Not only does she have terrible, painful and itchy skin, ears and eyes, but she is significantly underweight.
We are going to do everything necessary to help Jill get better.
Yeast Dermatitis or Malassezia dermatitis, is caused by the fungus Malassezia pachydermatis. It is an extremely common cause of skin disease in dogs.(aka yeast infection, yeast overgrowth):
The most common clinical signs of Malassezia dermatitis are:
- Thickened skin ("elephant skin")
- Hyperpigmentation (darkly pigmented skin)
- Musty odor
- Scales and crusty, flaky skin
- Itching and redness
- Chronic or recurrent ear infections
Yeast is part of the normal flora in a dog’s mouth, nose, ears, and gastrointestinal and genitourinary tract. It is opportunistic and will sometimes colonize or invade damaged tissues, especially of immune compromised dogs. It can happen in one specific part of the body (local), or it can colonize the entire body (systemic).
Pyoderma is just a fancy word for a secondary bacterial infection.
The most common clinical signs of Pyoderma of the skin are:
- Itchiness
- Pustules
- Crusted skin
- Small, raised lesions
- Loss of hair (alopecia)
- Dried discharge in affected area
Dogs have a higher risk of developing an infection when they have a yeast infection or an endocrine disease such as hyperthyroidism. You will often see yeast overgrowth and bacterial infections together.
The decision to treat with antibiotics and topical medications must be balanced against the risks associated with potential future antibiotic resistance and harmful chemical substances absorbed in the skin. You will have to decide what is right for you.
Here is a summary of a Plan of Care for yeast and pyoderma in a dog like Jill:
I have a veterinarian do a full physical. We determine how bad it is now, what organ systems are affected, the general condition of the dog, including age and prior health, and then if antibiotics are necessary for immediate health. It's very subjective and somewhat dependent on what has already been tried. It's worth a detailed conversation with your vet.
Some foods can certainly exacerbate and prolong a yeast infection and symptoms but the real issue is usually underlying medical. Feeding a good raw whole prey model diet will pretty much guarantee that food is not a trigger or cause.
If I do not suspect food at all, then I continue feeding like usual. If I have doubts, then I stick with what works. Feeding only those single meat proteins that cause no issues for 6 to 12 weeks solid. Nothing new and no treats or "oopsies". This is like a modified elimination diet and must be tailored to each dog individually.
If I have no idea whether or not any meats are a problem, then I start back at the beginning with chicken for 6 to 12 weeks, adding one new meat protein every 6 to 12 after that. Yes, it's a big, fat pain in the butt
What must be ruled out with your vet:
Basic skin scraping for demodex or sarcoptic mange, basic lab for diabetes and thyroid, and a skin cytology. There are so many things that can be a predisposing factor. But I don't go crazy with the vet and tests just yet. I start with the basics I mentioned.
In the beginning of an infection cycle, making sure it really is yeast is important so a skin cytology should be done. Surprisingly, it's not always yeast. The treatment won't necessarily change if it's not, but the expectations might.
Next, and just as important, if there IS an underlying issue like diabetes, thyroid disease, or other, those must be treated and managed. It becomes a vicious cycle treating the symptoms of something like a secondary yeast condition if the primary issue isn't handled.
Plan of Care:
Jill must wear a cone or be under direct supervision if the yeast is causing itching, licking and biting - preventing repeatedly damaging, scratching and opening up infected areas is critical to future healing. If the neck is an issue with yeast, wounds or discomfort, make a sheepskin tie for the cone and either avoid collars or wrap the collar in sheepskin too.
So at this point, the question is what to do for the itching. That depends on where the problem is and how bad it is.
Sometimes just easing the itching can make all the difference. Some folks are comfortable with Benadryl. If one of my dogs was in the beginning miserable stages, I might give Benadryl as a short term, emergent treatment to get over the hump, for a few days or occasionally, But not as a constant 'bandaid' and willy nilly or just for minor itching. I try to avoid its use when possible.
Massage can be a great method of easing itching. You can also try Dog Appeasing Pheromone, (D.A.P.) and Rescue Remedy. Give it a try.
Ears:
A 50:50 white vinegar and water solution works well. Use a cloth or gauze pad to apply and wipe gently in the ears.
I have used Zymox without the steroid for the ears because no cleaning out of the ears is necessary. It's an enzyme treatment. Read about it before deciding if this is an option for you. It's what I would consider a 'middle of the road' option; not full on medicine and not 'all natural' either, especially if you use the one containing cortisone (small percentage). This would be for the beginning bad stages of the ear issue - maybe 7 to 10 days only. (then see below)
If the ears are not chronic and horrible, I skip the Zymox idea completely and use the vinegar solution alternating with the application of a coconut oil based cream like Califormia Baby Calendula. You can also make your own with virgin coconut oil (it's solid at room temp, just heat in hot water) and a high quality EO (small amount). Finding a good herbalist can be a great thing if you're not all herbally yourself. I have an herbalist make a Yarrow Skin Blend ointment for use with our rescue dogs. Whatever you use, just scoop onto fingers, swipe into ear canal, massage in, you can leave in for a bit, then gently wipe excess out with a cloth or tissue or gauze pad.
A note about steroids and cortisone preparations. Short term, they can be beneficial, especially for bad cases, but can still cause sudden and long term health issues. As long as you are aware, then you can better decide if you will use them or not. They ease and mask symptoms and do not cure anything. We avoid them whenever possible.
Body:
The calendula, coconut or yarrow can be lightly applied to other areas of the skin as well but not the eye area. This is where the cone is important too. You can put a shirt and socks on the dog to discourage scratching and also lightly cover the areas where you've applied the cream so it doesn't get rubbed off on furniture, etc. For dogs with main body yeast issues, we take a swath of sheepskin and make a 'wrap' with a velcro fastener. Easy on and off and easy to wash.
You don't want to smother the skin or active wounds and prevent healing and 'breathing' but you can certainly lightly apply the products and cover, if necessary, as described above.
For open wounds, either use Manuka or medical grade or local honey. You can leave open or cover lightly with gauze.
Eyes:
You can apply the already mentioned products around the eye area but not too close to or in the eye. Except ointments made specifically for eye care OR any prescribed eye antibiotics. Generally, we leave the eyes alone unless the actual eye lid or eye ball is involved or infected. In that case, consult your vet.
Mouth:
Unless it's a bad case of what we would call 'thrush', I would wait to attempt any treatment like oral rinses. Mouth yeast will usually begin to resolve along with the rest of the body systems.
Bathing:
Generally, initial use of a topical shampoo like benzoyl peroxide would be used once weekly or so. This is to 'degrease' the skin and hair to allow better efficacy of subsequent medicated topicals. These work but they are full of potentially harmful ingredients. Short term, or a few times, probably won't do lasting harm and for some people, it's about weighing the pros and cons of the condition versus the treatment.
But here you also have other options. You can use Dr. Bronners or another liquid castille soap instead and it will be just as effective as a degreaser and then use a 50:50 white vinegar and water rinse, which is more effective than the leave in medicated stuff. Many vets actually suggest the vinegar rinse as the best method. A black tea rinse can also be used effectively after a few weeks or in between. The tannins work wonders on itchy parts. Just pat dry.
Supplements:
L-Glutamine. Look up its use and decide if it's right for your dog. I buy it in bulk powder.
Dog Gone Pain. This is one of the very few dog specific products I buy. I have had great success with it for dogs with all sorts of pain issues.
Therapeutic dose of fish oil without soy (one intended for humans and NOT pet specific).
For delivery of supplements, I use the meat protein that the dog can eat like the chicken heart or skin, tuck into meat slit, or ground. No peanut butter, bread or anything else.
There will be relapses. Expect them. It takes many weeks or months for the body to heal, especially if the underlying cause is not determined or addressed.
Wash bedding frequently with hypoallergenic detergents. Don't use any artificial products on or around dog, bedding, furniture. Limit all exposure to environmental triggers where possible. Limit time outdoors if environmental allergies are a problem or suspected problem. Some dogs end up dealing with flares the rest of their lives, even if cause is determined and a treatment regime is found that works.
This is the nature of the body and disease.
**These are my opinions based on experience and research and should not take the place of your own veterinarian's opinions or treatments. This is presented as a summary and not a detailed or specific Plan of Care as some steps may have been omitted. For more details, contact me.