Alternatives to vet's recommended (expensive) treatment for puppy?

January 16, 2008 12:40 PM

Puppy has developed bald patches on head and face. Antibiotics prescribed by vet a month ago haven't helped. Should the puppy's owner have a very expensive biopsy done, or just leave it alone and hope it goes away?

This is my friend's 5-month-old, mixed-breed puppy. I told her I would ask this for her because she's really unsure whether to go ahead with the procedure, considering that it costs several hundred dollars and she doesn't have a lot of money. However, she does want to be a good pet owner and make sure her puppy gets the treatment he needs.

The spots haven't worsened in the last month, but they haven't gotten any better as a result of the antibiotics. They don't seem to hurt, and he isn't displaying any other unusual symptoms. His disposition (hyper and typically puppy-like) is the same as always.

If anybody has any suggestions as to what else she can try or what might be causing the bald patches, please share. Her veterinarian's advice is, of course, to go forward with the biopsy - and she will if that's the only/best option. Feedback will be greatly appreciated.

posted by Ruby Doomsday to pets & animals (19 comments total)

Is she allergic to her food?
posted by chickaboo at 12:57 PM on January 16, 2008

Does he scratch? Did the vet to a skin scraping to look for mange?
posted by thejanna at 12:59 PM on January 16, 2008

I would suggest getting a second opinion. IANAV, and don't want to throw out guesses as to why the puppy is losing hair, but it seems strange to me that the vet would go straight to biopsy without ruling out other possibilities (mange, ringworm, allergies/hotspots) first.
posted by freshwater_pr0n at 1:00 PM on January 16, 2008

Second opinion. It's probably mange. I went through four vets before I got the right answer. And then it cleared up in a snap.
posted by Cool Papa Bell at 1:05 PM on January 16, 2008

If it were me (and my puppy), I would get a second opinion. And I am notoriously overprotective/ready to rush to the vet.

Anecdotal evidence - I have a Patterdale, and the hair on her face and head is thinner and closer to the skull than most dogs I've had before her. She likes to play and rub her face on the carpet at my office, and that habit occasionally causes her to have bald spots. So it could be scratching or rubbing doing it.
posted by KAS at 1:28 PM on January 16, 2008

We went through a nightmare series of tests and skin scrapings and blood work for our itchy and scab-laden dogs, which all came up negative and cost about a thousand bucks. We went through something similar with a giardia outbreak a year ago or so. Again...lots of expensive diagnostics with no results but with an ultimately cheap treatment.

This time, upon my insistence, they treated them as if they had mange (which the scrapings NEVER found) and gave our dogs a low ivermectin dosage which cost all of about 5 bucks per dog and it was GONE.

Next time, I'm going to insist on the treatment rather than a wild goose chase that may not reveal anything.

Sometimes I wish I still lived in the farm communities where everyone just did their own vet stuff unless something major was going on.
posted by answergrape at 1:28 PM on January 16, 2008

Perhaps mange, or a fungus. Would explain why antibiotics aren't working...they normally only target bacteria.

Skip the biopsy; see another vet.
posted by emd3737 at 2:26 PM on January 16, 2008

Sounds like sarcoptic mange to me. Or is it demodex? I always get them confused. If it's mange, and it sounds like mange, the only fix are fun and expensive hydrogen peroxide baths. My Golden's allergic to something in my house...she's getting scaly skin around her tail. It's not fleas...but I"m not sure what to do about it.
posted by TomMelee at 2:29 PM on January 16, 2008

Sounds a lot like localized demodex mange to me. For my pup, the vet did a skin scrape and had us give her Ivermectin for about a month. This is something that does need to be treated or else it can spread to the rest of the body and become a systemic problem (if you do a google image search for demodex, you will see some tragic and nasty pictures of what can happen if it goes untreated and generalizes.) If you live in the kind of place where they have feed & seed stores, they may have Ivermectin there for around 2/3 the price, labeled as an injectable for swine. Ask the vet about this if it's an option. Also, remember that an outbreak of demodex is a sign that the immune system is not working super-great, so watch the dog closely for other signs of illness. Tell your friend good luck and get well soon to her puppy!
posted by tatiana wishbone at 3:11 PM on January 16, 2008

Agreed on the second opinion, but if the second vet says the same thing, I'd get the biopsy done. Or at the very least, keep a very close eye to see if there's any itching, scabbing, etc. along with the bald patches that might indicate the dog is uncomfortable.

Anecdotally: My cat has an illness that first manifested in bald patches with some itching/scabbing. It took ages to get it diagnosed and treated, but I'm very glad I did, because it turns out to be an autoimmune disease. Which needs careful management that extends beyond just clearing up his skin patches. It also means I need to be extra careful about what he might be exposed to through other animals, what vaccines he gets, keeping a close eye on any other sicknesses he gets, etc., because he's got a weakened immune system. I'm glad I know this and can take care of him accordingly, rather than having given up after the first couple of tests didn't immediately figure out what as wrong with him.
posted by Stacey at 3:31 PM on January 16, 2008

I would definitely not employ "wait and see" here; that is, something should be done. But I'm seconding the opinion to get a second opinion first. It seems that there are many tests that could be done, and for instance what answergrape suggested: it might be easily treatable with an otherwise harmless med without even doing a barrage of tests. Have your friend speak to another vet who is willing to discuss alternatives. Your friend can even simply talk to some vets on the phone first, to explain the situation and screen them to see if they're willing to discuss other things without going straight to all the expensive tests.
posted by iguanapolitico at 3:34 PM on January 16, 2008

Probably mange -- microscopic worms that make pets itch and makes their hair fall out. It's easy to treat and painless, too. You can get some gasoline-smelling, clear liquid from your vet or pet store that will have your puppy smelling like an airport for a few weeks, but none the less back to his fuzzball self.
posted by bondgirl53001 at 3:39 PM on January 16, 2008

If it is mange (common at that age), the quickest and simplest remedy is Lavender oil. The vet wanted me to dip my dog in a chemical that required me to wear gloves. If it was that dangerous to me, I didn't want to put it on my dog.

I mixed up some lavender oil with vitamin E (any other mellow oil will work, avocado is good). The mange cleared up right away. (takes longer for the hair to grow back)

I also used this treatment on another dog with ringworm. I applied it twice and it was gone within a week.

You can also google it for more information.
posted by Vaike at 4:07 PM on January 16, 2008

Before she even goes to the expense of a second opinion, has she discussed it with her current vet? Most vets are appreciative of the difficult financial aspect of veterinary care, and are more than willing to pursue a more conservative/less expensive course before diving into expensive lab work and diagnostics. If a second opinion is needed, you may want to see if there is a dermatology specialist in your area. The office visit fee will probably not be vastly different from seeing a general practice vet, but their added experience and education may end up saving you from a barrage of tests.
posted by Rock Steady at 6:01 PM on January 16, 2008

Demodectic mange (the non-contaigous kind of mange) is common in puppies. They should do a skin scraping. It can easily be treated with oral ivermectin. I am not a fan of the dips that many vets like to use (Amitraz). The stuff is super toxic, and doesn't work as well as ivermectin.
posted by bolognius maximus at 6:15 PM on January 16, 2008

BTW- I would have the scraping done before the expensive biopsy. That sounds like a vet practice trying to wring the client dry. Go to a different vet.
posted by bolognius maximus at 6:16 PM on January 16, 2008

Ivermectin (aka Revolution) is useful as a general anti-parasitic so you could just try that as a replacement for frontline or advantage or whatever you use for fleas and ticks, and as noted above it's helpful in clearing up mange. It's also a good anti-heartworm med. In fact revolution is the only thing that works against our local fleas - they use advantage or frontline as bubblebath! (IANAV but my dad was.)
posted by anadem at 8:38 PM on January 16, 2008

What I meant to say was that trying Revolution will cost little, will be helpful for several things, and may cure your pup's problem.
posted by anadem at 8:53 PM on January 16, 2008

Revolution is selamectin, which is similar to ivermectin, but not the same mechanism. I've heard that it's good for sarcoptic mange, but nothing about demodectic mange. The two mites are quite different, so I don't know if Revolution would work or not. Hope you can find a vet with an answer!
posted by bolognius maximus at 11:04 AM on January 17, 2008