Lucy, you are worth it!

November 26, 2012

Favourite Articles, Rehomed, Skin Cases I admitted Lucy to the hospital. She was very distressed in her cage and so I gave her a dose of Valium (sedative) to help her settle down. As I was driving her home, I had a million thoughts bouncing through my head. Is Wally, my husband, going to support the news of me adding a new member to our household without involving him in the decision? Is she going to get on with my dogs? What if the answer to the two previous questions was NO, what then?

Where could I send her to when every shelter had rejected her?

When we arrived, I was relieved my husband wasn’t home as I wasn’t ready to face him yet. Lucy was excited to get out of the car as she appeared to suffer from motion sickness and happily waltzed into my backyard. She busied herself with examining the parameters and ignored my boys at first. They of course curiously followed her around until a mutual sniffing ritual occurred. I was so happy as the greeting between the three dogs couldn’t have gone any better.

My next task was getting my husband down with ‘the save Lucy bandwagon’. I had already prepared him for the situation over the phone. As soon as he arrived, he wanted to meet Lucy and she initially cowered and ran away from him. He was fascinated with meeting a Golden Retriever that wasn’t overly boistress and in your face. I promised him that she would only be boarding with us for a week or two.

He sighed and gave me the ‘Ya right, I’ve heard that line before!

In the days that followed, Lucy really warmed up to my husband and they fell in love. I couldn’t help but smile every time I saw Lucy on his lap him and both of them looking endearingly into each other’s eyes. I even started to feel a pang of jealousy as my husband arrived home and searched for and greeted Lucy first and foremost. I often started wondering if my husband would ever want to part with her. On the bright side, their new-found love meant it bought me more time to diagnose her skin condition and hopefully get on top of it. A huge load of stress was off my back as I didn’t have to work against a ticking clock… The primary plan was to get Lucy exclusively back onto Dr Bruce‘s Raw 76 Sensitive Skin Veterinary Formula. To make things more practical for myself, I stopped feeding my dogs their 50% Hill’s Science Dry diet and fully transitioned them to Lucy’s diet. My dogs immensely thrived on the raw diet. I was also thrilled to get Dr. Bruce involved in Lucy’s cause which facilitated the clinic in covering the costs of her new diet.

Lucy adapted really well to her new quarters. Two weeks after having her, I had to board a rescue dog I re-homed named Ro for two weeks. I was terrified about the dynamics of having 4 dogs loitering around in my backyard. To my utter surprise, Lucy and Ro became best mates and I would often spot them playing tug of war with blankets and other toys.

Lucy’s wonderful nature just made her so easy to have have around.

Lucy enjoying a walk with my two boyz. Lucy putting on her best ‘I deserve a treat’ expression among the group. Ro & my boyz were also doing a pretty good job. Initially, she was doing really well but expectantly her detoxification period was taking much longer this time around. She had several breakouts of hotpots around her head. To combat the itching and prevent major deterioration in her coat, I had to maintain her on a very low dose of cortisone given every 3-4 days. I also made sure she was on regular flea control with Revolution.

Two months passed and I was still finding it too difficult to completely wean her off the cortisone.

To make matters even more complicated, the summer season began and I could tell all the pollens and grass was making her skin crawl and I had to increase her cortisone intake; something I absolutely wanted to avoid!

At that stage, I was getting fairly confident that Lucy’s skin diagnosis was leaning towards Atopic Dermatitis; one of the most complex skin diseases in dogs. Not only does the dog react to allergens it gets in contact with but also those it inhales. There is no 100% reliable treatment for this disease and you can only manage this condition and keep your dog as comfortable and itch free as possible.

Before I could assume Lucy had atopic dermatitis, I still had to exclude a few other differentials. It is important for me to highlight that atopic dermatitis is a diagnosis formulated by exclusion of all other causes. So far, I had managed to scratch the following diagnosis off Lucy’s differential list: flea allergy dermatitis, mite infestation, cushings, hypothyroidism (not completely) and contact allergy (not completely). We still needed to do a proper food trial which could take up to 6 weeks and I had to find a new novel protein or put her on a hydrolyzed protein diet like Hill’s Prescription Ultra z/d.

I had to make sure Lucy didn’t eat anything but her exclusive diet. She was not going to be allowed on off-lead walks as there was an inherent s risk factor of her ingesting something that could compromise her food elimination diet.

Yes I am a veterinarian and even I was starting to get overwhelmed with Lucy’s never-ending special requirements.

I gained invaluable insight into what our client’s go through when managing dogs with complex skin issues and the high level of dedication and commitment bestowed upon them. It was very difficult but I was still not going to give up on my Lucy. The unconditional love she offered was just worth all my efforts.

At that stage, I decided I needed to bring out the big guns. I proceeded with collecting a blood sample from her and sending it off for allergy testing. This was a fairly new modality and I had heard great feedback about it. All I had to do was collect a decent amount of blood from Lucy (total of 10 ml) & send it off to a special laboratory for testing. I requested the full range of allergy testing which entailed a total of 91 allergens. This was a comprehensive list of allergens that consisted of grasses, trees, weeds and shrubs specific to my geographic area,common indoor allergens and the 24 most common commercial pet food ingredients as well as flea, Staphylococcus (bacteria) and Malassezia (fungus). Pretty impressive list, no?

I also requested the formulation of the appropriate vaccinations against any positive results in her allergy testing. The aim of this new therapy was to slowly help desensitize her immune system to the allergens she tested positive for.

Her allergen results came back showing she was severely allergic to a multitude of grasses, trees and shrubs which really didn’t surprise me. However, I also discovered she was allergic to some of the components in sensitive skin complete mix.

Here are her results (click on the image for a full size view): I consulted Dr. Bruce about her food allergy results and he devised a more suitable dietary plan for her.

I had to start her on a more simple diet which consisted of raw kangaroo meat mixed with sweet potatoes. She was now banned from having any liver treats as her allergy test showed she was allergic to beef. I also received 3 vials of increasing concentrations of her immunotherapy vaccination. I started giving her injections of the most diluted vaccine every second day. She would initially require frequent injections for the first 9-months of therapy. As for her long-term management with these vaccinations, she would require them for the rest of her life on a monthly basis.

If the treatment proved to be successful, it would mean she could completely be weaned off cortisone. However, her diet should never contain any of the food allergens listed.

Currently, Lucy has almost finished her first vial of diluted vaccine and I have not noticed any reactions so far. However, she is still requiring her oral cortisone as it is summer here and her itch levels are getting higher each day. In theory, I am not supposed to have her on cortisone while she is on these immunotherapy injections. Why? Well technically we want to be able to detect any major reactions she develops to these injections and cortisone will mask those reactions. We also want to buildup up her immunity against these allergens. After doing lots of research, I determined the healthy compromise was to avoid giving her any cortisone tablets on the days I am injecting her with the vaccine.

It is early days but I do believe the injections coupled with the new diet are helping. Lucy’s skin flare up is under control.

However, I do suspect that we won’t be seeing a complete recession of her skin flare up until she has had her immunotherpay injections for over 9 months. I would like to take her to a dermatologist to get an intradermal skin allergy test performed as it is more specific and will give me a more comprehensive picture of what she is highly allergic to. Unfortunately, I really don’t have any time to do so at this very moment so I will have to stall the visit to the dermatologist for now.

I have done everything and beyond in my power to keep Lucy as itch free and painless as possible so far. Sadly, I am now also feeling like I have done everything in my capabilities to manage her skin and now she needs to go to a more appropriate home. She is a very special dog and no one can ever regret committing himelf or herself to keeping her comfortable and enjoying a good quality of life. She just has heaps to offer and her unconditional love can never be matched 🙂

I am currently in the process of hunting for a highly compassionate and dedicated foster carer or even permanent owner for my beautiful Lucy.

I will only give her to someone with the appropriate criteria necessary to deal with her: single dog home, can afford her new diet & any ongoing skin issues, ability to give her the regular subcutaneous(under the skin) immunotherapy injections & organize more immunotherapy supplies in the future. She has one year’s supply at the moment. I know Lucy’s perfect owner or super dedicated foster carer is out there, please feel free to contact me if you happen to read this post.

allergy testing, Atopic Dermatitis, blood, boistress, breakouts, Bruce, canine, cowered, Cushing's, Cutaneous condition, deterioration, detoxification period, Dog, Dr. Bruce Syme, Eczema, flea allergy dermatitis, flea control, Golden Retriever, grasses, Health, Hill's prescription ultra z/d, Hill's Science Dry, hydrolyzed protein diet, immunotherapy vaccination, intradermal, itching, malassezia, mite infestation, motion sickness, mutual sniffing, novel protein, pollens, raw 76, Raw 76 Sensitive Skin Veterinary Formula, Revolution, shrubs, skin condition, Staphylococcus, subcutaneous, trees, unconditional love, Valium, weeds
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