My dog is scratching herself until she bleeds :(
May 25, 2017 2:00 AM   Subscribe

What can I do for my dog who's itching and scratching herself to the point of bleeding?

I'll try to do bullet points because her history up until now is a bit lengthy.

- Rescued from a shelter Feb. 14, 2017

- 2 y.o. female, formerly wild, some sort of pitt/staffordshire terrier mix (according to shelter)

- Several bald spots when we got her, shelter says the skin scrape was negative and it was from a prior flea allergy already treated. Shelter photos.

- Heartworm positive, was in Bad shape when we got her (constantly throwing up and struggling to breathe). Started with steroids and antibiotics to control her acute illness. Now undergoing pulse treatment with doxycycline. Vet put her on a regimen of 1 month on doxy, 2 months off, to be done 4 times in total, so she'll spend 4 months on doxy over the course of a year. She was on for the month of April, will start again in July. Also on a preventative flea med (Heartgard I think).

- Moved to a new house on April 1 (big fenced in yard vs. small strip of grass out back at the townhouse I lived in before)

- Treated the bald spots with Vetericyn at advice of the vet and all of the hair grew right back with no further issues

A few weeks ago we started noticing that she was itching a lot more. She's always been a bit anxious and licked her skin more than she should, but this was different. She'd itch her back and scratch until her fur fell out. We clipped her nails really short and got her medicated hot spot shampoo. We tried Vetericyn on the spots and it didn't help. Neither did the special medicated shampoo. It eventually got so bad she had scrapes and scabs all over her face by her eyes and in her ears.

My husband took her to the vet, who just said they didn't know what it was, took a skin scrape, and said try benadryl. I was very unimpressed.

Of course Benadryl didn't work either, nor did Chlor-Trimeton. We changed her food to see if it was a food allergy. She eats Diamond Naturals now, and gets sick less, but it didn't help her skin. She almost never goes outside and rarely goes on the grass when she does. We got her little doggy socks and a shirt. She pulls the socks off but tolerates the shirt. All that's served to do is redirect her scratching to places she Can get, like her ears and face. We wash her blankets and swap them out for fresh ones daily.

I simply don't know what else to do. She's miserable and it makes my heart hurt to see her scratch until she's crying with pain, but she can't stop scratching. Her skin is red and irritated. She licks and gnaws at herself incessantly. We just don't know why this has happened so suddenly and seemingly out of nowhere. The best we can figure is that the doxycycline was holding it at bay.

Any ideas or suggestions would be so greatly appreciated.

This is a photo of her feeling good and normal that I took on April 20, which was only about a month ago.

This is her tonight.
posted by Sherbil to Pets & Animals (29 answers total)
 
I had the same exact problem with our rescue-down to the negative skin scrape and unimpressive vet. I took him to a different vet and asked that we treat him like he had scabies (mange) and do a intense course of Revolution (I think it was Revolution, it was one of the flea treatments that also kills scabies). Worked beautifully. Turns out the shelter had treated him with the Revolution as a flea preventative and it knocked the scabies down enough where the skin scrape came back negative, but as time went on he suffered more as the numbers went up. For me and my risk tolerance, it was worth treating 'blind', YMMV.
posted by PorcineWithMe at 2:19 AM on May 25, 2017 [3 favorites]


Response by poster: Porc, I had considered something like this but dismissed it because my other dog, who does spend a lot of time outside, has no symptoms whatsoever, and neither do my cats. How likely is it that she has scabies while none of the other animals do?
posted by Sherbil at 4:23 AM on May 25, 2017


Do you have a specialty vet nearby, and if so, do them have a veterinary dermatologist on staff? My dog has had to see specialists twice now (a neurologist for idiopathic epilepsy, and an internal medicine vet + radiologist for a very strange bladder infection) and I was amazed both times at their expertise. Sometimes "primary care" vets are out of their depth just like human doctors.

Sending good thoughts your way. I hope your girl is on the road to recovery soon!
posted by schroedingersgirl at 5:09 AM on May 25, 2017 [2 favorites]


I am so sorry. She is beautiful! I only have a possible very temporary bit of relief. I had a dalmatian that had really sensitive skin (and maybe a bit anxious) and it took a long time to figure out what it was. In the mean time, days that he got LOTS and LOTS of exercise tired him out enough that the licking was secondary to a nice nap. He rested much more comfortably when he was tuckered out.
posted by ReluctantViking at 5:11 AM on May 25, 2017


Response by poster: Unfortunately I'm in rural hell, with only two vet offices within 45 minutes of me and the closest specialty vet 3 hours away. I am in health care myself, so I know that general practitioners don't always know specifics, but the lack of competence was astounding to me. It'd be like going to a walk-in clinic with excoriated skin that was itching relentlessly and being told to go home and put some cortizone 10 on it.

I had to google to find out that there are actually two medications to help if it's atopic dermatitis (which seems possible), Atopica and Apoquel. I was tempted to simply go in and request one or the other, but I really feel out of my depth trying to self-treat my dog with nothing by way of diagnosis. I figured it couldn't hurt to take to the internet first and see if perhaps others have had experience. If the vet won't diagnose her, I have to do something.

Thank you all for the well-wishes! She is such a sweetheart and it kills me to see her suffering :(.
posted by Sherbil at 5:29 AM on May 25, 2017


Sherbil- I really have no idea. Sorry.
posted by PorcineWithMe at 6:03 AM on May 25, 2017


You can spend weeks or months trying things blind, or you can spend a day going to the specialist. Dermatology is a very complicated specialty and there are all sorts of new treatments and advances in the field that the average primary vet would not be familiar with.

If there is a vet school near you you could try asking your primary vet if they offer consulations. Our teaching hospital offers them for free to any vet in the state. That way they can at least advise your vet on some things to try, but there may be tests they will recommend that your vet doesn't have access to.

Best of luck!
posted by Rock Steady at 6:22 AM on May 25, 2017 [2 favorites]


Allergies are another possibility. Your vet can send a blood sample to http://www.vetallergy.com/ . My dear old pittie boy had allergies to a few foods and many grasses. Given the increase in your dog's symptoms at this time of year, grasses and tree pollens could be the culprit.
posted by ReginaHart at 6:25 AM on May 25, 2017 [2 favorites]


Best answer: My dog is also allergic to fleas. And even though I never see any evidence of fleas or bites, as soon as flea season starts, she begins itching like mad. The one time it was really bad, it had been going on for weeks and she had scratched herself raw and was miserable because she couldn't sleep, she was so itchy all the time. The vet finally gave her a pain killer/sedative, that made her very sleepy for a couple days, and started a course of steroids and antibiotics. Also, Revolution flea treatment. She was too sleepy to scratch for a couple days, giving the steroids and antibiotics time to work to reduce her itchiness and start healing the skin. It worked in breaking the itch cycle. And now as long as i keep her dosed with Revolution year round, it's never gotten to that bad point again.

I am not sure this is what's up with your dog, but may be worth trying/asking your vet about. Good luck, I hope she feels better soon!
posted by fourpotatoes at 6:34 AM on May 25, 2017 [3 favorites]


Best answer: I'm not a vet but I've fostered hundreds of dogs who arrive in very poor condition. I'd second the Revolution suggestion since it's possible that it's some kind of skin infection or allergy, and you don't need a specific diagnosis to treat. Revolution takes care of a variety of parasites. It's a little expensive....but you give one for three months (or one every month for acute treatment under a vet's care). It's been miraculous for fosters with various skin conditions who have tested negative for the common causes like demodex. It's cheaper than multiple vet visits.

You could supplement any medication with a regular bath in a benzoyl peroxide shampoo for dogs (vets carry this), intended to clear the pores. And there's always good old-fashioned Benadryl for acute flare-ups.

You mention that she's heartworm positive - is the heartworm being treated either through the traditional arsenic treatment, or the less common long-term ivermectin treatment? Sometimes the ivermectin can be useful for things like parasites and can bolster other treatments, but it needs to be administered in very precise doses. But the slow-kill treatment with ivermectin can be sensitive for dogs who are far along in the disease. It took two years to clear my ancient chow foster, but she wouldn't have survived the traditional arsenic injection treatment.
posted by answergrape at 7:13 AM on May 25, 2017


I had a dog prone to bad flea allergies. In the end she was on steroids and flea drops every two weeks (this was back in the early days of front-line etc and under vet supervision with modern multi use drops be careful)and I had to be super careful to keep on top of fleas in the house in general as most flea drops need the dog to be bitten to work which lead to allergic reaction so they don't prevent the reaction just keep flea numbers down.

It may also be fleas in your area have built up am immunity to the drops used so you may want to try some other brands.

I saw ended up seeing a specialist to get things sorted and would suggest that as a starting place off possible. If the distance is top far they may be able to do a phone consultation with a copy of vet records and work with your local very re treatment.
posted by wwax at 7:14 AM on May 25, 2017


Best answer: My dog was just put on Apoquel last week for some itching/paw biting (as well as a probably-connected ear infection she had when I first got her). Her condition is nowhere near as serious as your dog's condition is, but the Apoquel is keeping things under control. (I go back to the vet for a checkup in a week and a half.) My vet said that food-related allergies are usually only the issue 10% of the time, but who knows where he got that number or if it's accurate.

I have previous Atopica and Apoquel experience from my previous dog, too. Atopica was kind of terrible, because it was a liquid and he haaaaaaated it (it was also $$$s), but Apoquel worked OK. He was allergy tested later and found to have a whole bunch of food-related allergies, so he moved to a very controlled diet instead.

Some things to be aware of with Apoquel: it can make your dog lethargic, especially in the first week when they're on a double dose, and it's an immunosuppressant (that's how it works), so it can cause other problems because of that.

Provided the checkup visit goes well, I plan on seeing how my dog is on it during the summer and fall, and transitioning off it after the allergy season is over to see if she actually seems to have seasonal allergies or if she has some other underlying allergies that are causing problems. If it's the latter, I'll be doing allergy testing to get the bottom of it.

Good luck - your dog is beautiful!
posted by minsies at 7:18 AM on May 25, 2017 [1 favorite]


All that's served to do is redirect her scratching to places she Can get, like her ears and face.

I know this isn't a long-term solution, but can you decrease the irritation that she can cause herself with a cone? There are a lot of soft/comfy cone options these days, although in my experience the traditional rigid plastic ones are still the most effective.
posted by R a c h e l at 7:25 AM on May 25, 2017


Just FYI - that missing hair around the eyes is what I've seen in fosters who have ended up having active demodex mange, which can also be super itchy. Just because one scrape was negative doesn't mean that she doesn't still have the demodex mite.

I've never heard of the "pulse" treatment, but I have treated dogs for months and months when a case of it is slow to respond to treatment, with intermittent blood work to verify that the disease is still active. Are they doing any bloodwork to show that the treatment worked? Maybe she needs to be on the doxycycline continually for a few months, rather than just a month at a time?
posted by answergrape at 7:26 AM on May 25, 2017


Something else to consider - grain allergy, beef allergy, dairy allergy, or chicken allergy. I don't know which of the Diamond dog foods you are feeding, but those are the most common food allergies for dogs, and can cause the itching as well as diarrhea and vomiting.
posted by Squeak Attack at 7:31 AM on May 25, 2017


The poor dear. Lots of good advice above, but one thing I didn't see is a suggestion about the moving - she may have an allergy to the grass or pollen in your new yard or a new insect, or something in your new house (carpets, hardwood cleaner). The recommendations for specialty vet are right on. If it were my dog I'd focus on environmental allergies first.
posted by juniperesque at 8:02 AM on May 25, 2017


Apoquel saved us. My dog was bloody all the time from scratching. It doesn't treat the underlying cause, but provides amazing relief. In 20 minutes! She was on it for 2-3 years. There is something new out that works the same way but only one shot is needed every 4-6 weeks. We tried it a week ago and so far so good. I'm thrilled, as it's so challenging to get itching under control. Both are rather pricey, but it's worth it for both of us.
posted by Vaike at 8:20 AM on May 25, 2017 [1 favorite]


Apoquel has been very effective for my dog, who had scratched and chewed bald spots all over his legs when I adopted him. He's been on Apoquel for over a year with no obvious side effects. He gets slightly itchy each morning before his daily pill, which stops soon after the dose.
posted by moonmilk at 8:27 AM on May 25, 2017


Our dog did this until we switched her dog food. We had been feeding her one with too much corn, if I remember correctly. Then we had to keep switching it every six months to a different protein ingredient.
posted by dpx.mfx at 8:30 AM on May 25, 2017


This may be way off the mark, but could it be some kind of doggie version of body-focused repetitive disorder? That was suppressed when she was in actual poor health at the shelter but is now emerging as she's comfortable and safe in your house? Something about your description, esp the part where if she can't get to her back she just scratches her face, made me think it might be more psychological/anxiety/compulsive than actually skin related. Not sure how you treat that but maybe something to look into.
posted by stellaluna at 9:38 AM on May 25, 2017


Agreed with stellaluna - my dog has flea allergies and even after the fleas were treated, she kept chewing. The vet said it was a comforting behavior. So definitely figure out and treat whatever's wrong, but don't be surprised if you have to work on making her feel mentally more comfortable before she gives it up completely.
posted by Bistyfrass at 10:52 AM on May 25, 2017


Poor thing!

It could be one of a million things that she's allergic to, if it's allergies. We are currently ruling out food allergies for one of my dogs and will move on to allergy testing once we're through that. As mentioned above, it could also be demodectic mange, which doesn't necessarily always show up in skin scrapings and can be very difficult to get rid of if the dog's immune system isn't taking care of it for whatever reason.

I second the suggestion to see a specialist, but it sounds like that isn't going to be possible right away. In the meantime, ask your vet for Apoquel. It had done wonders for one of my dogs and my friend's dog in alleviating the itching. My vet says it's expensive, but like magic.

That won't help the underlying condition at all, but it could at least get her some significant relief while you figure out what's going on.
posted by thejanna at 11:07 AM on May 25, 2017


I agree with all that has been said.

I have a dog who itches year-round, and once she licked her paws until they bled. I have her on a hypoallergenic diet, but the vet suspects she may be reacting to the preservatives. We use Apoquel, which makes her sleepy but works well. And baths can help if it is dermatitis, there are good dog shampoos out there but we use baby shampo if we wash her at home.
posted by chocolatetiara at 11:51 AM on May 25, 2017


Oh, I forgot to mention that Malacetic wipes and Malaseb shampoo were both very helpful in calming my boy's irritated skin. They are available without a prescription from Amazon and other sources.
posted by ReginaHart at 12:21 PM on May 25, 2017 [1 favorite]


While I would strongly second the recommendation of seeing a specialist (especially given the history of heartworms, etc) - my dog (also a rescue) had a similar problem (uncontrollable itching which got so bad that my vet put him on several medications, including a steroid which had the unfortunate side effect of making him urinate uncontrollably). In my case, what finally worked was 1). changing him from a mainly dog food diet to a combination of high-quality dog food (Orijen), rice, and wild-caught sardines in water 2). making sure to wash him with medicated shampoo at least every two weeks 3). making sure to rinse out ALL traces of the shampoo after each shower.

While the above (especially the feeding him an entire can of human-grade, wild-caught sardines with each meal) has been "deliciously expensive," in the long term, it's saved us a ton of money in vet bills - and my dog's coat has never looked nicer!
posted by soaringpineapple at 4:36 PM on May 25, 2017 [1 favorite]


When my dog did this, it was a food allergy and we ended up having to get dog food from the vet. Lots of baths, lots of exercise so he'd be to tired to scratch so much. It took months to get it stabilized. He's so lucky to have landed with you.
posted by theora55 at 5:21 PM on May 25, 2017


Response by poster: So many replies! I'm going to try to respond to all of the bits that stuck out at me.

It sounds like no matter what she may have picked up here, a strong round of Revolution could be helpful. I'm definitely going to ask about this.

Someone asked about ivermectin or arsenic for the heart worms; the vet did neither. The doxycycline is a new thing I think, and given how very sick she was, the vet thought it would be a good idea to go as gentle as possible over a year's time. It's the same idea as the slow-treatment before, just a different medicine. She almost didn't even tolerate the doxycycline :/. It made her throw up quite often. If she hadn't gotten used to it, we'd have had to go super slow and just given her preventatives until that cured it on its own. It ended up really helping her, so I'm glad it worked out. She still breathes heavily, but she doesn't collapse in exhaustion from simply walking around, and she's very playful now :).

We've changed foods 2 times now at the advice of the vet. They have never offered allergy testing though. That seems pretty basic. I'll ask about it. I have an appointment with a different vet on Tuesday. Trying to get a second opinion of sorts. And I'll ask if they can give us a referral to a specialist too.

I don't think it's simply anxiety, because sometimes she'll manage to get out of her shirt and scratch the hell out of her back, and she was scratching up her face and back both before we got the shirt. Her face looking really terrible is what made my husband and I realized we were out of our depth and take her to the vet for it. The vet's lack of assistance is what prompted us to start trying our own measures, including the shirt and socks. She still does scratch at her back with the shirt on but it protects it from a lot of it.

This has given me a lot to consider. Thanks everyone! These dogs are like my babies. I hope some of this helps her. If nothing else, it sounds like Apoquel is an expensive life saver :x.
posted by Sherbil at 6:23 PM on May 25, 2017


Price-wise, a 30-day supply of Apoquel for my dog (16mg tablets, 1 tablet/day) is $45. Not cheap, but not horribly expensive.
posted by minsies at 6:31 AM on May 26, 2017


I have a basset/beagle/corgi mix who would chew and chew at himself ceaselessly until he was covered with raw and bleeding spots. The vet put him on Apoquel and the chewing and bleeding stopped quickly. Now, his ears are another story .....
posted by blucevalo at 7:50 AM on May 26, 2017


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