Your Pet's Best Friend

What is Pyoderma?

A client writes in, "What is Pyoderma?"

Pyoderma means "pus in the skin".  That is, infections in the hair follicles.  Probably not fatal, but certainly very uncomfortable: sore and itchy.

Most are secondary to some other condition: An allergy or mite infestation or contact irritation or fleas can cause excess scratching.  This damages the skin and opens the body's defenses, and bacteria that live on the surface with no problem can invade and cause problems.

A dog with low thyroid function or other systemic disease can have poor body defenses, also allowing the surface bacteria to do undue harm.

The bacterial infection in the skin needs to be treated with antibiotics and medicated shampoos, but you also need to find and treat the underlying cause that allowed the bacteria to get a foothold.  Otherwise, the problem will only partially resolve and will come back.

Pain after Heartworm Treatment

A reader writes in today:

Had our cocker spaniel treated 5 hours ago with his first shot.
For the past 5 hours, he can not get comfortable, fidgets, lays in unusual positions.

When walking, his right rear leg is toeing-in and his walks clumsily, often positioning that right foot too far under his body.
In just the last hour, he has started some toe-dragging with that right foot. Not severe, and he corrects upon moving further into the stepping process.

Also, he has started to drool excessively. Both ears are wet as if he drank from a flat bowl.

Have given him 2.5 mg Diazepam to try to make him more comfortable.

Forgot to mention ... the vet had to stick him twice unsuccessfully and then changed needles and successfully administered on the third try.
Do you think he is just experiencing more pain than usual because of the three 'sticks' at the site, or should we be concerned that something else is going on?

 My Reply:

Please call your veterinarian and let him/her know what is happening.

The medicine in the treatment (Immiticide) can cause a lot of inflammation at the injection site. This can occur no matter how smoothly things go and how little it seems to bother the dog at the time.

This can range from being absolutely undetectable to a dog that is crying constantly with pain. Diazepam helps with anxiety, but has no pain relieving properties to speak of.

Please contact your veterinarian about this, as human 0ver-the-counter products can be harmful to your dog. However, it sounds very much like your dog needs pain medication.

The pain usually subsides in a couple of days, and most dogs don't have this type of reaction, but the ones that do get painful do need some help.

The difficulty in walking may indicate that the inflammation is causing enough swelling to put some pressure on a nerve root.  This can be very temporary, but certainly needs to be addressed.

Call your veterinarian and report this situation.  He/she will decide what anti-inflammatory or pain-controlling measures are needed to help your dog.  He/she can't help if they don't know about it.

What to do now that Immiticide is in short supply.

A reader writes in:

Hi. I have a 12 year old mixed breed who has been on Heartguard preventative most of his life. Unfortunately, he recently tested positive for heartworms. We live in the South, and he is an outside dog.

Anyway, the vet said because of his age and the expense that we should just give him prednisone, doxcycline, and sentinel, and that he would eventually suffer from congestive heart failure.

Will this regimen even help? What exactly will it do? What is the pattern of treatment? The vet mentioned to give him the prednisone alternating months. What do you recommend for the frequency of these meds?

My answer:

Heartworms actually are mostly located in the pulmonary arteries, the blood vessels that take blood from the right side of the heart to the lungs to get oxygen. Their presence in these tubes interferes with the circulation in the lungs, and makes the arteries themselves inflamed. This can cause swelling, which narrows the opening in the artery, further interfering with this blood circulation.

Even when there are no worms in the heart yet, this difficulty in the lung blood vessels makes it more difficult for the heart to do its work. This causes excessive wear and tear on the heart.

Doxycycline inhibits a microorganism called Wohlbachia that benefits the heartworms (much as the "good" bacteria in our intestines help us). When the dog takes doxycycline, the heartworms become weaker and physically smaller. Thus, they cause less interference with the dog's circulation. Doxycycline is also a little bit of an anti-inflammatory medicine.

Prednisone is a form of cortisone, which is a potent anti-inflammatory medicine. If the worms are causing swelling of the blood vessels (making the opening smaller, and more difficult for the heart to work against), the prednisone can open things up again.

There is currently a severe shortage of Immiticide, the drug used to kill adult heartworms. Until it becomes available again, the American Heartworm Society is recommending that dogs be managed in the way that your veterinarian is recommending.

I think that your veterinarian's recommendations are very reasonable, considering your circumstances. If you have more questions, please take the time to let him/her know. Many times we think that we are great communicators. If nobody calls back, we just assume all their questions have been answered. If you have more questions, I'll bet that your veterinarian will be happy to discuss them with you.