Dermatology and Our Pets

Learning About Ear Infections in Dogs and Cats

Ever notice your pet having redness or itchiness around its ear? This is more common than you may think, in our lesson today we’ll be learning about some new terminology and the anatomy of the ear. We’ll also be recognizing factors that contribute to the development of ear infections and the changes that occur after an infection has taken place. Lastly, we’ll learn how to treat and maintain the treatment of an infection to keep your animal happy and healthy.

indoor orange tabby scratching ear
Getting that pesky itch.

What Causes Ear Infections?

First, we’ll be dealing with a word you all may be familiar with, Predisposition. If an animal is predisposed to ear infections, it means that they have the anatomy or behavioral signs that indicate an increased risk of infection before analysis. Inversely, a perpetuating factor occurs as a result of a root cause. Either of these can lead to the primary factor, the direct cause of the infection. Secondary factors are an infection that occurs during or after treatment for another infection. Yeast and Bacteria are great examples of secondary factors. These two are a part of a symbiotic relationship, meaning that they both help each other produce and spread.

What kind of Ear Infections are there?

Discomfort, inflammation, and infection are the words of the day. When your pet is feeling these abnormal signs, use it as an opportunity to get treatment or analysis from a qualified physician. Most of the discomforts your animals are feeling will be scientifically described with Latin names that’ll identify what part of the ear is being affected. Otitis- is a general term for the inflammation or infection of the ear, which is then followed by a Latin term that describes the location. We’ll be going deeper into how the location of infection helps pinpoint root causes and then suggest a sufficient treatment for the affected area. Let’s get started.

Otitis Externa: External Ear Infection

Surface-level infections are easy to identify and treat. Otitis Externa, for example, is an inflammation of the external portion of your pet’s ear, usually the ear flap. Luckily, 99% of external ear infections can be treated with topical therapy, a solution that is applied directly to the surface of the ear. In this case, applying different solutions directly to the ear-flap will help maintain different kinds of nasty bacteria and yeast build-up that can become the primary factor of their itchiness. It’s good to be on top of these types of infections as they are the number one insurance claim for pet parents. Though, by doing cleanings 1-2 times a week, you can help prevent Otitis Media (Middle Ear Infections).

Otitis Media: Middle Ear Infections

Inner-ear infections are often perpetuated by an external infection. Often through negligence or not knowing the hidden harm that waits in your pet’s head. Otitis Media is a deeper ear infection that tends to affect the ear canal or even your pet’s eardrum. External ear infections can increase the debris inside of a pet’s ear canal. This extra debris can lead to inflamed ear canals becoming too swollen and causing issues with the tympanic membrane, or as we all know it, the eardrum. These issues can lead to hearing loss, head tilt, nerve paralysis, loss of balance, or even a ruptured eardrum. Based on your animal’s cytology (Cell analysis), there are a few different vehicles that can get vital medicine 2-4″ into the ear canal. Ointments would be perfect for waxy exudate or suspension solutions for purulent exudate. Exudate is a mass of cells and fluid that begins seeping out of blood vessels or an organ, especially in inflammation. Doing even basic cleaning of exudate, or any nasty gunk in your pet’s ears before applying these solutions, can do nothing but good.

shepherd mix puppy and cat roll in the grass together


Hypersensitivity to the elements that surround our pets will lead to one of the most prevalent animal disorders, allergies. Also known as atopic dermatitis, allergies can be blamed for 65-83% of otitis in dogs. Weirdly enough, cats only really take up 7-20% of the spectrum. Solving your pet’s allergies can be quite the task. Beyond popular belief, there are no accurate tests for food allergens. So the best way to solve issues with allergens is to be present and analyze what factors are leading to the sensitivity. For example, try a limited-ingredient formula dog food with some kind of hydrolyzed protein– pre-broken down proteins that are too small to trigger a dog’s allergies, a novel protein– a meat source that is uncommon to your dog’s genealogy, or if you believe there is an influx of reaction with the season, you should take some notes and report your findings to a professional. The more informed you are, the easier it is for a qualified physician to prescribe a solution, this is a type of monitoring therapy. If all else fails you can ask your vet if they have an animal dermatologist that they would recommend. There is bound to be one in your area.

I have to See a Dog or Cat Dermatologist?

Otitis will not be solved with therapy alone. Sometimes you need to call in a Dermatology specialist to help find, eliminate, or maintain the underlying cause. There are no cures for allergies, so having a representative that can point you toward the safest long-term plan is your next safest bet. They can also provide Immunotherapy– an option for both older and younger pets that has a high success rate in treating an animal’s allergies, these still can result in flare-ups from time to time, but it is touted as the only true treatment for pet allergies. If you are attempting to do all of this at home yourself, be careful if you are attempting to give any injections at home. Pets should be very calm when given their injections. Dermatologists work with very fine needles so, if this is impossible in your case, oral options are available as well.


Otitis is a multifactorial disease, you or a specialist need to identify and correct all factors of infection. The short-term goal, when an infection is present, is to allow for a cytology re-check from time to time and then clean or treat any secondary infections that may be discovered. The long-term goal is to initiate an investigation into what is causing the clinical signs of otitis. Once you feel your pet is back to normal, know that your newly relieved friend, who now receives excellent care for allergic disease, can have relapses. So start from the root, try a topical solution, and attempt to maintain good ear health in a way that’ll work best for you and your bundle of fuzzy joy.

Q and A in word bubbles

Unanswered Questions for Dr. Tina Brown

Will giving a dog local honey help with seasonal allergies?

It is similar to the concept of immunotherapy, in mild cases it can be helpful but it may not be the correct allergens for that patient, or high enough doses to change the immune system. It would not be harmful but might not be as helpful.

Zymox is an ear cleaner that doesn’t recommend cleaning first. It’s enzymatic according to the packaging.

This is a product that binds to the debris, the difference is that’s Zymox’s method is more for a treatment than a cleanser. For cleansers, they are going into a dirty ear, so you want to make sure it’s cleaned out before treatment.

If a dog is excessively sneezing or sniffing, is this allergies or something else?

It could be allergies, it could be other things. Sometimes you see respiratory issues, it could be nasal parasites, or a small foreign body. I would check with your vet to be sure!

Thank you for your help. Can you explain a novel diet or hydrolyzed diet?

Novel- meaning a different unique protein. Like rabbit, kangaroo, or something like that. A hydrolyzed diet would be a common protein source like chicken, but they make the particle size so small that it doesn’t usually trigger the system.

We see a lot of pit bull type dogs come in with allergies. It’s common practice for “breeders” to separate the puppies from the mother and her milk at 6 weeks old. Do you have an opinion on whether or not this practice can contribute to allergies in the adult dog?

Not to my knowledge. Most of the time pit bulls are more predisposed to environmental allergies.

For an ear infection, my vet prescribed HexZole as a cleaning ear flush before administering EasOtic. However, when googling HexZole, I didn’t see anything about using it in dogs ears. Instead it says that it is used for cleaning wounds and skin infections. Is HexZole actually ok to use in my dogs ears?

HexZole is fine! The hex is chlorhexidine, and if it was prescribed by your vet, it should be fine.

When doing an elimination diet, how long would you expect it to take before seeing results to a specific protein/ingredient?

Usually, we’ll say it can take anywhere from 10-12, even up to 16 weeks. From personal experience, you start to see them trending in the right direction by 4-6 weeks.

My little girl has a sensitivity to potato and would grow yellow scabs when she eats potatoes. What type of allergy is this?

It could potentially be a hypersensitivity to potato. It could also be a minor skin infection. It may also be environmental. An allergy to potato is unlikely, but I would try to eliminate potato from the diet to see if you notice improvement.

Should we go grain free for allergies?

No, I would focus on proteins with elimination diet.

Our pure breed pit had cancer last year. Our vet told us it was because of overactive histamine. It is now back after being removed.

I wonder if your dog had a mast cell tumor, as they produce histamine. They can have recurrence of other mast cells tumors that need to be removed.

What is the best way to determine if a dogs head tilt is related to prolonged inner-ear issues and is it reversible?

That is a good question! Usually starting out with a basic otic exam if you’ve had a history of ear infections, that probably makes middle ear infection more likely. If not, your next step may be CT or an MRI, and a referral to a neurologist.

You said dermatitis is a common symptom of allergies… does it ever occur only in one spot like only on the snout, one leg, or is something else causing it?

Yes, it can definitely just be focal areas. Sometimes it may just be one foot. One of my dogs when he has a flare up, licks only his one back foot. When I give him his allergy serum, he stops licking that one foot.

My lab pit mix has brown gunk when he shakes his head. Is this a signal? It leaves quickly, is this normal?

If it’s excess gunk, if he’s not bothered by it – it could be normal. If he does scratch or shake his head, it is probably an indication of an ear infection.

Can there be other reasons for my dog frequently shaking her head other than an ear infection?

It may not necessarily be an infection, it may be irritation. It could potentially be a change to deeper structures inside the ear. I would see your regular vet to check on this.

Tina Brown, DVM, MS, Diplomate ACVD

Highlights from Dermatology & Our Pets: Vet Advice on Common Skin Conditions, Such as Allergies and Ear Infections

Allergic Symptoms in Dogs and Cats

Scratching is typically the first symptom we think about with allergies. For dogs, if they scratch toward the back portion of their body, it could be fleas. With dogs that have red paws, itchy ears, or a red face, the allergy might be environmental.

Short coated dogs can have lesions that look like small areas of hair loss with scales. With bacterial infections, short coated dogs have patches of skin loss.

With long coated dogs, dry, flaky skin can be an active skin infection. You must part the hair to get a closer look at the skin.

Recurring ear infections are also common with dogs. They range from mild to very severe with a lot of bacteria and inflamed ears. Ear infections are associated more commonly with food allergies or bacterial infections rather than fleas.

With cats, they can lick and chew their feet just like dogs. Cats can also have ear infections. This is often the only physical manifestation of an allergy.

Diagnostic Plans and Treatment

You always want to rule out other causes, and then treat for secondary infections. Treating secondary infections will often help alleviate allergic reactions.  A skin scrape is usually the first diagnostic test. A skin scrape can diagnose mites, either scabies or demodex mites. Scabies are contagious and difficult to see in a skin scrape while demodex mites are not contagious.

Another test your vet could utilize is a flea comb to look for flea dirt that would indicate your pet has fleas. A trichogram can be used to examine cat hair and determine whether cats are overgrooming which can indicate an allergy. A Woods lamp also helps rule out ringworm, as well as a ringworm culture. A skin or ear cytology helps determine if there’s yeast or bacteria overgrowth.

Bacterial Skin Infections

Antibiotic resistance does occur. With a skin infection, you’ll want to have your pet on a minimum of three weeks on an antibiotic treatment. Previous antibiotic treatment does increase the risk of resistance. If your pet does not respond to treatment appropriately, your veterinarian will want to prescribe a different antibiotic.

Ear infections

There’s always an underlying cause for recurring ear infections, such as a food hypersensitivity or flea allergies. Chronic ear infections can result in your pet needing ear surgery so it’s best to seek treatment early to avoid surgery.

A young ginger tabby cat on the wooden floor.

Allergies or Atopic Dermatitis

The immune system overresponds to allergens such as indoor or outdoor allergens and food sensitivities. Allergy patients tend to have a different skin barrier that allows them to absorb allergens more than dogs without allergies.

Food hypersensitivity can look identical to environmental allergies but are not seasonal. It can occur at any age and is usually not associated with a change in diet. The dog must eat the same food for 1-3 years before developing sensitivities. An elimination diet is the best way to determine a food sensitivity because, unfortunately, allergy testing still is not accurate for food sensitivities.

84% of atopic dermatitis in dogs is mostly indoor while 24% is seasonal. Allergy testing can be used to identify the offending allergens.

Symptomatic Therapy: Antihistamines

Antihistamines can be effective in very mild cases. These don’t typically help for really allergic dogs and cats, and they don’t work right away. They usually take several weeks in order to provide relief.

Symptomatic Therapy: Steroids

Steroids work very quickly but over time lose effectiveness, and there is an increased risk of side effects like Cushing’s disease and diabetes. Therefore, steroids are safest in most patients for short term use at the lowest possible dose.

Symptomatic therapy: Apoquel/Cytopoint

Each medication blocks one mediator in the itch pathway. They are not a steroid and can provide immediate relief. Apoquel is not as specific as its target so there is a contraindication in the label with a history of cancer or severe infections. The advantage to both medications is that they don’t interfere with intradermal allergy testing. It is important to remember that neither of these medications should be a replacement for diagnostics such as a skin scrape.

Atopic Dermatitis

In the past, treatment to atopic dermatitis has been reactive. However, it requires an integrated approach. There is no quick “cure” for allergies, so you must find the safest long-term plan. This often requires pet parents to seek out a specialist to identify short-term and long-term goals. Allergies typically get worse every year, so a plan going forward is needed to keep the reaction under control.

Allergen specific immunotherapy is the only treatment option that does not suppress the immune system and can provide long term management. Intradermal skin testing tends to be the most accurate versus blood testing because it is more specific.

Allergy testing can be done in both dogs and cats. Most are a combination of grasses, weeds, trees, and molds. Unfortunately, you can’t completely avoid these allergens. The allergy serum is formulated and will be specific to each patient.  This is the safest, most affordable option for long-term management, especially if the pet has a history of cancer or some other underlying disease.

Dr. Brown’s Responses to Unanswered Questions from Class

Should you blow-dry the dog if you are bathing them daily due to allergies and using medicated shampooing?

I would say, it’s fine to blow-dry if they will tolerate it. But I wouldn’t use high heat to avoid excess itching.

What shampoo can I use with my cats to help with their itch as they over groom?

I would suggest any type of oatmeal or medicated shampoo, if it’s labeled safe for cats. Always, investigate the underlying cause if both cats are itching. Be sure they are on flea control to remove any external parasites as well!

What about allergies and continuing anal gland issues? I’ve had several dogs with allergies, and they all have seemed to get very full anal glands quite quickly. Is there a connection, and is there anything we can do to help the anal glands specifically?

Anal glands could potentially be related, because if the skin is inflamed, the anal glands could also be inflamed. If the pet is scooting or licking the area often, it could stimulate the area. I would recommend an allergy work-up to determine the cause.

I’m curious how allergies tie in to SLO (symmetrical lupoid onychodystrophy). My mother’s Greyhound has it, and I’m wondering if environmental or food allergies that are untreated can be a contributing cause to his SLO flares (which result in him losing a nail at random).

There have been some cases of SLO that have been related to food hyper-sensitivity, but that is not always the case. Many dogs have SLO with no underlying primary factors. Greyhounds are predisposed to this disease and will require, to some extent, lifelong therapy such as pentoxifylline or doxycycline /niacinamide. Fatty acid and Vitamin E supplementation may also be helpful if the patient continues to have problems. On these meds, you can also consider a food trial.

Is there a copy of this webinar for notes?

We will have the recording available for today’s session on this same website ( by next week.

My dog has ear infections, hot spots, warts on the paws. I recently got her tested for allergies, and she is allergic to EVERYTHING. What do you suggest for long term feedings? I have gone to preparing my dog meals. She is an American bulldog.

Many dermatologists feel like a homecooked diet is the best option to eliminate food hypersensitivity. I would contact a board-certified nutritionist to design a diet specifically for your pet if homecooked meals will be fed long term. This is to ensure the diet consists of the proper balance of vitamins and nutrients that your dog needs.

Is it dangerous to give hemp oil to my senior dog?

I would need to know more about this pet. I wouldn’t feel comfortable making a recommendation without knowing more about this pet & their needs.

My 10-year-old Yorkie has developed what the vet called papilloma.  She recently had an ear infection and after the treatment, she got these places all on her spine (primarily).

Multiple types of masses can occur as pets get older, some are benign and cosmetic – while others can be more serious. We usually recommend a fine needle aspirate and cytological review and removal if indicated.

Any information on tear staining? Our dog does not itch, and ears are fine but lots of tear staining.

This is a common problem in certain breeds. This may be a better question for a veterinary ophthalmologist.

In your profession, have you noticed general care vets turning to Apoquel and Cytopoint to just “treat the symptoms” instead of actually trying to determine the cause of it? I hear this a lot and have experienced with my own dog. I have been to multiple vets in different cities, and I always just get a prescription for Apoquel every single time, no matter the problem, with no care or explanation as to what it could be.

I think the veterinarian’s goal is to make your pet feel more comfortable. However, those things don’t treat the underlying problems. So it is important to do skin scrapings & cytologies.

Is a mouth swab allergy test accurate?

We do not believe mouth swabs or hair allergy tests are accurate currently.

Does Hollywood Feed have a natural product that includes vitamins, minerals, herbs & supplements like others you see on TV (that you sprinkle on their food) that work well in slowing the itching & really helping with their bones & tendons where they can walk & get around better?

Prudence Immune Health and Prudence Hip & Joint both contain natural ingredients including vitamins, minerals, and herbs. We see fantastic results from both of these supplements.

We have a topical itch relief spray with lidocaine. Is this safe to use on paws, if the dog is prone to licking their paws?

Lidocaine and other topical anesthetics such as Pramoxine are safe to use topically, but they may not be enough to reduce the itch.

With the scooting of the butt on the rug, what do you suggest for ease of comfort?

I would recommend following up with your vet. Consider these questions: Do the anal glands need to be expressed, and is the area itchy due to yeast or bacteria that might need to be treated?

My dog was tested at Dr. Brown’s office, but it’s been 2+ years since he has been on the vaccine, can he resume without retesting?

If we were doing well on immunotherapy before, we may not need to retest in order to resume the serum. We understand life happens, and it’s hard to follow up with the treatment long term. If the serum was discontinued because you feel like it wasn’t working, we can repeat allergy testing to identify new allergens. Contact Dr. Brown’s office for options!

I have a papillon that was diagnosed with PLE 4 years ago and has developed allergies and chronic ear infections more and more in the last couple of years. Most recently we used a different ear drop with an infection and she went deaf. She can’t really stomach steroids anymore and we’ve tried the Cytopoint shots. Do you have any recommendations and anything at all that might bring her hearing back as well as good shampoos or topicals to use during skin infections and itchiness?

More than likely the ear infections & skin infections are due to allergies. Even with PLE, you could pursue an allergy work-up such as intradermal testing. That would be a safe option with the current medications. Without knowing more about the medication used for her ears, I can’t comment on regaining hearing. There is a hearing test, but I would start with an Otic Exam.

What is a good shampoo to use?

If they are prone to skin infections, I would suggest a medicated shampoo. If not, a general shampoo labeled for pets would be fine to use.

I have a Shepherd Corgi mix with hot spots, dark skin spots, and crusty areas. Is fish-based food the best to change to? He is on Just 6 (turkey formula), and he is hypersensitive at springtime. Also, he has paws that lose hair and are itchy. He sneezes and does this weird cat cough. Vet keeps saying its allergies and we tried Apoquel. He responded badly to it after 3 weeks on it, with aggressive tendencies. He has been trained; the medication just made him unruly, so we took him off, and he’s back to normal).

I agree that you have some level of environmental allergies because you’ve noticed seasonal flares. It sounds like he has an active skin infection with the crust and dark spots. This may be why other symptomatic therapies have not helped. It’s a rare side effect, but I have had patients have changes in their behavior while taking Apoquel.

What should I look in a medicated shampoo and conditioner or sprays?

For medicated shampoos, I often use a 3-4% chlorhexidine. For a lower concentration of chlorhexidine mixed with an antifungal such as miconazole. Some pets can be hypersensitive to chlorhexidine. In those cases, I might use a benzoyl peroxide product for antibacterial properties.

I have a light golden who has significant bronzing on the cheeks, under ears, tail and paws but does not scratch nor lick. He does also have significant dark brown almost black goopy debris in the ears that I clean out frequently.   Anything else that can cause this bronzing? Is ear and skin cytology the best first step?

I would say ear & skin cytology is the best first step. It sounds like you may have mild allergies. Some patients that are very low level of itch and frequently lick can have significant bronzing, and others that lick their feet all the time can have no bronzing. For the ears, your pet may be making excess waxy debris, but if you don’t have an ear infection associated with it, continuing to use an ear cleanser to remove excess debris is a good idea.

My baby is on Cytopoint and Ketoconazole. What are some great topical items? My dog gets super smelly, like rancid smelly. We are bathing 2-3x a week.  There’s a waxy build up on the skin, and you can see it washing away. Baths sometimes relieve the itch and the stink and waxy build up can be back within a day. No ear infections, itch on the face, sides and paws, loss of hair at the paws and around the eyes. What does the waxy build up and smell tell you?

The waxy build up and smell tells me that the glands of the skin are inflamed and overproducing substances. We often see this with allergy patients. You are doing a good job with topical therapy. And I would use the medicated shampoo twice a week up to every other day. Treatment of the underlying allergy such as allergy testing and desensitization may help the problem more than Cytopoint. Cytopoint only helps the itch associated with the allergy.

I have a Husky about 1 and 12 years old and a small Chihuahua. The small dog licks the ear of the husky, and the husky has developed a reoccurring ear infection. What do we do?

The dog that is licking the other dog’s ear is not a primary cause. The husky is presenting signs of ear infections, but the infections are not being caused by the other dog.

Can i give my dog Apoquel and Zyrtec in the same day?

You can give these medications together.

Our dog (5 yrs) seems to have seasonal allergies – late summer fall itchiness started at 2 years old.  Two years she’s had minor skin infections between toes and abdomen.  Have cleared up with antibiotics from the vet.  Her allergies are fairly “under control” between using a prescription medicated shampoo weekly or more on feet and Benadryl all fall season. We start that when she begins itching in July and August and stop it usually in November.  We live in Iowa so with fall season she still is itching but this year and last is not developing skin infections or more severe things that we can tell.  Would you recommend keeping this approach as long as she isn’t severely symptomatic (still feel bad for her with itchiness) or is it worth trying one of the newer allergy medicines?  Not sure if it’s worth the potential side effects or unknown risks since they are “newer”.

I think you’re doing a great job managing her allergies with topical therapy and antihistamines. It sounds like the allergies are still mild. If she has an acute flare up and is uncomfortable, it’s not wrong to reach for new medications and therapies. If her allergies escalate and you’re having to get these medications on a regular basis, I would contact a local dermatologist for a work-up.

Since I’ve had blood allergy panel and still having issues mentioned above that you addressed, should we have intradermal test to get more specific?

If you have had the blood allergy panel and immunotherapy was not helpful, I would consult with vet to see if intradermal allergy testing would be your next step.

How often can I give Chlorpheniramine on a daily basis? The bottle says 2 – 3 times a day but I have heard long term it can cause organ issues. Also, how long does it take to start working?

We think that antihistamines are safe 2-3x times a day. We usually recommend giving these medications up to 2 weeks to determine if it’s beneficial or not.

If a dog has chronic yeast infections, ears or skin, will a low glycemic diet be beneficial E.g. raw frozen, Zignature or Country Naturals LID?

There is not a correlation between glycemic index and yeast overgrowth. I would focus more on avoiding any potential food hypersensitivity.

The cat I have was feral and has now become a pet. She has anxiety but now has bumps on her neck and is losing fur. All my cats are on flea, lice and mite meds. We tried changing her diet, but nothing has help. We can’t get her to a vet because she will not get in a carrier. I also cannot get a vet to do home visits. Do you have any advice of what meds to try or food to give?

If all the cats are on good flea control, it’s likely that you do have food hypersensitivity or environmental allergies. You can try an elimination diet with novel proteins. If you tried this in the past, it’s likely environmental. I would continue trying to look for more home veterinarians.

My dog has what the vet calls warts. Do they need to be removed or how can I treat them when they open? He has them on his feet, back, and neck.

If the skin masses are benign, they do not need to be removed. But if they are bothering your pet and becoming itchy or bleeding, they may be removed by something like a punch biopsy or a surgical removal.

EFAs and fish oils are recommended for skin and coat health.  With the warnings of heavy metal toxins, how do we choose a safe supplement?

Look for essential fatty acid supplements that are available for pets.

Would you suggest Betadine or Eqyss Antimocrobial shampoo for a regular weekly washing?

I would have to know the percentage of betadine to be sure it wouldn’t irritate the skin. I am not familiar with Eqyss. It seems like it’s formulated for horses. If this is for a cat or dog, you would need something that is formulated for them.

What is your biggest struggle when it comes to food elimination trials? What suggestions do you have that may help ensure owner and patient compliance?

One of the biggest struggles is if the patient is on oral medication and finding ways to give the meds using a treat that does not go against the trial. Also, making sure that everyone in the household is on board with the food trial.

Have you seen a correlation between dogs with atopic dermatitis with over-stimulated immune systems who have also been over-vaccinated (i.e. more than what’s recommended by AAHA protocols)?

I have not seen a correlation between these two things.

What is your opinion on Dinovite?

I don’t have a lot of experience with it. I have had some clients report to me that it didn’t work well for them, but that may be because those were extreme patients.

Which topical anti-itch medications do you recommend? I’ve been tempted to use hydrocortisone cream or betamethasone cream, but I’m afraid my pets will lick it off. Also, which medicated shampoos can help eliminate itching? Dogs are already on Apoquel and Zyrtec.

We do routinely use topical steroids, and minimal ingestion is usually okay. I would start with hydrocortisone. I would use sparingly on areas where the skin is thin like the abdomen.

Are Bichons predisposed to environmental allergies? What about food allergies?

Yes, this breed is definitely predisposed to environmental allergies. Food allergies are common, too.

How long should you keep your dog on Apoquel?

We use this medication to keep patients comfortable, but I would avoid chronic, yearlong usage of the medication.

Which non-prescription topicals do you recommend?

There are some over the counter promaxine containing and hydrocortisone containing topicals that could be used to spot treat those areas. However, speak to your primary veterinarian first.

What medicines are in “medicated” shampoo that help with infection resolution and itching?

 Most common antibacterial agents are chlorhexidine and benzoyl peroxide. For yeast, it’s miconazole. There are other meds that work by changing PH of the skin that help keep bacteria & yeast growth minimal.

Do you believe early weaning for a puppy can cause allergy symptoms later in life due to not receiving enough mother’s milk? In Memphis, we see a ton of bully breeds that were weaned and sold too soon. We almost always deal with itchiness and sensitivities as the puppy grows into adulthood.

I don’t know if there is any consensus on how age of weaning affects predisposition. However, bully breeds, especially in Memphis, are often predisposed to allergies.

One of my cats chews the fur on his legs and tummy. There is no redness on his skin. Is it allergies or stress?

More than likely allergies.

What kind of flea prevention works best?

This is individualized based on the pet and the household. I would need more information.

Will supplements for skin, like Omegas, help the skin defend better against allergens?

There are some studies that show that it can help provide anti-inflammatory mediators. However, in very severe allergies it may not be enough to completely alleviate a problem.


german shepherd bites paw outside

Does Your Dog Have Dry Skin?

You’ve noticed your dog has dry, flaky skin. If you’re able to rule out parasites like fleas or biting lice, which can cause excessive scratching, or mange, which can lead to dry, inflamed skin, you can try to incorporate a skin and coat supplement or switch to a fish-based food to see if either improve the quality of your dog’s skin over time. Since dry skin can be indicative of an underlying health issue, if the problem persists, it’s best to take your dog to the vet to eliminate possible concerns.

What Causes Dry Skin on Your Dog?

Your dog’s dry skin could simply be caused by the environment. Just like with humans, cold weather causes dry skin in dogs. Warm environments can also dry out your dog’s skin.

Do you give your dog a bath every week? Bathing your dog too much can also contribute to dry skin. No matter how gentle a shampoo you use, the moisture in a dog’s coat is depleted with each bath, especially if you are using human shampoo. Be certain you use a shampoo and conditioner designed for dogs to reduce the risk of dry skin and decrease the frequency of the baths you give.

In some cases, dry skin can indicate nutritional deficiencies. Adding more omega-3 fatty acids may be necessary to combat dry skin in this circumstance.

Allergies or environmental factors can also play a role in skin issues. If your dog’s skin is dry and inflamed or red, this may be the case. Adding a fish oil supplement could alleviate dry, red skin but a trip to the vet for prescribed allergy medications is necessary if your dog needs immediate relief from constant scratching.

There are underlying health issues associated with dry skin that would also require veterinarian assistance. Autoimmune issues or hormonal imbalances can result in dry skin. Your vet can help narrow down to these issues with testing and hopefully rule any serious issue out.

Supplements for Dry Skin

To combat dry skin, try adding Prudence Skin and Coat or Brilliant Salmon Oil for increased omega-3 fatty acid intake, which is a strong anti-inflammatory. They also help maintain the health of your dog’s skin and coat on a molecular level. Both supplements are in liquid form. You simply squirt a drop (or more depending on your dog’s size) on top of your dog’s food. They typically love the taste too.

You’ll want to try skin and coat supplements for a 60-day period in order to be able to notice the benefits. If for some reason the dry skin persists after trialing the supplements and your vet has ruled out any of the serious underlying issues like an autoimmune disorder, try switching your dog’s food to a higher quality food. Or if you’re already feeding a high-quality dog food, try changing the formula to incorporate a different protein. Any of our Feed Team members will be happy to help you select a new food for your pup!

itchy dog biting leg, thinning hair

What are Food Allergies and How Do I Stop Them?

When our pets have food allergies, it can be very frustrating for pet parents and for our dogs and cats. We don’t want our pets to lose hair, itch, and develop hot spots from excessive licking, and neither do they. But, where to start? There are so many foods on the market, so many ingredients to consider, and there are always conflicting opinions. There is also a lot of confusing information and marketing about what we should be feeding to our dogs and cats. I’m going to break down food allergies and solutions for you right here!

What is an Allergy?

An allergy is an inflammatory response to food, grass, dust, pollen, flea bites, etc. that causes an allergic reaction, or symptoms, that drive humans and pets crazy. Common allergic reactions are expressed through inflammation of the skin, which leads to itching, redness and hair loss.

An allergic threshold is the point at which we start to physically manifest symptoms. When allergens stay below that threshold, our body manages them well and symptoms are not expressed. Take a look at this chart:

The actual numbers on the chart are arbitrary and appear only to give scale. The yellow line would be the point at which these dogs begin to experience symptoms from the allergens listed in each column. As we can see, depending on how allergic our dogs are to each allergen, we can reduce the occurrences of allergic reactions by simply reducing the amount of contact our pets have with them. It is not necessary, or probable, to completely eliminate most allergens.

In addition, the more natural antihistamines, digestive enzymes and anti-inflammatories we introduce to our pets, the higher their allergic threshold will go and the less likely they’ll be to have symptoms manifest.

It is also important to remember that hypo-allergenic does not mean non-allergenic. Instead, hypo-allergenic means less likely to cause an allergic reaction. Advertisers love this word, so we should make sure we know the definition!

Questions To Consider When I Think My Pet Has an Allergy:

Have I tried an elimination diet with my pet to determine potential allergens?
To what ingredients do I suspect my pet is allergic?
What are the symptoms my pet experiences?

What is an Elimination Diet and Why is it Necessary?

An elimination diet is used to determine food ingredients which our pets can tolerate and isolate ingredients which we should avoid.

The most important thing to consider when feeding an elimination diet is that we must avoid ALL ingredients which are not part of that temporary diet. An elimination diet can take 12 weeks or even longer, but the results are very trustworthy and the cost is minimal compared to other less effective methods of determining allergens.

Before We Begin an Elimination Diet:

  • We need to isolate the primary ingredients in our pet’s food down to 2: one meat and one carbohydrate.
  • The selected protein and carbohydrate sources should be something which we can be relatively certain is not causing the problem.
  • I prefer to select protein sources with which our pet has had minimal contact. Some options include: pork, bison, turkey, duck and kangaroo.
  • Some great carbohydrate source options include: sweet potatoes, lentils, tapioca and garbanzo beans.
  • Other ingredients in the food should either be a healthy fat source, such as: fish oil, coconut oil or olive oil; or a simple vitamin or mineral supplement which should contain little to no allergic potential

Let’s Begin:

  • Now the diet we have carefully chosen should be fed as the sole diet for our pet. This includes any dog treats or table scraps we feed our dogs or cats. Absolutely nothing else!
  • We should observe our pets for an increase or decrease in symptoms. If symptoms begin to improve, then our pets should remain on that diet for up to 12 weeks or until the symptoms have completely subsided. If symptoms begin to worsen, it’s time to abandon one of the two primary ingredients and replace it with a different novel source.
  • It’s important that we only replace one ingredient at a time and then make note of the dates, ingredients, and any noticeable changes or benefits in our pet’s response.
  • We should continue to rotate through ingredients until we find a combination that drastically decreases or completely eliminates any symptoms.
  • At this point, we can start adding one ingredient at a time to your pet’s diet, in the form of treats or other similar pet food formulas, all the while taking note of your pet’s responses to each ingredient.
  • This is how we figure out, one by one, which ingredients our pets can tolerate.

Tell Me More about Ingredients

A true food allergy is caused by a protein. Almost all food items contain some form of protein, but many food items have a much higher percentage of protein than other food items. For example, a dog can be allergic to carrots. This is because their body recognizes the proteins found in carrots as a threat and will try to eliminate it from the body. This is why blood and skin tests done at veterinary offices will often return positive allergic responses for foods such as carrots, flax, potatoes or other produce. The problem with this classification of allergic reactions is that they typically fall well below the allergic threshold we discussed earlier, and probably do not need to be eliminated from our pets’ diets. When we are deciding on food for our dog or cat who is displaying allergy symptoms, we should avoid all foods containing beef, wheat, chicken and soy. These are the most common food allergens. Wheat and soy, while being grains and not meat, still contain a high percentage of high allergen proteins.

To replace those very common pet food ingredients, we should instead look for the novel ingredients we spoke about earlier: rabbit, duck, pheasant, kangaroo, and bison, all of which are commonly available in pet food. Again, good novel carbohydrate sources include sweet potato, tapioca, garbanzo beans, and lentils.

*Remember that any consumed food items can potentially trigger a reaction, not just our pets’ primary diet. We should be sure not to feed our allergic pets table scraps or treats which contain any of the most common allergens. Especially while we are doing an elimination diet to determine the source of our pets’ allergy. Most of the treats sold in grocery stores contain wheat, soy, beef or all three. Additionally, something as simple as the crust from a slice of white bread can set off a dog with severe allergies.*

What Are Some Brands to Consider?

Hollywood Feed carries many diets great for pets with allergies and for trying an elimination diet in all of our stores. The brands below have novel ingredients as well as high levels of natural antihistamines and anti-inflammatories. A few of my favorites are: Answers Pet Food, Orijen, Acana, Fromm, Holistic Select, and Natural Balance, which all have hypo-allergenic formulas. Also, the most common food allergens such as beef, wheat and soy are absent from the majority of the formulas and brands that we carry.

What Else Should I Know?

Finally, I should point out that food isn’t the only thing that can cause an allergic reaction, it’s simply the easiest to manage. Grass is another very common allergen, but because there’s virtually no way to escape it, we should minimize exposure. But we also need to be realistic about dogs being dogs. By eliminating as many other allergens from our pets’ lives as possible, we can most likely bring them under the allergic threshold to a point of comfort.

For an outline on skin/allergy disorders as well as some of the best nutrition available, watch and read: Dermatology and Our Pets, Cats, Dogs and DermatologyI Have an Itch that Needs Scratching and Solve 90% of Pet Health Problems through Answers Raw Nutrition .

dog getting a massage

What Should I Know about Acupuncture and Rehabilitative Care?

Last week, Hollywood Feed employees had the chance to learn about acupuncture and rehabilitative therapy from Dr. Kathy Mitchener, who is with the new facility Angel Care. Angel Care provides holistic and natural healing for pets and they are located at 1017 Oakhaven, Memphis, TN 38119. The phone number is 901-385-9172. They have some exciting treatments to check out!


A wonderful service that Angel Care offers is acupuncture! Acupuncture has been around for thousands of years. This is not some new trend that started recently. Part of the mystery surrounding acupuncture and it’s effectiveness is that it comes from ancient China, and when Western doctors are exposed to treatments they don’t understand, they tend to dismiss them despite the supporting evidence.

How It Works

The way acupuncture works is that a pin (or multiple pins) is stuck into a specific part of your body to stimulate specific nerves. The nerves receive this stimulation, and go running to the spinal cord with this message, and then the spinal cord carries the message to the brain. The brain then analyzes what is happening and sends a signal back out telling the body to decrease pain in the areas in question. This is called neuromodulation.

Neuromodulation is a way to modulate pain, but not a cure for the disease causing the pain. Acupuncture works in a way similar to aspirin, which helps to lessen pain as well. The main difference is that aspirin can have side effects while acupuncture has none. Acupuncture, in combination with exercise and diet changes for your pet, can be really great for maintenance of pain and extending your pet’s quality of life without lots of medications and their side effects. There are no medical risks involved with acupuncture if it is used hygienically, but it may help stimulate labor, so you may not want to use it on a pregnant dog or cat (or human!!).

Acupuncture Can Be Used to Treat

  • Allergies
  • Anxiety/aggression (if caused by underlying pain issue)
  • Arthritis
  • Compensatory pain
  • Degenerative disc disease
  • Hot spots/other self trauma
  • Immune system failure
  • Intestinal issues
  • Nerve paralysis
  • Nervous system pain
  • Organ failure
  • Pain from ANY other cause
  • Seizures
  • Sleeplessness
  • Stroke
  • Weakness
  • Many other problems

Dr. Mitchener said that about 15% of dogs don’t respond to acupuncture in the first few sessions, but given more time there is a chance they will be responsive. She has also been able to use acupuncture on cats with long, soothing sessions to calm down the cat’s nerves!

Rehab Services

Another service offered by Dr. Mitchener at Angel Care is rehabilitation. Rehab can be used alone or in combination with other treatments to help dogs lose weight, to help train agility dogs, and to help with difficulty walking and running. Some of the physical rehabilitation services offered include manual therapy, stretching, movement, balance, conditioning, and core strength. Dogs get to “play” with wobbly toys and blow up toys and work through obstacle courses to help with their rehab. Dr. Mitchener and her team use positive reinforcement through treats and praise to get your dog to do the hard work!

An exciting part of the rehabilitation services offered is Angel Care’s underwater treadmill! Dogs have a lot of fun using this, and the water helps to take the dog’s weight off of his joints so he can move around much more easily and start to use body parts that he has not been working as much due to pain. And dogs really seem to love it!!

Underwater Treadmills Can Help With

  • Arthritis
  • Conditioning
  • Degenerative Myelopathy
  • Paralysis
  • Strengthening
  • Surgical recovery

Other Services Available

  • Laser therapy
  • Massage
  • Herbal and nutritional treatment

Another great feature of Angel Care is that the clinic offers a calm and quiet space in which they will treat your pet. Dr. Mitchener said that their appointments take longer than at other facilities, simply because they want to try to make the dog feel comfortable in his surroundings before jumping right in with treatment. Most sessions also take place right down on the ground where your dog is most at ease.

long haired chihuahua scratches face on white background

I Have an Itch that Needs Scratching

Wondering Why Your Puppy Might be Itchy?

Unfortunately the list of possible reasons for a puppy to have itchy skin is practically endless. However, the following reasons are some of the more common causes that we see:

One. Puppies do quite a lot of growing at that age and their skin stretches to accommodate that growth. To some degree, this or general puppy acne could be the reason. Feeding a diet high in omega-3 fats (like fish or duck) might help to condition the skin. There are also many other health benefits associated with diets high in omega-3 fats. It reduces inflammation, helps to maintain hips and joints, and the DHA in it helps puppies learn and may prevent senility in older dogs.

Two. Your pup could be suffering from a food allergy or environmental allergy, or both. Unfortunately, it’s difficult to determine what particular allergen might be causing the issue as even allergy tests are fairly inaccurate. If you can eliminate some of the more common ones, you might see a drastic reduction in itching. In terms of food allergies, the most common are beef, dairy, chicken, wheat, soy, and corn. Try switching to a diet that doesn’t contain any of these items. And you could try bathing in a pet shampoo to rid the skin of environmental allergens like grass, pollen, dust, dust mites, etc. One of my favorites is Vet’s Best’s oatmeal and tea tree oil shampoo.

Three. Another, and probably most common, cause of itching in dogs and cats is flea bite dermatitis. Even though you might not see any fleas on your pup’s skin, all it takes is one flea bite to trigger a reaction for which the animal may suffer for weeks. I am all too familiar with flea bite sensitivity myself as I have a rescue that suffers yearly. I’ve found that it helps tremendously to use a topical flea preventative that actively repels and kills fleas just through contact. I use Advantix II (which is safe for pups seven weeks and older) and Advantage Multi with heartworm preventative. Oral flea medications (as well as several of the topical types) will only kill fleas once they have already bitten your pet and ingested the chemical circulating in their blood stream…which doesn’t really do a pet with flea bite sensitivity any good at all.

Remember that using antihistamines and steroids can have both short and long term side-effects and will only cover up your pet’s problem. While they may help a pet with severely itchy skin get some temporary relief, they will never resolve the problem completely or permanently. They may even exacerbate the issue by suppressing your pet’s immune system.

No one can say with 100% certainty that doing any of these would solve your puppy’s itchy skin issue, but any one might help and is worth checking into. They certainly couldn’t hurt. If possible, bring your pup into one of our stores so that we could get a look at him or her. We enjoy meeting our clients and watching them grow, and a face-to-face might help us determine what exactly is going on with your pet. Bring in any food or treats you might be feeding as well. We’ll gladly check them for anything that might stand out as a potential problem. Sometimes we end up suggesting that you take your pet to a veterinarian, but sometimes we can help.