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Good morning,

My husband received a call on Friday evening asking for us to long-term foster a German Shepherd with fairly severe dermatitis. We have two German Shepherds (Diesel - 4 years, Kimber - 1 1/2 years). The foster baby (Luna) came last night. She has very thin hair and very dry, scaly skin. We were told she did not have fleas, but she does. They dropped off all of her vet records as well. The owner surrendered her because he can no longer afford to spend hundreds of dollars a month for her treatments that are not working. She was diagnosed with a severe flea allergy. They did skin scrapings a year ago. She has been on different medications since then to try to control the flea problem (which it currently isn't). She has also been on different medications to help the dermatitis, which is getting worse. I put coconut oil on her skin last night and she seemed to get quite a bit of relief from that. The biting and scratching lessened and she slept (which I understand was not happening before).

My question is, when we get rid of the flea situation can the dermatitis continue long-term even when she is flea free or will her skin gradually get better. I plan to call my vet tomorrow who specializes in GSDs also. This poor girl has had so much testing done over the last year with everything coming out negative (thankfully) except the flea allergy. Not sure if this has any relation to the situation or not but she is from Bulgaria and she is 2 years 2 months. She has lost weight over this last year also, according to vet record with no other test results showing any indication of why.

Thank you!
 

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I would also have a complete thyroid panel run on her.
 

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Could be that and if so should clear up when fleas leave. But.... could be mange mites. Went through a severe case of this and it took a couple of years to recognize as "not allergy" despite allergy tests. Mange treatment brought dramatic relief in two adult dogs. Scrapings never did show mange mites by the way....
 

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Poor baby! Thank you for taking on this difficult health case. I have no advise just wishing you success in helping Luna get healthy and being able to enjoy life.
 

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Bulgaria.....Has she been through the treatment for mange? I imagine mange is common there and it does not always show up on skin scrapings.
 

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Wow! Poor dog! I feel your pain. I have one that is severely allergic to fleas as well and it was getting pretty bad off and on but not as bad as yours. No flea product worked and no amount of begging the vets for a solution produced any results. Finally a vet tech slipped me some Bravecto and the miracles began. Finally a flea product that actually killed fleas! I took him to yet another vet and he was once more put on antibiotics and steroids and his hair started to "straggle" in. The next step was going to be a thyroid panel but we gave it a little more time and things are improving, just not as fast as had hoped but the vet wants to hold off on the panel for right now as long as things are moving in the right direction.
 

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A good flea prevention like advantix plus will help keep the fleas away. It works very well. I had a poodle growing up who was severely allergic to fleas it was before all the fleas preventions were out - he would of benefited greatly.
 

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Instead of Advantix, I'd ask the vet for ADVOCATE from Bayer (the European name for Advantage Multi). It will work on demodex and scabies mites, as well as fleas.


What were the medicines the vet had you using? Was one of them an antibiotic, and if so, for what?



The reason I ask is that I've seen dogs with chronic, colonized staph infections looking like that. I would have them do another skin scrape at the vet to look for it. If there's staph that survived one round of antibiotic, I would send it out to a lab to be cultured, as antibiotic resistant staph is now emerging as a problem in dogs too. A short round of antibiotics won't touch that sort of infection. They end up needing antibiotics for 30 days or more, plus 2x weekly antimicrobial baths with chlorhexadene shampoo. It's a big ordeal to bring them back, if that's what it is. I hope it's just mites...but staph often comes secondary to allergies, so it worries me for this dog.
 

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Instead of Advantix, I'd ask the vet for ADVOCATE from Bayer (the European name for Advantage Multi). It will work on demodex and scabies mites, as well as fleas.


What were the medicines the vet had you using? Was one of them an antibiotic, and if so, for what?



The reason I ask is that I've seen dogs with chronic, colonized staph infections looking like that. I would have them do another skin scrape at the vet to look for it. If there's staph that survived one round of antibiotic, I would send it out to a lab to be cultured, as antibiotic resistant staph is now emerging as a problem in dogs too. A short round of antibiotics won't touch that sort of infection. They end up needing antibiotics for 30 days or more, plus 2x weekly antimicrobial baths with chlorhexadene shampoo. It's a big ordeal to bring them back, if that's what it is. I hope it's just mites...but staph often comes secondary to allergies, so it worries me for this dog.

Just wanted to say how much I appreciate your knowledge, and how often you chime in to help others. So far I haven't needed your help (knock on wood) but it's good to know you're out there.
 
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Thank you!

Let me start by saying thank you so much! It's hard to come into this a year into her issue and try to catch up on everything that's been done. Secondly, the previous owner spoke better Spanish than English and the vet records are all in Spanish. I speak beginner to intermediate Spanish so I've been slowly going through the records over the last 24 hours. I'm going to ask the vet this morning if they can give me all of her records in English. So far this is what I've been able to understand.

What she's been tested for:

1. T4, Free T4, cTSH - I do not see the results for that so I will need those.
2. Fecal tests - showed worms
3. Multiple Blood tests - I don't see results for these
4. Heart worm, Lyme disease, Ehrlichiosis and Anaplasmosis - Negative
5. Ear scraping
6. Microscopic Evaluation Skin Scraping - Allergy to Fleas
7.Superchem - CBC/5 part machine differential, Electrolytes, Internal Organ Function Screen - I don't see the results of these either.


Medications previously given:

1. Simparica for fleas, which obviously wasn't working as she had a lot of fleas on her. They have done multiple fecal tests.
2. Pyrantel for worms. They've also done multiple blood tests but it doesn't 3. 200 mg Simplicef but I don't see anywhere why she was on it but she was on it twice.
4. Relifor - for itching
5. Miconazole
6. Momatamax

Additionally, during all of this time they put her on the hydrolyzed protein diet but I don't see any testing on that.

I don't see anywhere that she was tested for mange so that will be the next step.

Thank you all for your advice! I will update as things progress. For now I have her in quarantine from my two. I just really want her to feel better!
 

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The skin scrape is really the only test for mange. But this one was done a year ago per your first post, so it's time to do another to figure out if there are mites, bacteria, fungus, or all of them at once!



So yes, this dog was on an antibiotic -- Simplicef is the brand name for Cefpodoxime...commonly used to treat staph on the skin. Mometemax is an antibiotic ear drop used for ear infections (those can become antibiotic resistant too, by the way). Miconozole is an antifungal medicine (usually used to treat ringworm, in my experience...but your pictures doesn't really like like that, so maybe they cured it, if he had it). It might also be used for yeast (which can also colonize skin secondary to allergy flare ups or mites).



I would really like for you to have this next skin scrape cultured at a diagnostic lab. It takes about a week to get the results back, but the report will not only tell you the exact microbes but also what medicines work against them (they test multiple antibiotics to check for resistance).



Show the vet that short courses of Simplicef failed to cure this -- so you can't do that again and expect a different result. Since it's a chronic problem, as it really does take a long course (at least a month) on the right med, in my experience.


My vet's dealt with this thousands of times, and our general approach is, "Let's stop fooling around with 'half measures' that don't work." We hit the staph hard and relentlessly to win the war -- the right oral antibiotic AND frequent topical antimicrobial baths for a full month, and then we reassess. The baths also help with the allergies by removing contact allergens like grass, if those are a problem.



I have more advice on household hygiene while you are working on diagnosing this properly, that I'll post in a moment.
 

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Aw, thanks ksotto333 and Beau's Mom! Just been there, done that with a lot of dogs...working on vetting issues for a rescue has been challenging, but I've had a great vet and great vet tech to teach me.

Michelle, here's an example of the sort of shampoo I would use on this dog:
https://www.amazon.com/Dechra-TrizChlor-4-Shampoo-8-Ounce/dp/B00K4X8TF6

The brand doesn't matter, but I would look for "4% chlorhexiden gluconate" as an ingredient. There are likely other brands of this sold in Europe. Just keep it below the neck only -- never on the head (as it can cause blindness if it gets in the eyes). Let it stand for the time specified on the bottle. It's thin and watery and doesn't foam, so it won't strip coat oil like regular detergent. When we're fighting suspected bacterial infections, we shampoo at least 1x week, and if it's confirmed to be chronic staph the vet has us do 2x week.

Aside from helping the dog, the other reason we want to knock down the bacteria topically with frequent antimicrobial baths is that we want to protect ourselves and our families, if the dog is shedding infectious bacteria. While the likelihood of it infecting a healthy person in the home is relatively low (I've handled lots of these dogs and never had a problem), if you have young kids, elderly, or immuno-compromised family members, I would be more cautious and separate the dog from their living areas -- and don't handle the dog yourself if you have any open cuts or wounds. A box of disposable gloves would be a good idea for bath time, and then wash your clothes. The antimicrobial baths help make it safer for everybody (and help the dog recover). Wash your hands well after petting the dog too.

I also try to use good sanitizing practices in the home when I'm fostering staph-infected dogs (washing the crate pan frequently outside, spraying it with 10% bleach solution, letting it stand for 10 min, and then rinsing and air-drying in bright sunlight).

I had a nearly hairless dog who looked a lot like this -- I recognized the tail rings in your picture! -- and we brought him back from it. His owner surrendered him because he was tired of the vet bills. We talked to his old vet and found out there were "compliance" issues--never refilled prescriptions, never wanted to pay for proper diagnostics, etc. When we buckled down and did exactly what was needed (the right meds, for a long course, with frequent baths), we got the dog through it, and he became gorgeous....but it took about 3-4 months for the coat to grow back.


I don't want to scare you about hygiene -- I've never had a problem fostering this sort of dog. However, the risk of antibiotic resistant staph emerging is very serious, and if you don't yet know whether he's got it (since it hasn't been cultured), just be careful. Use good, safe sanitizing practices while you help him recover.
 

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If it is mange that is causing the problem, it may well not show up on a skin scraping. Been there, done that. My dogs (yes, two of them) suffered horribly until treated for mange despite failing to get a positive scraping. Allergy panels showed this that and the other. Allergy shots had my dogs cringe when I approached (I wasn't particularly skilled with shots but even people who are have this experience with shots). And the shots did nothing for the dogs. Much money was spent on worthless treatments and tests. Because it WAS mange that was the problem despite no positive test results.


So I cannot repeat often enough - mange often does not show up on skin scrapings.
 
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