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Vets and vet nurses what's your opinion?(44 Posts)
My dog has allergies. Trigger unknown. He was previously under a vet in a different town and has had a special shampoo and steroid cream on repeat prescription to treat hot spots and keep his skin soothed. This worked great all of his until we moved towns and to a house with a garden. Last summer his skin was horrendous and his left ear was sticky and weepy. I took him to a local vet. Hundreds and hundreds of pounds later and various failed treatments we found a combination of allergy tablets and shampoo that worked. He stops itching in the winter so I took him off the tablets.
Summer rolls around again and his ear turns black and weepy and his skin flares up. I've been trying to get him in the vets for this and a broken dew claw since the start of june/end of May. They insisted it was not an emergency and they would not see him until today, obviously since he's been without his medication since the start of June his skin looks terrible.
We saw a different vet who diagnosed chronic dermatitis and chronic ear infection. I agree with the dermatitis diagnosis. He's had dermatitis (which to me means allergies?) since he was a puppy. The ear gunk, ime, is caused by his allergy not an infection but if they want to clean and give him antibiotics I'm willing to pay for that, although we tried that last year and it just kept reoccurring until we tried the allergy tablets. It did reduce the symptoms while he was on them so I'm happy to pay for them. This vet also wanted to give him antibiotic injections, steroid creams and take him to do a special wash on his skin. All unnecessary, imo but I'm sure it will calm the symptoms while he's on the steroids so again I'm wling to pay.
My issue is that he needs sedation for his dew claw treatment which means it needs to be an am appointment. I work for an agency swamped due to covid. We can't get time off without giving two weeks notice. There is no one else to deliver the dog to the vet at 8am so he will have to wait until August when I have time off booked. Its not ideal, I know but honestly, his dew claw is not bothering him much. He rarely looks at it. If it was bothering him I would call in sick to take him. I've booked the appointment for the 5th of August.
My issue is that his skin is bothering him a lot. He is really suffering and this new vet is refisimg to treat his skin until his dew claw is done. The treatments he's suggested cost £250+ for the initial treatment plus ongoing costs for the steroid injections and skin washing. Im very unhappy with the cost when I know the shampoo and allergy tablets he had last year are far cheaper and far more effective but I'm livid that they're willing to let him continue suffering even now they've finally agreed to see him. He's not registered at any other vets so I can't get a second opinion. Is it right that they leave his skin and ear treatment until I can take him for his dew claw? What options do I have? The vets reasoning is that his dew claw is the most serious issue and needs treatment first. He would not believe that his skin and ear bothers him more. I feel terrible for the poor dog. He is in pain and he is uncomfortable and there's nothing I can do for him until August. I can't afford to pay £250+ plus weekly injections while calling in sick every week.
I apologise for the horrendous typos and grammar. MN is buggy on my phone and crashes and freezes while I'm typing. I'm on the laptop now.
To clarify it was the same vet practise but a new vet. He had his notes from last year. The treatment the new vet wants to do for his skin and ear is as follows:
A deep clean of his ear (not done last year - will need to be done under sedation)
Antibiotic ear drops (done last year - worked while he was on them and then recurred)
A course of antibiotic and steroid injections for his skin (not done last year and unnecessary, imo, but I did agree to pay for this however I cannot take a day off a week to take him to the vet under sedation for injections. He was on antibiotic tablets for his skin which did not wok and an anti-inflammatory shampoo which made some difference but it was the allergy tablets that were the game changer )
A special skin wash/scrub (not done last year - will need to be done under sedation, imo this will make it worse as he has incredibly sensitive skin and will be allergic to it - we have to use special cleaning things and washing powder as it was identified early in his life that he had very sensitive skin)
He says the allergy tablets he was on last year are not strong enough so he wants to keep him on a mixture of steroid injections and creams. From what I gathered he will need to be sedated for the injections due to his temperament when I am not with him. I'm not allowed in the vets with him and he can be aggressive when he's scared.
I agreed to pay for all of that and asked for treatment on his skin to start immediately which was refused. I then asked if he could at least have the tablets and shampoo from last year while he was waiting for his foot to be seen to, which was also refused. Surely they can't just leave him suffering?
Poor dog. How far away is the other town? Too far to drive back and have him seen & ask for prescriptions?
If you are not happy with this vet just phone another one for a second opinion, you can move vets whenever you like.
He's not registered at the other vets anymore. No vet in the area are taking new patients because of Covid. I tried every vet within 20 miles at the start of June when his skin flared up. The dew claw happened a week or two later, I think he did that to himself while he was chewing on his irritated skin. His paws are hotspots, along with his stomach and bottom area.
He will for certain be changing vet practices the second we are allowed to be seen in a new practise.
I'm assuming the allergies have caused an infection in his ear and they need to flush it because it is chronic?
The dew claw and the allergies and not linked to each other so I'm confused as to why they can't treat for the allergies until the dew claw is done?! Does it need removing? Is it infected? What is the actual problem with the dew claw if its not bothering him?
I would go for another opinion at a different vets.
Sorry just seen you can't get a second opinion
North east coast. The dew claw is ingrown. This vet diagnosed it as broken but, tbh, I'm not sure how confident I am in his diagnosis given his reluctance to actually listen to me and take into account my knowledge of the dog's medical history. It may be broken, it may just be ingrown. It definitely needs removing under sedation, I agree with that. It does not appear to be infected. He walks without limping. Sometimes he chews the dew claw so it does bother him when he notices it but his belly, bottom and paws (ie his skin) bother him more. I have no clue how are why he ear does not bother him but he never pays attention to it.
Even if they just treat his general skin with tablets and gave him ear drops like last year until he can be sedated it would make a massive difference to his comfort
and imo cure his ear 'infection'
I'm only a vet receptionist but I've never heard something so ridiculous. (As in they cannot treat the skin until they've sorted the dew claw) but I may be wrong!
Hopefully a vet will come along with some advice.
I'm guessing he wants to wait because he wants to do the skin scrub, steroid injection, ear flush and dew claw all while under the same sedative? What I don't understand is why he cannot have the treatment he had last year (the tablets, the shampoo and the eardrops) while he is waiting. Surely some treatment is better than no treatment? Or even just any treatment? They do steroid tablets for dogs I know this because he had a weeks course years ago when he had a flea allergy. If he's so keen on steroids why can we not have a course of oral steroids while we wait?
I agree with you. He is your pet and needs to be on a treatment plan you are happy with. Is there another vet, a senior one, that you can push to speak to instead?
The vet can advise you, but you do not have to go down a treatment course you are unhappy with. At a guess you had apoquel last year, but is the new injection they are suggesting cytopoint as this is not a steroid, but a novel bio therapy.
If the ear is really very dirty then even if it is allergies a clean will help things.
Beyond this it is really difficult to comment on a case I have not seen.
Can you ask to speak to the vet you saw last year?
The receptionist, who was more willing to listen to me, is going to talk to the vet who treated him last year and call me tomorrow with her opinion.
At a guess you had apoquel last year
That's exactly what it was. I remember it sounding similar to applelaws and it stuck with me because that's what I feed him. He also a shampoo in a white and silver bottle with blue writing that I bathed him in once a week. It worked wonders for him. We had no hotspots all year for the first time ever. Last year she cleaned his ear while I held him without sedation but she didn't call it a deep clean so I'm unsure if it's the same thing? She squirted something into his ear and then wiped it with a cotton ball?
He explicitly mentioned steroids. Would he call cytopoint steroids? If it's going to work and the other one will no longer work I will happily pay for it but he'll need to be trained to accept it without sedation as I can't take unpaid time off work once a week to sedate the dog and carry him to the vet. I'd rather try the apoquel again first and then go down the route of weekly injections if it no longer works.
I think vets are so used to people with pet insurance just accepting everything they suggest that they do not think that they have to explain themselves to the client. Apoquel and Citopoint are brilliant but they mask any chance of discovering the cause of the problem and are very expensive for long term use. Cytopoint is an injection once every 4/6 weeks but this means that you cannot get a written prescription and have it filled more cheaply online which you can with Apoquel - a way of making a 50% saving.
The Allergy and ear thing is a nightmare to manage, many people find Piriton is helpful but again this masks the itch and makes it difficult to diagnose the allergy.
We spent years battling yeast infections with the vet prescribing drops and washes under sedation to no effect before we moved to a new vet and they instantly suggested that it was an allergy. Sadly this vet moved practice and were not happy with the next vet we saw at that practice.
We have had our dog on a hydrolized (not just hyperallegenic) for some years now and it does make a difference.
We have also discovered that he is allergic to Coconut oil and also other ingredients in the "oatmeal" shampoo that was prescribed for the allergy but this have taken months to find this out as the symptoms were masked..
We are also now on our fourth vet.... you are not being unreasonable - you are the client.
He was on a hydrolyzed food last year for a few weeks but it made him very, very aggressive around food and made little difference to his allergy so with the vets agreement I put him back on applelaws which he doesn't seem to react to. He is allergic to a lot of foods but it's generally quite easy to work out. As soon as he's finished eating he starts ripping at his skin and scraping his face along the edge the walls. He doesn't do that with Applelaws.
I'd forgotten all about Piriton. His first vet, the one from the different town told me to give him half a piriton a day during summer. Could I go and buy him some in the morning?
Allergy tests were mentioned by the second vet (the one from last year) but it was decided he was old, it only really bothered him during summer and the regime he was on at the time kept him comfortable. It's related to the garden and something in the garden in summer. His allergy is 1000% worse since we got a garden. He always had moderate skin complaints but they weren't as bad and never effected his ear until we got a garden.
Some chemists will not sell you Piriton if you say it is for a dog.
My dog has what it sounds like yours has - an allergy to pollen
I treat it with Quercetin 250mg tablets (it's a yellow powder in a capsule) sprinkled on her raw food - one capsule is enough for 4 meals
I wash her in Episoothe shampoo
Both are available on Amazon. They cleared up her allergy in a month. I also switched her to raw duck nutriment raw food and stopped giving her beef/chicken nutriment as I also found out that allergy to beef/chicken was common
She has NO skin condition, no itchiness now.
This was the article I read and why I tried it. I have a Scottie and skin conditions in Westies/terriers are common.
Be very careful with Apoquel using it long term, it can cause cancer and also mask cancer symptoms, although it works wonders!
Get some piriton from the chemist, you have to ask for it but don't say it's for a dog! I've also found a shampoo called Cooper & Gracie it's like a miracle worker for my itchy dog, but I know it might not work for your dog!
Is your dog a staffie by any chance?
I wouldn't have expected cytopoint to be called steroids, but steroid injections are either very short acting lasting a few hours or last approx. 3 weeks. So not certain about weekly.
Apoquel or cytopoint are preferable to long term steroids for a variety of reasons yes they do not resolve the underlying cause. Identification of the cause by intradermal skin testing or bloods is great if you are going to pay for immunotherapy, but that is more costly than apoquel/cytopoint.
I would be very happy to hear of other people's suggestions for managing allergies - we have been rinsing and drying the dog after every walk
and we have a "soft cone" to stop licking. vacuum every day and use non bio washing powder to wash dog bed
I get Piriton often, especially in summer, so the chemist should not question it. We're a family of allergic people. I'm going to get him some in the morning to help soothe him while we wait for his appointment in August and/or a vet whose listening skills are better.
Thanks for the suggestions of the food supplements and shampoo. I'll give them both a go.
If he was a puppy or suffered all year round I would go down the route of allergy tests but he's 14 and unlikely to see more than two more summers if he's lucky so I think it will be a lot of stress for him and expense for me for little benefit.
Cytopoint is great
It’s expensive but no side effects and it will work
Most people find you can eeek it out to 6 weeks or more and sometimes just a few injections per allergy season are needed.
Allergy tests and immunotherapy are a waste of money for a 14 yr old dog
Surely you could muzzle the dog and the vet inject him in the car park with you holding , given the circumstances.
Surely you could muzzle the dog and the vet inject him in the car park with you holding , given the circumstances
He was muzzled and is muzzle trained due to an ill spent youth biting vets and groomers. He's now trained to accept vets examining him and treating him and has not bitten anyone in years but that's with me there with him. There's every chance he would not bite a vet without me there but there is a small chance he would so I advised them he should be muzzled and explained his past. He listened to that part . I offered to hold him in the carpark and explained until I was blue in the face that the dog would not bite anyone with or without a muzzle if I was holding him. A helpful man waiting to be seen by the same vet even offered to go into the shop next door and buy me a mask and gloves to use while I was holding him.
He absolutely, point blank refused to give any kind of treatment for his skin until I take him to have his dew claw removed. His reasoning for this is that the dew claw is the most serious issue, even though I explained over and over that his skin is bothering him far more than his dew claw. I basically paid £35 to have a twenty minute argument with a young man in a car park
If the Cytopoint is more effective and safer than the tablets I would go for that over the tablets but he didn't explain that to me. He didn't really explain anything to me except the £££ and that he needs his dew claw treating first. He definitely mentioned weekly treatment and injections, although in fairness he did not explicitly say weekly injections. I surmised that from his speak of injections and weekly appointments. He 100% said steroid and antibiotic injections.
Hopefully the vet you spoke to last year will be able to get involved and help. If not is there a senior vet at the practice perhaps?