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.
Related articles
- Fostering a special needs dog (rayyathevet.com)
Dr Rayya's Online Veterinary Journal 
November 26, 2012 at 8:39 am
I have a feeling you now own another dog for good. She’s very sweet, and who could look after her like you do?
December 2, 2012 at 5:16 pm
Lol…Thankfully I have a very strong mindset. I love Lucy to bits but as much as I adore her, I know there is a more suitable home out there for her. She thrives on attention and needs to be the only dog. 🙂
November 26, 2012 at 8:39 am
I sure hope she find the right person in the right home for her.
December 2, 2012 at 5:17 pm
Thanks Francis, I hope so too 🙂
November 26, 2012 at 8:55 am
I do hope you find the perfect home for her. Boy, this brings back so many memories for me after living with a dog with severe allergies for so long.
December 2, 2012 at 5:18 pm
I’m sure she will find her new forever home soon. There is no rush, I will only part with her if I know she is going to the perfect home. 🙂
November 26, 2012 at 10:04 am
Awwww … She is so sweet! I’d take her in a heartbeat if I didn’t life halfway around the world.
December 2, 2012 at 5:18 pm
Hey Julie. It is too bad you live halfway around the world. 😦
November 26, 2012 at 10:52 am
Hey Dr. Rayya, Jet here.
Sending Jetty kisses and JJ’s golden hugs to you, your husband and Dr. Bruce for perseverance and loving Lucy. We sure hope she finds the right forever home. There’s a Chinese herbal formula for hot spots that our rescue group leader recommends and swears by. Mom always forgets the name. Would you like her to find out??
December 2, 2012 at 5:19 pm
Hey Jet,
Lucy and all of us welcome your kisses & JJ’s golden hugs. Please do find out the name of the chinese herbal formula and send it to me. 🙂
November 26, 2012 at 1:56 pm
Doctor, you are a saint. Wherever Heaven is, you will be there. The Red Man sends you Paw Snaps and Twirls!!
November 26, 2012 at 7:03 pm
Allergy cases like this can be so frustrating! I have several patients like Lucy here in Sicily, and it’s always a struggle to properly perform all the required diagnostics before deciding that a dog really has atopic dermatitis.
December 2, 2012 at 5:22 pm
Hey Elliott,
Absolutely, it is a very frustrating disease to definitively diagnose. There is just a very prolonged process to undertake before coming to that conclusion. I mean I am still suspicious of underlying thyroid issues but having her on pulse prednisolone will affect her thyroid testing results.
November 27, 2012 at 7:15 am
Whoa – beyond the call of duty and all that. How wonderful that you’ve been able to take Lucy this far. It’s a massive job when allergies cover so many external and internal sources. We wish you all the best in finding Lucy the home she needs. Your hubby and hounds have been so supportive!
December 2, 2012 at 5:23 pm
Thank you so much. I am hoping Lucy finds her forever home too. She would be an amazing new addition to her future family! 🙂
November 27, 2012 at 6:44 pm
Rayya, it sounds as if you have done everything that any vet could have done, and then some more! No wonder Lucy felt at home with you and your husband. She has a gorgeous face – I hope a loving and suitably caring home is found for her very soon. She deserves it!
November 30, 2012 at 6:00 am
Hello Rayya, just wanted to second the commenter above that said they would take her in a heartbeat if they did not live half way around the world. She is adorable, and hopefully she finds a permanent home soon.
December 2, 2012 at 5:24 pm
Thanks so much. I don’t think Lucy will be keen on getting on a long airflight to her forever home. However, you never know. If it boils down to it, then that’s what will have to happen 🙂
December 3, 2012 at 10:13 am
Have met the gorgeous Lucy in person & she is an absolute sweetheart. In real life she is even cuter than her photos if that’s possible. She’s a very lucky girl to have found Dr Rayya. Am hoping to catch up with her again at the weekend.
December 4, 2012 at 7:46 pm
Hey Fiona,
Lucy looks forward to your hangout. Hopefully she doesn’t get up to any more mischievous eating habits. LOL.
See you
December 4, 2012 at 4:59 pm
Lucy is one lucky dog to have met you! Woof Woof 🙂 I believe the right person will come along. Somebody out there needs to care for Lucy and give her a home as much as she needs caring for. She’s in good hands ’til then, for sure.
December 4, 2012 at 7:54 pm
Thanks heaps Michelle. I really can’t wait to find Lucy’s forever home. They will treasure her forever. 🙂
December 5, 2012 at 1:26 pm
Dear Rayya — My cat Bugsy has been having severe skin flare-ups under his chin, for months! and spreading on his lips, ugh . . . until my friend told me about a natural salve. It’s wonderfully fragrant — Bugsy is OK with it — and it is helping. RELIEF. Have a look? http://www.supersalve.com/salves1.html
December 9, 2012 at 6:40 pm
Thanks for the great tip. I am definitely looking into it and will be trying it to see if it works on some of my skin cases. 🙂
December 9, 2012 at 10:52 pm
I would love to know your experience.
December 6, 2012 at 10:07 am
awesome
December 6, 2012 at 10:32 pm
🙂
December 20, 2012 at 6:42 am
Dr. Rayya, have you found anyone for Lucy yet? I sure hope so. 🙂 Sampson and Delilah have both been itchy but our vet feels it is due to winter and the dryer heat (plus they love to lay in front of the fire place.) 🙂
June 25, 2013 at 4:57 pm
Reblogged this on fozzie.m and commented:
Anybody who would be able to take this precious girl on as a valued family member please contact Dr Rayya,she is a beautiful girl and would love a home of her own.
June 25, 2013 at 4:58 pm
Hi Rayya have reblogged Lucys story on my blog..here is hoping this little one can find her place in the world 🙂
December 12, 2013 at 11:55 am
I feel like we have just started on the very same long journey. Our beagle was rescued from a lab at the age of 1 1/2 years and came to us with a bottle of steroids. As we weaned him off the steroids the scratching began and has continued unabated After 6 months, a change of diet, oatmeal baths, topical creams, and the list goes on he has little relief. The diet seemed to help at first but no longer. I have a vet appointment for a blood draw and allergy test but my expectations are low. I know that this dog may be VERY expensive, maybe prohititively so, but I am patient and continue to hope there is something that will alleviate his itching. Thanks for your post, I hope that you find a great home for Lucy….
December 12, 2013 at 10:25 pm
Hello Tim. Well done on rescuing your lovely beagle. Please do let me know his allergy blood tests. I highly recommend starting him on cyclosporin medication if he is diagnosed with atopic dermatitis. Lucy found a perfect new home and is absolutely thriving. 🙂
November 11, 2014 at 9:22 am
I have just come across your blog and this story in particular resonates with me. I had two Tibetan Terriers. One was a mother/son (in-line) breeding and suffered from puppyhood.
He had problems with his joints, constant ear infections and then when he was about 5 we went to a specialist and understood as well as arthritis he had allergies.
My second Tibetan from the same breeder has Symmetrical Lupoid Onychodystrophy.
To cut a long story short my beloved Zac became allergic to practically everything and we were trying to manage his terrible skin itching and painful arthritis. He had no thyroid problems or any other underlying health issue that our vet could discover. The dermatological specialists we went to solved his current ear problems and told us we had a healthy boy who would live for years.
Within days of seeing the specialists we discovered he had fleas and his itching went into overdrive. Our local vet put him on cortisone which helped but we couldn’t wean him down to a lower dose and after about six months he showed signs of Cushings. Then we tried atopica which I knew was toxic but I read about many owners who had pets on it for years, our vet said it was our last hope. Within a couple of weeks Zac had distressing side effects due to the medicine and they were untreatable. This coupled with his painful joints and constant uncomfortable ear cleaning procedures was making his life miserable. We had to have him euthanised at age 8 and it broke my heart.
I read Lucy’s story and wonder if we did enough. We never did do a full panel of bloods to see what he was allergic too because our vet told us that desensitisation was expensive and rarely worked so he would only end up on cortisone anyway.
My concern now is that my Tibetan girl is 7 1/2. She has had itchy skin for years too. I give her a flea treatment monthly, have tried every shampoo product on the market. She went through the exclusion diet with no results. At the moment I feed her Black Hawk because I cannot get a reliable supply of Vets all Natural skin sensitive rolls and she wouldn’t eat the complete mix. She does not have corn or grains.
She had a short action cortisone injection last month and it was wonderful. She was relaxed, stopped scratching all the time and could sleep. Because her nails are broken and twisted her scratching doesn’t often break the skin but it is clearly distressing and becoming worse. She rarely sleeps for long because the itching wakes her and it is distressing for her and for us.
This is a long story in order to find out what happened to Lucy. Did the injections eventually help her?
I fear I will have to go the cortisone route again in order to improve my girls quality of life but I by doing so I will be condemning her to a shortened one.
Because my girl didn’t cope well when Zac died we brought in a Standard Poodle as a pal for her – he has no allergies.
November 14, 2014 at 7:09 pm
Dear Zena. Thanks for sharing your experience with your Tibetans. You almost sound like an expert on canine skin issues. With Lucy, I never really got a chance to give her the injections regularly as I rehomed her successfully. She had been doing really well just on atopica (cyclosporin) every couple of days. However, she recently relapsed and so her new owners took her to a veterinary dermatologist and she is currently starting the injections again. I will let you know how she goes. Recently we have come across this new product that has helped so much with pooches with skin issues. We haven’t trialed it ourselves yet but will soon. I highly suggest you give it a good go. It’s a natural shampoo that contains essential oils and neem oil and manuka. Check out the detail on http://washbar.co.nz/our-range/original-washbar-soap
As you are fully aware, cortisone has too many side effects and if you could find an alternative to reduce your dog’s intake of that, it’s worth a go.
Hope this information helps. Goodluck and please tell me how she gets on. I hope you can source the soap.
November 15, 2014 at 8:36 am
Thank you for your input. I will certainly try the soap. At the moment we are going through a short course of steroids but I will then stop them and continue to try and manage her problems without medication for as long as I can.
She is much more comfortable on the steroids but definitely has a loss of energy and I don’t want her to develop any other side effects. Although she is itchy all the year I think Spring in Melbourne has been particularly bad this year.
I’m sure I can source the soap.