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Permalink Reply by Beca and Mishka on March 30, 2014 at 8:59pm

I had that thought, too.  It's possible he's not resisting infections as well, and that's why the pyoderma spread beyond just one or two small spots.

On the other hand, my mistaking the spots for flea bites means other spots in the past (November, December, and January)  were probably pyoderma as well.   He'd get a tiny red raised spot, which would fade and then flake, sometimes losing a little fur in the spot.  Since he never got more than a spot or two at a time, and I couldn't find any fleas or flea dirt on him (and wasn't getting bitten myself) I was assuming that he'd gotten bitten outside, but the fleas weren't following him in.  Now I'm thinking he may never have had any flea bites at all - it could all have been pyoderma.  He has a really solid healthy coat, so unless I point out a particular spot to the vet or allergist, they're easy to miss during an office visit.  So far, no spots since finishing the antibiotics.  

When we first put him on Apoquel, my vet explained that the warning on infection susceptibility has to be on the literature because the drug is in the same family as the broad-spectrum, heavyweight drugs they prescribe to humans with stuff like severe rheumatoid arthritis.  Same family, but unlike the heavyweight drugs, Apoquel only targets one specific itch-signaling chemical (protein?) and not really anything else immune-related.  She tends to be very conservative about drug side effects, and isn't comfortable prescribing Atopica, for example - she lets the allergists handle that one.  But Apoquel sounded so promising, she spent a long time talking to the company about the details of the drug research.  From what she said, it sounded like the infection susceptibility was more of an "if we suspect he's getting pneumonia, we take him off until he's clear" and less of a concern for minor skin infections.

My vet said for most of the dogs in her practice on 1x day, the drug isn't effective more than 18 hours or so, and she has them taking their antihistamine late in the day again to cover as the Apoquel wears off.  

Good luck with the holistic remedies - I tried the apple cider vinegar stuff when he first was diagnosed, but it didn't seem to help him.  Beyond that, I stick with what the vet and allergist tell me to do.  :)

Permalink Reply by Rebecca on March 30, 2014 at 9:48pm

Do you give Mishka then the whole antihistamine then since you are only giving it to him one time a day? You sound like me as far as doing everything possible for your little guy.  

It sounds like you may be right on that pyoderma and it was probably what it was all along. Try the shoes for his bag feet.  It really helps unless he won't keep them on.  It was a battle of the 2 minds when I first tried them out on Jake.  I won:)

 

Permalink Reply by Beca and Mishka on March 31, 2014 at 12:27am

Mishka's pre-Apoquel dose was 2.68mg 2x day (so a total of 5.36mg per day, total - this was the upper limit the allergist gave me).  So now I just give him 2.68 1x day, at dinner.  It comes in 1.34mg tablets.

He's not licking or scratching much at this point, so I haven't had to cone him or sock/shoe him in a while.  He'll lick his feet sometimes, but not like he means it, so I figure it's a "normal" amount of licking.  I used to have him in a soft cone 24/7 - unless we were actively doing something together, like going for a walk or watching TV with him next to me on the couch - so that kept him from doing scratch damage with his back feet, and kept him from chewing.

Winning the shoes battle is pretty satisfying.  :)  I had Mishka in shoes on his front feet for a while because he dragged his nails to the quick and kept scraping a knuckle on the cement.  

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