We took Charlotte to the dermatologist this morning. She said that Charlotte has atopic dermatitis which has been causing the swelling in her eyelids and lower lip folds. The inhalant allergen/s (from the environment) caused the "classic" skin inflammation, which led to a mild yeast infection on her lips. Because she has been receiving Cytopoint injections, she has not felt itchy.

Before having her tested for allergies and then starting allergen immunotherapy, we are going to try this more benign treatment plan: Redonyl chews (an antihistamine), wiping her lip folds with an antimicrobial wipe, and applying an antifungal cream. We can add Benedryl if needed. We are going to follow up with a repeat visit in four weeks and if the antihistamines are working, wonderful! And if not, then we will proceed with allergy testing. 

Something mysterious has been happening with Charlotte which the vet believes is an allergic reaction to an unknown source. On Monday morning, Wednesday morning, Thursday evening, and Friday and Saturday morning, she's developed swelling on parts of her eyelids. Sometimes there is a large area that is swollen, other times it looks like multiple hives. There is no discharge and her actual eyes are clear and normal. A few times she has had swelling on her lower lip -- but just on one side. None of this seems to itch or bother her.

We have given her Benedryl and have taken her to the vet three times for Dexamethasone injections. Each time, this has helped to bring down the swelling. She was also given a shot of an antibiotic on Wednesday and I have been giving her a probiotic. I have a prescription for six days of Prednisone (tapering) but have not given this to her yet since on some days she seems to be totally fine. We are returning to the vet on Tuesday to try to come up with a next step -- perhaps bloodwork and maybe a referral to a specialist or two. 

We cannot identify anything that might be causing this and the occurrences seem random timewise. Her food is the same, the lawn hasn't been sprayed for pests, sometimes she is okay after a walk and sometimes she isn't. Sometimes she is fine when she wakes up in the morning and other times not. We haven't used any different cleaning products. We have been wiping her face and feet every time she comes inside, and she is never outside alone. We even shampooed her with a gentle shampoo to be sure that her coat is clean. 

I am hoping that someone reading this will have an idea that we haven't considered. Thanks. 

 

 

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  • I would beseech you to make an appointment with a specialist NOW. You will get a definite diagnosis and treatment plan, rather than continuing to treat with serious drugs (heavy duty immunosuppressants and possibly unnecessary antibiotics) based on guessing at what might be wrong. A dermatology specialist will likely have seen this before, where your vet apparently has not. 
    I can tell you that the symptom you are describing are extremely atypical for allergies. I can also tell you that every single member here who finally saw aspecialist for any reason was sorry they hadn't done so sooner, as it would have brought the dog relief much sooner. 

  • 3 dexamethasone injections in a week sounds excessive, considering that it is 10 times stronger than prednisone, and stays in the system 2 to 2.5 days. https://www.marvistavet.com/dexamethasone.pml

    DEXAMETHASONE - Mar Vista Animal Medical Center
    Dexamethasone is a member of the glucocorticoid class of hormones, these are "catabolic" steroids. In most cases, we do not use glucocorticoids for t…
    • Eep!  Scary.  Prednisone is really heavy duty stuff with lots of side effects already...

  • Thanks for responding, Karen. I value your perspective. Our plan is to speak with our regular vet on Tuesday (She isn't working on Monday.) to figure out which specialist/s near us would be the best choice. If I were back in Boston, I would know where to go immediately, but down here in Naples we have no relationships with specialists. 

    May I ask why your instinct is to say that it probably isn't an allergy? And besides possibly seeing an allergist or dermatologist, what other kind of vet specialist would you recommend?

    • This may sound immodest, but I really believe that I know more about allergies in dogs than most GP vets. It's not their specialty, and they don't study it beyond the basics. I have heard GP vets say things about allergies that I know for an absolute fact to be wrong. Whereas I was so gob-smacked when Jack was diagnosed that I started studying it to the point that I believe I could have passed vet school exams in dermatology, lol.  Part of my research was picking Jack's dermatologist's brains with a lot of questions, and I took notes. And even more so after Jack's dermatologist was out of town during a severe flare and my regular vet (who I love) gave him a shot of dexamethasone; when we finally got in to see his dermatologist and I mentioned the shot, she visibly winced and then told me never to let anyone give him a steroid shot again unless it was an absolute emergency. I also ran the Atopic Dermatitis Group here and shared info that others got from their dogs' specialists. So I have a pretty good grasp of allergy symptoms in dogs, and swelling of the eyes or lips with no other symptoms is not typical of allergies in dogs. It can be a reaction to some irritant, but that is not the same as an allergy. And it can occur as a secondary symptom in an allergic flare, but in that case, you would see other, more prominent symptoms first. There is always, always, always going to be intense itching and responding licking, biting, scratching, etc. 
      I think a veterinary dermatologist is the appropriate specialist to see. They deal with allergies, all skin conditions, and immunology. 

      • Again, thanks for responding so thoughtfully and with such insight. We believed that the dexamethasone was needed to bring the swelling down; little did we know of its possible dangers. I cannot go back now but can move forward with more knowledge. It's perhaps noteworthy that Charlotte has received three Cytopoint treatments (November, December and January) to combat environmental allergies in Florida. Previously, she was constantly rubbing her face, scratching her eyes, and licking the base of her tail. What she is experiencing now is totally different and unlike anything we've seen before. I wonder if the Cytopoint is playing a role in the current situation by stopping her body from itching. We will speak to our regular vet on Tuesday and then make an appointment to bring Charlotte to see a dermatologist. 

  • I am following this so that I can learn.  Please keep us updated about Charlotte.  I am so sorry this is happening to her.

    • Nancy, I remember you were glad you took Gordie to a dermatologist, correct? 

      • Absolutely the best thing we ever did was taking Gordie to a dermatologist. It turned out that not only was his antibiotic wrong, it was the incorrect dosage AND Gordie was allergic to the cortisone he'd been given which is a general vet's first line of defense for 'allergies.'  We spent less at the specialist than dragging our feet with his general vet. And he began getting well right away. 

        • Thank you for posting this, Nancy. That was my experience as well, and countless others. I think sometimes people are afraid of the cost of seeing a specialist, but in fact it almost always costs less than repeated visits, tests and meds at the GP vet. 

           

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