Dog “diaper area” oozing, angry rash on female

Dear Traumatized,

For Gracie, you wrote,

“My questions are:
a) what IS THIS
b) is it because of the kibble?
c) should Gracie eat kibble or should I bite the bullet and go back to rice and fish or something else?”

Lesions that are this extensive are due to ‘deep pyoderma’. This means that bacteria have invaded the underlying Sub Q tissues through hair follicles and weakened skin secondary to prolonged use of cortisone. She may also have some secondary yeast infection, which would be confirmed by the dermatologist with a skin culture/skin scraping.

While Prednisolone (5mg) per day is not a large dose for a big dog like Gracie, if she has been taking this same dose over 4-5 months, (or longer), then it has affected her liver, that is why you have noticed her weight gain around her rib cage and pot belly. This is due to a swollen liver.

A complete blood panel can confirm if her liver has been affected. Also, it has depressed her immune system. Bacteria is normally found on the skin, but if the immune system has been suppressed then the normal homeostasis is disrupted, the bacteria multiplies, the weakened skin breaks down and the bacteria is allowed to invade the deeper tissues.

You did not mention if Gracie has been spayed or not. If she has been in heat recently, and her immune system has been suppressed, she may have developed a pyometra, (infection in the uterus), which can make her VERY sick. But, if this were the case, the abdomen would be more swollen as if she were pregnant.

The DRY DOG FOOD is probably a BIG reason why her skin deteriorated so badly, along with the stress of you leaving. DRY DOG FOOD is not healthy for dogs. See our page on 10 Best Dog Food Options

The diet of rice and dried fish not a balanced diet, and while in Africa, if her diet had been improved, she may not have needed the Prednisolone at all. Now that you are in Switzerland, here’s the plan:

1. Decrease the Prednisolone to 2.5 mg ONE time daily for one week.
Then decrease to 2.5 mg every other day for TWO weeks.
Then STOP.
This may a rather rapid decrease in dosage, but if her liver is swollen, and her immune system depressed, and she has severe skin infection, I would like her OFF the cortisone ASAP. (as soon as possible)

2. Improve her diet. A Raw diet would be the best for her. But if her immune system is depressed, then start with a canned food, or homemade cooked diet. I am not familiar with dog foods in Switzerland, but if her liver is swollen and the blood panel shows elevated liver enzymes, then she will need to be on a diet that consists of:
1/3 starch, such as potatoes, or yams
1/3 carbohydrates, mostly vegetables; such as cooked green beans, carrots, zucchini
1/3 meat, very lean low fat meat such as chicken or turkey. (Beef will cause more gas).

TO BE CONTINUED IN PART TWO

Dear Traumatized,

Here is the rest of my response.

If you choose to feed a canned food, make sure it is VERY low in fat, (less than 5%) has medium protein (15-20%), and HIGH carbohydrates. NO preservatives, No artificial colors and NO By-Products.

To make sure the diet is balanced, she should have some supplements such as Canine Whole Body Support, Plus liver support:
Milk thistle 350-500 mg two times daily. Ok to add to food.
Hepatrophin from Standard Process , one capsule opened and sprinkled into food two times daily.
Immuplex from Standard Process, one capsule opened and sprinkled into food two times daily.

To maintain her body weight at 40 lbs, (18kg), she needs to eat at least 700 calories per day, or 350 calories two times daily.

If she is starting an antibiotic, (“Rilexine” ingredients=cephalexin), she should be supplemented with Acidophilus in her food TWO times daily 1/2 the human dose, and continue for two weeks after the end of the antibiotics.

3. Help her skin by clipping the hair away from the open wounds, under her tail, around her vulva and rectum, and on her thigh.

Keep these open wounds meticulously clean. Bathe the areas every day with a mild ‘Baby’ shampoo. (Not sure what is available in Switzerland). Rinse and dry well. She may need to wear a pair of men’s boxer shorts, with her tail going through the ‘fly’ when she is inside to prevent her from licking too much and to keep the areas clean. Change the boxer shorts two times daily.
Take them off when she needs to go outside for urination/defecation.

You can apply betadine solution to the open lesions two times daily, or use Calendula ointment. Calendula is a homeopathic remedy used for helping gaping wounds to heal. It is available in ointment form to use two times daily.

After one month, repeat the blood test to see if the liver enzymes have decreased and/or returned to normal. You may need to continue the liver supplements,and immune support for 3-4 months to help reverse what the cortisone has done.

It might be best to also consult with a holistic vet in the area, to recommend a homeopathic remedy once the antibiotics are finished, and also to ‘fine’ tune what I have suggested. To find a holistic veterinarian in your area click on the link below

Another resource for vets knowledgeable in homeopathy is AVH.org.

Please keep us posted by coming back to this page and clicking the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

Well, we’re working on it…

* The local vet determined the pyoderma an allergic outbreak, since we knew she had that already and she hadn’t had a bath in 5 or 6 weeks. But she didn’t have any interest in the liver or steroid aspect of the cause. Frustrating.
* Vet gave us a medicated shampoo for pyoderma, 2 baths/week, which has significantly helped, along with the antibiotics. Still very slow healing. The open skin finally covered over in the last 3 days.
* She also got some anti-allergy skin spray lotion called Allermyl which seems to soothe skin and wounds.
* Vet urged me to wait to cut back on the prednisolone, until the skin healed. So I kept it the same and now we’re cutting back.
* Cut back and finished the dog food, while working into eating pureed carrot, potato, green beans, apple and fish. I can’t give her anything that would cause gas like zucchini and spinach or broccoli, we tried that in Rwanda. She loves the new food but there has been NO weight change. Now she is solely on lightly-cooked veggies and fish or beef, and I’ll work towards raw.
* Got milk thistle and probiotics and digestive enzymes. Can’t tell if this is making any difference. Nothing as dramatic as the stories on milk thistle websites say.
* Now she has little cysts all over her skin, whole body. Pink or white. I don’t know what this is. Allermyl? Something else? So many possible factors.
* The skin on her barrel sides is wrinkling up like a Shar-Pei.
* At least she’s not itching at all!!!! And she’s happy and cheerful as always, maybe marginally even having more fun lately on walks. But these bumps all over….?

Thank you…

Dear Traumatized,

You wrote,
“* Got milk thistle and probiotics and digestive enzymes. Can’t tell if this is making any difference”

Since Gracie has still been on the prednisone while giving her the milk thistle, you will not see much of a response until you decrease the pred or discontinue it completely. In some cases, when measuring liver enzymes in a blood test, the enzymes do not start to return to normal until almost 6 weeks after the prednisone has been stopped.

You wrote,
* “Now she has little cysts all over her skin, whole body. Pink or white. I don’t know what this is. Allermyl? Something else?”

I would need a picture of these cysts to be able to comment. Possibly pimples, papules, hives?

You wrote,
* “The skin on her barrel sides is wrinkling up like a Shar-Pei.”

I suspect this is due to the chronic inflammation which as been suppressed, as the skin swelling has decreased due to the steroid, her skin is ‘shrinking’ and becoming wrinkled. Similar to a sunburn. When the skin is sunburned, it is red, swollen, and puffy. As the sunburn subsides, the skin is begins to ‘shrink’ and wrinkle, and (in some cases) peel. Her skin may also become darker, and more pigmented along with the wrinkled effect, due to the chronic inflammation/shrinking.

You wrote,
* “At least she’s not itching at all!!!! And she’s happy and cheerful as always, maybe marginally even having more fun lately on walks”.

Good! Continue with the vegetables and fruits to help add more moisture to her diet. Continue to decrease the Prednisone. Continue with baths one to two times per week. And, keep giving her the supplements for her liver!

You wrote,
“But these bumps all over….?”
Send a photo!

Another resource for vets knowledgeable in homeopathy is AVH.org.

Please keep us posted by coming back to this page and clicking the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

I am pretty sure they are hives. Not pimples for sure and not developing pyoderma. It’s all over her main body but not on her belly where the hair is thinner. But why would this be getting worse? The Allermyl spray seems to help with them – I waited a few hours to put it on after a bath yesterday and the hives increased, and she licked herself less after I sprayed her. I think we may be getting close to ready for a change to anti-allergy shampoo now that the pyoderma is healing. She also had a first yesterday – her skin flaked only a very little bit after her bath.

But what should she be eating to keep her from itching when the prednisolone stops? This is my chief concern as her constant scratching is miserable when it gets going. Is it the raw food, with the MSM in the fruits and veggies and the meat, that makes the difference? Any food in particular which helps the most? I’m also making sure she’s getting bones and ground up eggshells for calcium. Also are breadcrusts or cheese helpful or harmful – these are readily available (ha!) in a Swiss kitchen and she begs incessantly for them.

Thanks…

Gracie is ready to accept a raw diet, I’ve found, if it’s all pureed. So, for clarification:

A) is it okay for her liver yet to have raw meat (right now we have raw/frozen ground beef, other times we have frozen white fish)

and B) for the carrots/yams/potatoes/green beans, should they be raw or cooked for her maximum benefit?

I’m waiting for the rest of the liver support items to come in the mail from the US. Do you recommend the enzyme/supplement/probiotic by BARF? (love that name, sheesh)

Thank you!

Dear Traumatized,

You wrote,
“I am sure they are hives….why are they getting worse?”
Probably due to decrease in the Prednisone, so it is no longer suppressing her itching.

You wrote,
“Allermyl spray seems to help…she licked herself less after I sprayed her.”

So, now the Allermyl spray will be suppressing her itching. Between the Allermyl spray and the Prednisone, the Allermyl spray is the lesser of two evils!

You wrote,
“She had a first yesterday–she flaked only a little after her bath.”

So, has she had a lot of flakiness after bathing? Dry, flakey skin will be very itchy. She needs a massage or rub down with Coconut Oil prior to each shampoo. Rub the coconut oil all over the areas that are dry and flakey. Wait 1-2 hours to let it soak in. (You can leave it on 4-6 hours if needed. Make sure she is not jumping all over your bed or furniture, she may still be greasy!)

If she is still greasy, you will need to shampoo with Dawn dish detergent to remove the oil first, then rinse well, and shampoo her with your ‘regular’ or oatmeal shampoo.

You wrote,
“What should she be eating to keep her from itching?”

A raw home prepared diet with supplements to boost her immune system are important to maintain health. The excessive itching, tendency to skin infection, dry skin and hair are due to the ‘mistunement in her life force’ according to Dr. Samuel Hahnemann, the medical doctor that discovered Homeopathy in the 1700’s.

He said that fresh water, fresh air, good exercise and proper diet are all important to maintain health, but homeopathic remedies are used to ‘differently tune the energetic life force when the life force has been mistuned through disease to abnormal activity.” (Introduction to the Organon 6th Edition)

There are numerous remedies that are useful for excessive itching. Sulphur is a very good one. I suggest you start her on Sulphur 12c two times daily. You can give her the dry pellets-one pellet by mouth two times daily. Or dissolve one pellet in a 2oz glass dropper bottle with Spring Water, and give her one eye dropper by mouth two times daily.

Continue to decrease the Predinisone. Use the Allermyl spray as needed to try to prevent her from itching too much.

You wrote,
“ready to accept a raw diet…

A) is it okay for her liver yet to have raw meat (right now we have raw/frozen ground beef, other times we have frozen white fish)

Yes, but NO RAW FISH and NO RAW PORK

and B) for the carrots/yams/potatoes/green beans, should they be raw or cooked for her maximum benefit?

Cooked.

“I’m waiting for the rest of the liver support items to come in the mail from the US. Do you recommend the enzyme/supplement/probiotic by BARF?”

Yes, BARF (Bones and Raw Food) make a very good supplement to help balance a home prepared diet.

Please keep us posted by coming back to this page and clicking the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

I am still trying to find the coconut oil and sulphur is really hard to figure out with the French language barrier.

Can you be really specific so I can talk to a vet – what exact type of sulphur tablets, what dosage for a 20 kilogram (not pounds!) dog? And I read about sulphur and vegetable oil topical rubdown to help calm down skin problems, can you tell me what kind of sulphur powder is okay for that? I’m seeing one kind for gardens, is that safe?

The poor dog’s skin has gone nuts. She is red all over, the wrinkles along her ribs, and it’s not hives, but more pyoderma all over her body I think. And her legs and tail are getting worse again and opening back up. She’s still on the antibiotic and it doesn’t seem to be working anymore.

Thank God she is still energetic but her itching has gotten to the point that I can’t take her off the pred until I have something obvious to replace it, calm her inflammation and help her be comfortable. She is waking up in the night now and licking relentlessly, and was so agitated, clingy and crying this morning until she finally fell asleep exhausted.

This is really traumatic, I just want my dog healthy again, and it’s hard to be in a country where I don’t know how to find anything, and everything unbelievably expensive. I used to feed my dog rice and fish or beef, and throw in a quarter tab of pred, wash her once a week, and she was gorgeous and happy. Now she’s gone completely crazy and so have I…. All I can figure is her immunity is at its end, and the climate change from sunny Africa to snowy Switzerland. Because getting her off dog food made no positive difference at all.

I think another clue to this is the dry mountain air here instead of a really mellow, comfortable humidity in Rwanda (you only noticed it if you tried to close doors and windows!). Add in the fact that she likes to sleep next to a heater (it radiates dry heat, not blowing air), so perhaps with that, her skin is drying out like crazy. In which case the coconut oil is key.

April 6, 2013
Dear Traumatized,

Homeopathic Sulphur 6c or 12c potency is for HUMANS and can be used on animals too. Switzerland should sell homeopathic remedies, (including Sulphur) in the ‘human’ pharmacies. Homeopathic remedies are not dosed according to body size, but according to the strength of the Vital Force of that individual.

DO NOT use Sulphur powder!

While you are in the human pharmacy, see if they have RESCUE REMEDY. This is for humans. But it can be useful when diluted in Spring Water and sprayed on skin to ‘calm’ the skin itching/redness etc. You can buy a plastic pump spray bottle 4 or 6 oz size, add in 20-30 drops of Rescue Remedy and fill with Spring Water. If you keep it refrigerated it will be cold, so when sprayed on her skin, it will ‘cool’ it down.

Coconut oil is a solid at room temperature. It comes in a jar and is the consistency of margarine. Yes, you are correct that dry air will make her more uncomfortable.

If you are able to massage the coconut oil into her skin two times per week, (allow to soak in for several hours), then shampoo with oatmeal shampoo.

At all other times, make her wear a white cotton T-shirt to prevent her from scratching and causing more trauma to her skin.

You wrote,
” I used to feed my dog rice and fish or beef, and throw in a quarter tab of pred, wash her once a week, and she was gorgeous and happy. Now she’s gone completely crazy and so have I…. All I can figure is her immunity is at its end, and the climate change from sunny Africa to snowy Switzerland. Because getting her off dog food made no positive difference at all.”

If she had the pred for 6 months or a year or longer, I agree that her immune system has certainly been suppressed, and it will take a year or more to restore her health and her skin back to normal. Improving her diet will make a difference, but it is MUCH too soon to see anything now, since she has not even started on any homeopathic remedies, immune supplements or anything yet.

When you find the Sulphur 6c or 12c potency, please send a posting on the date you start her first dose.

Another resource for vets knowledgeable in homeopathy is AVH.org.

Please keep us posted by coming back to this page and clicking the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

Dear Tramatized,

In my previous posting I wrote, “make her wear a white cotton T-shirt to prevent her from scratching and causing more trauma”

I meant to say, make her wear a pair of men’s boxer shorts, with her tail going out the ‘fly’ opening.

Since most of her lesions appear to be located on her hindquarters, the boxer shorts should provide more protection than a T-shirt.

Please keep us posted by coming back to this page and clicking the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

Where we’re at:

She’s getting 6 pellets of child sulphur, 3 in the morning and 3 at night, ten minutes before dinner. We started on Friday April 4th.

Feeding her coconut oil as well, to put more oil into her diet and skin. Rubbed it all over her and left it on her overnight. She still scratched and her skin was incredibly hot. Next day we did a skin treatment of olive oil and homeopathic sulphur powder, for one hour, and then shampooed. But as you warned, getting all this oil and sulphur off the dog was harder than I expected. I haven’t seen oatmeal shampoo anywhere and I am cautious about using dish detergent because her skin is so dry. I shampooed most of it off but some of the oil is still there and some powder stuck to her skin, seems to be helping what could be dry (not weeping) eczema from the climate change. She’s still licking a lot and we had a horrible night last night, but in general her skin is calmer and just warm instead of hot around her barrel. Any recommendations for getting the oil and sulphur off her? I don’t mind some oil on her, it might be helping protect her skin from the dryness.

I found doggy calendula so that is helping on the really serious wounds and eczema spots, to keep them from cracking while they heal.

We tried the boxer shorts and it was hilarious, but she wouldn’t keep them on and she nosed around them. So we gave up. And after I did the sulphur treatment, everything closed up and calmed down.

So, between ingesting a lot of sulphur and oil now, being on an all-natural cooked diet (pureed potatoes, carrots, green beans, beef or fish, eggshells, fresh apple and celery), getting milk thistle for her liver, probiotics and digestive enzymes, I’m hoping we’re on the road to recovery here. As soon as her itching calms down from sulphur or oil, I’ll try again to take her off the pred. But right now she’s getting 2.5 total per day (1/4 a 5mg tab morning and night) and if I go any lower she’ll go bonkers. I got to 1/4 tab in the mornings only and we haven’t slept well since.

I turned down the heater where she sleeps. Fortunately the weather is finally getting nicer and going outside isn’t biting cold.

Apple cider vinegar rinse used to really help her a lot. Can I do that now, or is she still too raw?

After doing more research I really think in addition to whatever immune deficiency she’s got, she has typical eczema (I found pictures of hives and that was definitely not it, sorry!) from the stress of the transition and the dry air and heating, after leaving a humid/tropical climate. I read about her kind of eczema turning to pyoderma if not treated, so this seems to be adding up. Any thoughts on that?

Thanks…

Dear Traumatized,

April 7, 2013
Thank you for the update. To summarize, I will list all the medicine/supplements that Gracie is taking and add comments.

You wrote,

1. Starting April 4, Gracie is on 3 pellets child Sulphur. 3 in the AM and 3 in the PM 10 minutes before dinner.

Do you only feed her one time daily? She needs 700 calories per day. It would be easier to give her TWO meals daily of 350 calories in AM and PM.

There is no ‘child’ sulphur. Homeopathic sulphur is manufactured in different potencies, x, c, m or LM.

The different potencies are given to adults or children or animals depending on the vital force, NOT on their size or age.

Gracie needs to take one pellet of Sulphur 6C or 12C two times daily. If you are not able to find it at a pharmacy, you can order it online. One company is Boiron. Just Google ‘Boiron Sulphur 12c’.

2. You are giving her coconut oil in her food and rubbing it on her skin. Also massaging olive oil on her skin and ‘Homeopathic’ sulphur powder. And applying ‘Doggy’ Calendula to her skin.

This is TOO much on her skin. Her skin needs to be clean!! Shampoo her with dish detergent, it will act to de-grease her and remove all of the excess oils and the Sulphur powder. If her skin is oily or greasy it will attract dirt.

Of course dish detergent will dry out her skin. She needs to have the dish detergent rinsed off well, then a SECOND shampoo of oatmeal shampoo. Then rinse this off. Spray her with the diluted Rescue Remedy, which I mentioned in an earlier post, that is diluted in Spring Water. As often as she needs it until her next coconut oil treatment and shampoo, TWO times per week.

NO OLIVE OIL
NO HOMEOPATHIC SULPHUR POWDER
NO ‘Doggy’ CALENDULA ointment
NO APPLE CIDER VINEGAR

(Although, you can use the HUMAN calendula ***tincture**** diluted in Spring water to apply to any irritated areas to help them heal.)

3. Boxer shorts not tolerated by Gracie. Too bad!

4. Prednisone 1/4 5mg tablet TWO times daily, since she is TOO itchy at only one time daily.

Ok, that is still a low dose. Hopefully, once the internal homeopathic Sulphur of the correct potency is given, then you will be able to reduce the Pred.

5. Milk thistle, (her dose is 8mg per lb TWO times daily, mixed in food.) She will need at least 400mg two times daily.

6. Probiotics, she needs about 1/2 the human dose.

7. Enzymes for digestion.

TO BE CONTINUED IN PART TWO

Dear Traumatized,

Here is the rest of my response.

Her diet is all cooked vegetables and fish and beef. Is it possible to add in the beef separately and NOT cook it? Will she eat beef, or chicken or turkey raw?

***DO NOT FEED HER RAW PORK OR RAW FISH*****

If she is relapsing back to pyoderma at this time, she may need to resume the oral antibiotics. Hopefully, if you are able to keep her skin CLEAN, not greasy, using Rescue Remedy diluted in Spring water at any time to spray on her skin to reduce itching, OR use the Calendula tincture diluted in Spring Water to those raw open sores, and oozing areas to help them heal, you will be able to prevent the recurrence of the pyoderma.

See if you can locate a nearby holistic veterinarian, it may be easier to locate some of these products with one familiar with the area.

Click here to find a holistic veterinarian in your area. Another resource for vets knowledgeable in homeopathy is AVH.org.

Please keep us posted by coming back to this page and clicking the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

Gracie eats twice a day and gets her meds twice a day. She is still somewhat heavy and peaceful after eating so I think she is getting enough. She is also more energetic and chatty, and begging for long walks. Good signs.

Why did her skin get so hot and red when I massaged her in coconut oil? She also didnt feel well after her first sulphur and oil dose, she huddled up in her bed. by the next day she was fine.

I did see Rescue Remedy so I will get some. currently using baby shampoo as you advised and vet antibacterial shampoo on the healing wounds, which works well.

Should I taper off antibiotics or just quit? Its been 4 weeks.

the sulphur pellets are labeled 9 CH. does that ring a bell? I give them to her with coconut oil ten minutes before she eats breakfast and dinner.

Dear Traumatized,
Glad to hear she is being fed two times daily and getting enough to eat, and her energy level is good.

You wrote,
“Why did her skin get so hot and red when I massaged her in coconut oil?”

I am not sure, unless she is allergic to coconut? If she was also started on the sulphur 9C at about the same time, this may also have been an ‘aggravation’ and her response to the remedy, not the coconut oil.

You wrote,
“She also didn’t feel well after her first sulphur and oil dose, she huddled up in her bed. by the next day she was fine.”

If you mean the Sulphur powder that you applied topically to her skin, THAT would make her sick. SULPHUR powder is not healthy for a dog’s skin, especially when trying to use oral sulphur in homeopathic concentration.

You wrote,
“I did see Rescue Remedy so I will get some. currently using baby shampoo as you advised and vet antibacterial shampoo on the healing wounds”

Sounds good. And use the Rescue Remedy diluted 10-20 drops in a 4 oz pump spray bottle filled with Spring Water, to spray on her skin as often as needed to decrease her itching and redness.

You wrote,
“Should I taper off antibiotics or just quit? Its been 4 weeks.”

If her skin does not look infected, then you should just stop the antibiotics.

You wrote,
“the sulphur pellets are labeled 9 CH. does that ring a bell? I give them to her with coconut oil ten minutes before she eats breakfast and dinner.”

GOOD!! Sulphur 9CH, (in the USA the C and CH are the same), is a potency that is perfect, as it is halfway between a 6C and 12C. Although, it may not be so good giving it with the coconut oil. Some homeopathic remedies are inactivated with food. But ok with milk or water. Coconut oil is more like a ‘food’. You only need to give her ONE pellet. Do not touch the pellets with your fingers. Just pour one pellet out of the vial into the cap, and pull out the corner of Gracie’s lower lip, and just drop the pellet into the space between her lip and her teeth. She actually does not even have to swallow the pellet, it only needs to be in contact with her mucous membrane for a short time.

Another resource for vets knowledgeable in homeopathy is AVH.org.

Please keep us posted by coming back to this page and clicking the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.