Help needed in navigating getting medical condition diagnosed

[JillML]

Hello,

1. My dog’s name is Jude, age 10, male
2. Neutered
3. German Shepherd
4. 80 lbs
5. BEAM - this is my first post, so I’m not sure if this BEAM is rated on a numerical scale, but all BEAM areas are good at this time although I can tell sometimes he is exasperated by the itching and his energy and mood and can be affected by that. But other times he is playful when outside, loves to go on walks, eating well, etc.
6. Diet - currently part commercial (dry and canned) with some home cooking and working on transitioning to all home cooked
7. I adopted him at age 9. He had a series of vaccinations at the shelter (rabies, parvo, I think lepto as well). No vaccinations since
8. See info below on the problem / health concerns
9. I’ve noticed worse with emotional upset (mainly he itches more with stress or even when he senses stress in me).
10. Although I don’t know his full history since I adopted him as a senior and history was unknown prior to that, he was diagnosed with pyoderma while at the shelter, but that had resolved and his skin completely healed with medicated baths and diet change once I adopted him.

@Dr. Christina @Dr. Jeff

Primary issue: Increased itching/ biting at his skin in various areas throughout his body since 6/28. Have tried several baths and tried different shampoos. Previously skin issues were soothed by baths and now baths aren’t helping. Also around that time (when increased itching started) he was stepping on to the seat in the car and his front L leg slipped off He was ok afterwards (walking normally) and has been walking and running to chase balls without any issues since so doesn’t appear to have an orthopedic injury from that. He was biting a lot at his “armpit” area on the L front leg. That area became red and hot and he was sensitive to touch there. Within the last 2 weeks I’ve been putting a CBD salve on that area a few times a day. The redness in that area is less; it is still hotter than other areas in his body and he does still have some sensitivity to touch there, but it’s less since I’ve been putting the CBD salve on.

Secondary issues:
Increase muscle tension along spine / muscle flickering at times with brushing and/ or touch
When I touch certain areas of his body (mainly around his neck, shoulders), he’s also having more of a scratch reflex than he had prior to when all the symptoms started in late June.

Prior to starting the CBD salve, I took him to the vet because in addition to the itching he was also having pain with touch along his L and R sides of his ribcage and I was really concerned about what was going on. I was also feeling something in that area that I thought could be a mass so I wanted to get it checked out. The vet told me he was itching due to not being on a conventional flea and tick meds (I’ve been using essential oils topically) and didn’t assess the pain he was having at all. She recommended Apoquel. I’ve been giving him the apoquel because it does help decrease the itching, but I feel really frustrated because my main concern about the pain he was having wasn't addressed and i’m not sure where to go now.

I really don’t feel that this is a skin issue at the root. I understand his skin is involved because he’s itchy, but what I’m more concerned about is the area that seems painful and inflamed and wondering if what’s going on there is putting additional stress on his body and causing increased irritation in his system overall therefore causing more itching.

For the past few weeks I’ve been focused on putting the CBD salve on the areas that seemed painful to him. That has helped and he’s less painful in areas along his ribcage now. Next week I have an appointment with a vet specializing in internal medicine. That appointment was set up a while ago as a consult for further assessment of the clear nasal drainage that’s been going on since April and didn’t respond to other treatments. When I called the vet’s office to let them know the more acute symptoms Jude was having (the heat and inflammation in area of his L chest/ “armpit”, sensitivity to touch in that area, increased itching, and the potential mass I’m feeling) they said they may not be able to assess that since that’s not the vet’s speciality. I was really surprised at that response and now I don’t know what to do.

Jude gets stressed with vet appointments so I don’t want to put him through multiple vet appointments and I don’t want to take him to an appointment for a chronic issue when a more acute and pressing issue may be overlooked.

I want to advocate for him in getting the care he needs, but I don’t know where to turn. The vet I took him to a few weeks ago dismissed my concerns about pain. Now I’ve found out that the specialist may not be the right vet to assess it or may not even be willing to look at it, so I”m not sure whether to go through with that appointment or not. Other vet clinics in the area don’t have great reviews and I’ve even looked outside of this area and haven’t been able to find anyone else I feel comfortable taking him to. Also, I feel like I need to get this assessed soon rather than waiting to establish care somewhere new.

Is there a better way to navigate this situation?
Are there questions I can ask or requests I can make of the vet specialist to make sure Jude gets the care he needs?

Is there anything I should request as far as diagnostic testing, etc to determine what may be causing the excessive itching that seemed to start all of a sudden?

 

[Dr. Christina]

Welcome to holistic actions and good for you to want veterinarians to address the whole dog, not merely one problem or another.

First, take a deep breath, or several. His BEAM is good and that is the key right now. You have time to do some research, observe some more, and most importantly, to learn about how all of these symptoms are clues to his internal state. You are very observant, especially noticing the context of different symptoms (itching more when you are stressed, itching in an area that may have had a bit of soreness. downloading and assembling the Healthy Dog Journal will help you keep track of changes and responses to treatments as well as fun times over the years.

We have been trained by our culture to immediately remove symptoms. Itching is one that can be celebrated since it is evidence of a healthier internal energy field (rather than liver disease, etc). While it may take several weeks, read and follow all the steps in the Find a Veterinarian article and post again here where you live. There are great homeopathic veterinarians who can help virtually, and others trained in Chinese medicine, chiropractic, osteopathic, rehab who may be within a drive.

Schedule your 15 minute member call with Dr. Jeff or myself to help guide you.

Take the 101 health course, especially lesson one about the value to the animal of symptoms. In the resource library skin section, there are a lot of home remedies to soothe itching while you

Since the CBC is soothing, certainly continue that. Work on your stress. Keep looking for more and more ways to stimulate Jude's physical, mental and emotional states. Listening to the webinars about behavior & play can give you more insights.

You are wise to rethink the internal medicine visit for, as they honestly said, they have a limited focus. When you work with a good holistic veterinarian, they will address the underlying imbalance causing all the issues at one time. Nothing you are sharing about Jude, even the possible pain, has me concerned that you need immediate resolution (which would be to quickly stop the symptoms which weakens the dog overall). While the apoquel is decreasing the itch, it can have side effects, so you may want to try decreasing the dosage while you increase the play/less stress, etc.

Most importantly, remember there is no one right answer and no one expert. Follow you intuition.

Dr. Christina

 

[JillML]

Thank you for these suggestions @Dr. Christina . That is good to know about the itching as a symptom and I will try decreasing the apoquel. My biggest concern right now is the area around his L chest/ shoulder. That's the area where I'm concerned about a potential mass because of what I"m feeling in that area and there is also heat and redness there. That's the area I really feel needs to be evaluated by a vet as soon as possible and it's been disheartening for my concerns to be dismissed by the one vet I did see and now another vet telling me they may not look at it. I'm unsure of where to turn now.

I would ultimately like to find a holistic veterinarian for his care but I do need to figure out who to see to assess if there is a mass around his shoulder that is causing the heat and inflammation. I'm in Petaluma, CA. Do you have any recommendations for what I can say to a vet and how to prepare for an appointment once do I find somewhere to take him to make sure my concerns are heard and addressed?

 

[Dr. Jeff]

How about consulting with board certified dermatologist and homeopath Dr. Stephanie Chalmers in Santa Rosa:

Home | Holistic Animal Care

Holisitc practices, animal doctor, veterinary, vet, pet doctor, holistic vet, homeopathy California

www.holistic-animal-care.com

 

[JillML]

@Dr. Jeff @Dr. Christina
Thank you for that suggestion about Dr. Chalmers. I did call her office. They do very specialized testing and treatments, but not general vet care. They recommended I see a general vet first to get labs, etc, and then follow up with them if needed.

Since my original post, I discovered fleas on Jude and several spots of skin irritation mainly on his low back and underneath his tail (maybe a flea dermatitis or flea allergy?). With a combination of bathing, flea combing, and keeping his environment as clean as possible over the past 10 days, the itching and biting has decreased and I've been able to take him off the apoquel. Despite all of that his skin is continuing to flare up and he's been been uncomfortable. I'm also still finding live fleas. Just when I think I have it cleared up, it flares up again.

I really don't want to resort to a conventional flea medication, but I'm concerned about irritation the fleas are creating with his skin and any potential infections they could transmit and what that could be creating in his overall health. He also seems stressed by all the extra baths, essential oil sprays before going outside, and extra vacuuming. I know extra stress isn't helping the situation for either of us, so I'm not sure what the best route forward is .

I'll be taking him to his general practice vet tomorrow to get the the inflamed area around his L shoulder checked out as well as labs. I feel worried the vet is going to push for a conventional flea med and lecture me about not having already done that.

How can I prepare for that conversation? Are there any flea meds that that may be safer than others that I could ask about?

Are there any other holistic approaches I could try?

Thank you,
Jill

 

[GinnyW]

Yes! He needs his whole immune system strengthened - well, his entire bodily function. What does this best, after you have seen to diet, exercise, love, stimulation, etc. - is classical homeopathy, properly applied by a dedicated expert veterinary homeopath. All holistic care is better than conventional, most times, but none of it can address this sort of thing as well as classical homeopathy.

Do not let the vet browbeat you into anything other than diagnostics. If what he does for you is labwork, that's fine and helpful. But you need nothing else he will offer. Get yourself to Dr.Chalmers; she is well-trained and competent. Tell/show her whatever labwork you have, but stay off "meds" and palliatives from others. Feed him well and in great variety, love him hard, do whatever he enjoys, and pretend nothing is wrong - because it isn't, really; just a normal reaction to some insulting factor. He is strong and well able to resolve this when pointed in the right direction.

 

[Dr. Jeff]

How can I prepare for that conversation?

Great question Jill! The answer really depends on the degree of your local vet's open mindedness. It may help for you to decide, before you go, what you are trying to accomplish (which is the first step of Holistic Medical Decision Making).

For example, if you want to get rid of the fleas you probably need to tackle where they are breeding in the environment (they don't live or breed on the dog). DE and vacuuming inside (including the car), beneficial nematodes in the yard, etc.

If however you are not as much worried about the presence of the bugs but are instead concerned about Jude's reaction (which is probably a hyper-sensitivity) then you need to energetically address his susceptibility to flea bites. You'd do this with a trained vet homeopath or acupuncturist (tho that brings us back to finding the right vet!).

Are there any flea meds that that may be safer than others that I could ask about?

Lufeneron (Program or Sentinel) is a flea birth control that does kill anything, and seems to be pretty safe. It renders the fleas sterile so they eventually just die out in the house.

Capstar is a one shot insecticide that will kill the fleas on him when he takes the pill.

Are there any other holistic approaches I could try?

Absolutely! The middle path where you work with decreasing susceptibility, continue, flea combing, bathing, vacuuming, etc.

When it comes to fostering health, like flea control, think of this as a marathon not a sprint.