pyoderma

[shepgirl]

I was wondering if anyone knew of anything to help a dog suffering from severe pyoderma. The vet has him on prednisone and it's for life, but even that doesn't seem to be working. we have tried everything, sometimes the dog will do fine and other times the sores start over and he can't digest anything.

[Catlady711]

I'd get a second opinion if it were me.

Assuming it is a Pyoderma; you've mentioned the prednisone, but did not mentioned anything about antibiotics, medicated shampoos, having a culture and sensitivity done from skin scrapings, or ruling out allergies. It's not good to keep an animal on predisone all the time unless is the last and/or only option.


http://www.merckvetmanual.com/mvm/in...m/bc/70900.htm

Primary pyoderma occurs in otherwise healthy animals, without an identifiable predisposing cause, resolves completely with appropriate antibiotics, and is usually due to Staphylococcus intermedius or other staphylococci.

Treatment:
The primary treatment of superficial pyoderma is with appropriate antibiotics for ≥21 and preferably 30 days. All clinical lesions (except for complete regrowth of alopecic areas and resolution of hyperpigmented areas) should be resolved for at least 7 days before antibiotics are discontinued. Chronic, recurrent, or deep pyodermas typically require 8-12 wk or longer to resolve completely.

First-time bacterial pyoderma can be treated with empiric antibiotic therapy such as lincomycin, clindamycin, erythromycin, trimethoprim-sulfamethoxazole, trimethoprim-sulfadiazine, chloramphenicol, cephalosporins, amoxicillin trihydrate-clavulanic acid, or ormetoprim-sulfadimethoxine.
Amoxicillin, penicillin, and tetracyline are inappropriate choices for treating superficial or deep pyodermas because they are ineffective in 90% of these cases. Fluoroquinolones should not be used for empiric therapy. Severe deep pyoderma, recurrent pyoderma, or first-time bacterial pyodermas that do not respond to therapy should be treated based on culture and sensitivity.

Topical antibiotics may be helpful in focal superficial pyoderma. A 2% mupiricin ointment penetrates skin well and is helpful in deep pyoderma, is not systemically absorbed, has no known contact sensitization, and is not used as a systemic antibiotic that would increase the likelihood of cross-resistance. It is not very effective against gram-negative bacteria. This ointment should not be used in cats with any known or suspected history of renal disease because the preparation contains propylene glycol. Neomycin is more likely to cause a contact allergy than other topicals and has variable efficacy against gram-negative bacteria. Bacitracin and polymyxin B are more effective against gram-negative bacteria than other topical antibiotics but are inactivated in purulent exudates.

Attention to grooming is often overlooked in the treatment of both superficial and deep pyoderma. The hair coat should be clipped in patients with deep pyoderma and a professional grooming is recommended in medium- to longhaired dogs with generalized superficial pyoderma. This will remove excessive hair that can trap debris and bacteria and will facilitate grooming. Longhaired cats usually benefit most from having the hair coat clipped.
Dogs with superficial pyoderma should be bathed 2-3 times/wk during the first 2 wk of therapy and then 1-2 times until the infection has resolved. Dogs with deep pyoderma may require daily hydrotherapy. Medicated shampoos should be prediluted 1:2 to 1:4 prior to application to facilitate lathering, dispersal, and rinsing. Appropriate antibacterial shampoos include benzoyl peroxide, chlorhexidine, chlorhexidine-ketoconazole, ethyl lactate, and triclosan. Shampooing will remove bacteria, crusts, and scales, as well as reduce the pruritus, odor, and oiliness associated with the pyoderma. Clinical improvement in superficial pyodermas may not be evident for a least 14-21 days, and recovery may not be as rapid as expected.


http://inpractice.bvapublications.co...tract/25/7/418

PYODERMA - bacterial skin infection - is one of the most frequently seen conditions in small animal practice and yet also one of the most frustrating to treat. Around 90 per cent of pyoderma cases in dogs are associated with Staphylococcus species. These bacteria are not especially virulent and infection tends to develop secondarily to an underlying cutaneous, metabolic or immunological abnormality. Allergic, keratinisation and follicular disorders are the most common skin diseases to trigger infection.


http://www.jaaha.org/cgi/content/abstract/33/4/355

Twelve German shepherd dogs, each diagnosed as having a recurrent or refractory deep pyoderma (i.e., German shepherd dog pyoderma [GSP]), were evaluated for several parameters over a six-year period. Results indicated that GSP could be associated with flea allergy dermatitis, atopic dermatitis, food allergy, cell-mediated immunodeficiency, or hypothyroidism, or could be an idiopathic disease. The combination of diseases present for a given dog varied from case to case. Adequate control of the pyoderma was achieved only after each identified underlying disease was treated specifically, along with aggressive concurrent medical therapy using systemic antibiotics and medicated baths.


Just so you know staph infections are transmittable to humans!

[Jakesmom]

Definately try to see a dermatologist. My Golden has severe allergies and has had pyoderma flares since 6 months (he's now 11 years). With allergy shots, a restricted diet, and vigelance, he remains in fairly good control, needing antibiotic treatment a couple times a year. Steroids (prednisone), are not a good long term solution.

Good Luck

Jakes mom

[Freedom]

Prednisone is not a good thing to be on long term. It undermies the imune system.

Take the dog to a veterinatry dermatologist. They will do skin scrapings for test for a few things. They will try a few different antibiotics and antihistamines. If it is a food related allergy, food trials can determine which food is best for the pet. If it is not a food allergy, there are allergens (I thhnk 41) which they can test for. It will take some time but they can give you answers.

I just went through this with a cat. It took 4 months, and during that time thecat was wearing an e collar because he kept scratching and links until he was bleeding. He is now on a precriptn food -- Royal Canin green peas and venison. Within 3 days I was seeing a BIG improvement. At the end of 2 weeks we took off the e collar. It has now been 2 months. Kitty's skin is clear, coat has grown back in, and everything is fine.

It is time consuming and a bit costly, but well worth it to have a happy, healthy, medication-free pet!

[shepgirl]

Sorry, forgot to mention he had skin scrapings done, biopsies, goes on antibiotics with every flare up and has just recently been put on prednisone to see if it would help clear the flare ups. Seems nothing is working, he even has anti irch meds so he won't chew at the sores, and he does get medicated baths every second day . I know the vet said it was a life long thing but she was hoping he would get less flare ups, she is willing to try everything. As for skin specialist, we don't have any out here, the closest is 10 hr drive and we would have to leave him for I don't know how long and they can't guarantee it will be successful. He's been abused, that much we do know by his condition when found, so we hate to put him through more trauma.
Thanks for the info that was posted I appreciate it.

[Queen of Poop]

My RB dog Sami got severe pyoderma in 3 of her feet. Once we took beef out of her diet it cleared up and didn't come back. At 8 years of age she became allergic to all beef products. Perhaps your doggie has an allergy.

[Freedom]

You can do the food trials yourself, if you think perhaps it is a food allergy. I would NOT suggest starting with the "low allergen" prescription food, not for a case this severe. Ask your vet if he thinks it will help! The most common food alleries are to grains, and to proteins. The prescription food choices are venison, duck, quail, rabbit, all proteins which are chemically quite different from those found in traditional dog foods (chicken, turkey, fish, beef and lamb). As for the grains, the prescription foods are all grain free, as far as I know. But there is one commercially available food, Nature Variety Raw Instinct, which is grain free. Their web site has a dealer locator, so you can look to see if there is someone nearby who stocks it.

Here is the link:
http://www.naturesvariety.com/

It didn't work for my cat, however I DID see an improvement. So I learned he is allergic to grains and . . . something else. That is when I went to the dermatologist for the testing. She didn't do any testing! Reviewed what had been done by the vet (the scrapings, antibiotics etc.) and said the next thing to try is a prescription food to remove possible protein allergies. Only after you exhaust all that do they do the allergen tests (this method saves the owner money in the long run, as most pet allergies ARE to foods. So why do the allergy tests for $300 or so, when you can do the food trials first. There are no reliable allergen tests for proteins.)

Just a thought. Throwing out ideas for you to consider.

[Catlady711]

Sorry, forgot to mention he had skin scrapings done, biopsies, goes on antibiotics with every flare up and has just recently been put on prednisone to see if it would help clear the flare ups. Seems nothing is working, he even has anti irch meds so he won't chew at the sores, and he does get medicated baths every second day . I know the vet said it was a life long thing but she was hoping he would get less flare ups, she is willing to try everything. As for skin specialist, we don't have any out here, the closest is 10 hr drive and we would have to leave him for I don't know how long and they can't guarantee it will be successful. He's been abused, that much we do know by his condition when found, so we hate to put him through more trauma.
Thanks for the info that was posted I appreciate it.

If your vet did all that then it's probably time to see a dermatologist or allergy specalist. I know it seems like you'd be causing more trauma in the short term but if they can pinpoint what meds/foods will help control the flare ups then in the long term it could make the dog more comfortable. With this type of thing there are no guarantees unfortunately. Good luck.

[SemaviLady]

Don't know if this will help.

I had one Anatolian girl that had a brief case of pyoderma in one toe on one foot. We went to our vet who is both a large and small animal practitioner. The treatment we used for her included 10 day of antibiotics (I think it was Keflex, been a long time) and we also used Epsom salt soaks on her foot to help 'draw out' the infection in her foot. (cellular reaction to hypertonic solution). Her case was not severe or chronic, she had only one oversized fat and tender toe. It cleared up very quickly before the week was done. I used gallon sized ziplock bag to hold her soak around her foot. Made her sit by me while I did other work.

People drove from miles around with their stock trailers just to have this vet look at a calf or horse, while his lobby was often full of small pets (cats and dogs). Cool vet, retired now.

Anyway, the use of epsom salts with large animal cases of pyoderma is very common, but for some reason, small pets doctors (unless they are large animal practitioners too) don't usually offer epsom salts as part of the solution.

Example: A friend of mine in Australia had an aged Anatolian Shepherd male that developed a case of pyoderma. The vet she originally saw was a 'pet vet' in town, who gave all kinds of 'modern day' treatments to heal her dog including prednisone which can actually increase immune compromise. The problem got worse over two weeks (no improvement) and the dog lost one toenail before the gal gave up and went to her horse vet.

The horse vet suggested using epsom salt soaks. The dog had no puss within the first week and was back to normal before the second week was over.

Your mileage will probably differ. Both of these working dogs were not prone to allergy and other immune compromise. The Australian dog was on a raw diet, mine got raw once a week at least. They were primarily outdoor dogs who had healthy exposure to dirt and livestock (sheep, chicken and horse). I didn't see epsom salts mentioned so I thought I would.

Good luck!