't been dealing with it for THAT long!!
teary

Still itchy but we decided to stop the Prednisolone and see how it goes. If he's still itchy once the weather gets warmer, we may have to try the prescription diet again and then add in one thing at a time.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 02/27/10 03:16 PM

Poor Max. I hope that he does well on the Amoxi and gets better quick!
Posted by: aubie

Re: Mr. Max's Issue(s) - 02/28/10 01:13 PM

Poor Max! Big ol' fella can't catch a break! Still pulling for him and you! hugging
Posted by: Wisc.Tiger_Val

Re: Mr. Max's Issue(s) - 02/28/10 01:57 PM

Just throwing this out, but I will be interested in seeing what Max does on the Amoxi, some times ABX will trick an Auto Immune problem into settling down.

On the Fildeco PG girl I would bet it is a difference in hormone levels that has her feeling tinglie or twitchie.

I am a big believer in what different levels of hormones do to dogs.

Val
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 02/28/10 05:10 PM

I was wondering the same thing Val.
Posted by: LJsMom

Re: Mr. Max's Issue(s) - 02/28/10 05:18 PM

Doxy clears up all of LJ's environmental allergy symptoms.
Posted by: vio79

Re: Mr. Max's Issue(s) - 02/28/10 05:43 PM

I was also wondering if the Amoxi would affect him at all. I'll let you know!
Posted by: aubie

Re: Mr. Max's Issue(s) - 03/01/10 01:09 PM

Here's hoping the amoxi helps! goodluck
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/02/10 08:08 AM

Argh, three weeks on the NB diet and his itching is still the same. I would think there would be some slight change.

I hope we're not wasting even more time with this NB diet, because I am going insane! Can't leave him unattended for even 30 seconds, or he'll chew himself raw. It happens that fast. I have to make him follow me wherever I go.

We got pure tea tree oil, so we'll dilute a bit with water and spray him with it. Hoping that will help.

[On a side note, I noticed he seems a lot more tired. Like when we get back from a walk, he'll plop right down on the basement floor, when he used to stay standing so we could dry his belly. Though on the walks themselves, he seems okay.]
Posted by: Braverhund

Re: Mr. Max's Issue(s) - 03/02/10 09:26 AM

May I ask how long the raw diet was for, and was it DIY or premade?

It isn't a cure-all for everything, but a very simple DIY (not a premade mix) limited ingredient raw diet (correctly balanced) may give his body what it needs to help right itself, if done longterm. Variety can be added later.

I am wishing relief for Max!

Edit to add-- it does sound like, with the non-stop scratching and tiredness, a histamine-like reaction. Dogs have other chemicals besides histamine circulating when things flare up. Therefore, sometimes Benadryl helps, sometimes not. Has the vet discussed it with you?
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/02/10 09:56 AM

Patti,

Benedryl didn't work for him. Not sure if it still wasn't strong enough. The tiredness has only been in the past week or so, maybe even less, whereas the itching has been going on since the beginning of October.

Our raw diet had been a combo of pre-made (Nature's Variety venison) and raw muscle meat (beef). I think we were only on it for a couple of weeks before the vet took him in. We could try simple raw, but I'd have no idea what to use. There really are no novel proteins left that would be affordable. Rabbit is all I can think of, but not sure if it's available raw, by itself.

Maybe turkey or duck? I don't even know if going back to poultry would be okay since we have no idea if he's even allergic to it. I just know chicken/turkey would be the easiest ones to get. Fish could also be a good one. Just that they're all so expensive. And I need something I can use in treat form, too for walks. I can get dried cod treats, venison jerky, lamb treats, etc. No idea on poultry.

What I do know is that when Max was started on Prescription Z/D diet, he seemed to improve. I know it's not great food, but maybe putting him on that and then slowly introducing other ingredients to see if he reacts is the way to go. Unless the Z/D diet no longer works! He was on Ivermectin and Prednisone at the same time....

Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/02/10 02:48 PM

I really dislike the thought of Z/D, BUT, you have to be practical about it.

If he improved on it, and if it can provide relief, then it might be a good option, while you slowly introduce other stuff.

You would have to be very discipline with how you added any other foods and supplements. It would be a very slow process, but perhaps the best way for you to ultimately find what he can tolerate for the long term.
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/02/10 03:14 PM

Originally Posted By: MaxaLisa
I really dislike the thought of Z/D, BUT, you have to be practical about it.

If he improved on it, and if it can provide relief, then it might be a good option, while you slowly introduce other stuff.

You would have to be very discipline with how you added any other foods and supplements. It would be a very slow process, but perhaps the best way for you to ultimately find what he can tolerate for the long term.


Yeah I am not a fan of Z/D either. Especially since I don't even know if he's allergic to any food or something else completely. I'm still going to keep him on NB for now and only switch to Z/D if he's still bad when warmer weather comes. I just wish SOMETHING would change!
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/04/10 12:11 PM

Max has been on the Amoxi for 4.5 days now. No improvement on itching. He's been on NB for just over three weeks now. No improvement. I would think after three weeks, we'd see some difference. I know everyone says he needs to be on the diet for 6-8 weeks, but I'm guessing he wouldn't magically wake up one day and be itch-free! Sprayed him with tea tree oil last night, and that didn't seem to help either. And of course his poops are annoying - he poops on almost every walk, and though they're solid for the most part, it's a lot of poop. Makes me wonder what he's actually absorbing into his system.

My husband wants to keep up the NB diet for at least another two weeks and see if there's an improvement. What do you guys think? We're almost out of the food, so I'll need to get more if we continue.

If we don't, I'm really at a loss on what to feed him. Do we give him home-cooked simple stuff, raw simple stuff, prescription diet? (As I said, his itching subsided on Z/D but he was on other meds at the same time and we saw results within days.) We could go back to fish and sweet potato only, but that's assuming he has an allergy to Flax or something that's currently in the NB food.

(Sweet Potatoes, Venison, Potato Protein, Canola Oil, Dicalcium Phosphate, Potato Fiber, Flaxseed, Natural Flavor, Calcium Carbonate, Sodium Chloride, Choline Chloride, Taurine, Natural Mixed Tocopherols, Vitamin E Supplement, Iron Proteinate, Zinc Proteinate, Copper Proteinate, Ferrous Sulfate, Zinc Sulfate, Copper Sulfate, Potassium Iodide, Thiamine Mononitrate (Vitamin B-1), Manganese Proteinate, Manganous Oxide, Ascorbic Acid, Vitamin A Supplement, Biotin, Calcium Pantothenate, Manganese Sulfate, Sodium Selenite, Pyridoxine Hydrochloride (Vitamin B-6), Vitamin B-12 Supplement, Riboflavin (Vitamin B-2), Vitamin D-3 Supplement, Folic Acid.)

And then of course I wonder if he'll improve with warmer weather.

Just tearing my hair out - it's so frustrating to have to get up from my desk every few minutes to get Max to stop itching/chewing or jangle keys to startle him out of what he's doing! I can't imagine how frustrating it is for Max as well.

Guess I'll take him to the cemetery for a walk, which will hopefully tire him out a bit.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/04/10 02:24 PM

I think I've posted before that I thought the NB food was the wrong food. When you switched to it, you noted that he got worse, he did better on the fish based food.

Remember, if you try the Z/D, feed only that with no other supplements, and then add stuff slowly, taking several weeks to note response. the first thing I would add in once on the food for awhile, would be a joint supplement.

Poor Max, I hope he at least enjoyed his walk!
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/04/10 02:24 PM

Update:

My vet called and suggested we start him on Z/D diet now, so that he has a few weeks to get it in his system before the weather gets warm. I guess that could be an option instead of keeping him o his current diet for another 3 weeks when it isn't working.

But I am so worried about Z/D, because of its ingredients and the fact that his poop came out smelling exactly like the food! And you think he's pooping a lot now! When he was on that food, he pooped a lot and it was loose.

What to do, what to do....
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/04/10 02:51 PM

Just for craps and giggles, I looked up the ingredients to some of the other food Max has been on since we got him. Seems like the ONLY ingredient they have in common w/NB venison & sweet potato (outside of vitamins and minerals) is, drumroll please...

Flax!

Even when we had him on whitefish and sweet potato, we were using the Wellness canned food, which had flax.

So this means if we do put him on the Z/D diet (which has no flax) and he improves like last time, I'm guessing he's got an allergy to flax. If he doesn't improve on Z/D, then I guess it means there is something else, either environmental or food. Though I don't know what food it could possibly be.

This revelation makes me think we should start Z/D asap. Chances are we'll have March and April before the weather gets warm, which would be plenty of time to see if the Z/D works. Especially since last time he was improving after a week.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/04/10 04:03 PM

It very well could be the flax.

This is one reason it's important to feed one thing through the trial.

If it is the flax, you will be able to fee that fish food ultimately, whether or not you do the trial with the Z/D. . .
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/04/10 04:21 PM

Originally Posted By: MaxaLisa
It very well could be the flax.

This is one reason it's important to feed one thing through the trial.

If it is the flax, you will be able to fee that fish food ultimately, whether or not you do the trial with the Z/D. . .


What fish food?
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/04/10 04:40 PM

The whitefish food, I don't remember what it was, the one without flax.

I do think the food change is better done sooner rather than later.
Posted by: LJsMom

Re: Mr. Max's Issue(s) - 03/04/10 05:07 PM

Orijen 6 Fresh Fish, California Natural Herring & Sweet Potato, and Wellness Simple Rice & Salmon don't have flax.
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/04/10 06:04 PM

Thanks Joanne.

Lisa, I think the whitefish food (canned) we were on had flax in it. Maybe dry didn't.

If we start the Z/D diet and it works, is it safe to try one of these foods, or should we err on the side of caution and only add one ingredient at a time? I mean the common denominator in all of these foods has been flax, but it doesn't mean I'm not overlooking something else. I tend to do that, it seems.

If after all of this, flax is the culprit, I will be both totally relieved and totally mad! To think of all the money we've spent, on vets and various foods, argh. And I know several people mentioned flax (along with barley) can be allergens. I'll be kicking myself as I'm dancing a jig. But don't want to jinx myself...could have been a fluke that the Z/D worked before.

[On a side note, if Max's original food had flax, but he was on it for 5 months before the bad itching started, it could still be the flax, right? I know dogs can develop allergies to ingredients they're over-exposed to - just wasn't sure how quickly they develop. Though he was itchy since we got him. It was just manageable in the beginning.]

I ramble when I'm excited!!!!
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/04/10 09:54 PM

Yes, they can develop those allergies over time.

I sure am hoping it's the flax at this point!
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/07/10 04:11 PM

Forgot how much I HATE this Z/D food. Day three and the diarrhea has started.

Can anyone recommend a good probiotic we can add without compromising the "hypoallergenic" diet? Last time Max was on this diet, vet had given us some junk in a tube, but it was super-expensive and didn't seem to work.

Thanks!
Posted by: ALLIE&ATHENA

Re: Mr. Max's Issue(s) - 03/07/10 05:49 PM

No advice on the runs since I have no experience with allergies but I wanted to wish you both luck on the new food.Lets hope he improves and it is the Flax in the foods.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/07/10 06:08 PM

I was under the impression that he did reasonably well on the food, you mentioned how much he improved on the Z/D? Changing to a food that gives him the runs doesn't sound good frown

I would just go to the health food store and pick up something with acidophilous, bifidus and bulgaricus in it. If it's the food though, I don't think a probiotic will help, which might be the reason why the vet stuff didn't help before?

Good luck with this!
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/07/10 08:52 PM

We may just have to deal with it for a while and hope it works. Then get him off the food as soon as realistically possible. Maybe the diarrhea will clear up on its own once he's used to the food.

On another note, Max scared the crap out of us today! We were in the yard hanging out (it was almost 50 today) and Max was stalking his favorite tree that chipmunks live in. Sometimes he tries to bite the tree where the holes are, and we normally just let him do it, because he chews a little and then loses interest. At some point we were in conversation and looking away, and suddenly heard this sharp crying. It was Max, and his mouth was stuck to a knob on the tree! The sound coming out of him was awful - it will haunt me for days. I jumped up and ran over, wondering what I would do...luckily, just as I got there, he managed to free himself. I checked his whole mouth right away and didn't see any damage. He was also prancing around and swinging his Jolly ball minutes later, so I'm assuming he's fine. Hoping his screaming was just him freaking out over being stuck. But man, what a scare. I won't be letting him near that tree anymore!!!
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/07/10 11:59 PM

How scary, tell Max that those trees are too big for him to try carrying around!
Posted by: LJsMom

Re: Mr. Max's Issue(s) - 03/10/10 07:19 AM

How is Mr. Max doing on the Z/D?
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/10/10 08:50 AM

Originally Posted By: LJsMom
How is Mr. Max doing on the Z/D?


Thanks for asking! smile

So far no change, except for his awful poops - it's day 6 of feeding. I think last time we did this, he'd started improving by now. But I'll be patient. Just frustrating to see himself clawing away at already-red spots on his body. We've been making him sleep in a t-shirt and socks so we could avoid using the muzzle. Seems to work, though we still have to stop him from chewing/licking in the night. He seems especially obsessed with his feet; not sure if it's because he has all the old sores on them, which are now blackish and hard.

Also he's limping again, in spite of the continued use of Adequan. So we got some buffered aspirin to try, because I really didn't want to use Metacam.

If this food doesn't work, no idea where we'll go next...
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/10/10 11:21 AM

If this food doesn't work, you go to that fish-based food with no flax.

You should see improvement by now.
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/10/10 03:44 PM

Originally Posted By: MaxaLisa
If this food doesn't work, you go to that fish-based food with no flax.

You should see improvement by now.


You think that Orijen fish that Joanne suggested would be fine, even though it has tons of stuff in it? I'll just be so bummed if this food doesn't work - since I thought it worked before and it has no flax. Yeah it does have starch and corn starch, which seems odd to me.

We'll finish up this food, and if there's no change, we'll try the Orijen fish.

His itching could be better, but it's taking a different form. He seems to be scratching more with his claws around his head (ears, face, neck). He still chews on other parts of his body, but not nearly as much. I'm afraid to even use the prong collar, because his neck is so red and irritated. And he's losing fur. And like I said, he still goes at "old" spots, which I wonder is somewhat psychological at this point.
Posted by: LJsMom

Re: Mr. Max's Issue(s) - 03/10/10 07:16 PM

I wouldn't go with the Orijen fish. My first choice would be the California Natural Herring & Sweet Potato. The Orijen is a great food - but it can be very hard to get, it's expensive, and it does have lots of stuff in it.

Can you post a picture of the blackish skin? Does it look like this:
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/10/10 08:36 PM

Hey Joanne,

I remember you mentioning the CA Natural before - my only concern is that it has barley and oatmeal in it, while the Orijen is completely free of ingredients like that but has lots of fruits and veggies (which I'm pretty sure he never got with his old owner). I can get it locally, but yeah, it's expensive. But it looks like you feed a lot less of it.

Anyway, here are a few pics of Max. I couldn't get all good shots of his skin, because he's curled up.

Here's his foot:


Close up of his heel:


A red spot on his chest:


His neck - not sure if you can see where he's losing fur and red:
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/10/10 09:16 PM

Originally Posted By: vio79

I remember you mentioning the CA Natural before - my only concern is that it has barley and oatmeal in it, while the Orijen is completely free of ingredients like that but has lots of fruits and veggies (which I'm pretty sure he never got with his old owner). I can get it locally, but yeah, it's expensive. But it looks like you feed a lot less of it.



Also, EVO Herring & Salmon or Wellness Simple Salmon & Rice could work. Obviously I'd prefer EVO or Orijen.
Posted by: ALLIE&ATHENA

Re: Mr. Max's Issue(s) - 03/10/10 09:34 PM

If you think any of it is habit or psychological maybe more steriods while on the new food w/o flax.Why I suggest this is because of my cat.She fractured her hip,it healed then a month or so after she was licking the fur off the area.It was red and raw from her obsession.We tried pain meds on case her hip was sore and she still licked it.After being on the pred with wearing a cone for like 2 weeks she stopped licking and it eventually healed.She is all better now.
Just a thought.I so hope he gets ALL better soon.Poor guy.
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/10/10 09:46 PM

Originally Posted By: ALLIE&ATHENA
If you think any of it is habit or psychological maybe more steriods while on the new food w/o flax.Why I suggest this is because of my cat.She fractured her hip,it healed then a month or so after she was licking the fur off the area.It was red and raw from her obsession.We tried pain meds on case her hip was sore and she still licked it.After being on the pred with wearing a cone for like 2 weeks she stopped licking and it eventually healed.She is all better now.
Just a thought.I so hope he gets ALL better soon.Poor guy.


It's a good thought, but I feel like we've done that before. Max has basically been on the cone/muzzle for 9 months straight. There was a stretch of 3 weeks after his tail healed from surgery when he actually didn't need anything. And then he went to training camp...

Our vet didn't want us to start giving him Pred every day (we were giving it every other day and it didn't work). And it's not all psychological, because he'll wake up from a dead sleep scratching other areas of his body. I just think he may be a little obsessed with his feet at this point, because he's had so many issues with them since we got him and may just be in the habit, like your cat was. If it were ONLY his feet, I'd totally try your method!!!

Thanks for the thoughts!
Posted by: LJsMom

Re: Mr. Max's Issue(s) - 03/11/10 09:03 AM

The Evo Herring & Salmon is out - it contains cottage cheese. If you can get the Orijen fish, I think it would be worth a try.
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/11/10 10:50 AM

Originally Posted By: LJsMom
The Evo Herring & Salmon is out - it contains cottage cheese. If you can get the Orijen fish, I think it would be worth a try.



Darn, I forgot about his supposed dairy allergy. I'm losing it.

The poor baby - last night he had pure diarrhea, and we could tell he was having trouble. He kept us up all last night with his itching. And he's pretty bad today too.

I'M LOSING IT.

We also gave him buffered aspirin this morning, because his limp seems to be getting worse. He bunny-hopped up the front stairs last night, which he never does. Course the aspirin has corn starch in it, but so does his food.

Really don't know what to do. I'm really discouraged. And all my husband and I do is argue now, because we're so tired and frustrated with Max.
Posted by: Tara

Re: Mr. Max's Issue(s) - 03/11/10 11:13 AM

Tracy, I'd like to applaud you for the enormous amount of care and compassion you have for your Max! I followed your thread for awhile on the other board, but lost track and am glad to see you here and that you are still perservering, despite an apparent lack of progress. I just went back and read all 28 pages of the original thread, and I know you are thinking food allergy and I hope the solution is that it was flax all along, because that is manageable, but I was wondering what protocol was followed for the two Ivermectin courses? And when the last time a skin scraping was done and was anything seen? One of the things my vet gets very annoyed with is how many times they see dogs with chronic skin issues who have been treated with ivermectin inappropriately. I know you had mentioned that it may have helped the first time but you saw no change the second time you tried it, but Ivermectin can take months to be effective. Also, mites are often really hard to find on skin scraping. With the amount of steroids he has been on, I wouldn't be surprised to see demodex at this point on a skin scraping. If I lived near you I would do it for you just to see and so you didn't have to deal with the vet again! Heck, you could mail me a sample and I'd take a look if you want. I've got access to a microscope.
Posted by: Woodreb

Re: Mr. Max's Issue(s) - 03/11/10 11:17 AM

At this point, could you try giving him a little pumpkin to help with the diarrhea? If he still has the itchies on this diet, it may not hurt.
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/11/10 11:32 AM

Thanks Kristin smile

I keep wondering if maybe it's still mange somehow, because it just seems too crazy to be a food allergy. And with the red spots and stuff - I don't know.

Anyway, the first time, I believe our vet scraped, found nothing, and did an injection to be safe. She might have done two rounds. My mind is fuzzy. Along with the injection, she also had Max on prednisone and Z/D food. When the itching cleared up within a week, she assumed it was NOT food.

But then the itching came back. They did a scraping and found nothing. So we put him on three weeks of oral Ivermectin, which didn't seem to have an effect.

I believe that's all the treatment we did. You would think by now we'd be itchy ourselves from mites, if that's what they are. I'm on the floor with Max all the time.

Maybe it's time to check out a new vet for a second opinion. I've gotten two recommendations for one in Bolton, about 40 minutes from me. It's been almost a month since I've been home with Max, so I'm thinking his issues are not stress-related.

Johanna - I was considering pumpkin for the diarrhea since we have some. I know probiotics didn't help in the past.
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/11/10 11:52 AM

Okay Joanne - I called Dr. Caviness's office and we have an appointment for next Monday at 10:30 a.m.

Please cross your fingers that he can help figure out what's wrong with Max!!!!!
Posted by: Tara

Re: Mr. Max's Issue(s) - 03/11/10 11:59 AM

You're welcome! And the offer is open to take a look, just PM me if you decide to and we can come up with a plan. When I worked at a vet, I did a lot of searching for and finding mites.

Originally Posted By: vio79
You would think by now we'd be itchy ourselves from mites, if that's what they are. I'm on the floor with Max all the time.


Not necessarily. There are two types of mange- demodectic mange and sarcoptic mange.

With demodectic mange, you would not be itchy at all. Demodex is a mite that is host-specific to an individual dog. All dogs have demodex mites, but in most cases their immune system suppresses them and prevents itchiness. In immune compromised dogs, demodex causes itchiness. Sometimes a stress event can be the first cause- it may be that staying at the training boot camp was stressful enough to set it off. It's most common in young dogs and usually resolves itself, but can be found in older dogs and can be very very difficult to treat. It may be that the dose of oral Ivermectin was just too low to see any improvement.

Sarcoptic mange is the highly contagious form of mange that I think most people think of when they think of "mange". And while you and your husband could pick up mites from Max, I'm not sure how itchy they would cause you to be. Humans are not a primary host for sarcoptes, so they don't proliferate or necessarily cause the massive amounts of itchiness that you see in Max. I think it would be more localized itching that resolved itself. Also, I know Max has some dog aggression issues, so I'm guessing he's not around any other dogs to have passed it on.

ETA: Good luck at your appointment on Monday! I hope that this new vet can help you figure out a successful plan of attack.
Posted by: aubie

Re: Mr. Max's Issue(s) - 03/11/10 11:59 AM

Fingers crossed for Mr. Max and his AWESOME owners!!! You guys are a true example of great owners who try everything for their pet...it's inspiring! Hugs to you all!!! hug
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/11/10 12:23 PM

Thanks Tiffany. I really hope we get resolution - I forget what life can be like with a healthy dog!!!

Kristin, thanks for that information. I always assumed it was sarcoptic mange, just because of what you said about demodectic, and that he could have picked it up when he was in NH for two weeks at training camp, since it was a kennel atmosphere. But, from what the holistic vet said and Max's other issues, he could very well have a compromised immune system, especially with all the steroids he's been on over the past several months.

At the appointment on Monday, I'll mention what you said and find out if it could be the cause. Don't worry about looking at a scraping for now - we'll see how the vet goes. Thank you for the offer!!

So Ivermectin could treat demodectic mange as well?
I would love to find out it's not a food allergy and get him back to a raw diet.

It's so funny how excited I get when another potential option/fix presents itself. (I was on cloud 9 when I thought it was flax.) I just hope that this time we get to the bottom of it and Max is healed! The poor poopy.

Five days to get through and then (hopefully) a vet who can help. And our regular vet has already faxed over Max's health records and vet's notes! When I called, she was like, "Are you still coming to us?" I told her yes, that we just wanted a second opinion because Max is no better than before. I would think they'd understand.

They also said we can give Max 1 to 2 buffered aspirin (325mg) twice a day with meals.


Posted by: Tara

Re: Mr. Max's Issue(s) - 03/11/10 12:48 PM

Yep, Ivermectin can be used to treat both types. If you used the Comfortis and the vet wants to do Ivermectin, make sure they know about the Comfortis. I think they are contraindicated.
Posted by: BowWowMeow

Re: Mr. Max's Issue(s) - 03/11/10 02:12 PM

First of all, contact skin allergies can look very nasty and red and bumpy and not be mange. I'm going through this with my gf's dog right now and I also went through it with Basu. This foam or spray works very well for her dog: http://www.google.com/products/catalog?q=hot+spot+foam+dogs&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&cid=7757694441727735682&ei=8zGZS7SsEsGttgfmvPC2CQ&sa=X&oi=product_catalog_result&ct=result&resnum=3&ved=0CBYQ8wIwAg#ps-sellers

Daily baths just to the affected area with an oatmeal/coconut shampoo with a few drops of tea tree oil added in helped immensely. She is also on Inflammzyme which is helping a lot too. And we put her on a raw diet. She's still got problems but she's doing much better.

PLEASE do NOT use ivermectin on Max for potential mange. His immune system is such a mess and it could wreak absolute havoc on him and cause far more long-lasting problems. Comfortis (an oral pesticide, of course) should not be used with Ivermectin. If Max were my dog I wouldn't be using Comfortis on him unless he had a very bad flea problem.

I treated Rafi's demodex holistically and had 100% success. Someone else treated his stray pit bull the same way and also had 100% success and the pittie had lost of all his hair.

Here is the information on treating mange holistically: http://www.germanshepherdhome.net/forum/ubbthreads.php?ubb=showflat&Number=8493#Post8493

Topical sprays and shampoos with NEEM (Azmira makes a spray and a shampoo) and an apple cider vinegar & water spray (homemade) really helped Rafi a lot.
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/11/10 02:20 PM

Thanks Ruth.

I am going to see what the vet says Monday. Bathing Max "just" on his spots would mean bathing his whole body every day, which just isn't realistic for us. Maybe the vet will have additional ways we can treat it holistically, since he's both traditional and alternative. He'll have access to all of Max's files and history so would hopefully take all of that into consideration before determining a path.

He's not currently on Comfortis.

The other issue is that we don't know if it's mange - that was just something our vet thought initially and that Kristin suggested we consider, since no diet change seems to be helping. (We also had him on holistic herbs for about two weeks without any change.)
Posted by: BowWowMeow

Re: Mr. Max's Issue(s) - 03/11/10 02:20 PM

Let me say again how wonderful I think you are for hanging in there with Max! I went through this with Basu and have spent the last year dealing with health problems in my senior animals (down to one senior now) so I understand how frustrating and emotionally exhausting it all is! hugging

Coming in with more holistic help for diarrhea:

[Basu had terrible digestive problems and I've had to deal with very bad diarrhea in all of my dogs at some point or another]

This stuff rocks--it never fails to stop diarrhea: http://www.homeopet.com/digestiveupsets.html

Many stores sell it, including PetCo, I think.

When Rafi has digestive issues I put him on Perfect Form by Honest Kitchen. It worked really well for him.

Since he can't have probiotics you might want to try L-Glutamine and Slippery Elm. Both are very healing for the gut.

Lots of good products here--read the reviews and the ingredients carefully: http://search.onlynaturalpet.com/search.aspx?avs|Health+Condition=Diarrhea&avs|Pet+Type=Dogs
Posted by: Tara

Re: Mr. Max's Issue(s) - 03/11/10 02:23 PM

Ruth, that's fantastic you were able to treat holistically. I'm very interested to read the thread you posted. No time at the moment, but I will take a look later.
Posted by: BowWowMeow

Re: Mr. Max's Issue(s) - 03/11/10 02:23 PM

Originally Posted By: vio79
Thanks Ruth.

I am going to see what the vet says Monday. Bathing Max "just" on his spots would mean bathing his whole body every day, which just isn't realistic for us. Maybe the vet will have additional ways we can treat it holistically, since he's both traditional and alternative. He'll have access to all of Max's files and history so would hopefully take all of that into consideration before determining a path.

He's not currently on Comfortis.

The other issue is that we don't know if it's mange - that was just something our vet thought initially and that Kristin suggested we consider, since no diet change seems to be helping. (We also had him on holistic herbs for about two weeks without any change.)



Basu also had problems all over his body and I did have to bathe him often for a while. It really did help. So did the sprays.

I hope the new vet can help. My gf has been around and around with vets and dermatologists and honestly we've had better results doing the research and treatment on our own. They had her on steroids which were doing nothing except destroying her liver and making her feel weird. Hope your experience is much better!
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/11/10 03:52 PM

I would certainly consider mange here, low dose a Preventic tick collar swhould help.

Vio, get him off this food *now*
Posted by: LJsMom

Re: Mr. Max's Issue(s) - 03/11/10 04:03 PM

I agree with Ruth about not using the ivermectin.

I'm another vote for getting Mr. Max off the Z/D now.

I'm happy that you are seeing Dr. Caviness. He came highly recommended by my regular vet. He is very compassionate and gentle, and doesn't assume that you have unlimited resources.
Posted by: BowWowMeow

Re: Mr. Max's Issue(s) - 03/11/10 04:12 PM

Why use the collar and risk skin irritation when he's already dealing with potential contact allergies?
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/11/10 04:37 PM

Ruth, I believe that there is a mite issue.
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/11/10 04:42 PM

Ack I don't know what to do!!! I appreciate the suggestions but it seems crazy to stop this Z/D food now after less than two weeks! We haven't even given it a chance to do anything (besides upset his belly).

I know you all mean well (believe me) but there are so many conflicting suggestions here and I just don't have the experience to know what's best.

We have NO way of bathing Max indoors - we'd have to get him to a groomer. Our faucets are weird and we can't hook up a hand-held device. And pouring buckets of water over him doesn't work at all. We tried doing it once, and it was a fiasco.

I would be worried about a Preventic collar, especially when Max's neck is so raw and irritated already.

Lisa and/or Joanne: can you explain why you think it's so necessary to get Max off Z/D now? I would tend to agree, but hubby and I decided we'd give it a chance to work. There must be a reason that everyone says a dog needs to be on the diet for 6-8 weeks. Not to mention, who knows what we could put him on. I'd go for Orijen 6 Fish, but that's assuming we can find it...I know local places have the brand but everyone's saying this specific food is hard to get right now.
Posted by: JeanKBBMMMAAN

Re: Mr. Max's Issue(s) - 03/11/10 04:51 PM

His skin isn't as oogy as I thought it would be. I was just reading about seborrhea http://www.vetmanual.org/mvm/index.jsp?cfile=htm/bc/73200.htm which seems so simple but when you read it is a lot more complex!
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/11/10 04:51 PM

Max has done nothing but decline since you put him on this food. Do not let an emotional attachment to it keep you from thinking logically about it. His digestive system is being demolished, not to add that now you have to add aspirin, which is insult to injury.
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/11/10 04:59 PM

Originally Posted By: MaxaLisa
Max has done nothing but decline since you put him on this food. Do not let an emotional attachment to it keep you from thinking logically about it. His digestive system is being demolished, not to add that now you have to add aspirin, which is insult to injury.


Believe me, I have no emotional attachment to this food. I hate what it's doing to him, and I hate the food itself now that I've educated myself on what good dog food really is (aka not dog food at all). I was just under the impression that we shouldn't change foods this quickly without giving it a chance. All I ever wanted was Max on a high-quality food, but his supposed food allergy has limited us.

So what I am reading is that after 7 days on this Z/D food, we should have seen some improvement in his skin? Not talking about his digestion, since that could be something totally unrelated.

[And let's not forget that SOMETHING impacted him last time around, whether it was the Ivermectin, Prednisone, or the Z/D food. His itching greatly improved after 5 days.]
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/11/10 05:07 PM

Originally Posted By: JeanKBBMMMAAN
His skin isn't as oogy as I thought it would be. I was just reading about seborrhea http://www.vetmanual.org/mvm/index.jsp?cfile=htm/bc/73200.htm which seems so simple but when you read it is a lot more complex!


Yikes, that is overwhelming.
Well, new vet will have all of Max's records so may can help deduce what it could be based on prior treatments.

Max's skin isn't oogy (well, no idea what oogy is, but whatever smile ). It's really dry and flaky, and where he chews it gets red but quickly becomes dried out and scabby. If we were to leave him unattended to lick/chew, he would undoubtedly create hotspots.
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/11/10 05:18 PM

Off to get Orijen 6 Fish now....
Posted by: BowWowMeow

Re: Mr. Max's Issue(s) - 03/11/10 05:29 PM

Tracy,

I understand about all of the conflicting advice from people and vets too. That's what happened the last time my cat Cleo got sick and it was overwhelming. As you know, changing one major thing at a time is the only way to figure out what's working or what is causing a new problem. Of course all you want is to help Max feel better so you want to try 6 new things (food, medication, etc.) at the same time but for now just try to do things one at a time, no matter what we are telling you. crazy

Since you can't do baths, I do think adding in a topical spray won't hurt and could help. Again, of all the stuff I've used recently the two that worked best were the Azmira NEEM spray and that hotspot stuff that I posted the link for.

Some things (like herbs and supplements) do take longer to work (even up to a 3 weeks) while other things you get an instant result.

Please don't throw anything at me but Orijen does not work for every dog b/c it's high protein and for some dogs that just doesn't work (like Rafi). Regarding the Z/D--my friend had her dog on it and saw results very quickly. She used it just to get him stabilized and then got him off of it and onto a better food. Like Max, her gsd was falling apart. He did end up with mange b/c his immune system was so depressed.
We came up with a homemade diet for her dog that worked as well as the Z/D for her skin and digestive issues and was much better nutritionally.

I see that Joanne has recommended this new vet and that's great. thumbup

Hang in there!!!!!!!!!!!!!!!!!!!
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/11/10 05:39 PM

Please do NOT hang in there with the Z/D though. While it may have helped other dogs, it is clearly not helping Max.

The only reason I supported the Z/D initially was because you said that he did well on it. If that were the case,I would still support it.

He is not doing well on it and is declining. There is not one ounce of logic to staying on this food. He soon developed loose stools and now diarrhea and needs aspirin. I would go back to the kibble you fed before that goofy holistic vet messed up the food. That was fish-based, no flax. If there's a better choice, fine, but the Z/D is a bad choice, and Max is getting worse by the day.

I would actually like to see you support the thyroid and the liver. Starting with the thyroid. If flax weren't a problem, I would recommend Canine Complete. I'm not convinced flax is the problem. But to be safe, I would just experiment with some kelp, small amounts, and see what happens.

This is not caused by food issues I'm sure, but the food will make it worse, which clearly you've seen. So it's either something like thyroid or mange. Thyroid can take a good 2 years before it shows in the bloodwork.
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/11/10 05:55 PM

Thanks Ruth and Lisa (and Joanne, etc).

Just got the Orijen 6 Fish and some fish treats. Lisa you're right about the fish but the food we were giving him did have Flax. I agree with what you're saying and will just start with the food and then see what the new vet says.

So I know you're supposed to "transition" foods, but do you think given his condition it would be safe to just move right to Orijen???!!!!
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/11/10 06:04 PM

I would just move straight to the new food.

Sorry, I thought the canned had flax and the other didn't. I don't keep track of the kibbles real well.

I know how incredibly frustrating this is, and seeing him constantly suffer just wears on your soul too.

I ran across someone on the PF list, describes everything you are going through with Max, and it took her years of testing the thyroid before it showed up on the tests. I know LJsMom had a similar experience. Jean Dodds is the one that said it's often a couple years before there is any clue on the bloodwork. That is the reason that I don't think we have yet eliminated the thyroid possibility.

I hope that this new vet has some answers for you and Max.

hugging
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/11/10 06:52 PM

Thanks more, all. smile I really, really, REALLY appreciate it!!

We'll start him on the Orijen tonight - Ruth, hoping that it will work for Max. It can't be any worse than the Z/D, haha. I'll also look into the topical spray you recommended (we have been using a tea tree oil spray).

Lisa, I can bring up the thyroid again with this other vet. I guess it could be worth paying to have another panel done, if they confirm they'll do it through hemopet.

Crossing my fingers for this vet!!!!!! crossedfingers
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/11/10 07:42 PM

Just collecting some facts in one place:

Thyroid
FREE T4-ed (ng/dL) = 1.7 (0.7 - 3.7)
FREE T4-ed (pmol/L) = 21.9 (9.0 - 47.4)
T4 = 1.3
cTSH = 0.05 (0.9 - 3.9)

Skin Biopsy (Marshfield Labs in WI):
No ectoparasites or fungal organisms seen. Flea bite hypersensitivity and food allergy, as well as atopy, are considerations.

Nelco Vet Allergy Panel Results
Weeds
Lamb's quarter = low positive
English plaintain = High positive
Ragweed mix = low positive
Rabbitbush = high positive

Trees
Willow = high positive
Hickory = high positive
Mulberry = low positive
box elder/maple = low positive

Molds
stemphyllum = high positive

Inhalent
house dust = high positive

Basic food panel
milk = high positive
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/11/10 07:42 PM

Any reason why you aren't using the Comfortis?
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/11/10 09:00 PM

Lisa, we did try it and his itching got worse, if anything. And since, at the time, we were trying not to give him additional proteins (and Comfortis has pork derivative) we opted not to continue it.

Thanks for putting those lab results into this thread. I think they were left behind on the other board. wink
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 03/11/10 10:05 PM

I remember you tried it, but I didn't know why you stopped it. Interesting that it might have made things work. My Max here can't handle pork stuff.
Posted by: BowWowMeow

Re: Mr. Max's Issue(s) - 03/11/10 10:41 PM

I didn't mean to keep on going with the Z/D if it's not working. I think I said that with food you usually see quick results? I saw something about herbs not working and just wanted to say that some things do take a while to build up in the system and work and not to start him on 6 new medications at once.

Btw, dust allergies are really difficult to get under control. I have terrible allergies to mold and dust and dust mites and so did Basu. The only thing that has helped me is a neti pot and Oreganol (oil of oregano). I also have wood floors, a special filter in my furnace and a vacuum cleaner with a Hepa filter. If dust touches my skin I break out in itchy red bumps.

Do you have wood floor or carpet in your home?
Posted by: vio79

Re: Mr. Max's Issue(s) - 03/12/10 08:14 AM

Ruth - we have all wood floors except for one room in the back of the house (and the basement). Max is not normally in any carpeted areas. We just started using a higher-quality air filter in the furnace.

Is Oregano oil for you or Basu? I know people have mentioned that oil of oregano can help dogs as well.

Anyway, for now we'll just stick with the new diet and see what the vet says Monday, before going and buying a whole bunch of stuff.
Posted by: vio79

New Plan of Attack - 03/15/10 02:47 PM

We just got back from the new vet, Dr. Caviness. He didn't tell us what we wanted to hear. He doesn't think it's mange at all (did two skin scrapings). He doesn't think it has anything to do with his thyroid. He thinks it's allergies.

So what we have to do now is put Max on a white potato ONLY diet for 4 weeks and see if things improve. He also gave us Betagen spray to help with his skin and also a homeopathic spray to put in his water, which should help him build a tolerance to house dust and mold. He wants us to bathe Max in the medicated shampoos we got from the derm at least once a week. Luckily, there is a self-grooming place about 20 minutes away from us. We'll try that this weekend. We have a follow-up appointment with him 4 weeks from now.

So yeah, more money wasted on Orijen, unless they have a 100% satisfaction guarantee as well. I'll have to check.

If this diet doesn't work, it may be the end of the road for us.
Posted by: LifeAsMe

Re: New Plan of Attack - 03/15/10 02:51 PM

Why white potato? Is that to clean out his system? Why not a meat? I"m just curious the reasoning behind not feeding any protein. Are you supplementing any vitamins and minerals?
Posted by: vio79

Re: New Plan of Attack - 03/15/10 04:22 PM

Max has tried almost every protein/diet there is. Just ask Lisa (MaxaLisa) and Joanne (LJ's Mom).

This vet considers Max an "extreme" case who needs the simplest diet. And he figured potatoes are simple. If those don't work, he'll have us try chick peas. He says Max will be fine without the vitamins/supplements for 4 weeks.
Posted by: Tara

Re: New Plan of Attack - 03/15/10 04:57 PM

I'm sorry it wasn't something simple! So Max is on white potatoes and topical meds only for four weeks, no oral meds?
Posted by: Natalie559

Re: New Plan of Attack - 03/15/10 05:35 PM

Hmm, never heard of a carb only elimination diet. Are white potatoes novel? Ever tried tofu? Did the vet mention how much potatoes to feed? I would think a great volume as they are only about 25 calories an oz cooked.
Posted by: vio79

Re: New Plan of Attack - 03/15/10 05:42 PM

Kristin - once he finishes his Amoxi, no more oral meds. But we have to finish the meds for his UTI.

Natalie - yeah it seems weird. Vet said double what he normally gets. I guess if he starts losing weight, we'll add more.

The vet asked about Max's history with Cefa caps. He asked if Max was on them around the two weeks when he had no itching. I said he may have been, since it was soon after his tail healed from surgery and he had been on Cefa caps. He said that he knows of dogs that take one of those a day and it almost eliminates the itching. Just another option to consider.
Posted by: Wisc.Tiger_Val

Re: New Plan of Attack - 03/15/10 10:19 PM

WOW I was hoping for good news with Mr. Max.

I am assuming that Cefa Caps are Cephalexin, if that is the case then I have also heard the same thing from my vet with the one a day. It either keeps the infection at bay or tricks the immune system, this is one of those last resort type treatments.
Posted by: MaxaLisa

Re: New Plan of Attack - 03/15/10 10:57 PM

Ugh, that diet sucks. If it helps, the diet may be harder on you than Max, at least temporarily. It's just tough to feed only that. I sure hope he wilol eat only that on an extended basis.

I guess you'll know in a week or two if it's going to help. Be careful not to add anything at all so that your effort on this minimal diet pays off.

I still wonder about the doxycycline/niacinamide protocol, sounds similar to what he's thinking with the Ceph.

Well crumb, I was so hoping for something better. This does make sense considering everything that has been tried. Very disappointed that there is no magic wand frown
Posted by: vio79

Re: New Plan of Attack - 03/16/10 08:23 AM

Lisa and Val, I agree.

And we're not off to a good start. Max didn't even want to finish his breakfast of potatoes this morning. I even added a little salt for flavor, and no go. His Amoxi is still sitting in the bowl with half the potatoes. I thought Max, of all dogs, would eat them, since he seems to love everything.

May have to try adding in chick peas and see if that helps. I'll call the vet this morning to see what he says.

This is not going to be a fun three weeks (don't think I can even manage this for four weeks).
feelingblue
Posted by: vio79

Re: New Plan of Attack - 03/16/10 08:35 AM

I think we're going to mix in the Orijen w/potatoes at least until he finishes his antibiotics and then maybe see about a potato/chick pea combo. Hoping he'll at least like chick peas! But I'll see what the vet says too.
Posted by: vio79

Got a call from our regular vet office... - 03/16/10 10:30 AM

Yesterday I sent our regular vet's office an email, letting them know what the plan was from this new vet.

They just called to let me know that our vet does NOT support this diet at all and thinks it's a bad idea. They also said that if Max gets any health issues (anemia is one they mentioned) due to this potato diet, that we'll need to address it with the new vet.

She's going to call me herself, later today, to discuss everything. Before then, I'm going to call the "new" vet when they open at 10 and let him know about the potatoes and ask again why he thinks potatoes and no protein at all are the way to go. At least adding in chick peas would be a protein!!

I had a feeling this would happen. You know last night I felt so sick trying to sleep, just thinking of what this all-carb diet may do to Max. If I were to follow my gut, I wouldn't be doing this diet. But then I also would have no idea how to address his skin.
Posted by: Wisc.Tiger_Val

Re: Got a call from our regular vet office... - 03/16/10 10:43 AM

You have to get the Amox into his system that is important.

Have you thought of doing homemade fish and potato. It could be something added to the food that is his problem and not the actual protein or carb source.

Sort of an example, I can take two kibbles with similar ingredients, Cheyenne will do fine with one and explosive diarrhea on the other. The protein and carb sources are the same so it has to be one of the other 100 things that get added in.
Posted by: vio79

Re: Got a call from our regular vet office... - 03/16/10 11:02 AM

Hi Val - yes, I am considering that. Just spoke with our vet, who is also going to speak with her friend the holistic vet and call me back tomorrow with suggestions on a protein source.

Anyway, she said we NEED to add a protein source. I was thinking fish, since it seems to be best for Max, but of course our vet thought it didn't work. Then again, she only tried him on that diet for under 2 weeks and Max got into other dog food at some point during that time. And when we did it for a prolonged time, we were also using Wellness canned food, which had flax and a number of other ingredients in it.

I also mentioned having him on an antibiotic, and she agreed that we could try that as a last resort. She mentioned some old one she used to use 20 years ago for dogs like Max...I didn't catch the name. Sounded like grease-something. She said if we did that long term, we'd need to probably supplement with probiotics. Wonder why she seems so against Cepha/Cefa caps or what's been mentioned here.

Now I need to call this other vet we saw yesterday...
Posted by: MaxaLisa

Re: Got a call from our regular vet office... - 03/16/10 05:22 PM

Vio, listen to this new vet. Your old vets have not solved the problem, do not add a protein to the potatoes. You might be able to get away with a shorter duration, but work with this new vet.

I agree with Val on adding fish to the potato, but first try the potato only see what happens, and go one ingredient at a time.

Every trial you have tried has been undermined in one way or another, do it right and carefully this time.
Posted by: LJsMom

Re: Got a call from our regular vet office... - 03/16/10 05:43 PM

Originally Posted By: vio79
Now I need to call this other vet we saw yesterday...


Do what did Dr. Caviness say?
Posted by: vio79

Re: Got a call from our regular vet office... - 03/16/10 05:45 PM

Lisa, I'd like to do that, but Max won't eat the potato by itself. I think adding a little white fish to the potato won't hurt (and will get him to eat his antibiotic). Max has NEVER been on a white potato and white fish diet throughout this whole mess. And I really don't want to alienate our primary vet, even if she couldn't figure out everything with Max. And, like you said before, Max seemed to be the least itchy when he was on the white fish and sweet potato diet, even with the canned Wellness.

We'll stick with potato with a bit of white fish, which will appease our primary vet and hopefully eliminate whatever has been causing Max's skin issues.
Posted by: vio79

Re: Got a call from our regular vet office... - 03/16/10 05:48 PM

Originally Posted By: LJsMom


Do what did Dr. Caviness say?


I didn't speak with him directly, but the receptionist (or someone) called back and said he really wants us to do potato only, and if Max doesn't like it to try and mix with his old food until we can gradually eliminate the old food. Then, at that point, we'd need to go an additional 4 weeks of just potato.

I just think if he'd actually gone through Max's records, which were sent last week, that he wouldn't be recommending 4 weeks of a starch diet. Maybe if Max were younger and smaller...

Instead of mixing in Orijen, which had all sorts of stuff in it, we'll mix in some white fish (as I mentioned in previous post). Not a lot, but enough to make the meals more appealing to Max.
Posted by: vio79

Argh - 03/17/10 10:54 PM

Going to do research now but figured I'd post in the meantime.

We fed Max his dinner (potatoes and a little cod and sardines) and he just threw it all up, three hours later. It basically came out exactly the same as it went down - chunks of potatoes and all.

Should I be concerned? The only times he's ever vomited, it was the yellow bile from hunger.

This is his 4th meal of fish and potatoes, so I wouldn't think it's due to the change, but what do I know??
Posted by: Wisc.Tiger_Val

Re: Argh - 03/17/10 11:05 PM

First I would mash the potato even add a little water to make them sloppy, then I would only add a little cod and no sardines. You want to make things as easy to digest as possible. The ABX is killing any good tummy bacteria. You might want to call your last Vet and ask about giving some Probioitics to get the tummy bacteria back.
Posted by: vio79

Re: Argh - 03/17/10 11:07 PM

Originally Posted By: Wisc.Tiger_Val
First I would mash the potato even add a little water to make them sloppy, then I would only add a little cod and no sardines. You want to make things as easy to digest as possible. The ABX is killing any good tummy bacteria. You might want to call your last Vet and ask about giving some Probioitics to get the tummy bacteria back.


K, thanks. smile Just wanted to be sure it wasn't something to be concerned about. I'm waiting for a call back from our vet anyway, so I'll bring it up when we chat.
Posted by: MaxaLisa

Re: Argh - 03/17/10 11:34 PM

Did you put him on Ceph? Indy vomits within 10 minutes of that, and I think the last time Max was on it will be the last time he is ever on it - he had a tough time in the end.

This whole process may also sensitize him to white potatoes and thus leave you with nothing for a trial. Yet another trial sabotaged.
Posted by: vio79

Re: Argh - 03/18/10 09:08 AM

Originally Posted By: MaxaLisa
Did you put him on Ceph? Indy vomits within 10 minutes of that, and I think the last time Max was on it will be the last time he is ever on it - he had a tough time in the end.

This whole process may also sensitize him to white potatoes and thus leave you with nothing for a trial. Yet another trial sabotaged.


No, Max is finishing up his Amoxi - he has two pills left. He's been on Ceph in the past and was fine. How could he become sensitive to white potatoes so quickly? He's only been eating them since Tuesday. I'm about ready to pull my hair out if this doesn't work...
Posted by: vio79

Re: Argh - 03/18/10 03:16 PM

So sorry to keep posting in the topic - you all must think I'm a head case right now.

I'm literally bawling from frustration. I just found a massive hotspot on Max's back... I have NO idea when he got it, since I pretty much sit next to him all day long so it doesn't happen. I did let him bite himself for about 10 seconds, because it pained me to watch him sit there with his hind leg twitching to scratch himself, but I don't think 10 seconds could have caused the damage I just found. I just had to shave a 6"x4" spot off his back. Just when he was finally looking almost normal, with most of his fur coming back in (save the few spots where he's scratched his fur thin).

This is killing me! I sincerely hope it's not as bad for him experiencing this as it is for me witnessing it, because I can hardly stand to just sit there as Max tries to rest but can't stop his hind leg from twitching (like they do when you find a ticklish spot). Not just that, but the vomiting, head shaking, etc.

Not sure how I'll be able to concentrate enough to do my ABC final exam: 80 multiple choice questions and 35 essay questions. UGH. At least I have 2 weeks to study and take it.

And please don't tell me how great I've been to Max. I feel like an utter failure and am not looking for sympathy right now. It's just after almost 11 months of misery with this dog, I really don't know anymore what's best for everyone here. I just need to vent!!!!!
Posted by: JeanKBBMMMAAN

Re: Argh - 03/18/10 06:45 PM

Was this last vet a dermatologist? I don't know who has the best derm group - Tuft's, UPenn, or Cornell. I was very happy with Cornell and wish I'd gone there earlier. Not saying you'd get the same great result but that's some sensitive skin. Did he ever have his IgA levels checked-would that tell anything I wonder? Get him on some immunoregulin or something. Geez poor dog.
Posted by: MaxaLisa

Re: Argh - 03/19/10 12:26 AM

Okay, it's clear that the potatoes aren't going to work.

You deserve a good cry, and I completely understand the feeling like a failure part. Dealing with a chronic painful and debilitating disease with my Max, I do understand. The crying will relieve some of the stress and eventually on the other end, you will be able to regroup.

You have not failed Max. The treatments have been a failure, but you have not failed Max.

Okay. Do you know if he can tolerate frozen green beans?

Have you ever had Max on pork? Are you a member of Costco?

Not sure if this is a good idea, just at the thinking point, but do you still have the Orijen, or has it been returned?

I'm thinking homecooked, no grains, no starches.
Posted by: vio79

Re: Argh - 03/19/10 08:20 AM

Jean: this last one wasn't a derm. Not sure I like the derm route. The one we went to just blew us off, said it was environmental allergies, and sold us $500 worth of meds, including Atopica. She didn't even want to do allergy testing because of a supposed heart murmur that nobody else could hear.

Lisa: I'll have to discuss your suggestion with the vet - I want to clear everything with her, just so we have someone to treat him. He's had green beans before and was fine, besides the ongoing itching. We've never fed him pork unless it was part of a commercial food (I know it was in Comfortis, of which we gave him one tab). The only other thing I can think of that may be bothering him is the homeopathic household dust and mold spray the latest vet told us to add to his water. He tested high positive to house dust on the blood serum test, so maybe that's making it worse? Since we started the new diet and adding the spray, his itching has been the worst I've seen it since we got him. I've decided to stop adding that spray to his water, due to his itchiness and the fact that he seems to be drinking less because of it. It may be a route to try once we solve the food allergies and get his immune system back on track.

This morning was his last Amoxi pill, thank goodness. And tomorrow we plan to drive 30 mins to the closest self-serve grooming place and give him a bath using the medicated shampoo and conditioner that the derm sold us. Might as well get something useful out of that...

Thank you for the continuous support and advice. Not only do I need it, but I appreciate it!!!!

thanks
Posted by: kaisersmom

Re: Argh - 03/19/10 11:16 AM

I heard something yesterday that I never thought of before. In humans, the histamine receptors are in our nose, which is why our allergies tend to cause sneezing, runny nose, itchy nose, etc. In dogs, their histamine receptors are in their skin, which is why in dogs, the same allergens cause itchy skin. Maybe everyone else already knew this, but I didn't realize that and thought it was interesting.

If Max tested so high on the dust allergy, maybe his food really isn't the culprit? I think I remember you saying that his itchiness got worse when you moved to the house you're in now. Maybe the type of dust in your new house is different from the old dust - if that makes any sense!! The environment is different, so maybe there is something in the house dust that is different and causing him to react more. Plus with spring coming, there are all sorts of outdoor allergens that might be having an effect also. Kaiser doesn't have allergies and even he has been itching more than normal since the snow melted.

Have they tried any antihistamine besides Benadryl? I just found this on another website about how some antihistamines work better than others depending on the dog:

"It can be very worthwhile to try at least three other types of antihistamine to see if one works better. It is normal to try several different antihistamines before a final selection. The one with some of the best results is Atarax. However, others find the best dog antihistamine to be Benadryl, Chlor-Trimeton, Tavist, or Seldane. As each dog responds differently, there is no way of knowing which one may be best for your dog."

http://dogallergiesindogs.blogspot.com/2009/04/antihistamine-for-dogs.html

Maybe for Max a different antihistamine might help?
Posted by: kaisersmom

Re: Argh - 03/19/10 11:35 AM

Here's another website basically saying the same thing:

Antihistamines
Antihistamines can be used with relative safety in dogs. About one third of owners report success with them. The major drawback, as with people, is sedation. Dr. Ackerman recommends that a minimum of three different types of antihistamines be tried before owners give up on this therapy. According to Dr. Johnson, the most common problem with this type of treatment is that owners give the drugs at doses that are too low. Check with your vet on correct dosing. Examples of antihistamines commonly used for dogs include: Tavist, Benadryl, Chlortrimeton, Atarax and Seldane. Personally, I have seen the best results with Atarax.


http://www.k9web.com/dog-faqs/medical/canine-allergies.html

I know you've probably been to every website out there, but just trying to find a solution for poor Max (and you!!)
Posted by: vio79

Re: Argh - 03/19/10 12:12 PM

Hi Pat,

Thanks for the tips. We've actually lived in the same house since we got Max. He grew up in KY before we adopted him, which is why I thought maybe the climate change was to blame. But it seems like he definitely took a turn for the worse once we started the homeopathic spray.

I think we need to stop the spray and give his current diet a chance before trying anything else like antihistamines or other antibiotics.

Our main problem this entire time has been trying too many things at once, therefore never knowing what was actually to blame (or what was helping).

If the diet doesn't help, I can def look into other antihistamines, though given his lack of reactivity at all to Benedryl, I don't have high hopes.
Posted by: vio79

Re: Argh - 03/19/10 12:22 PM

Any suggestions for how to make him calm down? He can't seem to sit still and is constantly trying to go at himself.

I have valerian root, but I hate to give him anything orally, just in case. The only way I can seem to keep him calm is to literally lay with him, cradling his head in my arms. I can't even pet him anywhere but his head, though, without triggering his itch-response. frown
Posted by: kaisersmom

Re: Argh - 03/19/10 01:00 PM

Any chance you could ask the vet to try the Atarax? I know you don't want to start mixing things before the diet change has a chance to work, but Max has got to be miserable. I'm just thinking of how I feel when I have an itch I can't reach, let alone a whole itchy body that I'm not allowed to scratch - I just feel so bad for Max!!

Maybe if the vet would consider the Atarax it would help with the itching and would calm him down also? I think if it were me, I'd give it a try even if the Benedryl didn't make a dent in the past -like the article said, different dogs react differently to the various antihistamines. To me it just seems that the food thing is going to take some time, but in the meantime he needs some sort of medication or something to take the edge off.

There's just got to be something out there to help him!

And thanks for correcting me about the moving to a new house - I couldn't remember the details!
Posted by: MaxaLisa

Re: Argh - 03/19/10 01:13 PM

Acupuncture.

I would prefer scullcap over valerian root, but you can try the valeian root.

The homeopthic remedy could be causing an aggravation. I can't tolerate the Lallergy mix for our region here for a similar reason.
Posted by: vio79

Re: Argh - 03/19/10 01:16 PM

No worries about the house - even I can't keep track of Max's stuff. Someone had to remind me to not feed him a commercial food with dairy in it!

I can give our vet a call later and see what she thinks (leaving shortly to take Max and meet DH at the park). I'd just hate to put something else into Max's system that could skew anything the diet does. Maybe Atarax comes in a liquid form without additives/binding agents.

Hoping the medicated bath tomorrow will give Max some relief.

Praying that without this stupid homeopathic spray in his water, Max will improve...

Oops just saw your post Lisa. You have mentioned skullcap before. Maybe it's worth a shot. Was hoping for something other than Acupuncture, since that would mean driving Max back to Bolton and paying God-knows-what. The new vet practices that but didn't even mention it as something for temporary relief - he said bathe 2x/week. We can manage once a week.

Posted by: kaisersmom

Re: Argh - 03/19/10 01:26 PM

I definitely don't know anything about acupuncture, but that too is worth a try! Lisa knows much more about it than I do - heck, probably everyone here knows more about it than I do - but here is a site with acupuncture vets who belong to the International Veterinary Acupuncture Society - and there are some in MA who make house calls!

http://www.ivas.org/Default.aspx?TabId=124
Posted by: Kris

Re: Argh - 03/19/10 01:32 PM

Quote:
Jean: this last one wasn't a derm. Not sure I like the derm route. The one we went to just blew us off, said it was environmental allergies, and sold us $500 worth of meds, including Atopica. She didn't even want to do allergy testing because of a supposed heart murmur that nobody else could hear.


Tracy, I know Jean mentioned several Veterinary Teaching Hospitals above and you replied that you weren't sure you wanted to go the derm route. There is a difference between a specialist in private practice and a Veterinary Teaching Hospital. Just from my own experience, I highly recommend Veterinary Teaching Hospitals. They deal with the most current of treatments. Yes, you are dealing with students, but in my experience, there was always a department head involved in the exams/treatment. Because they are learning, I think they often probe much deeper into a problem than a specialist who is in a normal practice. As an example, a specialist here in Denver recommended treatment for Murphy (recurring nodule on her nose) to the tune of $4,100 (and that was years ago). We went back to the Colorado State University Veterinary Teaching Hospital (they had already removed it once before) and they removed it again for less than $300.

I'm not going to remember everything exactly, but Noble GSD Rescue took in a dog with skin problems - he was actually darned near hairless. Anyone remember Apollo? The one thing I do remember is that after dealing with the problem for a long, long time, they finally took him to a specialist (and it may have been a Veterinary Teaching Hospital, but I just don't remember) and that's where they finally got him on a regimen that worked. The transformation after that was unbelievable. I doubt that he and Max have the same problem, but my only point is that Veterinary Teching Hospitals are the best of the best. I have found over the years that they aren't more expensive than regular vets and in the two cases where I have taken my dogs, the diagnosis was quick and the problems were resolved.

Just a suggestion because I can "hear" the frustration and don't have anything else to offer...

My vet is of the opinion that most allergies are environmental and not food related. It's particularly a problem in our dry Colorado weather. However, eliminating anything in a diet that makes the problem worse is still a major part of the treatment.
Posted by: shepnterrier

Re: Argh - 03/19/10 02:12 PM

If you take him to an allergist/immunologist at Tufts as Jean suggested, you might want to ask your regular vet for a referral. The specialist will then directly communicate with your regular vet, and they can discuss treatment plans among colleagues without involving you or having you as a go-between in case they disagree - an impossible position for a client and veterinary lay person to be in.

I agree with Kris' vet, and I posted about it in the 28 Max pp on the old forum – airborne and contact allergies seem to be underrated in importance as compared to foods as a source.

It may be cultural - human diet issues loom so large in the USA and everybody is so used to worrying about what they eat. In my home country, Germany, we tend to obsess about indoor air instead. A balanced approach would address all three possible sources.

As I mentioned in the earlier post some weeks ago, that his itching started in October could be related to the onset of the heating season. Air cleaners and humidifiers are essential for all allergy sufferers - I itch out of my mind if I don't use them constantly in every room. In the long run, the investment was worth it for quality of life and the opportunity costs of medical bills.

Sarah
Posted by: JeanKBBMMMAAN

Re: Argh - 03/19/10 02:21 PM

Kris - yes, thanks, that is what I wasn't saying in what I was trying to say. Or something! I would not take my dogs to a regular dermatologist, or almost any other specialty doctor, unless my vet office was able to assure me that they had many good referrals there. I would always go to a vet teaching hospital. They like a challenge, too!

When I had Nina and we went, he was able to tell just by looking that the pathologist had incorrectly identified Nina's issue from the biopsy. All this time we had gone in the exact opposite direction than we should have, and one look told him that. hammer Of course, the guy we saw wrote the book on dermatology. Literally! Then, later when she had cancer, and we couldn't figure it out, so many services saw her trying to diagnose her, which is another advantage, if he needs someone from say...endocrinology, they are right down the hall.

Do a little research (because you haven't done much of that already ;)rofl) and check out the faculty at all three teaching hospitals, google their names, see what you find, read the research they've done and publications and see what you find.
Posted by: shepnterrier

Re: Argh - 03/19/10 04:35 PM

We are fortunate to have two teaching hospitals in Eastern/ Central MA: Tufts in Grafton/ Worcester and Angell Memorial in Boston/ Jamaica Plain. Teaching hospitals compared to a private specialty practice: Couldn't agree more. Jean's suggestion to check out faculty bios and publications sounds great, too. In my experience, we did get to see the specialists right away, the interns observed and assisted.

GSRNE takes its dogs to Tufts and are full of praise - you can also post on the GSRNE membership email list for experiences with Tufts and Angell dermatologists/ allergists/ immunologists.

I personally have taken my animals to Angell b/c it's closer for me. My experience there: It's crucial to have a referral from the regular vet to get an appointment within a few days. If you don't have a referral, you might have to wait 2 or 3 months for an appointment at Angell. The specialist vets there have all been excellent.

Poor Max.

Sarah
Posted by: Kris

Re: Argh - 03/19/10 05:40 PM

Quote:
As I mentioned in the earlier post some weeks ago, that his itching started in October could be related to the onset of the heating season. Air cleaners and humidifiers are essential for all allergy sufferers - I itch out of my mind if I don't use them constantly in every room. In the long run, the investment was worth it for quality of life and the opportunity costs of medical bills.


You can get humidifiers that attach to a furnace. I have one cat who starts itching around October and doesn't stop until about April. He's miserable and pulls hair out of his back and scratches his ears until they are crusty. I don't like steroids, but he does get a depo medrol shot about every two months during this time. Nothing else, including oils, quality food, etc. have made any difference. We do routine bloodwork to make sure the steroids aren't negatively impacting him.

The rest of the year, he still scratches some, but not to the extent he does during the Oct-Apr timeframe. I'm convinced it's the air in the house when the furnace runs. It's dry in Colorado year round, so that's the only thing that changes during that time.
Posted by: vio79

Re: Argh - 03/19/10 05:41 PM

Thank you all for the additional suggestions. I'll definitely do some research NOW around Tufts. I can't keep holding a grudge against them for their treatment of my family dog, years ago. Plus, that wasn't the dermatology department. Tufts is way more convenient for us, since we're in Worcester. Course the hubby is reluctant to take Max to a teaching hospital, because he doesn't want Max to be a guinea pig. I don't blame him - my grandfather got stuck in a teaching hospital for the last three weeks of his life and the experience was awful. I know that may not be the norm, but we're just concerned about Max since he's been through so much already.

If Max's skin doesn't improve next week, I'll give a call to our primary vet and ask her about referring us to Tufts dermatology. (And about the diet and about Atarax.) I'm sure she'll do it - she feels awful about the fact that she couldn't figure out Max's issues. Though she did say Atopica won't work on dogs w/food allergies, and since it didn't work on Max when she tried it, she assumed it was food.

Sarah - you pointed me toward GSRNE on the other message board, right? Did you get my PM that they are totally ignoring me? I applied to join the Yahoo! group weeks ago and never got a response. Not sure if that's the same thing as the membership email list.

I really wish I had been more involved in this message board back when Max first started showing symptoms. This may have been resolved by now if I had -- we may have taken a different path.

Good news is that Max seems less itchy today. Though that could be my imagination. hammer
Posted by: vio79

Re: Argh - 03/19/10 05:44 PM

Originally Posted By: Kris

You can get humidifiers that attach to a furnace. I have one cat who starts itching around October and doesn't stop until about April. He's miserable and pulls hair out of his back and scratches his ears until they are crusty. I don't like steroids, but he does get a depo medrol shot about every two months during this time. Nothing else, including oils, quality food, etc. have made any difference. We do routine bloodwork to make sure the steroids aren't negatively impacting him.

The rest of the year, he still scratches some, but not to the extent he does during the Oct-Apr timeframe. I'm convinced it's the air in the house when the furnace runs. It's dry in Colorado year round, so that's the only thing that changes during that time.


Hey Kris - we do have a humidifier attached to our furnace. Though I have no idea if it works. I assume it does, because I hear it go off every so often. I think back when you (or someone) first suggested that, I went down and turned up the humidity to see if it made a difference. I didn't notice anything. As I said before, I'll be curious to see if he improves with the warmer weather. But then who knows if it's something else we're doing... headbang
Posted by: Kris

Re: Argh - 03/19/10 06:00 PM

We HAD a humidifier attached to our furnace, but my dear husband detached it. He says the humidity makes him not be able to breath...oh geesh... So I don't know how they're supposed to work when attached to a furnace.

When I had a really bad cold this winter, I slept with a humidifier in our bedroom and it made a huge difference not only for my cold, but my constantly itching skin this time of year. And guess what - he didn't suffocate from not being able to breath! hammer
Posted by: vio79

Re: Argh - 03/19/10 06:01 PM

I was looking through the Tufts site and didn't see anything about dermatology being one of their services.

http://www.tufts.edu/vet/fhsa/clinical_services/

http://www.tufts.edu/vet/fhsa/faculty/

Am I looking in the wrong spot? I also found this:

http://www.tufts.edu/med/about/programs/academicdepartments/dermatology.html

But I think that's not at Grafton. Suckage. Did not want to go into Boston.
Posted by: vio79

Re: Argh - 03/19/10 06:02 PM

Originally Posted By: Kris
We HAD a humidifier attached to our furnace, but my dear husband detached it. He says the humidity makes him not be able to breath...oh geesh... So I don't know how they're supposed to work when attached to a furnace.

When I had a really bad cold this winter, I slept with a humidifier in our bedroom and it made a huge difference not only for my cold, but my constantly itching skin this time of year. And guess what - he didn't suffocate from not being able to breath! hammer


LOL
We did try sleeping w/a humidifier in the room a while back - I didn't notice a difference at all, for any of us!
Posted by: Kris

Re: Argh - 03/19/10 06:33 PM

Here's the rest of my long winded reply...

I'll be anxious to see if the warmer weather helps also. Just the timing - October - makes me so suspicious that it's environmental and not food. Did you have any problems between when you got him and October?

It sounds like you had a bad experience with a veterinary teaching hospital. But years ago we had a dog with an advanced case of Pannus. They entered him into an experimental drug program at CSU and the results were amazing. Not only did the pannus never get worse, but it actually receded. So yes, he was a guinea pig in that particiular circumstance, but they would have immediately switched him to a traditional treatment had the experimental drug not work. I can only speak for CSU, but even if they tried something experimental, they still rely heavily on traditional, known treatments. I think where I've always been impressed is by the diagnostics. There's not much they haven't seen, whereas a traditional vet in private practice may not see it but once in a great while.

In the case of Murphy who I mentioned earlier, she had a nodule on her nose. CSU removed it the first time and had it checked by three different pathologists. That's not something that most veterinarians have access to. The second time they removed it - again they had it checked by three pathologists. We had an intern as a primary, but every move she made was carefully watched by the head of the oncology department. He was the most amazing man I've ever met in my life. Fortunately for us, it was benign, but just had a tendency to grow back. After the third removal, she just has a little bump there and we've never messed with it again.

Oh, and the specialist that I took her to before we went back to CSU – before even seeing an oncologist diagnosed it as cancer and then worked up a nice little bill for $4,100 for removal, reconstructive surgery, chemo, etc. etc. I went to them only because I thought it would be easier than driving to CSU, but I was so wrong! I’m just glad CSU had removed it the first time, or I might have been sucked into the specialist’s recommendation.
Posted by: vio79

Re: Argh - 03/19/10 08:01 PM

Originally Posted By: Kris
Here's the rest of my long winded reply...

I'll be anxious to see if the warmer weather helps also. Just the timing - October - makes me so suspicious that it's environmental and not food. Did you have any problems between when you got him and October?


It could be. But Atopica doesn't work on food and is supposed to work for environmental allergies, and Max's trial on it didn't make a difference. Then again, maybe the vet didn't give it enough of a chance to work.

Every vet (except for the derm) we saw thinks it is food allergies. He could have some environmental, since he's been somewhat itchy since we got him, but I'm thinking food could be causing the worst of it. We had his spring/summer allergies under control w/Temaril-P.

Anyway, we'll see what my vet says if Max doesn't improve. I really don't want Max to be experimented on by interns.
Posted by: Kris

Re: Argh - 03/19/10 08:10 PM

Quote:
I really don't want Max to be experimented on by interns.


Just wanted to clarify. Interns don't experiment on dogs in veterinary teaching hospitals. Every move they make is monitored by a senior veterinarian or a department head (who is a senior, senior veterinarian). Every one of our vets that we use went through the same program. Just wanted to try to put your mind at ease about that... smile
Posted by: MaxaLisa

Re: Argh - 03/19/10 08:14 PM

It is clear that there is a food component by the history. That does not mean that there is not an additional environmental component.

I really would try a green bean and pork diet, nothing else, nothing pre-processed. And then start building his system up in a controlled manner. I wouldn't see another vet until that has been tried, I wouldn't bother with another Derm *at this point*.

Vio, I can help you if you want to go this route.

I forgot, do you know anything either way about how he does on lamb?
Posted by: shepnterrier

Re: Argh - 03/20/10 10:46 AM

[quote=vio79]He tested high positive to house dust on the blood serum test. [/q

That shows that he does have environmental allergies. Air cleaners, humidifiers, HEPA furnace filter, HEPA vacuum cleaner significantly reduce the house dust in your indoor air. It's what I postd on the old forum Max thread.

He may very well have food allergies in addition but I would address everything that can give him relief. Reducing house dust load is good for everyone in the household, too.

Regarding humidifiers, I use the Venta. Yes, it's expensive, but you get what you pay for. It does not blow a stream of water droplets int the air - that can make the air too humid, enabling mold growth. With a rotating drum made of lamellae it provides a large surface of water to evaporate. The evaporation rate decreases as the air becomes more saturated, thus keeping the saturation rate at a comfortable and healthy level.

Sarah
Posted by: shepnterrier

Re: Mr. Max's Issue(s) - 03/20/10 11:07 AM

Originally Posted By: vio79

We have NO way of bathing Max indoors - we'd have to get him to a groomer. Our faucets are weird and we can't hook up a hand-held device. And pouring buckets of water over him doesn't work at all. We tried doing it once, and it was a fiasco


If a standard sized hand held device doesn't connect to your shower, you can try to get a connector/adapter piece from a really good hardware store. Costs very little. I'd take off the shower head and take it to the store so they can find you the fitting.
If the hardware store doesn't carry it, they should refer you to a contractor store that carries all plumbing supplies.

The shower head in my house was so badly stuck that I couldn't remove it, although I am handy for a lay person. I had to call a plumber and they struggled too but they succeeded. To the pros! Plumber's visit cost me about 120 bucks or so, well worth it, as I now have my handheld.

Add a sink sieve (1 $ or so) if you don't already have one, to collect the fur and prevent it from clogging the pipe.

If you can bathe him twice a week at home, it will be so much easier and less expensive for you than driving him to a 'Laundromutt'.

As several members already posted, bathing gives them tremendous relief from the perpetual itching.

I had an itching foster dog and he hopped into the tub in eager anticipation!

Sarah
Posted by: JeanKBBMMMAAN

Re: Argh - 03/20/10 11:08 AM

Originally Posted By: Kris
Quote:
I really don't want Max to be experimented on by interns.


Just wanted to clarify. Interns don't experiment on dogs in veterinary teaching hospitals. Every move they make is monitored by a senior veterinarian or a department head (who is a senior, senior veterinarian). Every one of our vets that we use went through the same program. Just wanted to try to put your mind at ease about that... smile


Yeah, I've never seen a doctor at Cornell where there wasn't a supervising physician and then any variety of students, who generally did the interview, an exam, and then the doctor comes in, they report the interview to them (with me interjecting like an annoying control freak) and then the dog gets another exam, which I like, they generally get 3 sets of eyes, at least, in one exam. Then more, when needed if they think, oh, maybe the neuro should do a little check here, or whoever.

On this other stuff, I like shortcuts. I don't like futzing. I want to know what I am doing, then I will futz. How I find out what I am doing is by going wherever I need to, to find out what is going on with the dog. I have developed more of a battering ram approach since I got sick myself, and found that some doctors are okay with futzing around when it's not them who is sick. So I push and push (with a smile and happy attitude) until I get to the place where I know what is wrong. Even if the diagnosis is something you can't do much with, you know what you can do.

I will try to figure out the Tuft's derm thing - that is confusing. I know UPenn has a well known derm staff, I believe they are the ones who started the whole niacinimide (or however it is spelled) treatment, and the Cornell docs are among the first to ever realize that dog skin and human skin share disease processes.


Posted by: vio79

Re: Argh - 03/20/10 02:45 PM

Took Max to the groomer's this morning - luckily, we were just leaving as the first dogs started coming in. Max does NOT like getting bathed. He behaved well but was upset the entire time.

We didn't realize how bad his skin was until we shampooed and blow-dried him. Holy cow, his skin is FULL of red splotches and even darker spots where he must have drawn blood. No wonder he can't sit still. It's been about 4 hours since the bath, and he seems no better. We even took him outside and sprayed him with a hot spot and itch relief spray (no meds in it), which also hasn't had an impact.

This boiled potato and fish diet had better work.

As for the air, could be dust, but I would think he would have shown signs of it earlier on than October. Our heat was probably on by mid-September. Buying filters and humidifiers will be a last resort, because without my income we really can't afford to keep buying stuff in hopes it helps Max. I hate to say it, but it does come down to money. We're already $10,000+ in on him between trying different things, vets, medications, surgery, and standard dog care stuff. I try not to think about how that could have been a vacation...or more buffer for my unemployment. Okay, heartless rant over. smile

Last night was awful - constant scratching. I'll have nightmares of that sound, long after it's gone. Even socks on his feet don't seem to help curb the damage he's doing.
Posted by: MaxaLisa

Re: Argh - 03/20/10 03:52 PM

Originally Posted By: MaxaLisa
It is clear that there is a food component by the history. That does not mean that there is not an additional environmental component.

I really would try a green bean and pork diet, nothing else, nothing pre-processed. And then start building his system up in a controlled manner. I wouldn't see another vet until that has been tried, I wouldn't bother with another Derm *at this point*.

Vio, I can help you if you want to go this route.

I forgot, do you know anything either way about how he does on lamb?


Just so folks know, after a couple of pm's, Tracy is going to stick with the current diet to give it a fair shake, since she has stopped the allergy spray.



Tracy,

It could have been the spray. On the flip side, both grains and starches can contribute to itching.

What you have not yet tried, is a grain free, very low starch, high protein diet. Then add a bit of kelp just to see what that might do to the thyroid. Then he also needs some additional, carefully chosen nutrients, to help fight the environmental stuff.

I hope that the potato diet works, but if it doesn't, there is a huge option that you have not yet done.
Posted by: vio79

Re: Argh - 03/20/10 03:58 PM

Originally Posted By: MaxaLisa

Tracy,

It could have been the spray. On the flip side, both grains and starches can contribute to itching.

What you have not yet tried, is a grain free, very low starch, high protein diet. Then add a bit of kelp just to see what that might do to the thyroid. Then he also needs some additional, carefully chosen nutrients, to help fight the environmental stuff.

I hope that the potato diet works, but if it doesn't, there is a huge option that you have not yet done.


Yes, we'll give this a bit longer, and if that doesn't work, we'll switch to green beans and a protein. Question is, which protein? Lisa you suggested pork. What about buffalo? I think one of these brands (Bravo, Primal) must do plain buffalo. Just want to be sure we don't choose a protein that he could be allergic to. We could continue the fish as well, I guess, unless he's allergic to that as well. I obviously prefer a protein that's less expensive and easy to obtain, and fish fits the bill fairly well. Exotic meat not so much. But it may be worth it in the short-term, just to see.
Posted by: MaxaLisa

Re: Argh - 03/20/10 04:33 PM

I would try something that is not pre-packaged, that you cook at home, which you can control the ingredients. Later, if that works, way down the road once the skin is healed, you can do a trial with either he Bravo or Primal.

Nothing canned, fresh or frozen.

Costco carries lean pork at a good price (Indy's protein), and lamb at a good price for lamb (it's expensive, but of course that's what Max tolerates; I buy it by the case there). I don't think I"ve mentioned lately, but I hate cooking lamb.....if your Max is doing well on the fish, you could try that. I think the potatoes are probably more trouble than the fish, but it could be both in the long run.

The important things are no grain, no added starch, and everything prepared from scratch, nothing processed. In fact, in the beginning, I might even feed several days of only the protein, I'm not sure - that would be to see how he reacts just to the protein.

I don't understand where green beans fit with cross-reacting with environmental allergies. Max actually does best with steamed celery and bell peppers (the latter are anti-inflammatories, though in some individuals can flair arthritis). That unfortunately, is a lot of chopping that I often don't have time for, even with a food processor. But the majority of dogs seem to tolerate the green beans. In bulk, they are the cheapest at Sam's club here, though there are a few other warehouse grocery stores that carry them cheaper.

As a complete side rant, if the government really wanted to help the nation's health and obesity problem, they would stop subsidizing corn products and make vegetables and fruits less expensive!
Posted by: shepnterrier

Re: Argh - 03/20/10 05:35 PM

Hi Tracy,

Tufts Vet School has a dermatologist, Dr Lowell Ackerman, i just did a quick search on the Tufts page:
http://www.tufts.edu/vet/facpages/ackerman_l.html

I have not consulted him but he sounds like the right kind of specialist to me. Again, I recommend getting a referral from your regular vet. An urgent referral as this dog is really suffering. And his owners with him.

Fingers crossed for all three of you!!!
Sarah
Posted by: shepnterrier

Re: Argh - 03/20/10 05:41 PM

Here is the veterinary dermatologist at Angell in Boston, Dr Kathy Tater:

http://www.mspca.org/vet-services/angell-boston/dermatology/boston-dematology-meet-the-team.html

Looks like she also teaches dermatology at Tufts, like Dr Ackerman. That doesn't mean she also practices in the Tufts outpatient clinic though.
Posted by: shepnterrier

Re: Argh - 03/20/10 06:11 PM

I've posted on the GSRNE email list and asked for recommendations for dermatologists in your area, especially @ Tufts and Angell. If you PM me your email address, Tracy, I'll be happy to fwd all responses to you.

[Removed by Wisc.Tiger, contact the OP is you want instructions to join their paid email list]

Sarah

Posted by: MaxaLisa

Re: Argh - 03/20/10 06:38 PM

I have a feeling that Vio79 isn't going to be seeing a Derm just yet....
Posted by: MaxaLisa

Re: Argh - 03/20/10 10:18 PM

Vio79, I think you should consider this product for Max's environmental allergy issues: http://www.iherb.com/Now-Foods-Bioflavonoid-Caps-with-Ascorbic-Acid-and-Rutin-250-Capsules/440?at=0
Posted by: shepnterrier

Re: Argh - 03/20/10 10:36 PM

If there is a heart problem, I take them to a cardiologist.
If there is a skin problem, I take them to a dermatologist.
The skin is an organ, like the heart.
Just my two cents.

I hope Max and everyone who cares about him will get a good night's sleep!
Posted by: MaxaLisa

Re: Argh - 03/20/10 10:45 PM

And that makes complete sense, about seeing the specialist. I just have the sense that Vio isn't ready to see another vet, even a skin specialist, but I can't speak for her.

Vio, I have heard good things about this new vet that you have seen. While the diet that he used isn't the one that I would have used, I typically don"t hold that stuff against a vet, because about none of them would do what I would do. The new vet went with a single source ingredient, which makes sense. The fact that it's potato, well, at least he was thinking out of the box.



I did hold the diet against the last vet, since what she did really went against past experience with Max, and she upped to a more complicated diet, not something optimal in this situation.

I really do wonder what the new vet would say if you told him you were wondering about treating Max with acupuncture.
Posted by: vio79

Re: Argh - 03/21/10 08:47 AM

Well we're definitely stopping the potatoes and NOW. Last night was our worst night yet - Max was clawing at himself all night.

Lisa, you must have read my mind about Dr. Caviness, because I was about to come on here and swear him up and down. It's hard NOT to blame him, since Max's skin has escalated to a point I have never seen since we started the potatoes. Even the woman at the grooming place told us we should see him. When I told her he's the one who recommended an all-potato diet, she was shocked.

We'll stick with fish for now, since we just got so much of it. If he doesn't improve off the potatoes, then we'll have to switch up the protein too. No idea why he'd be allergic to starch....but I guess it's in so much stuff.

How did the last vet make his diet more complicated? I think Dr. Doolittle, the holistic vet, was the one who was complicating things. Dr. Trom (our primary vet) just recommended white fish and sweet potato. Ideally home cooked but said Wellness canned would work if we didn't want to home cook. Apparently she worked with a holistic vet friend for that diet suggestion. I knew her strong suit wasn't diet/allergies.

Anyway, whatever. I'm so tired/pissed right now, I can't even think.

NO MORE *BLEEPING* POTATOES
Posted by: vio79

Re: Argh - 03/21/10 10:07 AM

Originally Posted By: MaxaLisa
As a complete side rant, if the government really wanted to help the nation's health and obesity problem, they would stop subsidizing corn products and make vegetables and fruits less expensive!


Forgot to respond to this before. I feel the same way. Been getting into the whole organic/local sustainable thing and reading Michael Pollan. It's totally true, that the government supposedly wants us to eat more fruits/veggies (the whole food pyramid thing) yet pays all these subsidies to the industrial farmers to grow genetically-modified corn and soy to feed animals that should be grazing on grass and make crap like high fructose corn syrup.

I think that's what depresses me the most. You can't trust ANYTHING or ANYONE anymore. The government, which is supposed to be looking out for our well being, is really all about the bottom line like everyone else.
Posted by: MaxaLisa

Re: Argh - 03/21/10 02:15 PM

I love Michael Pollan. Years ago he had an investigative article where he bought a steer and followed it from birth to slaughter - very illuminating, that was the first thing of his I had ever read.

About the diet, I was thinking Dr. Doolitle, which I thought was the last "new" vet. I can't keep 'em straight, sorry!

I honestly didn't think the potato diet was going to work, but that's one reason I wanted to go all potato, per suggestion, so it didn't ruin the fish too - sometimes you can create a sensitivity by feeding it with a food that they are sensitive to, if that makes sense. I really do think grain free, low starch has to be the goal.

Let's hope that just fish works. If you can find a safe protein, then that's a huge first step.
Posted by: vio79

Re: Argh - 03/21/10 02:51 PM

Originally Posted By: MaxaLisa
I love Michael Pollan. Years ago he had an investigative article where he bought a steer and followed it from birth to slaughter - very illuminating, that was the first thing of his I had ever read.



Yeah, he discusses that steer story in The Omnivore's Dilemma (which I'm reading now). So sad. frown

I'm going to try and find that supplement you suggested. Whole Foods has the brand but not that specific one. I'll try Living Earth next - they are known for their vitamins and supplements. Worst case, we have Ester C we could give him to boost his immune system.
Posted by: MaxaLisa

Re: Argh - 03/21/10 03:17 PM

It's important that he have the bioflavanoids, which also contain quercitin. I recommended that particular product because I know from experience that it helps with environmental allergies.

You can always order that product online at that link. If you substitute, it's important to look for a bioflavanoid product, not just a C. Notice in that product that I linked, it has a small amount of C, compared to the bioflavanoids. I would recommend *not* starting a product that only contains C. You want one that is primarily a mix of bioflavanoids.
Posted by: vio79

Re: Argh - 03/21/10 03:33 PM

I found Quercetin capsules, which should also do the trick. Then I can just supplement with a bit of C if I want to. This has fewer mg of bioflavonoids per capsule than what you suggested, but it's a good way to work up...

Just baked cod for Max...smells so good, I'm jealous!!!
Posted by: MaxaLisa

Re: Argh - 03/21/10 03:52 PM

Is it quercitin capsules, or a bioflavanoid mix?
Posted by: vio79

Re: Argh - 03/21/10 03:59 PM

Quercetin capsules.
Posted by: MaxaLisa

Re: Argh - 03/21/10 04:04 PM

They won't do the same thing as a complete bioflavanoid supplement, which is why I linked that particular one.

The quercitin will act as a natural antihistamine, but I would recommend that you start with what you have, the quercitin and a bit of the ester C, and then order the ones that I linked for the long run. Try only one quercitin per day. When you get the ones that I linked, eventually you want to give one in the am and one in the pm, but you can give one in the am, and finish the quercitin by giving one in the pm.
Posted by: vio79

Re: Argh - 03/21/10 04:18 PM

Sounds good. The Living Earth said they would order them for me, so when I get about halfway through the Quercetin, I'll give them a call. Thanks!
Posted by: MaxaLisa

Re: Argh - 03/21/10 04:28 PM

I would recommend starting it sooner than that.
Posted by: Wisc.Tiger_Val

Re: Argh - 03/21/10 04:32 PM

Lisa, I understand about starting the supplements, but I would go a few days with the fish only diet.

Makes changes one at a time.

Val
Posted by: MaxaLisa

Re: Argh - 03/21/10 04:37 PM

I don't completely disagree with you Val.

I'm just trying to get Vio to stick with the right supplement when she does add it. By making all sorts of changes, it's not helping at all.

I believe that adding that one supplement will help.

Vio, Val has a good point. Since we can't seem to get the supplement straightened out, just stick with the fish right now and see what happens.
Posted by: MaxaLisa

Re: Argh - 03/21/10 11:07 PM

Vio, a blog you might be interested in, if you haven't already seen it, she regularly takes the food industy to task: http://www.foodpolitics.com/2010/03/michelle-obama-to-grocery-manufacturers-lets-move/
Posted by: LJsMom

Re: Argh - 03/23/10 07:42 PM

Tracy, How is Mr. Max? Hoping for some good news!
Posted by: GSDTrain

Re: Argh - 03/23/10 08:35 PM

yes, hoping for some good news!
Posted by: vio79

Re: Argh - 03/23/10 09:13 PM

Thank you for asking, but there's nothing really to report. He's been on green beans and fish since Sunday night and has not improved much, that I can tell.

My vet's office called and said they're happy to put him on an antihistamine or antibiotics if we want. Just let them know. Though they didn't like the idea of doxycycline/niamacide, or whatever that was. They were okay with tetracycline but thought the others had too many side effects. They were fine with Cepha caps and seemed to prefer that. I can't remember the antihistamine they mentioned, but it wasn't Atarax. Guessing it was something over the counter, because they told me how many mg to give him (I think 50 mg). I want to hold off for a couple days, just to see if the food makes a difference. We'll also bathe him this weekend again with the medicated shampoo.

I also noticed he's got worse eye boogies. He never had them before - now he's getting yellow gunk in his left eye.
Posted by: MaxaLisa

Re: Argh - 03/23/10 09:31 PM

Did you do fish only for several days? I'm wondering if the eye stuff is the green beans - usually they should be safe, but you know these dogs named Max frown

If you decide to use an antihistamine, the quercitin will act as an antihistamine, and too much will do the same thing as too much antihistamine, so treat it the same that you would a drug, though it is more healthy than the drugs.

Before you decide on an antibiotic, a question. Does any part of his skin look like it is blistering?
Posted by: vio79

Re: Argh - 03/24/10 08:30 AM

Lisa - none of his skin looks like it's blistering. It's mostly just red splotches and then scabs where he managed to break skin.

I guess once we start the quercetin, we'll see what happens. Though sounds like antibiotic would be the way to go in that case, so we're not overloading him with antihistamines.

Will mention that Max does seem to be sleeping through the night better. Not as much scratching himself. Unless I'm just so tired I sleep through it. wink
Posted by: MaxaLisa

Re: Argh - 03/24/10 12:00 PM

If you have a hint of improvement (please, oh please, oh please, let there be improvement), I would not yet change a thing and give the diet a longer chance by itself. (Other than the baths of course!)

This is deep in his system, so while I though wuick improvement might be seen, it would make more sense probably if it were slow.

Antihistamines or antibiotic, depends on the cause which woulod be better. Is the quercitin capsules of tablets?
Posted by: vio79

Re: Argh - 03/24/10 12:41 PM

They are capsules, so we'll dump the contents onto his food, when we start.

Yeah I mean it's really hard to tell if there's improvement. He seems a little better right now, just sitting here next to me. But 5 minutes ago he went at his tail when I was in the bathroom (45 seconds, tops) and now it's all red. I sprayed it with Betagen and hope I don't have to shave the spot. I'll keep an eye on it. Just goes to show how quick he is and that we literally need to be with him all the time - or muzzle/cone him when we're not. We're starting to wonder if it's partially psychological; since he's been doing it for so long, it almost seems OCD-like behavior (or CCD in the dog world, I guess). We'll stop him from chewing one spot, and he'll immediately start sniffing around for a new one. I really wish he was into chewing nylabones and stuff like that, but he's not.

If only I could go back in time and NOT have taken him to that two-week training camp. No idea what happened there, but I swear it screwed him up.
Posted by: MaxaLisa

Re: Argh - 03/24/10 05:52 PM

Where was that training camp? Was it housed outdoors where he might be exposed to fleas, mosquitos or ticks?

There are different levels of "bothersome". The highest level is when they can't leave it alone when you are in the room next to them and even you aren't a deterrent. You know it's better when they can leave it alone when you are there, even though they go after it when you aren't or they go into the other room so they can itch. Now when they start leaving it alone when they are by themselves, then that is true progress!! I go through these steps with my Max's fistula, I have different little signs to guage how much he is bothered. Sometimes it's determined on how far away he tries to get from me so he can bite at it, which really is so unlike him frown
Posted by: vio79

Re: Argh - 03/24/10 06:23 PM

The training camp was about two hours north in New Hampshire. Middle of nowhere. I think it was mostly indoors, except when they were outside for exercise or training. The first thought had been some sort of parasite, but apparently that was ruled out early on.

Aw, yeah, I hate when they try and go somewhere else to chew. My Max does that too. And he does try and chew/lick when I'm right here. I usually have to startle him with noise and, worse case, physically stop him. He listens to my husband better when he says stop, probably because of the deeper voice. I usually end up having to physically pull Max's head away. But he'll also go through periods, sometimes an hour, where he won't even try.
Posted by: MaxaLisa

Re: Argh - 03/24/10 09:18 PM

There are all sorts of weird bugs around that are difficult to detect, you never know...

Was he vaccinated right before he left?

With capsules, you always have the option of opening them, using half, and closing them up for the next day smile
Posted by: vio79

Re: Argh - 03/24/10 09:55 PM

It's hard to tell his vaccination history based on what we got from the shelter. Looks like he got Bordetella the month before we got him - and everything else in December of 2008. From our vet, he got a lyme booster last June and another in July. Then he got the big booster (Da2Lp-Cpv) in December, so after the training camp. He's due for another Bordetella, which we're obviously not going to do.

I would have thought between the dermatologist's scraping and the skin biopsies our vet did, something would have come up.

You're right about the capsules. We'd been doing that for his geriatric herbs from the holistic vet. Think it's safe to start him on a little of the quercetin now???
Posted by: MaxaLisa

Re: Argh - 03/24/10 11:06 PM

I'm so sorry to hear about all those vaccines frown

I would give the quercitin a try. What dosage does it say to give on the bottle?
Posted by: vio79

Re: Argh - 03/25/10 08:26 AM

They're 500mg each, and the instructions say take one as needed with meals or as instructed by your doctor. It also recommends taking in conjunction with vitamin C.
Posted by: vio79

Re: Argh - 03/25/10 10:08 AM

Oh and Lisa, I probably should have mentioned this before, too...

Even though he still seems obsessed with spots and will chew/lick himself all over, the spots on his skin that were super red (I think I posted a picture a few pages back) look a lot better now. So I'm really hoping once his scabs heal, maybe he'll be better in general. I'll have to take a good look at him next time were outside for a prolonged period though, to see if those spots get red again. I know his ears do.
Posted by: MaxaLisa

Re: Argh - 03/25/10 03:08 PM

I sure hope that what you are starting to see is true improvement crossedfingers

If you're going to give the quercitin, I would rather give 1/2 capsule at each meal rather than once a day. Later you might be able to taper that to half the amount. I don't see a problem with adding the vitamin C. Down the road, I wonder if we can find a pure MSM/C product.
Posted by: vio79

Re: Argh - 03/26/10 01:12 PM

Started the Quercetin this morning.

Though I've been worried about Max's poops over the past few days. (Of course, he can't just be straight on anything.)

I looked at this in the "Straight poop on poop" thread in the other board, and Max's poops resemble these descriptions:

Greasy stool -- often with oil on the air around the anus: indicates malabsorption

Excessive mucus -- a glistening or jelly like appearance: indicates colonic origin.

Yellow or greenish stool -- indicates rapid transit (small bowel).

Though his poop is definitely on the yellow side and seems more like mucus than greasy. It was greasy when he was on Z/D. There are so many things it could be... and his poops are small as well. He's pooped twice today, but normally he poops once a day, those small, mucus-y poops.

Then the other thing is the spots on his skin...with the exception of where he's already created scabs and stuff, I always check the areas where I catch him chewing, and there is always a little red spot there, the size of a pen tip. Could that still just be allergies? I understand red skin in general, but little red spots seems weird.
Posted by: vio79

max - 03/26/10 02:08 PM

Yuck. Just found a lump on the inside of Max's left front leg (near his armpit) - when I walked away really quick and came back, Max was bothering it, and it looks like it was filled with blood, possibly some other clear fluid along with it. I wrapped it, just so he would leave it alone.

I know he has another cyst on his side, but that one is just a fatty cyst (according to the vet) and was under his skin.
Posted by: BowWowMeow

Re: max - 03/26/10 02:12 PM

Probably an abscess--v. common for dogs with skin conditions. The fluid is most likely puss.

Apply a hot compress to it and try to gently get all the liquid out of it. You can put calendula on it too. I use tea tree oil but only if they can't lick the area.
Posted by: vio79

Re: max - 03/26/10 02:22 PM

Originally Posted By: BowWowMeow
Probably an abscess--v. common for dogs with skin conditions. The fluid is most likely puss.

Apply a hot compress to it and try to gently get all the liquid out of it. You can put calendula on it too. I use tea tree oil but only if they can't lick the area.


Thanks smile
Posted by: MaxaLisa

Re: max - 03/26/10 02:55 PM

For any dog with ongoing digestive problems, moreso if they are a GSD, I really am a big fan of digestive enzymes.

What are you using for flea control? I really would be using the Comfortis to cover your bases.

Has he ever been on a sulphur based antibiotic? Ever had MSM in any of his supplements?
Posted by: vio79

Re: max - 03/26/10 03:11 PM

We'll be putting him on revolution for heartworm, flea, etc. We have comfortis but didn't want to use it due to it having pork and whatever other ingredients in it that could aggravate his allergies.

You think the red spots could be flea bites, even though every vet has ruled that out?

Any digestive enzyme you'd recommend? I found this:
http://www.onlynaturalpet.com/products/Prozyme/228000.aspx

But ideally I'd want to get something from the human vitamin place at the organic market, because it would be easier to get. Think that would work, as long as it's in capsule form?

As for antibiotics, no idea. And we did used to have him on a supplement that had 500 mg of MSM (along w/500 mg of Glucosamine and 400 mg of chondroitin. But our vet had asked us to stop it way back, because it contains shellfish and rice flour.
Posted by: MaxaLisa

Re: max - 03/26/10 05:35 PM

I was thinking that he tested positive for flea bite allergy,but he didn't with the blood test, though that was a possibility from the biopsy.

Let's not add anything just yet, but bounce a few ideas around, before you spend more money on stuff that might get wasted.

These are the things I'm thinking....

We wait a week or so and see if the quercitin/diet are having the effect that we are hoping for.

Consider a bit of kelp to see if the thyroid is a factor. I have heard enough anecdotal stories with exactly this scenario, that I think this is a definite possibility.

Consider the fact that the digestive system has been pretty messed up by the Hills excursion. Some non-diary probiotics, maybe some soil organisms, before jumping to digestive enzymes, though enzymes are often really good when folks have immune system problems and allergies.

Consider pure MSM powder, if there is no sensitivity to it, sulphur being very important for skin issues.

We've got some time to wait and watch what is currently happening while we brainstorm. Ideally, in a bit, we then try exactly one thing, and we want to get some bang for our buck. Curious Vio if you are thinking of anything else, or if anything here jumps out at you as a first instinct?
Posted by: vio79

Re: max - 03/26/10 06:16 PM

His skin biopsies came back saying "Flea bite hypersensitivity and food allergy, as well as atopy, are considerations." I don't recall it coming up in the blood serum test.

I agree that it makes sense to wait and give the current diet/supplements a chance to work. He's been on the green bean/fish diet since Sunday, so less than a week, and we added the quercetin/Ester C this morning. Maybe his poops will get better after his system gets used to this diet. Patience, however, is not one of my virtues. smile

There are definitely a few things you suggested for Max, all good suggestions in my opinion. I would lean toward kelp, even though all of the vets we saw pretty much dismissed thyroid as the underlying problem. Maybe between the kelp and bioflavonoids, Max would be covered without MSM for the time being.

I wouldn't trust my instincts though - so far they've only seemed to create more issues for Max. And mentally, I'm ready to try anything. If Max hasn't improved at all in a couple of weeks, I'm going to try antibiotics. Is that why you asked about sulphuric antibiotics? Maybe something that would be more effective, like cotrimoxazole? Though not sure that's considered a broad-spectrum antibiotic or suitable for a dog.
Posted by: MaxaLisa

Re: max - 03/26/10 08:14 PM

I was asking about the sulphur abx because a few of our GSDs tend to pee if they get MSM or extra sulphur in their diets (eggs, garlic, etc.) I don't understand it, but it seems to be the case. I wouldn't want to try MSM in a dog that couldn't tolerate sulphur abx.

I would want to try the kelp too. Let's keep that thought.

For the skin, if the vet is willing to tray a tetracyline, you might want to ask about doxycycline. It can be administered less frequently, and is less sensitive to things like calcium interference and such. I believe that capsules are less irritating to the stomach, from my own experience with the two here. Those abx can also be antiinflammatories, so they might help on two different levels, in terms of the inflammation (particularly skin), and any infection.
Posted by: MaxaLisa

Re: max - 03/26/10 08:16 PM

How are the gunky eyes?
Posted by: JeanKBBMMMAAN

Re: max - 03/26/10 09:34 PM

Ah! Earlier I think it was Kris who mentioned Apollo. I found his thread:
http://www.germanshepherds.com/forum/res...omorrow-am.html
Posted by: vio79

Re: max - 03/26/10 10:02 PM

OMG Jean, that Apollo thread is crazy! What a poor dog! The change was amazing though. Luckily Max is nowhere near that bad. I didn't read through it all, but it sounds like he was on some strong antibiotic and then other stuff to help with the yeast? Not sure if any of that would work on Max, since nobody seems to think it's mange.

Lisa, I'll ask again about doxycycline - she did mention tetracycline and I'm not sure why she didn't want doxycycline. I know she was against niamacide, or whatever that other one was.

Max's eyes are all right - his right eye is fine, but his left eye gets a little bit of yellow goop during the day. Nowhere near as bad as some of the photos of other dogs I've seen with eye goop. The eyes themselves are perfectly clear. Just that one corner... and his skin is looking red again. Guess the redness comes and goes. And today it was freezing! It's supposed to be 19 tonight.
Posted by: JeanKBBMMMAAN

Re: max - 03/26/10 10:11 PM

Isn't that nuts?!?!?! He was on a pill that cost I think...$13 for each pill? I helped with the rescue with a flyer for a fundraiser where people could buy a pill for him...

These poor dogs.
Posted by: MaxaLisa

Re: max - 03/27/10 12:11 AM

Doxy is certainly not the first tetracycline that folks usually think of. I just know that it has easier dosing, doesn't matter for your purposes either way probably. There's a human med for ezcema that is low dose doxy, I used to see it advertised.

I didn't read any of the thread, but took a quick look at the pics. I think Jean's point was sometimes it's obscure, requiring an obscure med. Regular vets don't have the experience with that, and certainly not with many of the meds that derms are more comfortable with. For example, go back and read what your vet said in response when I first mentioned doxy on an early page on your thread on the other board. Frankly, it showed the ignorance of your vet in this area. Not meaning that in a derogative way, but just as a matter of fact.

The beginning at the training camp perhaps, and the failure of response to many varied treatments, might mean it needs something highly specialized that none of us have a clue about. We had a dog like that on the other board once, they had to use a med that she had to wear gloves to administer, but that was what was required. Derms are comfortable and knoweldgable about that stuff, regular vets are way out of their league.

I'm surprised that not one vet has considered putting him on an anti-fungal and appropriate abx.
Posted by: MaxaLisa

Re: max - 03/27/10 12:22 AM

There are so many different directions to go, that you'll drive yourself nuts in the process.

If we get to the point that we think we want to try the kelp, I think a good plan is to make a few calls to your vets, tell them what you are going to do, and ask them if they are willing to do a trial run of thyroid supplementation instead. They will probably decline, but it wouldn't be terrible to give them a chance.

If the redness continues to get worse, if there are red dots, heck, some weird tick diseases do that, so I might push for the doxy.

These are all steps that most vets would reasonably be ruling out too, though they would be quicker with the meds.
Posted by: MaxaLisa

Re: max - 03/28/10 06:47 PM

After a review of *everything*, as Jean would say, stop fuzting around, though I think she would spell it differently.....

Back on 1/1/2010 was when we fist talked of doxy, discussed tylan for staph, discussed an anti-fungal in combination with an abx. You reported on 1/5 that your vet said that none of those meds apply to what she thinks Max's issues are.

Just curious, are you still seeing the vet that gave Max his full complement of shots when he had numerous health issues and significant tick exposure, are you?

http://www.lambertvetsupply.com/Bird-Bio...pr--001TLBIO100

Not that I would normally advocate this on your own, but for a 75 lb dog, start with 200 mg twice a day, with food,,,,,Either under the supervision of your vet, or not. You have a dog with ongoing digestive issues, serious joint problems, with a history of significant tick exposure and at least one attached tick (which means that there were most likely more). This possibility needs to be eliminated. In light of a HIGH WHITE BLOOD CELL COUNT from a previous blood test, I have to ask why that vet runs these things if they don't pay attention to it????

I am almost as frustrated with your vets as you are Vio.
Posted by: vio79

Re: max - 03/28/10 07:48 PM

As per my PM back to you...

Vet that did blood work and noticed high WBC count was the first vet we took Max to, back when we got him last May. He attributed it to infection on his tail and put Max on Cepha caps. We did not go back to that vet, because he was at a VCA and I didn't get a good vibe from him.

But yes, our current vet is the one who gave Max his full complement of shots in the midst of his health issues. I think one problem was that we were seeing multiple vets in that practice, depending on who was available at the time. She did not know about any tick exposure. She just gave the Lymes booster (her or her husband, I can't remember) because of the medical records, or lack thereof, they had, and the fact that he had been in NH.

I am going to try and get doxy through my vet, just so she is apprised of the situation. I think she will go for it. If not, I will do it on my own.
Posted by: MaxaLisa

Re: max - 03/28/10 07:54 PM

Okay.

Then we'll give this a try. The possibility needs to be eliminated, and testing has too many false negatives - you'd want to treat even if everything comes up negative.

My Max and Indy do better on the capsules, but most vets have the tablets.

The backup plan if this doesn't work is out of the box, but I'm pretty sure that this is going to make a difference.
Posted by: MaxaLisa

Re: max - 03/28/10 08:03 PM

Vio, I missed the pm earlier, just sent one back.
Posted by: vio79

Re: max - 03/29/10 09:55 AM

Originally Posted By: MaxaLisa


http://www.lambertvetsupply.com/Bird-Bio...pr--001TLBIO100

Not that I would normally advocate this on your own, but for a 75 lb dog, start with 200 mg twice a day, with food,,,,,Either under the supervision of your vet, or not. You have a dog with ongoing digestive issues, serious joint problems, with a history of significant tick exposure and at least one attached tick (which means that there were most likely more). This possibility needs to be eliminated. In light of a HIGH WHITE BLOOD CELL COUNT from a previous blood test, I have to ask why that vet runs these things if they don't pay attention to it????

I am almost as frustrated with your vets as you are Vio.


I just called the vet, and the one we normally work with isn't in until Thursday. Her husband, who we've also worked with, is in today, so I told the receptionist to run it by him. She kept trying to push other things (even prednisone) and I said I want it to be doxycycline. When I said he may have a tick disease, she asked if we wanted to bring him in for a heart worm test?!

I hope I don't have to wait until Thursday to get the doxy. That would suck. I want to try getting Max better ASAP. And off this green bean and fish diet.
Posted by: myamom

Re: max - 03/29/10 11:47 AM

For what it's worth...my foster has terrible skin...she had ongoing flea dermatitis for many years which has gone into a staph infection due to the duration she had it. She had no hair on her back when she was pulled from the shelter. I have some other more pressing issues to deal with with her...her mammary cancer and high heartworms...so it doesn't feel as pressing to me...but it is a concern. No past antibiotics have helped with her skin...but I thought I'd post and say that she is now on doxy for her heartworms...and the Dr said he is hopeful it will also take care of her skin issue. We've just started...I'll share the impact if any it has on her skin issue.
Posted by: vio79

Re: max - 03/29/10 12:50 PM

Please do Mary Ann - thanks for sharing! Sorry about all of your other issues. frown It would be great if the doxy helps everything.

I'm still waiting to hear back from the vet...
Posted by: MaxaLisa

Re: max - 03/29/10 02:05 PM

The HW test also tests for 3 tick diseases. However, it's not very sensitive for two of them, and there are other diseases out there that it doesn't test for. So the receptionist was completely off base. IF you wanted to test, I would have recommended a full panel run at Protatek labs, they specialize in this tick stuff. BUT, with all the falso negatives out there, to cover your bases, you'd want to do a trial treatment anyway.

crossedfingers

Eta: wonder if the beans are cross-reacting with some of the environmental allergies. Not the right word though...
Posted by: vio79

Re: max - 03/29/10 02:11 PM

I agree. Plus, I don't want to make Max go back to the vet, again, and get pricked.

Still waiting to hear. I wonder what they'd do if I tried to order it through 1-800-petmeds. Though I wanted to get it more quickly than that.

Beans: they could be. I know you mentioned peppers and something else to try. Just don't know if we should keep it up with the beans and fish, add the doxy, and see what happens. As I said in the PM, would like him off this diet in general sooner than later. His poops suck, when he poops, and you know about the eye goop.
Posted by: vio79

Re: max - 03/29/10 06:10 PM

Okay, got the doxy from the vet. They gave me 90 tablets and want me to give him 100 mg twice a day, as needed. They based in on the weight they had in the system (84 lbs - no idea where they got that, as he was 92 lbs last time, I think, and 94 lbs when weighed at the new vet) and the fact that it's just for itching, not for a potential tick disease.

So we'll give him 200 mg twice a day, like you said Lisa. I doubt he's still 94 lbs anyway - he looks a lot thinner since we started the beans/fish diet.
Posted by: MaxaLisa

Re: max - 03/30/10 01:39 AM

Oh good, 200 mg twice a day is a low dose for Max, at 75 lbs. Max's aggressive dose would be almost twice that.

Best to give before a meal, to diminish the possibility of stomach upset.

PetMeds, any doxy for dogs, will require a prescription btw!

Aaargh, the diet, what to do about the diet. Did he have eye goobers ever before? On the Orijen?
Posted by: vio79

Re: max - 03/30/10 08:19 AM

No eye goobers before - at least not nearly this bad.

Yeah I know Pet Meds requires prescription - was hoping it would force them into it.

So is 400 mg a day not even going to do anything???
Posted by: myamom

Re: max - 03/30/10 09:05 AM

Cheyenne (at 71 lbs) is getting 300 mg. a day.
I wonder if there are reasons behind the dosage adjustments?


(Ava has her well appt. today...I'm going to ask about doxy dosages and why Chey is only getting 300 mg....I'll let you guys know what I find out)
Posted by: MaxaLisa

Re: max - 03/30/10 02:30 PM

If he's around 84 lbs, 400 mg for the whole day is half the aggressive dosage for a tick disease. Many dogs can't handle the aggressive dose.

Do you have any idea what the weight is?
Posted by: vio79

Re: max - 03/30/10 02:43 PM

Max was 94 lbs last time he was weighed. I'd say he's closer to 90 now. I think I read the dosage was 5mg for every kg of weight...I suck at calculations, but I think that means Max should get about 200 mg. Though according to PetMeds, he should get 2-5mg per pound, which would be a range of 180 - 450 every 12-24 hours.

I just want to know if the dosage we're giving him, 200mg in the morning and 200 mg at night is going to make a difference.
Posted by: MaxaLisa

Re: max - 03/30/10 02:54 PM

Myamom and Vio,

There is a wide range of dosage for doxy. The *aggressive* dose to fight a tick disease is 10 mg/kg every 12 hours, which is roughly 5 mg/lb. Since pills are typically 100 mg, you just try to get close to that.


The low dose for treatment to be 1/2 that. Myamom, treatment for heartworm stuff might have its own dosing?


So Max's aggressive dose (90 lbs) is 450mg BID (twice a day). His low dose is half that. Since the 200 mg is less than that half, that dose gets questionable for him. I would start at 300 mg BID for him and see how he tolerates it. Glad you asked Vio, I have a hard time thinking about a dog that size.

Even for inflammation, I'm pretty stunned that your vet would prescribe at that 100 mg dose. For inflammation, you would start higher, and then very slowly taper down.
Posted by: vio79

Re: max - 03/30/10 03:17 PM

I think the problem is that they have him at 84 lbs in their system and are dosing it based on his being itchy. Their attitude is: if you want to increase the dosage, we need to weigh him and give him a HW test.

I'd rather just do it on my own, explain why, and hope they'll give us a refill when we need it.
Posted by: MaxaLisa

Re: max - 03/30/10 04:06 PM

Even at 84 lbs, they've given you the same dose I use on my 33 lb dog?

One of the worst things you can do with an abx is not start strong enough, which tends to create superbugs, even for itching.

On the tick list, we have seen mis-dosing like that even for tick diseases ;thinking: (I don't think we have that smilie???)
Posted by: myamom

Re: max - 03/30/10 04:55 PM

darnit...I forgot to ask...sorry! I am curious how they come up with the dosages. (the meds I have were donated from another dog that needed them for hw treatment...she was a female and was supposed to get 400 mg.....maybe it's because of Chey's progressed stage/symptoms...)
Posted by: myamom

Re: max - 03/30/10 04:57 PM

oh...and Vio...I can SO relate to the incessive itching,chewing and scratching....I really hope the doxy helps them both!
Posted by: vio79

Re: max - 03/30/10 06:06 PM

We're assuming Max has a tick disease. But if he doesn't, will the extra doxy harm him? I can increase his dose to 300 mg per meal.

Mary Ann, I also hope the doxy helps them both! crossedfingers
Posted by: MaxaLisa

Re: max - 03/30/10 06:23 PM

No drug is harmless, BUT the most frequent issues with the doxy is the digestive intolerance. You will notice that if it's an issue. With my Max, too high a dose and he has terrible panting issues. Since you watch your Max closely, you will notice if something is off.

There are occassions, when tick treatment is started, liver enzymes increase. An ongoing debate is whether that's the doxy, or a side effect of the die off of organisms. Enzymes resolve after treatment is stopped.

Just continuing keeping an eye on him as you do. General rule for abx tratment, go a full 10-14 days before stopping, at that point, evaluate. Note, before treatment, the condition of the eyes, the joint issues that you're treating, the digestive issues, any weird bevahiours, licking, etc. For my Max, it was huge in his eyes and digestion. Now it's a critical part of his fistula treatment, which is quite odd.
Posted by: vio79

Re: max - 03/30/10 06:57 PM

Why is it weird that it's critical in your Max's fistula treatment?

We'll try the 300 mg/meal and see if anything changes. If so, it's hopefully for the better.
Posted by: MaxaLisa

Re: max - 03/30/10 07:46 PM

If there is such a thing as a protocol for fistulas, Max just doesn't follow it. My Max's response to the doxy and the fistula is just more evidence if inflammation caused by infection, in spite of hundreds of dollars worth of negative blood tests!

Continued crossedfingers for your Max!
Posted by: vio79

Re: max - 03/30/10 08:06 PM

If we ever get a dog after Max, you can bet we won't touch that name with a 10 foot pole! wink
Posted by: MaxaLisa

Re: max - 03/30/10 08:48 PM

Wouldn't be my choice either!!
Posted by: vio79

Food? - 03/31/10 05:55 PM

Max is definitely losing weight on this diet. We could give him more fish/green beans every meal, but I'm wondering if he needs to be on this diet. It's only been a week and 3 days, which is the only thing I'm worried about. If he was having food allergies, is it a good idea to change back to Orijen 6 Fish or stick it out with this fish/green bean diet? Everyone says it takes 4-6 weeks to get "old" food out of his system and show improvement on the new food. I know it's been mentioned here that results could show faster than that.

Right now, I think we're going through about 6 lbs of baked cod a week, 14 cans of sardines, and 4-6 lbs of green beans. No idea if this is the right amount based on what he needs, since it's not really "balanced" nutrition in any sense of the word.

Orijen 6 Fish would be a lot less expensive and would have all the vitamins/minerals he needs. BUT, no idea if he was allergic to anything in it.

His itching doesn't seem any better on the home cooked diet, though it may be too soon to tell.
Posted by: MaxaLisa

Re: Max/Food? - 03/31/10 06:02 PM

He will lose weight on a low carb diet. The important question is whether he is losing muscle or not.

Have you notice *any* change in the itching, skin, etc. on this diet, other than increased eye goobers?
Posted by: vio79

Re: Max/Food? - 03/31/10 08:55 PM

Honestly, it's really hard to tell. He could be slightly improved - his skin seems slightly less red. But he's been indoors a lot more due to all the rain (again). His skin seems to get more red when he's outside a lot. But we still have to stop him from chewing himself at least once every 10 minutes.

Anyway, go figure that right after I posted the question, he suddenly decides he doesn't want green beans. Two days ago he was eating them from my hand like they were treats; tonight, he was spitting them out and only eating the fish. He kept spitting out the pills, too. We had to give him sardines in their juices just to get him to eat his pills. I even tried the whole force-feed method, which has worked in the past, but he still spit them out. Guess I'll see if he still hates green beans tomorrow morning!
Posted by: MaxaLisa

Re: Max/Food? - 04/01/10 03:15 AM

The doxy may be bothering him.

I dip the pills them in a bit of yogurt (or jam!) and then feed, so they don't associated the pills with their meal. Some folks need to give pepcid with the pills, but I use probiotics and l-glutamine, at least that's worked so far.

Hard to tell if he is better, sure wish he was itching less frown
Posted by: vio79

Re: Max/Food? - 04/01/10 08:54 AM

Last night he was pretty bad, itch-wise. This morning he's been going at himself a lot. *sigh*

Not sure dipping the pills in jam makes sense, if we're on an elimination diet.
Posted by: vio79

Re: Max/Food? - 04/01/10 11:43 AM

Yeah he's super bad today. I can't even sit at my computer and work for two minutes. So close to just throwing on his muzzle and making him wear it all day long...
Posted by: MaxaLisa

Re: Max/Food? - 04/01/10 04:17 PM

Was he the best on the Orijen, itch-wise?

Think really carefully on this!!

You could try just the fish for a few days while you are thinking.
Posted by: vio79

Re: Max/Food? - 04/01/10 04:42 PM

He was only on Orijen for 4 days before we saw the vet and started the potato only diet. Doubt that short amount of time could have told us anything.
Posted by: MaxaLisa

Re: Max/Food? - 04/01/10 04:56 PM

sorry, I lost track, thought he was on that one before.

Several scenarios.....

He is getting deficient in a number of things that are contributing to the itching....

He can't tolerate the green beans....

He can't tolerate the fish.....

Any instinct Vio?
Posted by: vio79

Re: Max/Food? - 04/01/10 07:04 PM

Yeah, it's hard to keep track of the food. I only can because I've been marking it all on the calendar.

Since he was okay on fish way back and started the eye gooeys after the green beans, we're going to follow your suggestion and remove green beans. Hopefully that helps. Since he's been itching for months, not sure if it's a deficiency thing, though maybe at this point the crazy diets are taking their toll. Then again, he was on Natural Balance Venison and Sweet potato for 4 weeks before we changed to Z/D, which he was on for a week before Orijen, then potato, then fish and green beans. So he should have been getting decent nutrition for a while there.

He also just got his first dose of Revolution for the season.

I guess if he's still bad on the fish, we can try a new protein? Or go back to a kibble with all the vitamins/minerals.
Posted by: MaxaLisa

Re: Max/Food? - 04/01/10 07:08 PM

Bodies under stress and illness require more of some "stuff"; I am sure that if we found the right nutrient(s), his body would soak it up and make good use of it. I agree with you that it's most likely not the diet, but they I'm sure that they contribute to some degree, and I'm sure he has some sort of deficiencies.

When did he get his first dose of Revolution?

You have lean pork left as a trial for a protein.

If you are giving the quercitin, looks like it's not helping, so might as well not?
Posted by: vio79

Re: Max/Food? - 04/01/10 07:48 PM

Oh, would quercetin work that quickly?

I'm sure you're right about the nutrients.

We gave him the Revolution around 4:30 p.m. (almost three hours ago).

And he just ate his first fish-only dinner.
Posted by: MaxaLisa

Re: Max/Food? - 04/01/10 08:44 PM

With the quercitin, I would think you would see a bit of an abatement in a couple of days, just like an antihistamine, but it got worse.

Oh, the Revolution was today, already after the itching was worse, just wanted to check on that.

Okay, I guess we see what happens with fish only for a bit.

I really like the idea of no commercial food at this point.
Posted by: vio79

Re: Max/Food? - 04/01/10 08:48 PM

Yeah we had to start giving him some sort of parasite protection, especially with the weather warming up. We used Revolution so he didn't have to take heart worm preventive orally.
Posted by: vio79

Re: Max/Food? - 04/02/10 11:25 AM

We're going to start adding in probiotic. I think the doxy's getting to his stomach. This morning he had yellow-green diarrhea.

I guess kelp would be the next step if nothing changes over the next few days.
Posted by: MaxaLisa

Re: Max/Food? - 04/02/10 02:09 PM

I don't understand the colors...

I have to imagine the fish and doxy, and that's it, doesn't feel great on the stomach.

I sure wish I knew if he would tolerate flax. I like that Canine Complete (that has kelp in it).

Is his itching *any* better at all?
Posted by: vio79

Re: Max/Food? - 04/02/10 03:57 PM

Doesn't seem to be. Every time I think it is, he'll go through a fit where he won't leave himself alone. Though his scabs seem to be better now.

And his poor butt feels so bony. Maybe it's normal and I'm just used to him being overweight, but he seems so scrawny to me now. Wonder if I should try and take pictures to post and get your opinion.

Just bought three more pounds of white fish and 12 cans of sardines. I think the people at the store think I'm weird.
Posted by: vio79

Re: Max/Food? - 04/02/10 04:32 PM

He hasn't had flax in his diet since March 5th, though I know that doesn't necessarily mean he's NOT allergic to flax.

Here are pics I just took:











Posted by: MaxaLisa

Re: Max/Food? - 04/02/10 04:58 PM

I don't think I'm seeing his ribs at all, so that's good. It looks like he could use some more muscle, and it's pretty clear that this isn't a great diet, but hopefully something will become clear soon.....

The healing scabs might be from the antibiotic.

Are there less sores on his skin now than before?

Is the itching the same or worse or better since you stopped the homeopathic that you put in the water?

When is the last time you did a trial of Benadryl? I don't remember - did it have any effect on his itching?

I'm trying to get a feel for any type of progress, how much might be food vs a lot that is environmental. We have a bit to wait for the antibiotic to kick in. Is he moving around any differently at all?
Posted by: vio79

Re: Max/Food? - 04/02/10 05:23 PM

I can see a couple of ribs, and feel them, but they're not prominent. And I know it's okay for a couple ribs to show. It was more the boniness of his butt/hips I was concerned about. And his spine is protruding more. It's hard to keep muscle with him, given his joint issues. This morning was his biweekly dose of Adequan.

He seems to have fewer sores. His neck is looking better (less red, fur growing back). He still has little red pinpoint spots where he chews, and places where he had gone nuts and got red skin have turned dark. To the naked eye, his legs look all battered and bruised. frown

Itching is definitely better after having stopped the homeopathic spray and potatoes, but obviously not gone and still fairly bad.

It's been some time since we gave him Benedryl, though we used to give him three at a time, which made him drowsy but didn't seem to curb the itching. Temaril-P had worked last summer. But prednisolone wasn't working a couple months ago. The vet said Atopica didn't work either, which is why she assumed the uncontrollable itching was from food allergies. His seasonal allergies were under control with Temaril-P every other day.
Posted by: MaxaLisa

Re: Max/Food? - 04/02/10 06:03 PM

The Temaril helped with exactly which symptoms?
Posted by: vio79

Re: Max/Food? - 04/02/10 06:46 PM

It kept him from itching as much through the summer. But when he got back from training camp at the beginning of October, it didn't help anymore.
Posted by: Wisc.Tiger_Val

Re: Max/Food? - 04/02/10 07:03 PM

I have been trying to keep up with this. The pictures weight wise he doesn't look bad, the spine/hip bone thing is probably feeling that way from lack of muscle tone. His coat looks pretty good in the pictures.

I have a question, is he doing more scratching or chewing/licking at given spots?

Val
Posted by: vio79

Re: Max/Food? - 04/02/10 07:17 PM

Val - he does seem to go for specific spots. Though there are quite a few of them! He has several on his legs (which he usually turns into sores), his hind knees, a couple on his back, a couple on his sides/ribs, the tip of his tail, and then his neck/head/face/ears where he claws with his hind legs. He also likes to lick his elbows where the black skin is thickened.

When you put all the spots together, it's basically his whole body! But they are specific spots. If that makes sense.

And to add to the Temaril-P, he had a couple good weeks before he went up to training camp where he didn't need to wear any restrictive things. Before then he did, but it was because he was healing from tail surgery. They continued his Temaril-P during the training camp. When we picked him up from training camp, he had a wound on his back foot that he kept wanting to lick, and then everything escalated from there.

We had taken him to the vet because we were concerned about his air-humping and licking his penis so much, since it was behavior he'd never displayed before the camp. That appointment we learned he'd lost about 10 lbs in the two weeks as well. Obviously it was not a good time for him, and we're kicking ourselves for letting the shelter convince us to bring him there. frown

Oh I just realized I may have misunderstood your question. He's doing mostly chewing/licking where he can get to with his head. All other spots around his head he scratches.
Posted by: MaxaLisa

Re: Max/Food? - 04/03/10 05:26 AM

Tracy, while we're kicking around ideas here, giving the diet and the antibiotics a few more days, will you humor me? I would love for you to pick up some Scullcap and try it for about three days. It won't interfere with anything.

It's not a super common herb, but anyone that carries the full complement of Nature's Way herbs would have it. Maybe call before you go look?

Every so often, I just get a strong sense that this is a nervous system thing. Just the problems with the tail, and then the training camp....well, I can think of a whole lotta things that can happen at a training camp that might mess up the nervous system. And just the sense that he sounds like he is feeling like stuff is crawling at parts of his skin, or maybe he is getting weird nerve sensations.

It would be quick to eliminate this possibility by seeing his reaction to the scullcap.
Posted by: vio79

Re: Max/Food? - 04/03/10 08:49 AM

If it won't interfere, it's worth a try. Though we had been giving him valerian root before.

What dosage would you recommend for Max at 92 pounds??
Posted by: MaxaLisa

Re: Max/Food? - 04/03/10 03:37 PM

I would give him 2 capsules in the morning and again in the evening for three days and then evaluate.

Scullcap is very different than Valerian root. I think Valerian root would have just made him more sleepy?
Posted by: vio79

Re: Max/Food? - 04/03/10 04:59 PM

So that would be 1700 mg/day, since each capsule is 425. Just wanted to be sure.

They had it at the Living Earth. They also had kelp, which I was tempted to grab, but we'll try one thing at a time. smile
Posted by: MaxaLisa

Re: Max/Food? - 04/03/10 05:10 PM

That's what I give Max here when he is having a flair-up of issues, works particularly well when he gets his annual hotspot and wants to bite at it.

This will be something quick to try. The other stuff isn't so quick. The only other very quick thing, if this doesn't work, would be another anti-histamine, like Zyrtec, just to see the reaction.

Anything beyond those two things, are more major endeavors. If the scullcap has any positive effect at all, that will give us some info.
Posted by: vio79

Re: Max/Food? - 04/03/10 09:51 PM

All right, well we gave him two tonight and will give him two tomorrow morning.

The only thing that makes me doubt it's his nervous system (unless this could be a symptom too), is that when we rub him in certain spots, it obviously itches because he starts kicking his leg. I wouldn't think that's his nerves fooling him. But who knows. I'm still hoping...
Posted by: MaxaLisa

Re: Max/Food? - 04/03/10 09:53 PM

Yeah, that could be the nerves. Well, we'll know one way or another I guess.
Posted by: vio79

Re: Max/Food? - 04/05/10 03:01 PM

Day 6 of Doxy
Day 2 of Scullcap
Day 4 of fish-only diet
Day 16 w/out potatoes
Day 20 w/out commercial dog food

No significant change. I wouldn't even say there's decent improvement. There may be none at all. He still needs to be muzzled at night (and sometimes when I'm right here on a call because he relentlessly goes at himself) and has to wear an e-collar when he's alone.

His weight loss is worrying me. Though the pictures didn't show ribs, I can see at least 3 ribs, depending on how the light hits him, and his hip/butt bones are really protruding. My father, who hasn't seen him in a month, thinks we're starving him to death.

He poops maybe once a day, and it's small and soft.

I'm on the verge of giving up here, because I feel like we're slowly killing him.
Posted by: Wisc.Tiger_Val

Re: Max/Food? - 04/05/10 09:54 PM

Tracy,

We know you are beyond frustrated right now, but don't throw in the towel just yet.

Also with giving Doxy it is going to be hard to judge if the bad poops are the fish or the Doxy. Any Antibiotics job is to kill bacteria, good or bad the Drug can't tell the difference. So poor poops could be the result of minimal good tummy bacteria.

Hopefully Lisa will weigh in on this, but I think maybe you need to do some Probiotics once a day midway between the Doxy. I would do a simple Probiotic with just Acidophilus. This you can obtain at a health food store, at the grocery store in the health food or natural section or in the refrigerator case.

There were time with Raya when she wouldn't eat that you could play the xylophone on her ribs. I know Max is loosing weight but you have to give the fish only more than 4 days, IMHO

Val
Posted by: MaxaLisa

Re: Max/Food? - 04/05/10 10:05 PM

Well. Crumb, although that's not really the word I used.

Do you want to try a trial of antihistamine? I'm confused about what it did and didn't help before. There's always the possibility that there is a contact or inhalent allergy in the house or the environmant?

Other than that, we start building him back up slowly.

First the diet.

Options are...

1) Try pork.

2) Try to add in some kibble, super slowly, and see if there is worsening of symptoms.

3) I'm guessing, but don't remember, that chicken was bad?

4) You don't seem to have good options for raw, unless I'm missing something, and his state, I might be a bit concerned.

5) Something I'm missing...




Also, build him up...

I would like to do this via a modified Belfield program, including support for the thyroid. I know some of the skin stuff that should be good, but finding the right product might be tricky.


I'm concerned about a commercial diet, but I have to trust what you say that his itching is really not improved off the kibble. It's just so hard to believe that nothing has made a true dent in his itching. And I know how difficult this is for you, living with the discomfort he is having, how utterly frustrating and heartbreaking this must be.


Of course, another option is always Jean's communicator wink

Let's bounce around the options a bit and see if one (or more) make more sense than the others.

Thoughts?
Posted by: Wisc.Tiger_Val

Re: Max/Food? - 04/05/10 10:47 PM

Just me, but I would want to try some Probotics, in 90% of cases they don't do any harm. It isn't a quick fix it is going to take about 10 - 14 days but if you get the gut balanced some other things might change.

Val
Posted by: MaxaLisa

Re: Max/Food? - 04/05/10 11:13 PM

Probiotics are always a good idea, and part of the building him back up.

We'd have to find a nondairy source, but definitely something to add to the list.
Posted by: vio79

Re: Max/Food? - 04/06/10 09:00 AM

I don't know ladies, I'm just ready to knock myself unconscious. I am REALLY sick of just trying this and that and getting nowhere. And I doubt Max likes all of these changes either.

I can't really even start to explain how I feel right about now. I look at Max and want him to just get better and feel sick to my stomach at the thought of even giving up. But then I start to wonder how happy he really is living this way and maybe he'd be better off. Maybe it just wasn't meant to be, with the itching, joint issues, and aggression. Finally, I look at my own life (because at the end of it all, this is my life) and wonder what the hell happened in the last 6 months. I'm miserable, we're spending more than we make on a weekly basis, and I feel this is largely in part to what's been going on with Max. I feel guilty leaving the house and am always rushing home to be with Max, so he doesn't have to wear the e-collar for too long. That is no life for me!!

My husband and I had agreed that if doxy didn't work, that would be it. I think before that we'd agreed if the elimination diet didn't work, that would be it. We keep making exceptions for new trials that don't work. I have bags full of stuff that we bought, used hardly any of, and put aside for something else.

We've seen several kinds of vets, all of whom couldn't help in any practical way.

As for food, I don't know if he has problems with anything besides a pure potato diet. He was fine for 5 months on Eukanuba GSD formula, which had all sorts of crap in it. Ever since he got back from training, nothing has helped, food-wise. We'll try and get through 4 more days of fish only, but then I'm pretty sure I'm going to screw this food trial and just feed him good kibble. At least good kibble has all the nutrients he needs and costs about a third of what we're paying now for this stupid fish!

The Benedryl didn't do anything for Max except make him drowsy.

I know it's hard to believe nothing has worked. Believe me, I am ready to kill someone. Every time we think of something else to try, I get my hopes up and think "this is it!" and am just disappointed once more.

The only time of day he's somewhat normal is on walks...but he'll still stop randomly and try to scratch himself. And then on walks I'm always on edge, just waiting for him to see/hear a dog and freak out.

Pets are supposed to add years to your life - Max is killing me. I love him, and I feel sorry for him, but I resent the jerks who bred him and the people who had him for almost 6 years, supposedly without issues and then turned him into a shelter. I am only human and can only put up with this for so long before ruining my life over a dog I got under a year ago. And then I look at Max's sweet face and hate myself for thinking that way.

I don't know. I just don't know.


Posted by: vio79

Re: Max/Food? - 04/06/10 12:38 PM

Originally Posted By: Wisc.Tiger_Val


There were time with Raya when she wouldn't eat that you could play the xylophone on her ribs. I know Max is loosing weight but you have to give the fish only more than 4 days, IMHO

Val


Max has been on fish for almost three weeks - he was just also eating green beans before. Those seemed to cause eye goobers, but in the days since removing green beans, there has been no change.
Posted by: Mary Jane

Re: Max/Food? - 04/06/10 02:08 PM

Tracy,

I have no bright idea about what is troubling Mr. Max, but I feel terrible that after all your effort and concern, his ailments are beginning to wear you down. Reading much of this thread, it's clear both how devoted you have been and how serious regarding the great number of possible contributors to Max's state.

I just fervently hope that your patience and thought are rewarded with some relief for you and your dear dog.

Mary Jane
Posted by: vio79

Re: Max/Food? - 04/06/10 07:20 PM

Originally Posted By: MaxaLisa

I'm trying to get a feel for any type of progress, how much might be food vs a lot that is environmental. We have a bit to wait for the antibiotic to kick in. Is he moving around any differently at all?


Would we know if the doxy was working by now?
Posted by: MaxaLisa

Re: Max/Food? - 04/06/10 08:40 PM

Originally Posted By: vio79
Originally Posted By: MaxaLisa

I'm trying to get a feel for any type of progress, how much might be food vs a lot that is environmental. We have a bit to wait for the antibiotic to kick in. Is he moving around any differently at all?


Would we know if the doxy was working by now?


How long has he been on the high dose?
Posted by: vio79

Re: Max/Food? - 04/06/10 08:54 PM

Originally Posted By: MaxaLisa

How long has he been on the high dose?


Since March 30th.
Posted by: MaxaLisa

Re: Max/Food? - 04/06/10 08:56 PM

That's barely a week.

Curious if he is moving any better though?
Posted by: vio79

Re: Max/Food? - 04/06/10 09:21 PM

I had been under the impression that we'd notice a change faster than that. I'll have to go back and read.

Movement? No, he's the same.

He also seemed a little wheezy last night, but he seems better today.
Posted by: vio79

Re: Max/Food? - 04/06/10 09:29 PM

Quote:
With a low dose, I don't know how quick you will see a response. I just switched Indy back to doxy from amoxicillin and it took about a week and a half. I'm betting you should see something within a week since he is kinda a mess. If you see nothing in 2 weeks, then either the dose is too low or this isn't it.


There it is - from your PM.

So we're at just under 8 days on doxy at this point. And when you sent that PM, we were thinking 400mg/day. We're actually giving him 600mg/day.
Posted by: MaxaLisa

Re: Max/Food? - 04/06/10 10:11 PM

You have better wheezing, you have healing scabs (or at least you did). Whatever Max has, it's a bad case for sure. I wouldn't completely give up on the doxy yet.

Because the food hasn't made a dent in the itchies, that's why I was wondering if you wanted to add just a bit of that Orijen at each meal and see what happens. Like a half a cup per meal, for about a week, and not digestive and itchy response, and see if you can build back up to a decent kibble. I was thinking that you still had the Orijen around the house?

If that works, then we throw the kitchen sink at him, but a carefully selected kitchen sink....

Part of me worries about fungal issues...that has never been addressed.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/06/10 10:38 PM

Vio, I forgot, if the TEMARIL helped, why aren't you using it now?

I thought it was another antihistamine, but just now looked it up:
http://www.pfizerah.com/Product_Overview.aspx?drug=TM&country=US&lang=EN&species=CN
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/06/10 11:20 PM

Nevermind, I know, you were trying to figure out the root cause?

Is there no way to try acupuncture?
Posted by: kaisersmom

Re: Mr. Max's Issue(s) - 04/06/10 11:35 PM

Quote:
Part of me worries about fungal issues...that has never been addressed.


That's what I'm wondering about also. If most of Max's problems occured after he came back from the training camp, maybe there was something in the soil there, some sort of fungus, that he picked up and can't get rid of? Maybe something he picked up from one of the other dogs there? Where was the training camp?

I don't remember if he's been tested for ringworm, but I'm thinking that by now he probably has. What about a yeast infection? Even a systemic yeast infection? I know you've given him baths with medicated shampoos, but were they anti-fungal shampoos?

http://www.thefind.com/pets/info-ketochlor-shampoo

This is a long article and this lady is not a vet, but here's the link:

http://www.greatdanelady.com/articles/systemic_yeast_mini_course.htm

Here's one paragraph that stood out in particular:

Quote:
It is my opinion the majority of systemic yeast overgrowth problems in dogs, get mistakenly diagnosed as a food allergy.


And another article about systemic yeast infections:

http://www.wellsphere.com/pet-health-article/yeast-infections-in-dogs-are-common/735661;jsessionid=573223E78BFB38CB6703FC9182B6A896

And an interesting paragraph from that article:

Quote:
Copper is perhaps nature’s finest anti-fungal agent and in several tests have proven that a deficiency of copper causes yeast infections. Zinc is also known to deplete copper in the body, and as a result copper and zinc should always be taken together.


To me it just seems like more than a coincidence that Max got so much worse after he got back from the training camp. Maybe there's a way to test the soil there for various fungi or check with the health department in that area to see if they know of anything?

Maybe your vet would consider a trial of ketoconazole which covers a variety of fungi? I'm sure Max feels like a guinea pig by now, but maybe it would work.

http://www.petplace.com/drug-library/ketoconazole-nizoral/page1.aspx

I can definitely hear the frustration and desperation in your posts - you've definitely gone above and beyond for poor Max and I'm hoping beyond hope that there is a solution waiting for him!
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/07/10 01:22 AM

Originally Posted By: kaisersmom
To me it just seems like more than a coincidence that Max got so much worse after he got back from the training camp. Maybe there's a way to test the soil there for various fungi or check with the health department in that area to see if they know of anything?

Maybe your vet would consider a trial of ketoconazole which covers a variety of fungi? I'm sure Max feels like a guinea pig by now, but maybe it would work.

http://www.petplace.com/drug-library/ketoconazole-nizoral/page1.aspx


I agree with you on all points. (Well, except for the copper zinc stuff, more on that in my next post.) GSDs are said to be particularly susceptible to fungal issues.

My Max got a lot better when the Derm added ketoconazole to his regimen. It's also available online.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/07/10 01:40 AM

Vio, I've been thinking about your Max quite a bit. I am pretty frustrated too, so it must mean that you are clearly near the end of your rope. I understand that, I have a Max too....

So I was thinking about what I would do if your Max were mine.

This is what I would do, all at once.

Since taking away different foods didn't seem to help the itching too much, I might play around with different proteins to see if there is a mix that will maintain weight better. While it takes awhile to see if a food makes things better, very often it's quickly seen if it's worse.

I would add the anti-fungal, whether on my own or with the help of a vet. I would stay on the doxy, even if you drop it to 200mg twice a day.

I would add to the diet a multivitamin, extra zinc (30 mg a day initially), biotin (intially 3 mg per day, then 2 mg per day maintenance), and a bit of kelp. If I thought that he would be okay with flax, I would add fresh ground flax, but, to be safe, best not to at this point.


I understand that you might have different thoughts on this. Regardless of what you decide to do, you will have the support of folks here.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/07/10 08:11 AM

I need to think about this.

Wouldn't yeast have shown up in his skin biopsies or any of the tests that the dermatologist did?

The shampoo was antibacterial.

I read "How did I miss this?" from this article:
http://www.greatdanelady.com/articles/systemic_yeast_mini_course.htm

And it sounds like what's been going on with Max.

But his skin isn't turning black, except on his legs. His back and everywhere else he chews is still normal color.
Posted by: JeanKBBMMMAAN

Re: Mr. Max's Issue(s) - 04/07/10 08:43 AM

I like these articles:
http://www.onlynaturalpet.com/KnowledgeBase/knowledgebasedetail.aspx?articleid=145&Keywords=

http://www.onlynaturalpet.com/KnowledgeBase/knowledgebasedetail.aspx?articleid=93&Keywords=

And would of course wink recommend seeing a University dermatologist to see if this is possibly it, and to chart out the course of treatment.

Heck, if you go to Cornell, I'll drive down and meet you there!
Posted by: myamom

Re: Mr. Max's Issue(s) - 04/07/10 09:14 AM

Vio...I belong to Noble GSD rescue...have you read Apollo's blog? (he was much worse than Max)

http://nsrapollo.blogspot.com/

I would suggest corresponding with Apollo's foster mom...I'm sure she would be happy to help//discuss Apollo's case/give advice. She is extremely knowledgeable. I know he is under the care of a University Dermatologist and they are making good progress. Let me know. I'm sure it would be nice to talk to someone going through the same thing.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/07/10 11:00 AM

I've read a whole bunch on yeast infections, and Max does show many of the symptoms and lifestyle indicators.

However, he doesn't smell and never did, and his legs are the only parts of him that have darkened.

In any event, I left a message with the Dermatologist we saw back in December and asked if there's ANY WAY, based on their cultures, that Max could have a yeast infection.

I also have an appointment with our primary vet tomorrow afternoon to discuss this. I could bring in the Hemopet paperwork and have them send out for a full thyroid panel, if you think that's worth it.

But I will tell you, at this point I'm pretty pissed off if it is yeast. That means it's been festering for months without a proper diagnosis and will probably take months of hard work to heal. Not sure I have it in me. It may be a case of too little too late in my book, which I know sucks. But I blame EVERY VET WE SAW who didn't think outside the allergy box.

mad

I also KNOW raw is the way to go to expedite results, but I'm not ready for that yet, unless I get the premade stuff.

Do you think Orijen is high-quality enough to start with for now???? Especially to try and get some weight back on before figuring out a regimen?
Posted by: kaisersmom

Re: Mr. Max's Issue(s) - 04/07/10 11:02 AM

Quote:
Wouldn't yeast have shown up in his skin biopsies or any of the tests that the dermatologist did?


I don't have the answer to that and I don't have any personal experience with my own dogs, but just from reading the one article by the Great Dane Lady, it sounds like yeasts are very difficult to test for and even more difficult to diagnose. Maybe they have to test for a specific yeast or fungus? Maybe the results were a false negative? I wish I knew. All I know is that at this point, I think I'd be at the end of my rope and would try a voodoo dance if I thought it would help!!

Quote:
The shampoo was antibacterial.


That won't do anything for yeasts - it would probably help if there was a secondary bacterial infection, but wouldn't touch the yeast. That makes me wonder even more about yeast/fungus.

Quote:
But his skin isn't turning black, except on his legs. His back and everywhere else he chews is still normal color.


Maybe because he can get to his legs easier than his back and chews on them more than anywhere else because they're accessible?

I sure wish I had the answers, but I really think the fungus/yeast possibility needs to be investigated before throwing in the towel for good - and I know you're doing everything you can for your boy. hug
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/07/10 11:37 AM

We must have posted at the same time. smile
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/07/10 02:41 PM

I went and got Nature's Variety Instinct: Rabbit Meal formula. It's a protein Max has never had, and I figured it's a good way to transition him until we're ready for raw.

Also got a probiotic/digestive enzyme to help him out.

I'll see what the vet says tomorrow. I took some of the information, put it into a Word document, and highlighted significant things, which I'll have our vet read. And I won't leave without Ketoconazole.

Question is: do I insist on Thyroid panel through Hemopet, or would that just be money down the drain?
Posted by: LJsMom

Re: Mr. Max's Issue(s) - 04/07/10 04:17 PM

Tracy, if you read this and do the math out, you will see (IF my math is correct) that Max's values are all under the 50% point. I really think it would be worthwhile to do a 30-day trial of Soloxine.

http://www.diamondsintheruff.com/HowtoAnayzeYourDogsThyroidTestResults.pdf

Which probiotic/digestive enzyme did you get?
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/07/10 04:45 PM

Joanne, your calculations were right. His cTSH is the lowest of them, falling at the very low end of the range. Though I think someone said that one didn't mean as much.

I'm happy to request soloxine as well as ketoconazole, so long as they are okay to take together.

I got NaturVet Enzymes & Probiotics, mainly because I was at the pet store at the time.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/07/10 04:59 PM

PS - in case the vet asks, anyone know the dosage for soloxine for a dog Max's size, about 90 lbs?
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/07/10 05:34 PM

Ugh and I'm finding more blood/pus-filled cysts on him. One just broke while we were playing in the yard...these are new as of a few days ago.
Posted by: 3K9Mom

Re: Mr. Max's Issue(s) - 04/07/10 06:46 PM

Jean asked me to stick my head in here (so blame her!)

A couple of thoughts right off the top of my head.

How old is your house? Where is it located? (Near a lake, wetlands, sea, windy area, etc?) I ask because Max's mold number is high, so it's a strong place for us to look. Old homes can have mold growing in them, just because well, they're older, and stuff grows over the years. NEW homes REALLY can have mold because they're built air tight. They don't breath like the homes we grew up in. Yes, they have to be air tight to be energy efficient, especially if you have air conditioning. But that means that moisture has no where to go.

Go outside and look at your roof and high on your walls. Do you see opening where your stove and bathroom vents are? If not, that moisture is just venting into your attic. Do you lack bathroom vents and just have windows? (Which is standard building code in pretty much every state -- you have to have vents OR a window. You don't have to have both). If you're not opening your windows while you're taking a shower, then you have excess moisture in your home. Does your furnace use up some of that moisture? Maybe. But maybe not.

Do you have any idea what's in your crawl space, attic and walls?

So. Mold. Poke around your house and see what you can figure out.

In the interim, I'd avoid a HUMIDifier, which creates more moisture.

As Shepnterrier suggests, filters. HEPA filters. Vacuums with filters. Filter filter filter.

Also, does Max have access to barns, sheds, raised planters, compost piles, etc? Anywhere that might be moist and have mold growing in them?

Second -- balance of vitamins and essential fatty acids.

B vitamins, but especially Biotin.

Quote:

A patient suffering from a lack of biotin may have poor hair, skin lesions, dried eye discharge, diarrhea, decreased litter size, and in advanced cases, a paralysis of the limbs.

http://www.peteducation.com/article.cfm?c=2+1662&aid=712

I was doing a food elimination diet with my dog and a couple weeks of eating foods without biotin messed up his skin and coat significantly. I was amazed. He had dry flaky skin and as he scratched, his fur broke off. I stopped the elimination diet, put him back on his veggies, fed him B vitamins and his skin and coat are recovering.

If Max were my dog, I would bring him into my vet and ask for regular B complex injections, perhaps several times a week, for several weeks to several months, and see if that helps. There is almost no downside to doing this, and the upside is good.

We can offer foods that have biotin and other B vitamins that have almost literally no chance of upsetting his ZD diet. I have NEVER heard of a dog being allergic to Swiss Chard, http://www.whfoods.com/genpage.php?tname=foodspice&dbid=16 for example. I steam it and stir it into my dogs' meals. My little beagle girl eats it straight and loves it. It provides fiber too, which may help his GI issues.

Essential fatty acids. We LOVE To throw Omega-3 fatty acids at dogs with bad skin. But O-3s HAVE to be balanced with O-6s. Every time we feed fish oil, olive oil, canola oil, etc, we HAVE to think, what O-6 am I balancing this with? The "balance" ratio is disputed. You can read anything from 1:20 (the dog food companies) to 1:3, which seems low to me. Dogs are carnivores, after all. I try to keep my dogs around 1:4-6.

http://www.livestrong.com/article/25872-foods-high-omega6-fatty-acids/

Another nutrient essential for skin/fur/immune system health is zinc. If Max is eating sufficient amounts of red meat, he's probably getting it. But otherwise, we need to look to other sources as well.

Hyaluronic Acid is also supposed to be helpful in skin health. So if your dog isn't on an HLA supplement, I would consider adding that. HLA has been tested to be considerably safe even at doses far higher than recommended, so I'm extremely comfortable giving it to my kids.

Given Max's current condition, I would ask and work WITH your vet with regard to actual supplements. I'm comfortable suggesting supplementation by vegetable food sources. These can be mixed in with your kibble or eventually, your raw diet.

I've fed Instinct on and off for years. I like that it doesn't have potato. But it does have alfalfa meal, which my last GSD was allergic to. Otherwise, I think it's one of the very best commercial foods on the market, and NV staff are very helpful.

Store the food in its original bag, then in a tightly seal-able bin (like a large Rubbermaid). If we dump the food into the bin and pour new food on top of the old (even crumbs of the old), we risk storage mites, which sensitive dogs are often allergic to.

Buy the food at a store that moves stock VERY quickly, even if it costs a bit more. Food that's been sitting around is also more likely to have storage mites. While storage mites are more common in foods that have grain, it's not unheard of for them to find their way into GF food.

One more idea I'll toss out there. Some of us have had good luck with it; some haven't. Raw local honey (it has to be both raw and local) is supposed to be great for inhalant allergies like pollens: the idea being that it works like allergy shots; a tiny "dose" of the pollen is in the honey. My last GSD did great on it now. I just started it with Celo, so it's too early to tell. I will add one caveat, since Max's immune system seems a little out of whack. They suggest not feeding raw honey to babies because it's not pasteurized, so not 100% safe. I've never doubted using LOCAL raw honey. But you may wish to wait until he's a bit more stable. Use your best judgement.

Scratching IS a calming signal. It can be a sign of anxiety. AND -- (I do this if I'm not careful) we often reinforce that behavior with attention, even if it's not "positive" (happy) attention. Before we got Celo, we painted with a mold-killing paint, put in all new carpet, put in a new vapor barrier and took other steps to ensure that our new little GSD pup wouldn't have as bad of allergies as our last GSD. Sure enough, he has some allergies, but I KNOW my house isn't causing them. He doesn't really scratch much outside or when he's playing with Meri around the house, or even when we're training and he's busy. But he scratches more, when he's around me when we're just hanging out and not doing much. What does that tell us? He's learned that scratching gets him attention. Bad Lori! Bad trainer! (or good trainer? He learned the lesson well? headbang ) So watch out of the corner of your eye and ask others to watch. Even set up a video camera. Is Max scratching more at some times than others? If so, you may be able to hone in on the PLACE that is causing the scratching (is he near your fireplace? Maybe he's allergic to the wood you're burning. Next to your bathroom? Maybe it's the mold. Or your bath oils.) Is he scratching in certain circumstances? Who is around? What are they doing? When doesn't he scratch?


BTW, Benadryl made my dog MORE anxious. I didn't realize it until I worked with a new trainer and she said "hey, this has been my experience with several dogs that take Benadryl." I took him off of it, and his anxiety decreased about 50% in about a month. It was amazing. I won't give my dogs that stuff at all now. If I have to use an antihistamine (which I really avoid if at all possible), I use Chlor-Trimeton, which I buy at Walgreens in the generic for a great price. Is it possible that Max scratches even more after you give him the antihistamine because it makes him anxious?

Keep a notebook and track his scratching and any other behavior no matter how insignificant it may seem. It may reveal more than you realize.

Finally (whew!), if the vet asks what the dosage of solaxine should be, take Max and walk out of there. This is a common drug and the vet should know the dosage. If s/he doesn't, you want a new vet. smile

Anyhow, I hope that perhaps something in that brain dump was helpful. I KNOW what it's like when the furry guy you love is miserable and you're doing everything and NOTHING is helping...but hang in there. I eventually found a combination that worked for my guy. I'm confident that you will too.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/07/10 08:00 PM

Originally Posted By: vio79
Joanne, your calculations were right. His cTSH is the lowest of them, falling at the very low end of the range. Though I think someone said that one didn't mean as much.


If the thyroid is low, then, if the TSH is working, then it should be high - they are supposed to work inversely wrt each other. The fact that the thyroid levels are below the 50% marks for a dog his age are a concern. The fact that the TSH basically says that he is *hyper* thyroid rather than hypo, says that something in that feedback loop is not working, or that the thyroid output maybe is at a maximum just to keep even a low amount of the hormone in the system.

I don't know if I would retest the thyroid, or would go straight for the trial if the thought is thyroid. I only say this because for every reason to treat, someone else can read that panel and see reasons not to treat. Ideally, it would be nice to have a free T4, free T3, and TgAA.

The standard dose is .1 mg per 10 pounds, twice a day. So a 90 pound dog gets .9 mg twice a day. At 75 pounds, my Max gets .7 twice a day which has worked for him. Indy, at 33 lbs, gets .3 in the am, and .2 in the pm, we keep her a bit low because of her heart and she throughout her life was on the lower end. Your vet, if you run a thyroid trial, might want to start lower, but I wouldn't go too much lower.

I do agree with 3K9 about being able to work with your vet....great post Lori.

My Max's Derm didn't bother to run any fungal/yeast tests for him. Basically she said, he's a GSD, he has issues with yeast, they all do. She also said that yeast is *incredibly* difficult to find, but there is typically a response to treatment.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/07/10 08:40 PM

Originally Posted By: vio79
Ugh and I'm finding more blood/pus-filled cysts on him. One just broke while we were playing in the yard...these are new as of a few days ago.


Are these perhaps old cysts that are just opening up?
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/07/10 09:20 PM

WOW. Thanks for this.

Originally Posted By: 3K9Mom
Jean asked me to stick my head in here (so blame her!)

A couple of thoughts right off the top of my head.

How old is your house? Where is it located? (Near a lake, wetlands, sea, windy area, etc?)


The house was built in the '60s. When we bought it, we gutted the kitchen, bathrooms, and den and rebuilt them. Both bathrooms have windows and vents to the outside. Same w/the kitchen. The attic got new insulation.

Location - we are an hour west of Boston (aka ocean) and in the "Hills of Worcester." So it's a hilly, breezy area with small man-made lakes around but no wetlands that I know of. Well, except for the newly-created "wetlands" from all the rain we got last week!

Quote:
Do you have any idea what's in your crawl space, attic and walls?


Not besides the new insulation. But we had no mold issue upon inspection when we bought the house three years ago, and I would think the changes would be for the better.

Quote:
Also, does Max have access to barns, sheds, raised planters, compost piles, etc? Anywhere that might be moist and have mold growing in them?


Nope, we are in suburbia.

Quote:
If Max were my dog, I would bring him into my vet and ask for regular B complex injections, perhaps several times a week, for several weeks to several months, and see if that helps. There is almost no downside to doing this, and the upside is good.


Yet another thing I can add to the "list" I bring with me tomorrow.

Quote:
Another nutrient essential for skin/fur/immune system health is zinc. If Max is eating sufficient amounts of red meat, he's probably getting it. But otherwise, we need to look to other sources as well.


Max hasn't had red meat in a while. And now we're on rabbit. I had thought about zinc in the past, and maybe that was when I was considering Nupro. The unused tub's still in our pantry...

Quote:
Hyaluronic Acid is also supposed to be helpful in skin health. So if your dog isn't on an HLA supplement, I would consider adding that. HLA has been tested to be considerably safe even at doses far higher than recommended, so I'm extremely comfortable giving it to my kids.


Is this just a supplement on its own that I can get at the vitamin place?

Quote:
Store the food in its original bag, then in a tightly seal-able bin (like a large Rubbermaid). If we dump the food into the bin and pour new food on top of the old (even crumbs of the old), we risk storage mites, which sensitive dogs are often allergic to.


Good thing that's how I've been doing it. wink

Quote:
Scratching IS a calming signal. It can be a sign of anxiety. AND -- (I do this if I'm not careful) we often reinforce that behavior with attention, even if it's not "positive" (happy) attention. Before we got Celo, we painted with a mold-killing paint, put in all new carpet, put in a new vapor barrier and took other steps to ensure that our new little GSD pup wouldn't have as bad of allergies as our last GSD. Sure enough, he has some allergies, but I KNOW my house isn't causing them. He doesn't really scratch much outside or when he's playing with Meri around the house, or even when we're training and he's busy. But he scratches more, when he's around me when we're just hanging out and not doing much. What does that tell us? He's learned that scratching gets him attention. Bad Lori! Bad trainer! (or good trainer? He learned the lesson well? headbang ) So watch out of the corner of your eye and ask others to watch. Even set up a video camera. Is Max scratching more at some times than others? If so, you may be able to hone in on the PLACE that is causing the scratching (is he near your fireplace? Maybe he's allergic to the wood you're burning. Next to your bathroom? Maybe it's the mold. Or your bath oils.) Is he scratching in certain circumstances? Who is around? What are they doing? When doesn't he scratch?


I know all about this. And yes, we do have to physically stop him from scratching, but he'll start scratching in a dead sleep or wake himself up from a dead sleep to scratch. He'll do it at night when we're in bed sleeping. He'll become so engrossed in it that when we whack the couch with something to stop him, he looks like a bomb just went off beside him. But it's not a bad idea to track thing...I've been tracking what we've been doing TO him on a calendar, but not what he's been doing.

Anyway, we'll do our best. Based on what I read about yeast, I really think that's the culprit. But who knows what else is going on because of that...since his whole immune system could be messed up. Maybe between ketoconazole, soloxine, and the better diet (and maybe supplements), Max will improve sooner than later!
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/07/10 09:24 PM

Originally Posted By: MaxaLisa


Are these perhaps old cysts that are just opening up?


No, these are new. Almost like enormous zits. The one from a few days ago dried up, but now there's the one that popped right next to his...er, forget the name. Front flexor pad thingy? Like his equivalent of a wrist. I first noticed it this morning. It's in a noticeable place, so I wouldn't have missed it before. Anyway. And I found another one on his right side, near his hip. But that one doesn't have a "head" yet or anything. I just find it odd that he's suddenly getting so many. Maybe nothing to be concerned about, but I can have the vet take a look.

Not sure 30 minutes will cover this appointment!!!
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/07/10 09:40 PM

I'm not big into the healing crisis thing, but I'm wondering if the doxy is bringing them out. If they are opening up and immediately healing, hmmmmmm...


Wonder if it's just more of a deficiency. Wonder if it's from the source of the fish (ugh, it's always something). Wonder a bunch of stuff...
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/07/10 10:03 PM

Yeah same here.

Well assume I should stop the doxy at this point, since if we're thinking yeast, not sure any sort of antibiotic would be beneficial.

And we're weaning him off fish, and I now have a list for the vet....
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/08/10 12:24 AM

I wouldn't stop the doxy. If you're talking yeast, add the ketoconazole. You still want to make sure that the tick issues aren't contributing to joint problems, or other issues. It will still act as an antiinflammatory. Finish out the prescription since you've come this far with it - might be that the doxy and keto combo might work very well together.
Posted by: kaisersmom

Re: Mr. Max's Issue(s) - 04/08/10 09:40 AM

The concern I have is that if Max's problems are from yeast or fungus, the Doxy may be adding to the problem. I really don't know what I'd do at this point - just thought I'd raise the possibility because in people Doxycycline is one of the major causes of yeast infections in males because it kills a lot of the good bacteria and allows the yeasts and other stuff to flourish - I'm not sure about dogs though.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/08/10 10:42 AM

Pat, that's what I assumed as well. Not sure if adding the digestive enzyme/probiotic would balance out the Doxy...

It just seems blindingly obvious to me now that it's yeast. The following (which I'm bringing to my vet today) basically describes Max to a tee:

"Here is a typical scenario……let’s say your dog is 3 years old and been fed a grocery store level food. It was on antibiotics a couple times for an infection. He has been healthy up until now, but one day you notice he is shaking his head, scratching his ear or perhaps chewing at his feet -- only once in a while. Then a few days later it seems to be with more frequency. Soon the dog chews its coat, its skin is raw or itches himself more often than normal, and it is obvious there is a skin infection. There starts to be patches of baldness and black spots particularly on the underbelly and legs of the body (yeast die-off residue) remember that skin is the biggest filter organ on the body. In extreme cases the dogs can start to have seizures, constant issues with reoccurring urinary tract infections, lethargy, skin welts and baldness etc.

So off we go to the vet….and what do be get?....we get an antibiotic ointment for the ears, antibiotic for the coat to make sure there is no secondary infection, and a shot of steroids to temporarily stop itching and a suggestion that "this is a food allergy" let's switch to Hills or Purina prescription diet.

The dog improves for a few days, thanks to the steroids and the antibiotic starts to clear up the itching secondary staph infection, then all of a sudden days later the dog is in full blown chewing, itching, red feet and ears and absolute misery.

And as always, when the body is in a "heightened state" of response, the least little thing can set it off and it seems come up on an allergy test as some kind of reaction from belly button lint to lima beans, from wheat to Kleenex, from fleecy toys to popcorn. You name it your dog "seems" to be allergic to it! I have seen it all on these tests. The owners return home baffled (we never eat lima beans?) and confused and a whopper of a bill and one "big-arse bag" of that expensive prescription dog food that your dog REFUSES to eat. By the time you are done with all this, you could have bought a time-share in Cabo and Prada shoes!

It is my opinion the majority of systemic yeast overgrowth problems in dogs, get mistakenly diagnosed as a food allergy."


I remember yeast being mentioned a while back as a consideration, and maybe we should try ketoconazole, but at the time Max didn't really show any related symptoms. In hindsight, I wish I'd pursued the avenue back then, maybe preventing him from getting to the point where he is now!! (There needs to be "kicking myself" icon.)

Though I will say, you'd think that between our vet, the holistic vet, the dermatologist, and the "integrated" vet, someone would have considered it. Is yeast THAT far outside the box???!!!!!
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/08/10 03:12 PM

Originally Posted By: kaisersmom
The concern I have is that if Max's problems are from yeast or fungus, the Doxy may be adding to the problem.


I absolutely agree, BUT, at this point, there might be a couple of things going on. Finish the doxy, at the same time, start treatment for fungal issues. Fungal treatment is ongong and takes a LONG time, the doxy will be done soon.

Also, if there is pus opening up right now, there are secondary bacteria issues.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/08/10 03:16 PM

Originally Posted By: vio79
Though I will say, you'd think that between our vet, the holistic vet, the dermatologist, and the "integrated" vet, someone would have considered it. Is yeast THAT far outside the box???!!!!!


It's something about the mindset...

I can't tell you how many times I talked to my regular vet about the yeast issue, yet she didn't want to treat without further evidence. Yet that's about the first thing that the Derm did when we walked through the door.

Yeast on the skin should also be treated with an anti-fungal shampoo, it's different than internal yeast. A dandruff shampoo like Selsuin (sp?) Blue was what the Derm said she has her clients use, since human dandruff is the same yeast (I hadn't known that at the time!)

eta: the probiotic would *really* help with balancing the doxy.
Posted by: kaisersmom

Re: Mr. Max's Issue(s) - 04/08/10 03:20 PM

Quote:
Also, if there is pus opening up right now, there are secondary bacteria issues.


True...... Maybe the vet will culture some of the pus and find out what exactly what antibiotic the infection is susceptible to in case it's not Doxy.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/08/10 03:52 PM

Well I'm leaving in a few minutes for the vet....I'll let you know how it goes!
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/08/10 06:06 PM

I don't even know why I'm posting this, because I know what the reaction will be. But I feel obligated to. Please don't make me feel worse than I already do! And don't tell me yet again to switch vets. At this point, if what we do now doesn't work, I'm done.

I brought Max in, and the vet's first reaction was how skinny he was. His weight is now 84 lbs, which is down 8 lbs from his weight on March 15th. As I explained our latest yeast theory, I took out my paper about yeast infection, highlighted and everything, and she just kind of brushed it off. She agreed that it could be yeast, but she also said it might not be. She said the darkening of his skin wasn't necessarily due to dead yeast cells.

But she humored me and is putting Max on the ketoconizole (800mg/day for a week and then 400mg/day for a week). She also gave us Cefa caps in case we need them for his pustules and told us to stop the doxy.

She would NOT give me Soloxine, saying the Free T4 levels weren't low enough and the TSH wasn't high. She was concerned adding soloxine would cause Max to lose even more weight.

Here's the part you'll flip at: she gave him both ivermectin and prednisone injections "just in case." When I tried to object and ask why it was necessary, she said she wanted to cover the bases. And she did everything so quickly...I probably should have put my foot down, but I suck at standing up to these people!!!

Anyway I have to check back in with her next week and possibly get blood work to check on Max's liver values.

Of course if Max improves, we don't know if it's due to the injections or whatever else.

Oh yeah we also have special medicated shampoo for yeast - with ketoconizole in it.
Posted by: JakodaCD OA

Re: Mr. Max's Issue(s) - 04/08/10 07:36 PM

Tracy, I feel your pain and I know nothing can be more frustrating:((

I don't know if I ever mentioned my aussies 'fungal' episodes, but here it is, take it for what it's worth, Jag began developing these nasty 'sores' quite a few years ago, at first I thought food, (and I have tried every food out there, nothing lasted long). The 'sores', begin as itching, erupt into raw, nasty pus draining skank (is that a word? LOL) I would treat them, they last for awhile, but when it finally scabs over, the scab is like black tar(only description I can think of) as soon as the scab peels off, within a day of scabbing, there is clean new pink skin. On to another spot.

I notice they would crop up in late winter, fall, so I was going air/ground allergies since the 'food' thing was not working.

What's interesting is, he never gets these "eruptions' on his stomache or legs, it's usually, face, neck, hip, sides area.

I kept getting skin scrapings, nothing was showing up, but maybe timing was off..the last one I got was a couple years ago, and it's FUNGUS..He is a major DIRT eater:))

He continues to get these sores, and we're clearing up a couple right now. My vet suggested using Athlete's Foot creme, since athletes foot IS a fungus.

While it hasn't 'stopped' the eruptions, it has helped in healing them. I also give him medicated baths atleast once a month, and also use a foam spray for fungal hotspots(forget the name right now)..Does provide relief, he isn't as 'itchy', and his sores heal faster.

I also had switched him at one point to Pro Plan sensitive skin/stomache which he did great on, but started porking on the pounds. Right now he's on fish based TOTW. But I don't personally think his problems have anything to do with food.

Ok, done,,just wanted you to know you aren't alone, it can be very frustrating going from one thing to another.

I hope the keto helps, (I would be surprised if it didn't!!It's supposed to be good stuff)

Hang in there, I hope Max feels better on his new meds.
Posted by: 3K9Mom

Re: Mr. Max's Issue(s) - 04/08/10 08:41 PM

Does he SMELL yeasty? I was just chatting with my vet, and she said that dogs, esp GSDs who have yeast infex, smell yeasty. That when you walk into the room, it's almost always overpowering.

Diane has a good idea. Also if you look in the women's hygiene aisle, you can find name-brand anti yeast and anti-fungal creams. I might be inclined to try one of those for a week. And if I didn't have success, then give him a week off, then try the other. I wouldn't go with the one-day creams (which I kind of think might be too potent?), but with the 3 or 7 day.

But as in all things, run this by your vet. Of the whole team that you have, isn't there ONE vet that you feel like you can bounce ideas off of? One of them that's willing to think outside the box a bit? Take suggestions?

Today, I brought Celo in for his itchy skin and my vet told me what she thought it was and what course of action she thought was appropriate. I asked her about a vitamin B injection for him and something else. She said the B injex was a good idea and she's glad I thought of it, and the other, she thought wasn't necessary, and here's why. With difficult cases, I've just found that I HAVE to have at least one *partner* that I can talk to and ask What about this? Have you thought about that? And this? My vet carefully considers everything I say even I tell her "my online GSD friend suggested we do this." BTW, my best partner in a case is not necessarily my regular vet (heck, it might even be one of my best friends who is a surgeon). It just depends.

You have received a lot of advice in this thread. Some of it is VERY contradictory, and some of it, I would never follow. That's why I think that you need to have a vet that you can work with. I have a great team of vets and specialists that I've worked with over the years. But there are only a couple that I can trust to really listen to me, and more important, they HEAR me. And they respect me enough to tell me the truth about what they think. Unvarnished, not sugar-coated, the truth as they see it.

It sounds like from the specialists you have assembled, you probably can find someone like that within your team. But if not, then you may need to keep looking. Why? for Max's health AND your sanity. In complex cases, we can't make informed decisions without having good information and an honest sounding board.

And most importantly, this person can be objective. When we're stuck in the day to day agony of our dog's illness, our partner can say, "it's time to do X.... " X may be a procedure we've been avoiding, driving 20 hours to a university hospital, using a drug that we absolutely didn't want to do, or something else. But the partner keeps us honest. And THAT is what my dog -- and I -- deserve most of all. Perspective and objectivity can be hard to find in these cases.

Please know that I'm not criticising you Tracy. I've just been there, deep in the trenches with several of my dogs. I know how agonizing this can be. We need someone we can lean on, but not just a friend or family member who is kind and loving (although that certainly helps). Rather, we need someone who can hold the candle to help show us the way and so that there always seems to be a bit of light at the end of the tunnel. hug
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/08/10 08:52 PM

Max doesn't smell yeasty at all. In fact, he has a nice smell.

The vet I just saw has usually been the one I can talk to - but I think even she's given up on us. She's basically giving me almost everything I ask for. Probably because she feels badly about having boarded him for two weeks and him coming out of it worse than he went in. But yeah, I'm always telling her about the advice I get on this board. Some of it she adamantly disagrees with (Soloxine for one) and some she's willing to work with (Doxy).

I guess at this point I'm having trouble putting forth more time, effort and money. It sounds bad but we got Max last May. During this whole past year, we've only had 2 weeks of "normalcy." We were misled by the shelter from the get go. If we'd known his age and medical issues up front, I'm sad to say we would have left the place without him - and I'm sure he'd be euthanized by now.

If this treatment doesn't work, I'm done...really. No more vets, no more treatments, nothing. You guys can swear me to hell if you want, but I can't afford this mentally, physically or financially anymore.
Posted by: 3K9Mom

Re: Mr. Max's Issue(s) - 04/08/10 08:55 PM

BTW, a single steroid injex may be very helpful. It will act as an anti-inflammatory, relieve his itching (and break the cycle of itch/scratch -- which causes more itching -- therefore itch/scratch). I DON'T like cortisone injex at all as a general rule. But a single injection can be like a roadblock. It stops traffic for a while so that the body can do some road repairs to the skin. While side effects CAN be substantial, they aren't that common. There's a reason why this drug is used so frequently by vets and physicians alike.

The ivermectin? I'm no expert on that at all. But what's done is done. If he does have scabies, that is an accepted treatment.

So don't kick yourself for not protesting more strongly. Who knows? These MIGHT work. Hopefully, they won't cause side effects.

One suggestion I would make is that if you possibly can, bring a friend (preferably a strong-willed friend) with you next time you go to this vet. Or, go to the holistic vet instead. I assume she's a DVM: she should be able to prescribe Rx drugs (if they're indicated) as well. I've kind of been wading through the details: did any of the other vets think the thyroid meds were necessary?
Posted by: 3K9Mom

Re: Mr. Max's Issue(s) - 04/08/10 09:11 PM

Originally Posted By: vio79

If this treatment doesn't work, I'm done...really. No more vets, no more treatments, nothing.


One of my neighbors went through the whole "trying to find the cause" thing with her little dog's skin issues. Nothing. I gave her all of the info I could. We tried everything. She's a great person and an awesome dog owner. Her little dog now lives on ZD (and ZD snacks, that's it), steroid shots (and an occasional Benadryl). Is it ideal? No. But he's doing well. He's happy: he's living his joyful little life. His fur has grown back in. SHE isn't pulling out HER hair, so he's not anxious because she's a wreck worrying about him. We don't know what the long-term prognosis is for him (she knows the cortisone and Frankenstein food must have long term side effects).

But at some point, there's a quality of life issue. The ZD and shots aren't inexpensive, but she feels like they're doing SOMETHING, unlike all of the tests and everything else she was spending money on.

The pursuit of "Perfect" can get in the way of "Good." I tend to be a "Perfect" pursuer, but I always try to keep quality of life as my highest and best goal (that's part of the job of my partner -- to ensure I don't forget that).

Let's see how Max does.

If he does seem to improve at all, though, ask about the Vitamin B injex. That will help the skin repair itself.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/08/10 10:53 PM

Nobody mentioned the Thyroid. Even the vet who came highly recommended by several people scoffed when we suggested thyroid (he had all our records). Holistic vet just wanted us to give him home-cooked everything and tons of random supplements.

Anyway, we'll see how this goes. I'm hoping for improvement, and if there is any, we'll go with it. I agree about the whole Z/D story...if we find something that works for him, we'll go with it. But so far, NOTHING has for more than a week. And I'm sure you don't want to read through all 30 pages, plus what I started on the old message board, but just ask Lisa or Val. We really have tried almost everything!!!!

(Thanks for being understanding. I think my mental state is clouding my vision.)
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/08/10 11:14 PM

Vio, I would still consider the zinc and biotin. Btw, zinc is important for thyroid function, so that may help there also.

Be careful of adding any supplements that may contain yeast. For example, if you went with a B complex, most of this are yeast based. you will be okay with a zonc only and biotin only though.

My max was put on 200 mg of keto per day, later I will try to remember to look up the therapeutic dosage. But Max here she said will be on it for life most likely, because his fistula meds are most like for life. I hope the higher dosage means that it will work quickly.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/08/10 11:18 PM

Btw, my Max never smelled much, unless his ears were flairing up.



Jakoda, did you ever treat Jag with keto? Does he keep reinfecting himself from the soil?
Posted by: kaisersmom

Re: Mr. Max's Issue(s) - 04/08/10 11:42 PM

All good thoughts and fingers, toes and paws crossed that this new regimen of drugs helps.

The reason I asked a few posts back about the location of the training camp was because if it was some distance from where you live, the vets in your area might not even be thinking about some of the fungal diseases seen in other areas, found in the soil in other locations, etc and that might be why none of them considered yeast/fungus possibility.

Hopefully the steroid injection will give Max at least a little break from the itching and scratching and if it is yeast/fungus, the keto med and shampoo will have a chance to work.

I don't know if you're familiar with the Nzymes products, but here is a link to their website with several stories and photos of dogs with systemic yeast infections - you might be interested in "Blizzard's" story in particular. They sell a "Yeast Kit" also (I realize you're not going to buy the product now, but just thought the stories were similar to Max's):

http://www.nzymes.com/pc/viewContent.asp?idpage=16
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/09/10 08:20 AM

I think next week when we see the vet (I'm making my husband come this time), we're going to bring the Hemopet paperwork and insist they send blood there. At least then we can absolutely eliminate a thyroid issue.

Though Max did fit the descriptions for yeast, I'm still not totally sold.

This morning he seems just as itchy as before...but I can't remember if the steroid shot would have instant results. Ivermectin wouldn't.

Today I need a day off...no work for me. Maybe watching movies with Max and our midday walk in the rain. sleep
Posted by: PositiveDog

Re: Mr. Max's Issue(s) - 04/09/10 11:23 AM

hugging Hugs to you and Max. It has been a difficult year and Max is in the right place with you.

I know you are making some difficult decisions, but I see things like this:

Quote:
Today I need a day off...no work for me. Maybe watching movies with Max and our midday walk in the rain


Even on your much needed day off, your time is spent with dear Max. He is much loved and you will do whatever is best for him. Whatever that is, you will find support here.
Posted by: Avamom

Re: Mr. Max's Issue(s) - 04/09/10 01:00 PM

Hello Vio79,

I don't do the forums much anymore, so I had not seen this or your thread on the other board, but I had several people direct me to this thread due to my saga with Apollo.

First let me say I totally understand how overwhelming this is emotionally and financially. I would be in tears with Apollo many times because it hurt me to watch him scratch himself bloody and be miserable. And to see drug after drug not fix him and vet advice that conflicted or just seemed like guesses.

My goal and wish for Apollo has always been for him to just have quality of life, he didn't have to look perfect or smell perfect as long as he was happy, 2nd goal was to fix him....Now, 3 years later (and several vets later), Apollo is a happy, happy boy who rarely itches now...but he is still predominately bald. We haven't "fixed" him yet, because with skin issue you normally don't cure them...just manage them....but he is happy, that is what is important. I'd like to talk to you about how we got to that stage and see if any of my experience might help you and Max.

I have read through this whole thread and see you have tried many things and spent countless hours researching things, unfortunately none of which have made him stop itching or stopped what caused the itching. I know how frustrating that is...

Can I ask you a few things...
1.) How long ago was his last skin biopsy?
2.) Has he ever had a skin culture to test for antibotic sensitivity?
3.) Is he on anything for his environmental allergies that you have results for, i.e. antihistimine, allergy shots, etc?
4.) Do his pustules look like circular rashes, and/or ant bites (the stage when its red with a white/yellow pus head)?
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/09/10 01:37 PM

Originally Posted By: Avamom

Can I ask you a few things...
1.) How long ago was his last skin biopsy?
2.) Has he ever had a skin culture to test for antibotic sensitivity?
3.) Is he on anything for his environmental allergies that you have results for, i.e. antihistimine, allergy shots, etc?
4.) Do his pustules look like circular rashes, and/or ant bites (the stage when its red with a white/yellow pus head)?


Biopsy was in December, I believe.
I don't believe he's had a culture for antibiotic sensitivity.
Nothing we've tried for environmental has worked. Never did allergy shots because nobody tested for allergies (most thought it was food).
The pustules look like large mosquito bites, and then they pop. I never notice heads on them beforehand.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/09/10 01:43 PM

Avamom, what a great resource you are!

A slightly offtopic question, have you ever considered melatonin for the hair loss? Thinking something like Alopecia X, which I'm thinking would be pretty obscure for a GSD.


Vio79, my main issue with the steroid shot is that, previously, neither pred nor Aropica could control the itching or make much of a dent. Remembering that, I don't see how the steroid shot would help. It should act pretty quickly if it would help, I would think.

I don't know how fast the ivermectin would help if this were mange.

I also understand how you don't yet completely buy into the yeast thing. Having had so many treatment failures, I would be cautious, as you are being. But we can have a little hope, and maybe Avamom can help with getting this nailed down.

Eta: I just gotta add a bit of a rant here about the vet and doxy. Go do a search on Pemphigus and doxy. Pemphigus is a pretty severe simmune system ulcerative skin disease. Before trying steroids, doxy is the treatment of choice for modulating the immune system, skin inflammation, and some bacteria. While it may turn out not to be the right abx for Max, it's clear that your vet isn't aware of these other things. I really *hate* it when people dismiss ideas that they really aren't well-informed about. I hate that at every level, it shows no intellectual curiosity either.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/09/10 04:06 PM

I guess that's the one thing about vets who have been in practice for a long time - they're pretty set in their ways. Not sure they're as good at staying abreast of new discoveries and stuff like human doctors need to be.

*sigh*

It's annoying have to do all the work on your own - I guess it's sometimes the same with human doctors though. Half the time you need to do research and MAKE them consider other options.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/09/10 04:56 PM

Do enjoy the movies with Max.

Saw your pic with him hanging his out of the car, great shot wub
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/09/10 05:06 PM

Thanks smile

Driving is his absolute favorite thing (well, I bet chasing squirrels would be better if we let him). It doesn't matter where we're going, he'll jump into that car until his legs won't let him!
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/09/10 06:19 PM

I didn't notice the tongue sticking out in your avatar - that's pretty funny laugh
Posted by: 3K9Mom

Re: Mr. Max's Issue(s) - 04/09/10 06:21 PM

Hey Tracy, I don't want to disappoint you, but Dr. Dodds may not "absolutely" rule anything in or out. With TWO of my dogs (different breeds, different ages, different symptoms), she offered a big mushy "maybe." So, I think it may be worth doing the Hemopet test. If she says "yes," then your vets will probably accept it and a clear "no" will allow you to put that matter to sleep and give you peace of mind (on that issue at least).

But she may not give you the black & white "yes" or "no" that you are hoping for.

Sigh. It's never easy, is it?
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/09/10 06:24 PM

I agree, BUT, if you do run a full panel (her T5 panel that includes the TgAA), hers is usually the cheapest and then at least you have the blood values. Interpretations, even Dodds', as Lori says, are just that, interpretations, and often mushy.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/09/10 07:02 PM

Originally Posted By: 3K9Mom
Hey Tracy, I don't want to disappoint you, but Dr. Dodds may not "absolutely" rule anything in or out. With TWO of my dogs (different breeds, different ages, different symptoms), she offered a big mushy "maybe." So, I think it may be worth doing the Hemopet test. If she says "yes," then your vets will probably accept it and a clear "no" will allow you to put that matter to sleep and give you peace of mind (on that issue at least).

But she may not give you the black & white "yes" or "no" that you are hoping for.

Sigh. It's never easy, is it?



True, but if we can get a more comprehensive report, and maybe a leaning one way or the other, I may be able to convince my vet to prescribe soloxine. But that's only assuming the full panel expands upon what we already know: that his levels are below 50%.

If Max is somehow doing better by next Thursday, then we won't have them send blood work to Hemopet.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/09/10 11:09 PM

Originally Posted By: vio79
Originally Posted By: Avamom

Can I ask you a few things...
1.) How long ago was his last skin biopsy?
2.) Has he ever had a skin culture to test for antibotic sensitivity?
3.) Is he on anything for his environmental allergies that you have results for, i.e. antihistimine, allergy shots, etc?
4.) Do his pustules look like circular rashes, and/or ant bites (the stage when its red with a white/yellow pus head)?


Biopsy was in December, I believe.
I don't believe he's had a culture for antibiotic sensitivity.
Nothing we've tried for environmental has worked. Never did allergy shots because nobody tested for allergies (most thought it was food).
The pustules look like large mosquito bites, and then they pop. I never notice heads on them beforehand.


Vio, in all the stuff you have tried, you forgot about the allergy tests! Here they are:
http://www.germanshepherdhome.net/forum/ubbthreads.php?ubb=showflat&Number=18110#Post18110
This is one of the reasons I wanted to build up with the Belfield protocol, to help with those allergens.
Posted by: JakodaCD OA

Re: Mr. Max's Issue(s) - 04/10/10 09:10 AM

Lisa, no I never went with keto on him, and yes he keeps reinfecting himself, he's a major dirt eater, and well, I can't monitor him 24/7 and I do see the 'outbreaks' more frequent when he has gone on one of his dirt eating missions. I'm sure his immune system isn't the greatest (the result of a merlex merle breeding)

His 'sores', are only smelly when they first erupt and ooze, keeping them clean definately gets rid of any odor..

I'll have to see if I can get some good close up pics of his later today..He's got one that's healing nicely, and one that's still rather icky.


Tracy, I'll tell you what I would do at this point with your boy, (and I know how frustrated you are). I'd be dumping that vet who seems to be going in circles, and I'd take him to either Angell Memorial or Tufts (since your in MA these are both pretty accessible to you)..I know it's more expense, but that would be my last ditch effort , and I would be content to know I had done everything in my power and then some.

If that doesn't pan off, I'd take him off EVERYTHING, and go from there...

That would just be "me", if I were in your situation.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/10/10 10:03 AM

Originally Posted By: JakodaCD OA

Tracy, I'll tell you what I would do at this point with your boy, (and I know how frustrated you are). I'd be dumping that vet who seems to be going in circles, and I'd take him to either Angell Memorial or Tufts (since your in MA these are both pretty accessible to you)..I know it's more expense, but that would be my last ditch effort , and I would be content to know I had done everything in my power and then some.


I know what you're saying, but what will Tufts try that hasn't been explored? What's left? We're treating him for yeast, we're transitioning him to better food, we've added probiotics, we'll add in more vitamins once he's digestive issues are better... I just hate to put him through the hassle of "getting to know" another set of vets just to be told the same thing again.

We also found a tick on him last night. Grrr. Must have just gotten him, because it was totally flat and flesh-colored. Pisses me off though. Between the Revolution, Ivermectin, Etc., I would think ticks would find his blood so unappealing. $@#%$ ticks.
Posted by: kaisersmom

Re: Mr. Max's Issue(s) - 04/10/10 10:24 AM

Quote:
I'd take him to either Angell Memorial or Tufts (since your in MA these are both pretty accessible to you)..


I'm currently reading a book by Dr. Nick Trout, one of the vets at Angell Memorial called "Tell Me Where It Hurts". He talks about how vets' patients can't tell them where it hurts, so vets have to be able to "think outside the box" more than human physicians and in a place like Angell, they've seen so much more than a vet in private practice possibly can and the Angell vets deal with both routine and the most difficult cases. Just reading about their thought processes in the book is pretty amazing - makes me wish I lived in Boston if my dog ever needed vet care for a difficult case!

Angell Memorial and the vets there sound awesome. I totally agree with giving them a try - their website says you need a referral from your primary vet, but I wouldn't think that would be a problem.

http://www.mspca.org/vet-services/angell-boston/dermatology/

I know you're skeptical at this point about trying somewhere new and are wondering what they can do that hasn't been done already. But since Angell (and Tufts) are in your area, I'd at least consider giving one of them a try, especially if Max doesn't start to improve with the new regimen. They've seen the worst of the worst cases and have the luxury of consulting with other members of the team.

Quote:
I know what you're saying, but what will Tufts try that hasn't been explored? What's left?


Who knows?? But that's what places like Angell are for - it could just be a certain combination of drugs; some supplement that he's lacking; etc. I know it feels like you've tried everything and you're at the end of the road and at the end of your rope. But instead of spending any more money trying this and trying that with your current vet, especially since by your own admission you feel like your current vet is giving up on you, I'd give Angell a try if Max doesn't start to improve.
Posted by: JeanKBBMMMAAN

Re: Mr. Max's Issue(s) - 04/10/10 10:53 AM

Originally Posted By: JakodaCD OA


Tracy, I'll tell you what I would do at this point with your boy, (and I know how frustrated you are). I'd be dumping that vet who seems to be going in circles, and I'd take him to either Angell Memorial or Tufts (since your in MA these are both pretty accessible to you)..I know it's more expense, but that would be my last ditch effort , and I would be content to know I had done everything in my power and then some.

If that doesn't pan off, I'd take him off EVERYTHING, and go from there...

That would just be "me", if I were in your situation.


First, Tracy, not sure how you keep track of all this!

I agree with Jakoda. I would take the questions from Avamom and go to either Angell, Tufts, UPenn, or Cornell. I see that Dr. Tater (love that name) trained at Cornell, so she trained under two incredible dermatologists and can also more easily pick up the phone and give them a call than most for a consult.

UPenn has some advantages because they developed the niacinimide (or whatever) protocol. Among other things, that has kept Sean from this board going for many healthy years, with a condition (histiocytosis) that is extremely difficult to manage. I believe his mom sees a dermatologist in IL with him. Anyway, I would consider them for this reason.

My mind numbing insistence on seeing specialists is due in part to watching a dog on IMOM slowly slip away from mange. Demodex mange shouldn't kill a dog, but by the time they got her to UPenn, it was doing that. She was an adorable GSD named Simone. Had they seen the dermatologist in time, she might have made it. Sadly, she did not.

While Max is not in this boat, he and you are uncomfortable. I have eczema and there are days when I want to rip my pinky finger right off because of the itch, if I can't get to my hydrocortisone cream. The bubbling and the clear liquid stings and burns!

It seems like KathyW, SeanRescueMom, Avamom, ShepNTerrier, myself (maybe there are more I have missed) have all had great experiences going to a dermatologist. I always take a list wherever I go (my doctor, vet offices, wherever) and am more than happy to work with you via PM to make one up. I have learned to advocate and work as a team with a physician after not being able to get a diagnosis for myself for 3 months...seeing specialists, etc. Lists and print outs are a big part of that. Each time one my dogs or fosters goes to the vet for a procedure, the girls at the desk ask for "the list". smile

And finally, agree very much with Jakoda about taking him off everything. My vet says for every molecule in a med or supplement that does what it is supposed to do there are other molecules doing other things...and in his case, that may agitate. When Bella's alien came back, I took her off everything and am slowly adding things. Ava had funky bloodwork last month and instead of supplementing to fix it, I did nothing so that I would have a good comparison this month.

Also, all of these things in this thread should only be suggestions that you review with a trusted veterinary doctor as a partner. One that sees nothing but skin issues day in and day out would be my choice. When Dr. Scott walked into the room with Nina...he took one look and said the pathology report diagnosis (not from Cornell) was incorrect. Not only that, he was ready to be a partner in her care from that point on and requested the slides from the path lab and personally reviewed them to give us the correct diagnosis.

Just like that show Mystery Diagnosis, it takes the right person to help us after seeing many others.

You have not quit yet! I know you can find someone like this.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/10/10 02:02 PM

Taking off everything I really have to disagree with. It's not like he's on a bunch of stuff. He just started ketoconazole and perhaps finishing off the doxy, both reasonable trials. Even if a Derm appt is scheduled, I would not stop those meds until it was clear they did nothing or the Derm gave me a better option. It's not like he's on a bunch of supps, I think he's on exactly none at this point.

Vio, Revolution sucks at tick control. It only claims to be effective against dog ticks (not deer ticks that carry lyme, etc), and my neighbor here had terrible problems with dog ticks while her Golden was on Revolution.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/10/10 02:09 PM

I see what you guys are saying, and....

@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*@#$%@&%*

I guess since we don't think it's allergies, I can go back to HeartGard and Frontline Plus (or Bug Off, or whatever) for the time being.

The Pred/Ivermectin did CRAP.

This is all I have to say for today.

(Max is on Ketoconizole & probiotics.)
Posted by: Wisc.Tiger_Val

Re: Mr. Max's Issue(s) - 04/10/10 02:28 PM

Tracy,

What is the schedule with the Meds and the Probiotics? It is important that there be at least 4 hours between the two. I am sure that I posted it before, but some times things can get lost in all the information.

Val
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/10/10 02:53 PM

Originally Posted By: vio79
The Pred/Ivermectin did CRAP.


Yeah, the sign of a good vet is that they don't repeat failed treatments frown

I'm sorry Vio hugging
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/10/10 03:09 PM

I lied. I have more to say. I'm also ready to THROW SOMETHING.

Dr. Tater from Angell is on medical leave until the end of May, so scratch that. I could try Dr. Ackerman at Tufts, and will call Monday.

My vet just called me from Tampa, where she's at some vet conference. She said she spoke to some dermatologist down there and they have a new plan of attack. I really don't know if I agree with it, and I know you won't. I want to cry now, I really do. Oops, I am...

1. Start adding the Cefa caps to his regimen.

2. Put Max on a Hills J/D diet (any "vet" who prescribes this is insane) - she said she's okay with us giving him any food that's better for him, whatever we want, but add omega 3 fatty acid supplement "until he gets diarrhea and then pare back."

3. Restart the Comfortis as a precaution.

4. In three weeks, give Max his next tick treatment. She's okay with Frontline, but shed have to check about collars and any reaction with the other drugs.

5. Put Max on amitriptyline. I looked this up and it's an anti-depression med! They think it will help with his obsessive itching.

6. Bathe every week with antibacterial or antifungal shampoo. This is unrealistic for us, at least until the weather gets warmer.

I agree with improving his diet, which we're doing. I agree with bathing. I agree with trying Comfortis again. Why not? We spent $80 on the pack and only used one tab. She already called in the prescription for amitriptyline to CVS.

I asked about a referral to Tufts or Angell, and she said she doesn't think we need one, but they can call her on her cell if for some reason we do.

So I guess at this point I can call Tufts on Monday...I don't feel good about giving him all these drugs!

Val, we are giving him the meds and probiotics at the same time, because both need to be given with food and we only feed him 2x/day. I guess I could give him midday "snacks" with the probiotic, which would be between breakfast and dinner...do you have a suggestion?

Anyone have suggestion for a good fatty acid supplement? I'm too overwhelmed to think right now.

PS - should we do Hemopet when we're there next Thursday at this point?
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/10/10 03:21 PM

Vio, I'm pretty sensitive to oils, and have done well on this one: http://www.vitacost.com/Country-Life-Omega-3-Mood

Back in a bit to talk about drugs and Derms.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/10/10 03:35 PM

Forgot to mention, that's the same oil I give Max.

About Derms and drugs. Most Derms use drugs, they use multiple drugs, they use scary drugs. But that's what they do, and their comfort level with them is different than a regular vet's.

Basically everything that that derm told your vet, we have here in this thread, but they use them all together, and are better at directing you to do that.

The anti-fungal keep. Add an antibiotic for the skin (cepha vs doxy), add the anti-depressant (that's the scullcap connection), hit the Comfortis for insurance, use an antifungal shampoo, etc.

Derms are more comfortable stacking everything together, because the problem, particularly at this point, is not one thing, it is several things. So to treat, it's the kitchen sink approach. That's not to say that it's not well thought out and reasoned, but when there are multiple issues going on (as with your Max), you have to hit every single side of that issue at once - all treatments used together are needed, otherwise all treatments used individually fail.

So, to adjust your mindset, you will have to throw the kitchen sink at him to get him better.
Posted by: JakodaCD OA

Re: Mr. Max's Issue(s) - 04/10/10 03:43 PM

would like to clarify, as a last ditch (and I mean last ditch) would I take him off all meds and go from there..didn't mean to suggest to just stop it all now.

And I totally agree with the Angell or Tufts having seen it all and most likely have much more knowledgeable doctors there because of this.

I'm glad your calling Tufts, and I truly hope it works for Max.
I know you'll keep us updated
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/10/10 03:47 PM

That makes sense Diane.

Max is having similar nasal infection problems with the yard, at least I think that's a contributor, so I feel your pain Diane!!

I wonder if giving him a soil organism, like a probiotic (primal defense) would help with the dirt eating?



Vio, forgot to mention, probiotics don't need to be given with food. I've found them more effective away from food. Maybe your probiotics have something more in them, or are not capsule?
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/10/10 04:12 PM

Lisa, the probiotic is a powder form...I don't think he'd eat it on its own. So I could easily just give it to him with a handful of food around 1 p.m. every day.

Are you saying you agree with this "all at once" approach? I thought it's bad to do, because then you don't know what's actually working? Or in this case, does it matter anymore, so long as it works? And then remove things one by one.

Diane as for Tufts, we'll see. My husband isn't as gung-ho about it as everyone else, especially if they'll just tell us more of the same and charge us a ton of money.
Posted by: Wisc.Tiger_Val

Re: Mr. Max's Issue(s) - 04/10/10 04:24 PM

Tracy, Probiotics with or without food isn't a problem. The problem is giving them with ABX. You basically knock down the effectiveness of the ABX because it is so busy killing the good stuff in the Probiotics, that it runs out of steam so to speak to work on the bad stuff you want it to.

I will give you my take and experience with Cefa assuming you mean Cephalexin. Since Max has already been given them, If this is the right treatment then in my experience your Vet needs to give a pretty high dose and for an extended period of time, not 20 days I am talking 45+ days. If there are bus like Staph causing some of his problems the short treatment before just made the bug more resistant to the Cephalexin. I know others had their opinion but I was leaning towards a Staph infection. When Lakota flares up this skin will get black or darken, he will pop oozing sores, he will itch himself bloody and he will chew on his feet until they bleed.

The other possibility when reading what Diane posted would be Yeast infection. Look at the links she posted and go to the instructions for the Yeast Kit. It will give you food ingredients that are good and bad. It isn't a bad idea given that it looks like Max might be on ABX again, which makes the yeast growth even more possible.

Val
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/10/10 04:27 PM

Originally Posted By: vio79
Are you saying you agree with this "all at once" approach? I thought it's bad to do, because then you don't know what's actually working? Or in this case, does it matter anymore, so long as it works? And then remove things one by one.


I'm trying to figure out how to answer this.

My first response is yes, I agree with it. My second response is that I would have picked out a different kitchen sink, to continue with a possibly bad analogy. That's one of the reasons I wanted to continue with the doxy (since it had already been started), and wanted to combine some key nutrients, and previously had asked about the Comfortis, but I think you had just applied the Revolution.

At this point, it's not one thing. Perhaps it never was.

Had all of this come up before I started battling PFs with Max, and before I knew about dogs like Sean, I would be so much more hesitant (and resistant) with the drugs. In discussions with the Derm and experience on the GSDs boards, so much of this is about the GSD immune system, the ever so faulty GSD immune system frown Skin and mucous membranes are often their weakest point, immunity wise, due to low IgA.



I understand where your husband is coming from, because there is quite a bit of initial cost, and you will be going over ground that has already been covered, in order to get to some of the newer stuff. However, it's the derms that really do know how to put all this stuff together. Notice your vet didn't even have a plan until she talked to a Derm? Now if she has this Derm on her speed dial, that might be different wink

About the powder, that makes sense. You could probably also mix it in some apple juice if you don't have a snack handy....
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/10/10 04:33 PM

Oh yeah and Max was on Prozac months ago and it didn't help.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/10/10 04:35 PM

Didn't see Val's post up there....Tracy, she has lots of experience with the Cepha and the Staph.... I havd been using the Tylan here for the Staph issues with Max since he doesn't tolerate the Ceph so well. Probiotics are *really* important with that abx.
Posted by: JakodaCD OA

Re: Mr. Max's Issue(s) - 04/10/10 04:36 PM

Lisa, I hadn't thought about the probiotics, I think I just may try it:))

and as a side note, I just had masi xrayed and stuff the other day, and the witch came up positive AGAIN for anaplasmosis:((

I am so sick of this, I even said to them , 'what the heck, every stinken year I have to expect my dogs to come up positive for this?" No one had an answer,,DUH...

So back on major doxy dose, I'll do it for 90 days, and when I retest I think I'm going to have them send out for 'levels' this time.. Aussies get tested next week, I'm sure they'll come up positive AGAIN to, good thing I have stocked up on doxy..

Sorry to hijack this!
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/10/10 04:39 PM

Val: Max is not on antibiotics right now. He's on Ketokomizole, based on the idea that it could be yeast. But now that we have to go back on Cefa, I'll start the probiotics in the afternoon instead of with dinner. I did look at those links before, but I'll go back again for the food aspect.

Lisa: maybe my vet got the guy's (or gal's) phone number and will stay in touch. Who knows.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/10/10 04:41 PM

PS, see my avatar? That's what Max says to all of this! wink
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/10/10 04:41 PM

Originally Posted By: vio79
Oh yeah and Max was on Prozac months ago and it didn't help.

Perhaps it was the wrong anti-depressant - some work better for the nerves than as an anti-depressant? For example, Neurontin is great for nerve pain, but as an anti-depressant, not so good. Her sleeping pill works pretty good for anxiety and not just sleep. There may be a specific reason that one was mentioned.

I don't think that the problem is psychological, but at this point, the system is so screwed up, they want to give him some relief, and also to help him heal by not scratching so much (kitchen sink). Everything, in theory, would act synergisticly (is that a word?). There may be ways to get at the same thing with supplements and diet, but if you are going for controlled treatment, you gotta go by the one protocol so it doesn't get messed up.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/10/10 04:42 PM

Originally Posted By: vio79
PS, see my avatar? That's what Max says to all of this! wink


I don't blame him at all.
Posted by: Wisc.Tiger_Val

Re: Mr. Max's Issue(s) - 04/10/10 04:58 PM

Tracy, I really do understand your frustration and I love the Pic of max sticking his tongue out.

Unless there is a lot of starch as a filler or binder for the Probiotics, they shouldn't cause any problems and given away from the ABX will be very helpful. If the Ceph starts to irritate the tummy or you see a big lack of appetite then I would up the amount of Probiotics.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/10/10 05:10 PM

Cool, will do....
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/11/10 04:15 AM

Originally Posted By: vio79
.....PS - should we do Hemopet when we're there next Thursday at this point?


It's always nice to have a full panel in a situation like this. Just ran across this:
http://www.ourdogsonline.com/ubbthreads.php/topics/254918/Re_dog_allergies#Post254918



Also, there is one anecdotal report on the tick list about a dog that seems to be tick free after starting Comfortis???? If anyone else has evidence either way, I'd be interested.

Interesting if it were true - ticks, unlike fleas, related to spiders, much like mites, so the power of Comfortis might not just be flea related, but mite related??? This is just speculation based on one tick observation (which may be coincidence), and a lot of itchy dogs that got better on that product.



Vio, before filling the anti'depressant med, let's do a check for interactions with the keto first. I don't have time right now, but I know both of thos drugs can interact with stuff...
Posted by: LJsMom

Re: Mr. Max's Issue(s) - 04/11/10 08:45 AM

http://www.drugs.com/cons/ketoconazole.html
Posted by: LJsMom

Re: Mr. Max's Issue(s) - 04/11/10 10:05 AM

http://www.drugs.com/ppa/chlordiazepoxide-amitriptyline.html
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/11/10 03:33 PM

Thanks Joanne!

So it appears that the Keto will increase the amount of Ami in the blood, making it so a lower dose of Ami should be used when those two are together.

I think that the dose of keto is pretty much at the top of the range, and I don't know the dose of the Ami prescribed, and if I did, I would have no clue what the proper dose is under the circumstance. The important question is whether your vet knows. A Derm that uses these all the time should know how to use them together. A vet that isn't used to such a regimen I would be extra sure to double check. I would probably look to see what the standard dose is, and then see if it's significantly lower. I would also ask her if she is available and not still out of town.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/11/10 06:14 PM

The standard for dogs is

Dogs: All weights The usual initial dose is 0.5-2 mg per pound of pet’s body weight every 8-12 hours

We're giving him 85 mg, twice a day. So 1 mg per pound. So a little under the middle range.

I guess we'll ask for the thyroid panel on Thursday, just to see. Especially if there's no improvement.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/11/10 06:39 PM

Sounds like you have everything under control (or are faking it well hugging )

I would think you would see something different by Thursday??????

Hopefully you can get him out and exercise him and have some fun in the meantime. Enough of this, it's time for him to be healthy, poor you guys, poor Max frown
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/11/10 07:38 PM

Lisa, you'd think so. I hope so.

Did the woman on the other board happen to say how quickly the ThyRX worked? Looks like a prescription's not needed for it, which is good.

Just wondering if I could convince our vet to prescribe Soloxine (if Max isn't improved by next Thurs) without the full thyroid panel. Just because it seems stupid to spend an extra $100 when we already got the panel - if nothing else works, it's the only other thing I can think of.

We did take Max to a nice field and did some jogging with him - he had a blast and decided to tackle me in the field smile We just got back from walking him at the cemetery, too. So he's had a busy day!

No change so far, but he's only been on Keto since Thursday and the other two meds since Saturday.
Posted by: Avamom

Re: Mr. Max's Issue(s) - 04/11/10 07:47 PM

Sorry for the delay in coming back to post (had a minor medical emergency with Ava--trying to bloat again)

The reason I asked about the last biopsy and skin culture was that skin issues are on going, what didn't work 4 months ago or for that matter, what did work 4 months ago won't always work now. His skin could be in a completely different place now, so don't depend too much on what a test a while ago said.

He has had a lot of antibiotics through this ordeal, I would ask the vet to do a skin culture for drug sensitivity before starting another drug....I only say this because if someone had told me to ask for this 2 yrs ago, I could have saved Apollo months of itching and us hundreds of dollars on meds and vet visits that didn't help.

One of the reasons, the biggest reason, Apollo took soooo long to get better was he had a drug resistant bacterial infection so none of the commonly used drugs worked on it, all it did was make him worse b/c it gave him a super bug!

I worry that is what is happening with Max, he has had so many abx that haven't worked, it MAY be b/c he has never had the RIGHT abx. A drug sensitivity skin culture will tell you what drug class specifically his exact infection is sensitive to, then he can get on the right drug.

He actually sounds like a staph infection problem to me, not necessarily yeast...yeast usually has a big smell to it...but staph can make the bad itching, rash-like redness and pustules.

I also recommend talking to them about some relief for his itching (i.e. prednisone) I know this is not going to be a popular view and several people will tell you the horrors of putting him on a steroid, but Max is miserable with the constant itching and you are miserable watching him. Stopping the inflammation response and itch cycle which is what pred will do will provide great relief to him and allow him to stop tearing up his skin worse. I know you have tried this before, but I don't see where it was used for longer than a few days or an injection or two...he would need twice a day at an appropriate dose for several weeks...a decrease in itching will probably come in a few days, when at the right dosage.

Apollo has been on pred for over 2 yrs now, b/c off of it he scratches himself bloody...all his blood tests, which we do regularly are perfect. Yes, pred can have side effects...but like I said in my first post, the most important thing to me when looking at Apollo's issues was to make him happy and not having his skin on fire and constantly itching was making him miserable. Honestly if it damages his liver in the long run, its worth it because we were to the point his vets were talking about quality of life and would he be better off put to sleep....no, I'd rather shorten his life a bit with pred and have him have several years of being pain free than NOT try a drug b/c it might damage his liver or kidneys and instead put him to sleep, that seemed counterproductive to me. He is down to a very low maintenance dose right now, and hopefully will be off of it once allergy shot regime is complete.

Apollo's food allergies are controlled by being on a grain free, fish based food (Taste of the Wild, Pacific formula), what we can't control are his massive environmental allergies, one of which the worst is dust...can't control house dust, with three dogs that is going to happen. We used VARLgold allergy testing and start the allergy shots in the next couple weeks. They are putting together allergy serum shots for us, based specifically on what he is allergic to, to try to build up his tolerance to the allergens so that his body can begin to fight the allergic response itself.

The other med he is on, that has really helped is Hydroxyzine HCI...a prescription antihistamine...Benedryl and Claritin never really were enough for him, but with environmental allergies you HAVE to be on something to help with the histamine reactions.

No matter what, hugs to you and Max, I know how frustrating this all is...I'd be happy to talk to you more about this and all the other stuff we've tried, if you'd like...just PM me and we can exchange numbers.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/11/10 08:26 PM

Avamom, Max has been on pred, he has been on Atopica, they did not dent the itching frown

His allergy tests brought up exactly one food, dairy products. Though there are a ton of env allergies, and it appears he has some food sensitivities that are not technically allergies.

I don't know about the anti-histamine.

==>Vio, has he ever been on Ceph before? Let's hold off a few days before talking about Thursday, hopeful that we see some positive signs.

==>Val, any hunch on how long the Ceph would take to see a glimmer of response?

==>Vio, I'm so glad that you both had a great day. I think that is a huge part of recovery too!!
Posted by: LJsMom

Re: Mr. Max's Issue(s) - 04/11/10 08:50 PM

Tracy, I'm wondering what's the longest amount of time that Max has been on any one antibiotic?
Posted by: JakodaCD OA

Re: Mr. Max's Issue(s) - 04/11/10 09:00 PM

I was telling Lisa I came across this stuff (saw an ad on RFD Channel last nite)

http://www.vetericyn.com/

Good for fungus/yeast/ open wounds..There is a link to stores in your area as well. I'm going to give it a try on my fungus boy aussie. Will let you know how it's priced when I get some..

Just thought I'd throw this out there..
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/11/10 09:07 PM

Max was on Ceph when we first got him (I think for the ear infection) and then again when he got tail surgery. The tail surgery period (once he healed) was probably the only time he was "normal" - so the late Aug/early Sept period. We were free from antibiotics until recently, when he had the UTI, for which he was on Amoxi. And then the latest was Doxy.

Joanne - I think Max was on the Amoxi for 21 days for the UTI, and that's the longest he's ever been on an antibiotic, since we've had him.

Avamom - as Lisa said, Max was on Prednisolone for weeks without improvement. He also got a Prednisone shot last Thursday when I saw the vet, and it didn't do a thing. He was on Temaril-P last summer, which helped his itching better than pred, but that was before all of this happened.

Max seemed a bit manic today - wonder if it was the amitriptyline?
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/11/10 09:10 PM

Originally Posted By: JakodaCD OA
I was telling Lisa I came across this stuff (saw an ad on RFD Channel last nite)

http://www.vetericyn.com/

Good for fungus/yeast/ open wounds..There is a link to stores in your area as well. I'm going to give it a try on my fungus boy aussie. Will let you know how it's priced when I get some..

Just thought I'd throw this out there..



Oops, missed this one. Thanks. Let me know how it goes with you. Looks like they sell it at the place I've been getting his food recently, so that's good. smile
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/11/10 09:31 PM

Originally Posted By: vio79
Max seemed a bit manic today - wonder if it was the amitriptyline?


Could be. When my mom started both her meds (at separate times) for nerve pain, and also a different one to help with sleep, she felt bizarre for a couple of days, and wanted to stop. After about 3 days it "normalled" out.
Posted by: Wisc.Tiger_Val

Re: Mr. Max's Issue(s) - 04/11/10 09:44 PM

Originally Posted By: MaxaLisa
Avamom, Max has been on pred, he has been on Atopica, they did not dent the itching frown

His allergy tests brought up exactly one food, dairy products. Though there are a ton of env allergies, and it appears he has some food sensitivities that are not technically allergies.

I don't know about the anti-histamine.

==>Vio, has he ever been on Ceph before? Let's hold off a few days before talking about Thursday, hopeful that we see some positive signs.

==>Val, any hunch on how long the Ceph would take to see a glimmer of response?

==>Vio, I'm so glad that you both had a great day. I think that is a huge part of recovery too!!


Lisa and Tracy the amount of time to see improvement is dependent on a few things, one the dosage and two the extent of the Staph infection. The way it sounds is it is deep Staph infection, black thickening skin, draining sores. When Lakota gets too bad (bad Mom) we always do about a week of Pred. and then it can take at least two weeks to visually see improvement. But when I have found is that using the Zymox Medicated rinse helps. Tracy I don't have a great place to wash dogs either, so I just mix the rise up in a pail, pour some on the dog and take a clean sponge and work it in to the skin. Then we go for a nice walk to dry off. You want to try to get the outer layer of skin healed up to prevent continual reinfection.

The drug sensitivity test sounds good, we have done it once, but I would start Ceph. until the results come back. Ceph is the most common drug used for Staph. But the one thing I will say for most Vet's is that don't 1: use a strong enough dose and 2: take the dog off too quickly. The dog's immune system is so beat up and compromised that the Staph will continue to try to get a foothold even while on ABX if the duration is too short.

If it is Staph that you are dealing with then extra washing of any blankets the dog lays on, if he doesn't lay on a blanket then start having him do that so you can wash it, I know more work. But if he lays in one spot, gets up and comes back withing 12 hours depending on the Temp. the bug is still living.

Val
Posted by: Wisc.Tiger_Val

Re: Mr. Max's Issue(s) - 04/11/10 09:49 PM

I would like to know what is in this product:
http://www.vetericyn.com/

One of the few things that I know of that is effective against MRSA is TeaTree Oil. DH has MRSA and is extremely sensitive to TTO.

I use cleaning products that have TTO in them.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/11/10 09:52 PM

Originally Posted By: Wisc.Tiger_Val
I would like to know what is in this product:
http://www.vetericyn.com/

One of the few things that I know of that is effective against MRSA is TeaTree Oil. DH has MRSA and is extremely sensitive to TTO.

I use cleaning products that have TTO in them.


I looked for quite awhile for the label, and at the bottom of this link is the ingredients http://www.drugs.com/vet/vetericyn-vf-wound-infection-treatment.html

Oxidized Water, Sodium Hypochlorite (NaOCl), Hypochlorous Acid (HOCl), and Sodium Chloride (NaCl).

I don't understand them....we need a chemist???
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/11/10 10:03 PM

Val - I'm not sure how long the vet plans on having us use the Cepha caps. He's getting 2,000 mg/day.

Are we even sure this is staph? Some stuff doesn't really match up with Max's issues.

Would the anti-fungal shampoo the vet gave us do any good (since we have it)?

What specifically does the drug sensitivity test entail? Is it just a skin scraping?

Max has three beds he sleeps on, and all have washable covers. Of course they are a pain to get off and on....maybe we'll cover the beds with a sheet or something that we can wash more easily.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/11/10 10:37 PM

I think folks are thinking maybe a combination of staph and/or fungal. Even a skin scraping can miss something, from what I've read. So to cover both bases, both the keto and the Ceph - I think the Derm is thinking the same thing.

If I recall, you have used an anti-bacterial shampoo without too much benefit (though I don't how frequently you used it), so the last shampoo you got was the anti-fungal. Without using them frequently, I don't know if you will see much affect?

I have some old sheets that I put over the dog beds so that I can wash them weekly. For your Max in particular, I would be doing this because of the environmental allergies.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/11/10 11:28 PM



Vio, check out the update on this thread.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/12/10 08:38 AM

Nice...so I guess if there's no improvement by Thursday, I'm going to see about Soloxine or get that thyroid supplement on my own.

Yeah the antibacterial didn't work, so the vet had given us an antifungal shampoo to try. We would probably just be able to get him washed once a week, weather-permitting. I could also try Val's method.

Hmm, wonder if my parents have old sheets I can steal smile

Good news is that Max's poops already look better. They're a nice color and more solid. Not 100% but I'll take what I can get.

poop
Posted by: LJsMom

Re: Mr. Max's Issue(s) - 04/12/10 09:13 AM

My secret to finding cheap sheets for the dogs beds is Savers.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/12/10 09:15 AM

Savers! Yes, there's one right down the street! Thanks for the tip!!!!
Posted by: JakodaCD OA

Re: Mr. Max's Issue(s) - 04/12/10 09:19 AM

or cheap towels:))

I'm not a chemist either:(( but what the heck I'll try the stuff, going to call the place today and see if in fact, they do carry it, and cost wise...
Posted by: myamom

Re: Mr. Max's Issue(s) - 04/12/10 10:17 AM

Soloxine needs to be prescribed through a vet. I would not be giving any meds without being under the guidance of a vet. You need to be working as a team. Your vet will be able to tell you when enough time has elapsed...that you are either on the right track...or not. There is no magic cure or quick fix for this. Changes are often subtle and take time. If you don't have confidence in this vet...then pull your chart and take your notes (on EVERYTHING you tried..diet, supplements, etc) and get one you do have confidence in and feel like you are working with as a team. Here's an example...I LOVE my vet...been with him many many years and have total confidence in him. When I got Cheyenne...it was the first time I had some fears. He wasn't totally up on the newest HW treatment protocols for a dog in her stage. (we don't see hw very often here...so I can understand) I immediately called my go to girl...Sinclair...who gave me the latest protocols. Luckily...when I went back to my vet...he had educated himself and was on the right track...if not...sadly I would have had to take her somewhere else. Yes...I knew what to do (doxy and heartguard)...but still...I wouldn't have wanted to do that without a vet standing behind me. What if there were some side effects? what if something went wrong? I wanted a vet guaging her progress. Are we on the right track? improvement? etc. See what I'm saying?
Anything you have tried on your own (supplements) I would make sure I told my vet about. What if they are countering something else she had you do? Etc. Etc. Etc.
Cheyenne has a Staph infection. Been ongoing for....gosh I don't know how long. I have seen very little improvement (although some people in her thread mentioned they see some...YEH smile I'll take it) But...I don't expect it to be overnight. In light of her heartworm and cancer...it's almost a side issue for me..and given the fact that she's on other things fighting the more pressing issues...we're not even in a position to tackle that right now. I look at her every day and am just happy that she is alive and happy and that we have been blessed with her..and given the opportunity to give her a good life.

Take a deep breath...enjoy your boy...plod along...take your time...and get a great vet that you can work with and feel comfortable with. Hugs to you and Max.
Posted by: Wisc.Tiger_Val

Re: Mr. Max's Issue(s) - 04/12/10 12:16 PM

Originally Posted By: vio79
Val - I'm not sure how long the vet plans on having us use the Cepha caps. He's getting 2,000 mg/day.

Are we even sure this is staph? Some stuff doesn't really match up with Max's issues.

Would the anti-fungal shampoo the vet gave us do any good (since we have it)?

What specifically does the drug sensitivity test entail? Is it just a skin scraping?

Max has three beds he sleeps on, and all have washable covers. Of course they are a pain to get off and on....maybe we'll cover the beds with a sheet or something that we can wash more easily.


Tracy 2,000 mg/day tells me they aren't looking at messing around. If it isn't Staph and it is Yeast I am pretty sure you will see that, if it is Yeast the ABX would probably make that worse.

When they did the Drug Sensitivity culture on Lakota they used the gunk they flushed out of his Sinus Cavities, Another time they did skin punches, both of theses need to be done under anesthesia. The punch is better than a skin scrape as the take multiple layers of skin, they actually put a stitch or two to seal up the hole. They usually take them from sore or erupted area's.

Don't use a medicated Shampoo unless you can get your dog rinsed off really well, That is why I used a Rinse that could stay on or needed minimal rinsing.

Tracy, no matter what this is it is going to be a long haul to get it cleaned up, Max has been having problems with it for 6 - 8 months. I think realistically you are looking at a month or more.

I would try the DAP plug in and this calming collar, http://www.calmingcollars.com/digishop/cart.php?m=product_detail&p=4

I wouldn't put any more things into his system, as some one pointed out herbal can interfere with Meds.

When you look at symptoms on line, not every dog is going to have all of they symptoms. When Lakota had his Staph Infection in his Sinus Cavities I would not have know it except he started bleeding from his nose for no reason. All of the signs were inside his nose and had to have a scope to see.

Val
Posted by: Avamom

Re: Mr. Max's Issue(s) - 04/12/10 12:47 PM

Apollo's drug sensitivy culture was just a swab of his skin that they sent off...kind of like when you were a kid and they's swab your throat for strep. That is cool Val, that they could do it from the nasal irrigation...I've heard that being done on lung aspirations too. Hopefully Max would just need the swabing and not the punch biopsy...so much less evasive...but sometimes necessary.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/12/10 01:44 PM

I refuse to do skin punches again - we did that before, and it sucked. So unless they can do a scrape or swab, we're not going that route again.

I really don't think Max needs a calming collar. He's pretty calm all day, except when he tries to itch. Hopefully the amitriptyline will help with that.

He's passed out right now, because we did an hour-long walk at the cemetery. That's a lot for him these days.

All he's getting right now is:

Cepha caps
Ketocomizole
amitriptyline
probiotics
revolution (we'll switch over to other protection once it wears off)

And possibly the rinse or shampoo if we get nice weather and can let him air-dry.
Posted by: Woodreb

Re: Mr. Max's Issue(s) - 04/12/10 01:56 PM

Regarding the Vetercyn product: I think you need more than just a chemist, possibly a pharmaceutical formulator. Here's a couple of links I found regarding the compounds in this mixture.

Oxidized Water:
http://www.woundsresearch.com/files/docs/072706_occu.pdf

http://www.entrepreneur.com/tradejournals/article/177987332.html

http://www.kungshusen.se/clean-data/3-CIC_Antimicrobial%20Effects%20of%20Aqua%20Oxidized%20Water.pdf

Sodium Hypochlorite (bleach):
http://www.lenntech.com/processes/disinfection/chemical/disinfectants-sodium-hypochlorite.htm

Hypochlorous Acid:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1853323/

It seems that the first 3 ingredients have been identified as compunds that can be used to heal skin issues. I'm going to guess (I'm not a formulator) that the salt is there to stabilized the formulation.


Sorry - should have quoted the post. It looks like my post is kind of coming out of the blue here.


Posted by: Wisc.Tiger_Val

Re: Mr. Max's Issue(s) - 04/12/10 02:26 PM

Tracy, maybe that is going to be part of the Key is to get Max some exercise. He might just have an OCD type cycle with the itching and exercise helps take that down some.

Let's hope that this is the right combination and max gets to feeling better.

Val
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/12/10 02:55 PM

Woodreb, thanks for the info on the vetricyn

I saw some reference to oxychlorine? On one of the sites, but one has to figure there is something in there that kills stuff, amazing that it appears to leave the healthy stuff alone.
Posted by: LJsMom

Re: Mr. Max's Issue(s) - 04/12/10 04:27 PM

Tracy, will your vet give you a discount on bathing there? When Steel needed a skunk bath I stayed at the vet with him. It might be cheaper if you weren't using kennel space or drying time.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/12/10 05:31 PM

Not sure on the bathing. It's hard to take Max there at all, because it's always so crowded with dogs. No even sure where their bathing facilities are.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/12/10 09:59 PM

Originally Posted By: MaxaLisa
Vio, I'm pretty sensitive to oils, and have done well on this one: http://www.vitacost.com/Country-Life-Omega-3-Mood


Lisa, forgot to tell you. We should be getting this in the mail tomorrow. Was going to go to the store to get it, but it was cheaper to get it online, even with shipping!!
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/12/10 10:17 PM

I hope the fish oil helps!!
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/13/10 10:44 AM

Hope so too.

Max seems to be puking in his mouth a bit. At least that's what it looks like. Vomiting a little and then swallowing a lot to keep it down. Like people do sometimes.
Posted by: myamom

Re: Mr. Max's Issue(s) - 04/13/10 01:35 PM

I can't remember...did you see a dermatologist?
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/13/10 01:55 PM

Yeah, in December.

Maybe he's vomiting a bit from all the fur he ingests when he tries to chew himself.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/13/10 02:59 PM

You can buy some DGL licorice for an upset stomach, or maybe use something like either pepcid or zantac, at the lower dose (though I hate adding more meds). My Max starts doing that on Ceph, Indy started doing that, but now she just throws up any ceph within 10 min.

I'm just guessing that it's the ceph, could be other things too. Of everything he's on and the time frame, the ceph makes the most sense.
Posted by: LifeAsMe

Re: Mr. Max's Issue(s) - 04/13/10 07:17 PM

just a thought from a post on another board. have you tested him for epi?
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/13/10 07:38 PM

Originally Posted By: LifeAsMe
just a thought from a post on another board. have you tested him for epi?


EPI, as in Exocrine Pancreatic Insufficiency? He doesn't really have any of those issues. His digestive issues were mainly due to the diets we've had him on. When he was on raw, his poop/stomach was fine. It's his skin that has always had the issue.

Unless you're talking about something else???
Posted by: LifeAsMe

Re: Mr. Max's Issue(s) - 04/13/10 07:48 PM

EPI can sometimes be managed by RAW diets. Just seems that everyone is looking for one magic bullet. Maybe there is more than one problem. And maybe it's not presenting in textbook fashion.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/13/10 08:03 PM

Originally Posted By: MaxaLisa
I hope the fish oil helps!!


Human dose is 2/day...should that be what we give to Max?
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/13/10 08:05 PM

Originally Posted By: LifeAsMe
EPI can sometimes be managed by RAW diets. Just seems that everyone is looking for one magic bullet. Maybe there is more than one problem. And maybe it's not presenting in textbook fashion.



I guess anything could be an issue, but his weight has only been an issue since we started feeding him only fish. Otherwise, he's been a good weight, if not a little too heavy at times (like when we got him).

And just after less than a week of being on the new diet, his poops are much better. Dark, solid, not greasy.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/13/10 08:33 PM

Vio, I give my Max two a day.

Are you feeding th Orijen?
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/13/10 08:39 PM

I wanted to try Orijen Red, but nobody had it. So we're feeding him Nature's Variety Instinct, the rabbit meal formula (mixed with either Evanger's 100% rabbit or the canned version of the dry food so he eats his pills).
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/14/10 08:38 AM

Max barfed up two huge clumps of grass this morning.

And he's itchier than ever today!!!
Posted by: myamom

Re: Mr. Max's Issue(s) - 04/14/10 09:18 AM

I can't remember in all this...what did you not like about the Derm you saw in December?
Posted by: myamom

Re: Mr. Max's Issue(s) - 04/14/10 09:20 AM

and...
Now your vet has consulted with a different Derm who has made suggestions which you are following? correct? (who has not seen Max...correct?)

What did the first Derm think of all this?
What is the feeling of this Derm?

just trying to understand smile
Posted by: myamom

Re: Mr. Max's Issue(s) - 04/14/10 09:23 AM

and lastly...

Are you still planning on seeing a Dermatologist at Tufts?
Posted by: myamom

Re: Mr. Max's Issue(s) - 04/14/10 09:25 AM

I think you can get the picture that I really feel that Max should be under the care of a good Dermatologist...that you have confidence in...and can work as a team.....like a Derm at a place like Tufts smile
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/14/10 09:36 AM

Mary Ann,

The Derm we saw in December was hardly in the room. She had her techs do all the work. And she claimed to hear a heart murmur, so she didn't want to put Max out to do the allergy test panel (even though we took the whole day off work and booked the time). Never mind that he'd just been put out twice: once for tail surgery and once for x-rays! From the get-go, she was just promoting Atopica and didn't seem at all interested in any other options.

Yes, we're still with our vet, who consulted with a dermatologist down in FL and suggested additional treatment based on what she told this derm of Max's issues/history.

I haven't called Tufts yet. We have an appointment tomorrow with our vet, and I want to see how his blood work looks and what she thinks of Max's [lack of] progress. The derm I'd preferred is out on medical leave. My husband is very wary about having Max go into yet another new situation to be poked and prodded, especially since he doesn't know what a new derm would say that NOBODY else has suggested. I kind of agree.

Posted by: LifeAsMe

Re: Mr. Max's Issue(s) - 04/14/10 10:47 AM

Just a note from my personal experience....a dog can develop a heart murmur after being anesthetized. Their blood pressure drops while under and it can cause one. So just because he had two previous surgeries with no problems doesn't mean a murmur did not develop during the second one. Just went through this with a fostered doberman.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/14/10 10:57 AM

Our vet checked Max's heartbeat when I told him about what the Derm said, and he said Max's heartbeat was fine. In fact, he may have been put out after that point for his skin biopsies.

The point is I think that Dermatologist was trying to rip us off by forcing us to go back there a second time, when it costs almost $200 just to walk in the door, let alone any procedures.
Posted by: Wisc.Tiger_Val

Re: Mr. Max's Issue(s) - 04/14/10 11:05 AM

Tracy,

Ceph is had on digestive systems. Eating grass would be an indicator to me that Max's tummy is a bit upset. I would try upping the Probiotics some and see if that helps. Are you give the ABX with food? Ask you Vet what you could give to settle his tummy that won't interfere with the Meds.

Since it is possible that max has a heart murmur, then you probably don't want to risk putting him under again unless necessary. There are blood tests that might not pick up every thing but would give you a pretty good idea.

Like I said if it is Staph it is going to take a while. If it is yeast with the ABX I think it would get worse.

Val
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/14/10 11:24 AM

Val - he may have been eating grass because of the bee. Though he has been doing the whole licking/swallowing thing for several days. Last time he was on Cepha, he was fine. But yeah, I'll ask the vet tomorrow about anything to help him. We do give the abx with food.

I don't think he's got a heart murmur...but I also don't want to put him under again unless it's necessary. Is there any way to determine if it's yeast versus staph besides biopsies or just waiting to see if Max gets worse or improves??

It's just so frustrating to think that if it's not a staph infection, we could be making it worse AND making him nauseous, unnecessarily.

Posted by: Avamom

Re: Mr. Max's Issue(s) - 04/14/10 11:39 AM

Why was he put under for tests??? Apollo has had every test possible for his multiple and severe skin issues and has never been put under...his allergy tests were simple blood draws, cultures were done with skin swabs and mite checks by skin scrapping all of which were painless---what kind of tests did Max have?

Ceph is very tough on the digestive system...there are other drugs out there, which is why I was advocating for a drug sensitivty culture to be done, especially since so many drugs have been tried that haven't helped...his "bug" may not be suspectable to the common drugs used.

I am so sorry you are having such bad experiences with vets...but every vet isn't great, so changing until you find one that you are comfortable with and gives you good explainations and reasons for why they are doing each test and why they are using which drug may be a good avenue to pursue.

Having a dog with skin issues is so very stressful and frustrating but it is made much easier if you and your vet work as a team and it doesn't seem like your vet is giving you advise you either trust nor agree with.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/14/10 12:25 PM

It's really hard to believe that a culture will help when they couldn't find any bacteria or fungus or anythong last they looked? I remember reading Apollo"s blog, and in each case (food allergy, bacteria, etc.), something showed up. This hasn't been the case with Max.

At this point, I would argue for a supplement and thyroid trial before seeing another vet, since this is not the type of trial most vets will do and will have to be done by the owner anyway.

The Derm I saw said almost everydog that comes through her door either needs deto or Atopica, so I bet that is why your Derm Vio was in auto pilot and insisting on the Atopica.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/14/10 12:32 PM

"At this point" meaning IF the current regimen does not work. I'm still hoping it will work.
Posted by: Wisc.Tiger_Val

Re: Mr. Max's Issue(s) - 04/14/10 12:46 PM

Tracy, I am not sure there is a magic bullet other than to give the current treatment time to work. I am just guessing on the Yeast Infection that the ABX would make it worse, it might not.

Ceph while it is nasty on the tummy is a drug that works for most Staph infections. Like I have said earlier the problem I see with most Vet's is that they don't prescribe enough mg's or for as long as they should. Your Vet's with 1,000 mgs twice a day isn't messing around with lower dosage.

Val
Posted by: Avamom

Re: Mr. Max's Issue(s) - 04/14/10 12:48 PM

My point is that with every culture done on Apollo something DIFFERENT showed up...Max's last testing was in December, he may have something different going on now. I have never even had Atopica brought up by any of Apollo's vets so maybe we are just dealing with regional differences here?? And something has shown up with Max, he has environmental allergies...no food change or thyroid meds are going to help that (they may help other issues, but until his environmental allergies are addresses he will continue to be itchy).

Our first several vets were all wrong, using the wrong drugs and assuming the wrong afflictions, they though mange (it wasn't); they thought food allergies (he has very little food issues); they thought thyroid (but every thyroid panel ever done shows its fine); they though bacterial and threw multiple different abx at him leading him into a drug resistant strain....it took lots of wrong regimes to finally get the right thing for Apollo--all the while doing major and probably permanent damage to his skin, he will probably never grow hair again in most patches....

All I am trying to do is help someone else that I see in a similar situation that I only WISH someone had said to me several months and several vets ago...just hoping to try to save Max some of the suffering that Apollo had to do. I am sorry if my suggestions don't apply but I had to say them or it would bother my conscience...I will leave this alone now.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/14/10 01:24 PM

Avamom, I do appreciate your input here. Don't get me wrong! Just know that Max's issues have been pretty consistent since October. The only difference now is that his skin is darkening. Whether it's due to yeast or just the fact that he's been bothering it so much, I don't know.

Max was put under for x-rays and they also took skin punches (from three spots) for biopsies.

The integrated vet did two skin scrapings in March and found nothing either.

Lisa, if Max doesn't improve, I will insist on Thyroid supplements.

Max has "thrown up" twice since this morning. I put it in quotes because both times it looked like mostly water with a little phlegm-like substance and literally two pieces of food. During our walk at the cemetery, he spent the first 10 minutes trying to eat grass. I stopped him and he eventually lost interest, thank goodness.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/14/10 01:31 PM

Avamom, I think the more information that Vio has, the better she and her husband are able to make decisions. I am just trying to highlight some of the differences, though that doesn't mean there aren't similarities.
Posted by: LJsMom

Re: Mr. Max's Issue(s) - 04/15/10 08:09 PM

Just wondering how things went at the vet today?
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/16/10 11:24 AM

Thanks for asking, Joanne.

Somehow Max lost another pound over the past week, despite the fact that he's back on "normal" food, and we're giving him more than even recommended.

She did two scrapings and found nothing. She took a good look at his skin and said she didn't see bacteria and doesn't think it's staph.

She took blood and his liver values are normal.

In her opinion, all that's left to try are allergy shots based on his blood serum results or another trial of Atopica. She was fine with us seeing another Derm but wasn't sure what's left.

Before we left, she convinced us to let her give him another steroid shot: dexamethasone this time. When we asked why, she said maybe he'd react better to that than prednisone, and we just need to stop the cycle.

She also gave us 4 weeks worth of Atopica, if we want to try it.

Last night was awful. Not sure if it was the steroid injection or what, but Max was crawling out of his skin. He couldn't sit still and his hind leg was twitching. All night. None of us slept. He's better today but still trying to chew at himself. I'm assuming he's exhausted.

We gave him one dose of Atopica last evening, and he had diarrhea this morning. He's also still doing that gag-reflex thing. I don't think we'll continue the Atopica. Given his issues and the potential side effects, it doesn't seem worth it.

We can continue the ketocomizole and see if that helps, but we're in agreement that this isn't fair to Max. He's undoubtedly suffering, and we can't keep putting him through this. We're all stressed out at this point.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/16/10 12:04 PM

I'm sorry, but what is not fair to Max is to continue to do the exact same things over and over. Steroids didn't help, so give him steroids. Atopica didn't help so give him atopica. But no, let's not try something 1/2 way reasonable that hasn't been done before (thyroid).

Vio, please get that one thyroid supplement from the other board. Get a mutivitamin, get some extra zinc and some extra biotin and some extra vitamin E.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/16/10 12:15 PM

Should probably add - also continue with the probiotic, continue with the fish oil.

Consider zyrtex for the environmental allergies.

Do this all at once.
Posted by: JeanKBBMMMAAN

Re: Mr. Max's Issue(s) - 04/16/10 12:20 PM

I am going to sound like a broken record, but here is why my needle is stuck.

Go to vet A, vet A doesn't nail it. Maybe it's a chronic issue that will need lifelong management. If so, then let's figure out what it is and how to manage it.

Go to vet B, who does some really expensive stuff, but...eh...whatever, not me, not my dog so...good luck.

Go to vet C, here is some stuff, try this.

Go back to vet A a few more times. Vet A, who has no diagnosis talks to a vet who has never seen, touched or smelled (my vet likes to sniff things out) Max and based on what vet A who doesn't know what is wrong with the dog says, says some other things.

I am all for telemedicine and think it's great that a doctor hundreds of miles away can help a stroke victim, but this ain't that. smile

Then you have a chorus here of people who have also never seen, touched or smelled Max giving you enough suggestions to make me need my dramamine, I am spinning around so much.

And to me, the only ones that make sense to me are the posts that say, find the vet who will be your partner in this. The one who will have a system. Who will do stuff like this: http://support.mspca.org/site/DocServer/MSPCA155_CaseStudy_r5_HRes.pdf?docID=2181 (not saying it is pemphigus no no no) but pointing out the thoughtful system used in diagnosis. One that will look at those questions Avamom asked and will say this may take a while, but we will figure it out. We may need to try this bad food for a while and tell you how long, we may need to do this for a while, but this is how we rule things in and out.

Where is this vet? Not being in your area, I do not know. I don't know the names and do not have references for a great derm there. Perhaps people in your area can tell you the great derm experiences they have had. I have only had experience at Cornell. I only know what I've read about UPenn.

But that's what you guys need. Someone to work with you. Here n these boards and there in a vet office, tossing spaghetti against the wall to see what sticks isn't the method to use on skin issues like this.

I keep saying you guys can do it, because I know having chased down doctors for 3 months, I got diagnosed myself. My friend, with the same illness, was at the point where she thought she had lymphoma, took almost a year for diagnosis. Much more stressful and a bajillion times more scary.

You can do it.

My "chowness" forces me to post when I would rather not! I am stubbornly allowing let my broken record play on because I want you guys to enjoy your lives together.

Take care.
Posted by: Wisc.Tiger_Val

Re: Mr. Max's Issue(s) - 04/16/10 12:44 PM

Tracy,

I really don't understand your vet, I was trying to figure out what day you started the Ceph. Looks to be around the 10th, you saw the Vet yesterday on the 15th? so that is only 5 days for the Ceph to work and you might not see results after only 5 days. I am concerned that she hopped off that so quick.

I am going to chime in with Jean and some of the others.. Go find someone who can help Max.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/16/10 12:52 PM

And I am going to sing a slightly different tune.

If it's subclinical thyroid, or a zinc deficiency, any new Derm is gonna miss that too.

Try treating for what I think is the obvious, deficiencies. (Can't believe I also forgot the vit C).

Right now wash every bed covering hot water, cover them in sheets that you do the same for every 4-5 days. Wash him down with a wet wash rag everytime he comes through that door. Combine that with zyrtec.

I agree with Val that continuing with the current regimen makes sense.

IF you are thinking of seeing a new Derm, email him, list what you have done, ask where they are gonna start and what different options there are.
Posted by: JeanKBBMMMAAN

Re: Mr. Max's Issue(s) - 04/16/10 01:00 PM

Actually two different regular vets I had:
One "got" the zinc deficiency.
One "got" the subclinical thyroid.

So why wouldn't a careful and deliberate dermatologist do the same?

When you fill out the pre-appointment form, you have the opportunity to list everything done. So they have questions set up for you to answer to make it easier.

ETA - Just checked, they sent a 5 page form (was 5 when I filled it in) with questions and instructions.

I would be looking for recommendations from people in your area. People your vet has referred to, and if not your vet, maybe try the GSRNE group.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/16/10 01:13 PM

If the panels are showing "normal", it's a rare doc that will treat anyway. So you are still rolling the dice. But if the derm answers the email, should be able to determine philosophy from there. Derms don't start with trying things where blood tests are in the Lnormal" range, they end there.

There's a high probability that any Derm will want a trial run under their conditions *first*, which means a trial of meds and probably Z/D or similar before they get to that point.

I don't have a problem with seeing a Derm, I think there are some obvious things that haven't been done in the mean time.
Posted by: JeanKBBMMMAAN

Re: Mr. Max's Issue(s) - 04/16/10 01:26 PM

Keeping in mind that a derm might have a policy of not responding to anonymous emails from potential clients.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/16/10 01:33 PM

So noted.
Posted by: JeanKBBMMMAAN

Re: Mr. Max's Issue(s) - 04/16/10 01:37 PM

Didn't want someone to miss out on a good doctor because they can't do that.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/16/10 01:56 PM

You're right.

And I'm not against it, I just want to try all that stuff together, first. Heck, in two weeks it takes to get an appt with the Derm, you've done your trial.

Avamom's Derm did a thyroid, it was normal, I might have looked closer at thyroid for the hair loss. I certainly would looked into the melatonin for alopecia X, so I'm just saying thet a good derm is worth a ton, but they don't know everything. All those nutrients together with the thyroid - that will never be recommended by any vet. The allergy stuff, we all shoulda thought abouit the washing and wiping months ago!
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/16/10 02:10 PM

All,

Appreciate the comments/advice/feedback. But this is where I stand. I'm going to go with Lisa's suggestion and try a Thyroid supplement while we wait. No harm in that. This is assuming I can't get the vet to prescribe Soloxine.

If there are no changes with that, the probiotic, the fish oil, and wipe-downs, then we're calling it a day.

It's unfortunate that it's come to this. I am partially to blame, since I didn't know what to do and wasted months trying random stuff that was suggested to me. Maybe if we'd gone through with the allergy panel and started Max on shots months ago, we'd be somewhere else. Maybe if I'd seen a "decent" vet or dermatologist from the get-go, we'd be somewhere else.

But a series of bumbling mistakes has gotten us to where we are now. And we just can't tolerate starting over with a new derm/vet that may have us going through more of the same with elimination diets, shots, treatments, etc.

And if the thyroid treatment helps, then great! But I'm not holding my breath.

It sucks and I feel awful, but until any of you have been in my shoes and dealing with these exact issues for almost a year, then you can't judge. I'm confident that Max would have been dead last May had we not adopted him, so I'm hoping we at least were able to give him a semi-decent life (aside from all the crappy treatments).

So, hopefully you guys don't feel too mad/frustrated after all the time you've put in and the help/advice you've given.
Posted by: shepnterrier

Re: Mr. Max's Issue(s) - 04/16/10 02:12 PM

The veterinary dermatologist at the MSPCA Angell Memorial Hospital in Boston, Dr Kathy Tater:

http://www.mspca.org/vet-services/angell-boston/dermatology/boston-dematology-meet-the-team.html

Her credentials and her published case studies are top tier.

In the waiting areas you'll meet people who have driven hundreds of miles for their dog to see a specialist at Angell.
Posted by: JeanKBBMMMAAN

Re: Mr. Max's Issue(s) - 04/16/10 02:24 PM

I don't think anyone is judging. People have been in this position either with pets, family, or themselves for sure.

I do think though that doing thyroid treatment without it being that (not saying either way what it is) CAN be harmful.

Just wanted to say that, because I know a lot of people read this and wanted to make sure that if it is, someone who knows can say whether or not this is true.
Posted by: myamom

Re: Mr. Max's Issue(s) - 04/16/10 02:30 PM

but many of us have been in your shoes...and quite frankly much worse. Take Sinclair...have you pm'd her? I can't even begin to tell you know knowledgeable she is...and what great advice she has...and what a comfort she is...not to mention...she is going through a worse situation with a dog that isn't even hers per sae. I have Cheyenne...and many others have posted. It quite frankly is pretty common....frustrating...yes...a death sentence...no.

Max does not deserve to die due to mistakes. If you can't go further...please try to find a rescue for him.
Posted by: vio79

Re: Mr. Max's Issue(s) - 04/16/10 02:58 PM

Originally Posted By: shepnterrier
The veterinary dermatologist at the MSPCA Angell Memorial Hospital in Boston, Dr Kathy Tater:

http://www.mspca.org/vet-services/angell-boston/dermatology/boston-dematology-meet-the-team.html

Her credentials and her published case studies are top tier.

In the waiting areas you'll meet people who have driven hundreds of miles for their dog to see a specialist at Angell.



She is gone on medical leave.
I already called about seeing her and posted about it a few pages back.

I can't imagine thyroid supplements could be any worse than Atopica.

We already tried to find a home for Max. Between his health, dog aggression issues, and age, nobody's interested. (Don't forget he has arthritis in both back knees and elbow dysplasia in both elbows.) The ONLY way to get GSRNE's help is to put him back in the shelter from where we got him. I looked into it. Ain't gonna happen. So unless you know of someone who doesn't have dogs, who has a lot of time and money and patience, and who has GSD experience, that ain't gonna happen either.

People may be in worse situations than us, but apparently they have the time, funds, and experience. We have none of the above anymore. AND WE ADOPTED MAX LESS THAN A YEAR AGO. I know that's no excuse, because it's not his fault. But we are not experienced dog owners, let alone GSD owners, and this is more than we can handle.

You may say we're giving up too easily, it's insane to put down a dog because of itching, etc. But you're the only ones. EVERYONE who knows us, Max, and what we've been going through thinks we've gone above and beyond.

I do not want to put Max through the stress of more vets, changes, etc. If you have an issue, take it up with his ORIGINAL owner, who bought him from some crappy breeder in Kentucky, overfed him, and then let her ex-husband dump him in a shelter. I have her email address...Or you can take it up with the shelters that gave him a clean bill of health, said his temperament was fine, and told us his age was 2-3 years old.

My husband has been telling me for weeks to stop posting here and getting advice, because although you mean well, all you're doing is confusing me, making me feel guilty, and sending me in all different directions, without even really knowing what we're going through.

So, I think I'm done here. Be pissed all you want, but I am not going to go broke and suicidal over this. Maybe after a good night of sleep I'll regret everything I just said, but this is how I feel right now. I love animals and I love Max, but this is just insanity. And it's not like Max is loving it either.
Posted by: Avamom

Re: Mr. Max's Issue(s) - 04/16/10 02:59 PM

Originally Posted By: MaxaLisa
Avamom's Derm did a thyroid, it was normal, I might have looked closer at thyroid for the hair loss. I certainly would looked into the melatonin for alopecia X, so I'm just saying thet a good derm is worth a ton, but they don't know everything. All those nutrients together with the thyroid - that will never be recommended by any vet. The allergy stuff, we all shoulda thought abouit the washing and wiping months ago!


Actually we did several thyroid panels, by several vets...in fact, all three vets have because all my vets were just sure that thyroid had something to do with it...we even did several months of thyroid meds just in case it was subclinical...no improvement. So some vets WILL try things even if the tests don't show it. There are many vets educated on supplements and alternative treatments, sometimes you just have to talk to them about it.

I have been in your shoes Vio, for three years this July, and I am not judging you...just trying to point out that often it is through all the mistakes we make (and God did we make them with Apollo) that you find you need to go a different direction, different vet and start over. Its frustrating, bankrupting and I have had numerous fights with the hubby over it...but in the end we keep plodding on because Apollo was worth it. We are seeing a light at the end of the tunnel now, Apollo goes in Tuesday to start his environmental allergy shots and the hope is that he will respond well to them...its been a long road, and often times I thought about giving up but I would take Apollo outside and throw the ball and he would forget about his itchiness and be a normal happy dog and I would remember why we keep plodding along. He's been relatively itch free now for months and we've been able to cut back his meds a lot, the hope is he will be off them entirely if the allergy shots work.

Its normal to be frustrated and good for you to vent, but I promise you that it gets easier when you get with a vet that you can partner with, who explains what they want to do and why so you understand all the reasons and time frames/goals they have for each treatment method and one who you tell them what you want to try and what you have tried and you work together. Because there are things that can harm more than help or not mix well so its important to have a dialogue with your vet.
Posted by: Wisc.Tiger_Val

Re: Mr. Max's Issue(s) - 04/16/10 03:14 PM

I and many others haven't been judging you. I can tell you that dogs are tough and I will bet that Max isn't ready to throw in the towel. I really hope that it is just frustration speaking. I am with Mary Ann, see if there is a rescue that can take him in.

I am frustrated with your Vet giving up on treatments as fast as they do an going back to things that didn't work the first time.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/16/10 03:31 PM

Originally Posted By: vio79
.....So, hopefully you guys don't feel too mad/frustrated after all the time you've put in and the help/advice you've given.


We're not mad, we are just frustrated, as you are, that there has been no relief for Max, in spite of all the time and money that you have put into him. I do understand what you have been through with him.

Vio, if you try the thyroid supplement, please also try the other nutrients too. This is sounding like a last shot deal, don't do it half way.
Posted by: MaxaLisa

Re: Mr. Max's Issue(s) - 04/16/10 03:40 PM

Originally Posted By: Wisc.Tiger_Val
I am frustrated with your Vet giving up on treatments as fast as they do an going back to things that didn't work the first time.


Frustrated is an understatement - malpractice. She was out of her league, shoulda referred out long ago. And then to stop treatments as quick as she starts them, and to keep trying things that have already been tried. She plays a big role in this.
Posted by: aubie

Re: Mr. Max's Issue(s) - 04/23/10 10:44 AM

Just wondering how Mr. Max is doing...while not commenting (I'm letting the pros do that) I'm stil following and praying for Mr. Max!! lurking
Posted by: PositiveDog

Re: Mr. Max's Issue(s) - 04/23/10 07:11 PM

Me, too! How are both you and Max today? hugging
Posted by: aubie

Re: Mr. Max's Issue(s) - 04/30/10 11:54 AM

lurking