HELP! Skin problem driving me (and my vet) nuts

All,
I'm hopefull someone here may be able to shed some light on a skin problem
my 2 year old German Shepherd has. I've taken him to 3 vets and a
dermatologist. 2 months and $1k later, all I have is an I don't know...

His problem started last winter, a red spot in his stomach, right where his
ribs end. A trip to the vet and a low dose of Hydroxazine (pills, green and
white), and it went away.

About 4 months ago, it came back -- with a vengance.The best way to describe
it is a 2" circle, the skin is very bumpy/wrinkly, hairless, and red. This
time it's accompanied by deep red/purple over the entire inside of his hind
quarters. (I can take some pictures and post if someone feels they'd be
helpful). He constantly scratches and licks at it. He also developed a few
puppy zits. About dime-sized, and when they pop they squirt white stuff. One
was on his side, one behind his ear.

In the 4 months,none of the symptoms have worsened at all, but also have not
improved at all. We've been to a bunch of vets, none of whom have any ideas.
Here's what's been tried so far:

Thought: Maybe it's the same thing?
Hydroxazine -- nothing.

Thought: Maybe mange of some sort?
A series of Ivermectin -- nothing.

Thought: Ok, maybe allergies?
Kept him out of his crate for all but ~2 hours a day in case it's plastic --
a bit better, but not really.
Benadryl -- nothing
Steroid (can't recall which one) -- nothing
Food change -- nothing

Thought: Ok, just reealy dry skin?
Moisturizer -- almost instantly turns the red spot and his inner thighs to
white, but it doesn't go away, and he still itches.
Aloe/cortizone/itch creme -- turns it white, but again, nothing

Sorry for the long book post, but I'm kind of desperate. If anyone has any
thoughts, please, help!

On Tue, 21 Feb 2006 10:19:05 -0500, "japhar81" ,
clicked their heels and said:

All,
I'm hopefull someone here may be able to shed some light on a skin problem
my 2 year old German Shepherd has. I've taken him to 3 vets and a
dermatologist. 2 months and $1k later, all I have is an I don't know...

His problem started last winter, a red spot in his stomach, right where his
ribs end. A trip to the vet and a low dose of Hydroxazine (pills, green and
white), and it went away.

still sounds like an allergy, but I know those can be a bear to pin
down sometimes. Btw - it's Hydroxyzine (brand name Atarax).

Food change is not a quickie result thing. Elimination diets take
time, and are not simple.

My sister's lab had a darkened groin for most of his adult life. He
did better when he drank filtered water, but other things weren't
consistent enough to really make a difference.

There are a number of books on pet allergies and special feeding and
elimination diets. Dr Pitcairn's books have been very useful, and you
may want to read up on Billinghurst and such as well.

--
Janet B
www.bestfriendsdogobedience.com
http://pg.photos.yahoo.com/ph/bestfr...bedience/album

I've been reading alot about allergies, but everything I read says a steroid
should show some change..

We tried the new foods for at least a month each, again, based on my reading
I would have thought some result would appear. Should we go longer?

"Janet B" wrote in message
...
On Tue, 21 Feb 2006 10:19:05 -0500, "japhar81" ,
clicked their heels and said:

All,
I'm hopefull someone here may be able to shed some light on a skin problem
my 2 year old German Shepherd has. I've taken him to 3 vets and a
dermatologist. 2 months and $1k later, all I have is an I don't know...

His problem started last winter, a red spot in his stomach, right where
his
ribs end. A trip to the vet and a low dose of Hydroxazine (pills, green
and
white), and it went away.

still sounds like an allergy, but I know those can be a bear to pin
down sometimes. Btw - it's Hydroxyzine (brand name Atarax).

Food change is not a quickie result thing. Elimination diets take
time, and are not simple.

My sister's lab had a darkened groin for most of his adult life. He
did better when he drank filtered water, but other things weren't
consistent enough to really make a difference.

There are a number of books on pet allergies and special feeding and
elimination diets. Dr Pitcairn's books have been very useful, and you
may want to read up on Billinghurst and such as well.

--
Janet B
www.bestfriendsdogobedience.com
http://pg.photos.yahoo.com/ph/bestfr...bedience/album

I've gone to 4 regular vets, and to a dermatologist (referral). None have a
clue.

I live in an apartment, which is carpeted with standard apartment shag. We
don't use any products on it, just a vaccum. He's not exposed to any
chemicals, I'm 99% sure.

Food wise, he's on Royal Canin - GSD right now. I've tried solid gold wolf
cub and petsmart's hypoallegenic blue wolf stuff. Each for at least a month,
with no effect.

Pattern-wise, it started as a winter only thing last year, but started in
the middle of summer again, so I don't know. I doubt it.

No goopy eyes, but his ears are red, and have had a few infections which we
treated with an antibiotic cream the vet gave us. His nose is EXTREMELY dry.

I have contemplated a humidifier, but the vet didn't seem to think there was
a point.

I will say, a bit of water on the red spots turns them white.

"Suja" wrote in message
news:CnHKf.102471$4l5.10775@dukeread05...

"japhar81" wrote in message:

Sorry for the long book post, but I'm kind of desperate. If anyone has
any
thoughts, please, help!

A few questions first. What kind of vets has he seen? Has he been to a
doggie dermatologist/allergist? Is your flooring in the house carpeted?
Do
you use any particular cleaning product for floors/his bed? Have you
tried
changing these to those made for allergy sufferers? What food is he on
now,
and what have you tried so far? Are there any patterns (seasonal for
example) for when he gets this? Have you tried adding a humidifier to see
if that makes any difference? Does he have any other issues - goopy eyes,
ears that need frequent cleaning out, dry skin on nose/foot pad, etc.

Suja

"japhar81" wrote in message:

Sorry for the long book post, but I'm kind of desperate. If anyone has
any
thoughts, please, help!

A few questions first. What kind of vets has he seen? Has he been to a
doggie dermatologist/allergist? Is your flooring in the house carpeted? Do
you use any particular cleaning product for floors/his bed? Have you tried
changing these to those made for allergy sufferers? What food is he on now,
and what have you tried so far? Are there any patterns (seasonal for
example) for when he gets this? Have you tried adding a humidifier to see
if that makes any difference? Does he have any other issues - goopy eyes,
ears that need frequent cleaning out, dry skin on nose/foot pad, etc.

Suja

"japhar81" wrote in message:
I've gone to 4 regular vets, and to a dermatologist (referral). None have
a
clue.

Do you have a veterinary university near you? They might be your best bet.
I am going to assume that the vets did skin scrapings/biopsy/culture and
came up empty. Do you know if they did any blood work? He hasn't had any
joint/muscle problems (soreness, lameness, trouble getting up/around, etc.),
or seemingly unrelated problems (fever, lethargy, etc.) has he? Skin
problems can be difficult to troubleshoot, because there could be lots of
causes for it. I don't have any ideas on what could be going on (although
there is a nagging little voice that thinks that this is systemic), in your
shoes, would try the following:

Do an allergy panel, if it hasn't been done yet

Do complete blood work-up

Put the dog on a prescription, hypo allergenic diet, such as Z/D Ultra for
at least 8 weeks, and cut out all external supplements.

Supplement with fish oil (before or after the hypoallergenic diet, not
during) and possibly Vitamin E.

Add a humidifier

I hope someone else has some ideas for you. You might want to post this to
the vet newsgroup (alt.med.veterinary) as well.

Suja

"Suja" wrote in message
news:67IKf.102558$4l5.39019@dukeread05...

I am going to assume that the vets did skin scrapings/biopsy/culture and
came up empty. Do you know if they did any blood work? He hasn't had any
joint/muscle problems (soreness, lameness, trouble getting up/around,
etc.),
or seemingly unrelated problems (fever, lethargy, etc.) has he?

........I'll ditto all that, especially the question about biopsy and fungal
culture. Personally I would be kind of shocked of a dermatologist hadn't
done a biopsy/culture or skin scrapings. I'm assuming they did several
skin scrapings with no results before giving ivermectin, JIC the dog had
demodetic mange? Please tell us exactly what tests were done, plus the
results.

........plus (to the OP) - is there a regular spray program for insects in
your apartment building? If you don't know for sure, ask the building
manager.

Supplement with fish oil (before or after the hypoallergenic diet, not
during) and possibly Vitamin E.

.........if they're going to give fish oil (that's body oil like salmon oil,
not cod liver oil), it's best to always add Vit E so the EFAs don't oxidize
in the body. Personally I'd also add Vit A - which helps heal up skin and
mucous membrane issues.

........to the OP - The skin is often the last place a body tries to get rid
of garbage if the internal system is overwhelmed. As unrelated as it may
seem, I'd make sure the gut is in good shape. A good chunk of the immune
system is in the gut. Maybe digestive enzymes, definitely probiotics - at
least for a month.

buglady
take out the dog before replying

There were scrapings done, and no other symptoms/illnesses other than what
I've mentioned. He has seemed a bit lazy lately.

Tets-wise, they did the standard allergy test (no results), blood work (I
didn't get specifics, but it all came back normal), two scrapings (normal)
and a culture that turned up yeast spots on his back, which were treated and
went away.

"buglady" wrote in message
k.net...
"Suja" wrote in message
news:67IKf.102558$4l5.39019@dukeread05...

I am going to assume that the vets did skin scrapings/biopsy/culture and
came up empty. Do you know if they did any blood work? He hasn't had
any
joint/muscle problems (soreness, lameness, trouble getting up/around,
etc.),
or seemingly unrelated problems (fever, lethargy, etc.) has he?

.......I'll ditto all that, especially the question about biopsy and
fungal
culture. Personally I would be kind of shocked of a dermatologist hadn't
done a biopsy/culture or skin scrapings. I'm assuming they did several
skin scrapings with no results before giving ivermectin, JIC the dog had
demodetic mange? Please tell us exactly what tests were done, plus the
results.

.......plus (to the OP) - is there a regular spray program for insects
in
your apartment building? If you don't know for sure, ask the building
manager.

Supplement with fish oil (before or after the hypoallergenic diet, not
during) and possibly Vitamin E.

........if they're going to give fish oil (that's body oil like salmon
oil,
not cod liver oil), it's best to always add Vit E so the EFAs don't
oxidize
in the body. Personally I'd also add Vit A - which helps heal up skin and
mucous membrane issues.

.......to the OP - The skin is often the last place a body tries to get
rid
of garbage if the internal system is overwhelmed. As unrelated as it may
seem, I'd make sure the gut is in good shape. A good chunk of the immune
system is in the gut. Maybe digestive enzymes, definitely probiotics -
at
least for a month.

buglady
take out the dog before replying

"japhar81" wrote in message
...
There were scrapings done, and no other symptoms/illnesses other than what
I've mentioned. He has seemed a bit lazy lately.

...........I'd get a 6 panel thyroid test done then, if his demeanor has
changed. Just T3 and T4 isn't enough as these values can be affected by
other illnesses than hypothyroidism.

A discussion of hypothryoidism, testing, etc.:
http://www.vetinfo4dogs.com/dthyroid.html

.........No biopsy? Have they ruled out pyoderma (Staph) infection?

Tets-wise, they did the standard allergy test (no results), blood work (I
didn't get specifics, but it all came back normal),
.........it's good to get a copy of lab work. That way you can take it to
another vet without waiting on the former one to copy it/send it. I don't
think allergy tests have a very good track record in dogs. Personally I
think most allergies are due to an improperly functioning gut.

two scrapings (normal)
and a culture that turned up yeast spots on his back, which were treated
and
went away.

A good article on fungal problems in dogs and how to diagnose them:
http://consumer.vetmedcenter.com/con...M-In_A-fungald
iagnosisFK1JO.xml&dt=K

.........they don't think the whole problem might be yeast? Did they do
slide impressions on many parts of the body? What did they treat with? I'm
surprised they found yeast as the fungal cultures are innoculated with stuff
to kill Candida yeast but let other fungi grow. Malassezia is the yeast
organism most likely to infect pets. Yeast of any kind is usually a
secondary problem, not the primary issue.

...........from another part of the above site:
*Candidiasis
Candida sp. is a small fungus that normally lives quietly and harmlessly in
the gastrointestinal, nasal, and genital tracts in most mammals. Considered
an "opportunist," the organism causes infection only when another problem
weakens the immune system. The signs of Candida infection vary. If the
fungus infects the mouth, then the tongue, gums, or lips may have white,
cottony type growths. Intestinal infections often show up as chronic
diarrhea or weight loss. Infected ears may become inflamed. The genitals may
have a white discharge if the reproductive system is infected. Infected skin
may become moist and oozing, especially around the base of the nails.
Candida can also cause systemic infection, including microscopic abscesses
in various organs, fever, and infection of the bone or brain. Diagnosis is
usually based on identifying the organism, generally by cytology, in samples
from infected tissue....
..
Malassezia
The yeast Malassezia pachydermatis normally lives in low numbers on the skin
and in the ear canal of dogs and cats without doing any harm. When the skin
or ear becomes chronically moist, irritated, or when the immune system of
the pet becomes weakened by disease this yeast may cause problems. In most
cases, Malassezia causes thickened, oily, and irritated skin. The most
common sites of infection are in the ear canal, the throat, the face, paws,
and groin, but the yeast can cause problems anywhere. Infected skin or ears
may smell like rising bread. Diagnosis is made by identifying the yeast
while examining skin or ear debris under a microscope.

Malassezia skin infections can often be cured with creams, lotions or
shampoos containing antifungals such as clotrimazole, ketoconazole, or
miconazole. Skin products should not be used in the ears, but there are many
anti-Malassezia ear preparations available through veterinarians. When the
yeast appears in several places on the animal, or if it is difficult to cure
with topical preparations, treatment with an oral systemic antifungal drug
such as ketoconazole may be effective. In order to achieve a permanent cure,
it is important that we treat any concurrent disease that may have allowed
the fungal yeast to grow out of control to begin with. These diseases may
include allergies, seborrhea, thyroid disease, and Cushing's disease. Dogs
suffer from Malassezia much more commonly than cats. Infected cats should
always be tested for severe immune-suppressing diseases such as feline
leukemia, or feline immunodeficiency virus. People do not catch this disease
from their pets.*

.............I'd do some reading on these issues so you're familiar with
them. It is important you know what might be going on so you can discuss
the next step in treatment with your vets. Personally I would not use
keoconazole without doing further tests such as thyroid. You don't need to
be stressing your dog's body out more than it already is:
http://www.petplace.com/drug-library...ral/page1.aspx
...........On that issue, I would not be getting any vaccinations either
until this dog's skin issues are resolved. Vaccinations require a fully
functioning immune system to work. It's a load your dog doesn't need right
now. While skin issues can drive you crazy, be thankful the problems are on
the outside where you can see them and know something is wrong.

.......If the issue is Malassezia, you may need nothing more than a vinegar
rinse. Dermapet is a good web source for skin issues. In this article they
discuss treatment of Malassezia in the ear using a vinegar/boric acid rinse.
The only dog who did not resolve was one who also had cutaneous problems
with this yeast:

http://dermapet.com/dermapet.pdf

.......I'd still make sure the skin was nourished with the proper nutrients,
such as EFAs (salmon oil plus Vit E) and Vit A. EFAs are important in the
structure of skin cells. And again I'd recommend probiotics. Many times
skin issues need to be addressed from the inside out.

best of luck
buglady
take out the dog before replying

I'm going to re-read this before I try to respond.. I'm not sure I grasp it
yet. In the meantime, in case they help, here are pics:

They didnt find anything when they ran the test. If it helps, here are
pics...


The spot:
http://hzdev.net/mag1sm.jpg
http://hzdev.net/mag3sm.jpg
http://hzdev.net/mag4sm.jpg

The hind quarters:
http://hzdev.net/mag2sm.jpg

I don't know if these are relevant, but his nipples are kind of dry/crusty:
http://hzdev.net/mag5sm.jpg

"buglady" wrote in message
ink.net...
"japhar81" wrote in message
...
There were scrapings done, and no other symptoms/illnesses other than
what
I've mentioned. He has seemed a bit lazy lately.

..........I'd get a 6 panel thyroid test done then, if his demeanor has
changed. Just T3 and T4 isn't enough as these values can be affected by
other illnesses than hypothyroidism.

A discussion of hypothryoidism, testing, etc.:
http://www.vetinfo4dogs.com/dthyroid.html

........No biopsy? Have they ruled out pyoderma (Staph) infection?

Tets-wise, they did the standard allergy test (no results), blood work (I
didn't get specifics, but it all came back normal),
........it's good to get a copy of lab work. That way you can take it to
another vet without waiting on the former one to copy it/send it. I don't
think allergy tests have a very good track record in dogs. Personally I
think most allergies are due to an improperly functioning gut.

two scrapings (normal)
and a culture that turned up yeast spots on his back, which were treated
and
went away.

A good article on fungal problems in dogs and how to diagnose them:
http://consumer.vetmedcenter.com/con...M-In_A-fungald
iagnosisFK1JO.xml&dt=K

........they don't think the whole problem might be yeast? Did they do
slide impressions on many parts of the body? What did they treat with?
I'm
surprised they found yeast as the fungal cultures are innoculated with
stuff
to kill Candida yeast but let other fungi grow. Malassezia is the yeast
organism most likely to infect pets. Yeast of any kind is usually a
secondary problem, not the primary issue.

..........from another part of the above site:
*Candidiasis
Candida sp. is a small fungus that normally lives quietly and harmlessly
in
the gastrointestinal, nasal, and genital tracts in most mammals.
Considered
an "opportunist," the organism causes infection only when another problem
weakens the immune system. The signs of Candida infection vary. If the
fungus infects the mouth, then the tongue, gums, or lips may have white,
cottony type growths. Intestinal infections often show up as chronic
diarrhea or weight loss. Infected ears may become inflamed. The genitals
may
have a white discharge if the reproductive system is infected. Infected
skin
may become moist and oozing, especially around the base of the nails.
Candida can also cause systemic infection, including microscopic abscesses
in various organs, fever, and infection of the bone or brain. Diagnosis is
usually based on identifying the organism, generally by cytology, in
samples
from infected tissue....
.
Malassezia
The yeast Malassezia pachydermatis normally lives in low numbers on the
skin
and in the ear canal of dogs and cats without doing any harm. When the
skin
or ear becomes chronically moist, irritated, or when the immune system of
the pet becomes weakened by disease this yeast may cause problems. In most
cases, Malassezia causes thickened, oily, and irritated skin. The most
common sites of infection are in the ear canal, the throat, the face,
paws,
and groin, but the yeast can cause problems anywhere. Infected skin or
ears
may smell like rising bread. Diagnosis is made by identifying the yeast
while examining skin or ear debris under a microscope.

Malassezia skin infections can often be cured with creams, lotions or
shampoos containing antifungals such as clotrimazole, ketoconazole, or
miconazole. Skin products should not be used in the ears, but there are
many
anti-Malassezia ear preparations available through veterinarians. When the
yeast appears in several places on the animal, or if it is difficult to
cure
with topical preparations, treatment with an oral systemic antifungal drug
such as ketoconazole may be effective. In order to achieve a permanent
cure,
it is important that we treat any concurrent disease that may have allowed
the fungal yeast to grow out of control to begin with. These diseases may
include allergies, seborrhea, thyroid disease, and Cushing's disease. Dogs
suffer from Malassezia much more commonly than cats. Infected cats should
always be tested for severe immune-suppressing diseases such as feline
leukemia, or feline immunodeficiency virus. People do not catch this
disease
from their pets.*

............I'd do some reading on these issues so you're familiar with
them. It is important you know what might be going on so you can discuss
the next step in treatment with your vets. Personally I would not use
keoconazole without doing further tests such as thyroid. You don't need
to
be stressing your dog's body out more than it already is:
http://www.petplace.com/drug-library...ral/page1.aspx
..........On that issue, I would not be getting any vaccinations either
until this dog's skin issues are resolved. Vaccinations require a fully
functioning immune system to work. It's a load your dog doesn't need
right
now. While skin issues can drive you crazy, be thankful the problems are
on
the outside where you can see them and know something is wrong.

......If the issue is Malassezia, you may need nothing more than a vinegar
rinse. Dermapet is a good web source for skin issues. In this article
they
discuss treatment of Malassezia in the ear using a vinegar/boric acid
rinse.
The only dog who did not resolve was one who also had cutaneous problems
with this yeast:

http://dermapet.com/dermapet.pdf

......I'd still make sure the skin was nourished with the proper
nutrients,
such as EFAs (salmon oil plus Vit E) and Vit A. EFAs are important in the
structure of skin cells. And again I'd recommend probiotics. Many times
skin issues need to be addressed from the inside out.

best of luck
buglady
take out the dog before replying