Expert: Dr. Louis N. Gotthelf - 2/28/2008

Question
Dear Dr. Gotthelf,

A couple of weeks ago my almost-10yo lab/beagle’s only health issue was a stiff back right knee from an injury several years ago.  Then during this past Valentine’s Day he slipped during an ice storm and did a split.  For a few days we thought his difficulty walking was from that, and I called a vet to exam him.  That appointment was this past Monday.  

In between the phone call and the appointment I then noticed that the spaces between his paw pads were very red and inflamed, and that he was constantly licking.  Also about a month ago his elbows started looking very raw, and lately we noticed he was really smelly, but because it’s winter I decided I couldn’t give him a bath.

After the exam the vet told me that he thought my dog had Lupus, or a similar autoimmune disease.  I don’t have, nor can I get, $600 for tests, but the vet seemed to think it was pretty obvious.  Besides his sore feet, my dog had lesions on his side and up in the crease between his back legs and torso; that infection is where the smell is coming from.

He is on Prednisone and Cephalexin for the next month, at least, starting this past Monday, February 25th.  His paw pads are looking a little better, however he is getting weak in the back legs.  I’ve read some things on the Internet that suggest Cephalexin can cause that weakness in some dogs.

As you specialize in dermatology, can you give me some suggestions for antibiotic treatment and dosages for the bacterial infection?  I kind of tied the vet’s hands, I’m sure, by not having money for testing, plus asking him to choose treatment from Wal-mart’s list of $4 prescriptions.  Cephalexin was one of them, plus Amoxicillin, Ciprofloxacin, Doxycycline, Erythrocin, Erythromycin, Metronidazole, Penicillin VK, SMZ/TMP, and Tetracycline.  

I will be calling the vet on Friday to discuss this, but would appreciate another viewpoint.  Our next appointment is the 17th of March, but I’m to call and let him know how my dog is doing before we get to the last 10-day Prenisone dosage (every other day).

I feel so guilty about this!  I thought maybe it was a yeast infection or something like that.  When the vet said Lupus every thought just went out of my head.  My mother died last year at her home, and I moved up there to take care of her until the end with the help of Hospice, while my husband and kids stayed here at home.  I feel like I should have somehow seen signs or something, but in any case I didn’t take good care of my best friend.  

Thank you for reading, and for any suggestions you can give.  It is greatly appreciated!    

Sincerely,
Linda

Answer
Almost all skin infections in dogs respond to cephalexin, so I would continute that. Cephalexin rearely has side effects and the one I most often see is vomiting, not weakness.  I would also bathe the dog twice a week with benzoyl peroxide shampoo.  If the prednisone is not helping dry up the leasions, then ask the vet for something stronger, like dexamethasone.