Expert: Dr. Louis N. Gotthelf - 3/9/2011

Question
I am writing, with permission from our vet, for your professional advice.
We are expats living in Kuala Lumpur Malaysia.

King Charles Cavalier, 6 year old spayed bitch.

In the summer of 2009 my bitch, Holly, contracted a case of mange and was treated accordingly.
However, 6 weeks later after the mange disappeared, she exhibited symptoms of:-
1.   acute hair loss on both her back legs and under her tail.
2.   pale brown gritty substance around her nails.
3.   dry itchy scabs covering her whole body.

Diagnosis from my vet, after skin scrapings and blood tests, was an acute fungal infection which he said was quite common after a case of mange. The diagnosis was formally known as Malassezia infection, common in tropical countries.

He prescribed for period of 2 weeks the following medication:-
Ketoconazole – half tablet twice a day after food.
Norfloxacin – ½ a tablet twice a day after food.
Weekly baths of Sebosol.

After a 2 week break a further 2 weeks of the above treatment although we continued with the Sebosol shampoo baths.

As a result she showed temporary improvement e.g. the scabs disappeared and the hair began to grow back. However, 6 weeks later the fungal infection started again showing all the previous symptoms.

This has now been going on for nearly 2 years and she is now displaying signs of depression and exhaustion.

My vet explains that to continue indefinitely with these medications could cause kidney failure so we are hoping that you may be able to offer some alternative, new, remedy or medication that will alleviate/cure her problem.

My vet is very willing to discuss this with you.

Please feel free to ask me any further questions or to contact me with any queries.

Look forward to hearing from you

Grateful thanks

Mrs Louise Mills (Caryll's sister)
Home number: (006) 0378773359

Answer
I think that I have already answered this question.

Malassezia skin infections are almost always secondary to an allergy.  In a dog that has had mange, you would not want to use the conventional therapy, which is steroids.  Ask your vet to use cyclosporine (Atopica)instead.