Mastiff with Pyoderma

Question
Hi there. Thank you for reading my question. Brutus is a 5yr old English Mastiff and he belongs to my fiance. He has been sick for a month now. He has what I found to be all the symptoms associated "pyoderma," (rashes/lesions on entire body, pus-filled pimples/pockets, crusting/scaling of skin, hair loss, excessive drinking, involuntary urination, etc.) I realize that pyoderma is the secondary symptom or result of something else that must be going on inside him, ie. some other infection or bacteria problem or even a hormonal or thyroid issue. What I am most concerned about is that our vet has yet to figure out what the original cause of his pyoderma is from. My fiance has already spent a grand on the vet bills and so on. The dog is on prednisone, antibiotics, and various supliments like fish oil %26 vitamin E. The vet has taken samples of Brutus' blood %26 urine; and a thyroid result is coming back to us this week...To make matters worse, a fellow mastiff owner had a dog, coincidentally also named Brutus, who had the same pyoderma reaction, and his vet (a different one than ours) never found out the original cause either and the dog died within 2 months time. They still don't know what happened. I am desperate to cure our Brutus since he has already lost 15 pounds, even though he is still eating %26 pooping regularly. What should we do? I feel like our vet doesn't have a clue what's wrong with our dog and it will cost him his life if they don't figure it out soon! Thank you again for reading this. Take care, Lauren

Answer

Hi Lauren,

Did your regular vet do smears of the pustules, or crusty areas to give you the diagnosis Pyoderma? And are you dealing with surface, superficial or deep pyoderma?

The most common underlying triggers of pyoderma include fleas, flea allergy dermatitis, atopy (contact and inhaled, chronic hypersensitivity disorders that are often inherited), food allergy, hypothyroidism, hyperadrenocorticism, or seborrhoea. Appropriate diagnostic testing and treatment of underlying triggers is mandatory. The most common causes of recurrent bacterial pyoderma include failure to identify an underlying trigger, antibiotic undertreatment (dose too low or duration of therapy too short), wrong antibiotic, or wrong dose. It's also possible that the exact cause will never be known, and the best you can do is to treat the symptoms. It's also possible that if the condition is treated successfully, that it will be recurrent.

Antibacterial shampoos that contain benzoyl peroxide, chlorhexidine, chlorhexidine-ketoconazole, ethyl lactate, or triclosan can be very helpful. Dogs with superficial pyoderma should be bathed 2-3 times a week during the first 2 weeks of therapy and then 1-2 times until the infection clears up. Dogs with deep pyoderma may require daily baths. Medicated shampoos should be pre-diluted 1:2 to 1:4 prior to application to help facilitate lathering, dispersal, and rinsing. Shampooing will remove bacteria, crusts, and scales, as well as reduce the pruritus, odor, and oiliness associated with the pyoderma. Clinical improvement in superficial pyodermas may not be evident for a least 14-21 days.

You've said Brutus has been sick for a month, but how long has he been on antibiotics? The primary treatment of pyoderma is with appropriate antibiotics for 21 (as a minimum) and preferably 30 days. With this condition it matters which antibiotic is used. Amoxicillin, penicillin, and tetracyline are inappropriate choices for treating superficial or deep pyodermas because they are ineffective in 90% of these cases. If Brutus has received any of those antibiotics you need to ask the vet to give you another medication.

If you don't have confidence in your current vet (and even if you do) with a difficult case, it's helpful to have the dog examined by a specialist. Even though you know somebody with a dog that had the same condition, that is a coincidence and doesn't mean that Brutus can't be helped. Your regular vet should be able to give you a referral to a veterinary dermatologist, or you can locate one here:

https://www.acvd.org (click on "find a dermatologist" from the menu on the left side)

I hope I've been a help.
Best of luck,

Patti