Suds over drugs: Daily bathing beats antibiotics for resistant skin infections in dogs

Are you the owner of a dog suffering from drug-resistant skin infections? There's good news from the North American Veterinary Conference in Orlando.

My year-old Scottish Deerhound, Rawley, turned out to be a dog with allergies -- only my second dog so afflicted, ever. We've been struggling hard trying to deal with them.

And as regular readers will remember, two or three years ago my Borzoi, Kryie, had a severe drug resistant staph infection -- or series of infections -- that never resolved until we got her on thyroid supplementation. (Interestingly she never did test below normal on her thyroid panels, but that's a subject for another day.)

So when I saw a session on managing chronic resistant skin infections with special reference to dogs with atopic dermatitis (the form of allergy Rawley has), I couldn't stay away.

Board-certified veterinary dermatologist Dr. Valerie A. Fadok took us on a fast overview of the general topic of resistant skin infections in dogs, dug down into the various drug options in these resistant cases, and then presented her recommendation: ditch the drugs and bathe the dog.

I'm not quite sure what made me happier, being at a session where the recommendation was low-cost and low-tech rather than a Newer! Better! Costlier! product of Big Pharma, or being at a session where the pet owner was being given complete control of the therapy.

Dr. Fadok's presentation was part of a series sponsored by Pfizer (also one of our sponsors here at Pet Connection), and she did mention that she was a fan of the Pfizer injectable antibiotic Convenia -- just not, she said, for resistant staph infections, which are almost always resistant to this class of drugs (the cephalosporins).

In addition to her recommendation to bathe dogs daily to treat skin infections and reduce symptoms of atopy, including itching, she went over a number of shampoos, rinses and sprays she'd seen good results with -- both veterinary and over-the-counter products. These included:

Duoxo (her biggest thumbs-up)
Zymox (over-the-counter)
Vetericyn VF spray

A number of chlorhexidine-based shampoos were also highly recommended -- I'll pull a complete list from the session CD when I get to a real computer.I can tell you they covered all price points.

Other important recommendations were to wash daily or, if that's truly impossible, to use one of the more effective topical products on the whole body every day that a bath is not given.

Leave the shampoo on for 10 minutes, and shampoo the dog from head to toe every time, using a sponge to get the area around the eyes.

It's pretty intensive, but it's cheap, almost any dog owner can do it, it stops contributing to the emergence of resistant staph, it's very safe, and it actually works better than the more expensive and riskier pharmaceutical alternatives.

I'm going to start daily baths with Rawley the minute I get home, and I'll keep you posted on how it goes!

One more note: She also talked about the use of desensitization for allergies, something else we're doing with Rawley. But, she said, not all dogs with chronic skin infections and itching have allergies. Some of them are sensitive to staph itself. I've heard about this before, and am going to be checking around to see what, if any, research has been done on the topic.

Now, time for lunch and then I'll be checking out some disgusting ear infection sessions -- my favorite!

Comments

[Christopher@BorderWars]

I was asked to review a hypo allergenic shampoo and in doing my research on other products offered in the market, I came across one name on the internet on the must-have shampoo formulation: Malaseb.



"Malaseb Shampoo contains Miconazole – an antifungal with potent activity against fungi and yeast – and Chlorhexidine Gluconate – a proven antimicrobial agent active against gram-positive and gram-negative bacteria."



Of interest, it seems that the original manufacturer of this shampoo, DVM Pharmaceuticals, was *shut down by the FDA* over quality concerns with the parent company, Teva who also made human pharma products.



My question is if anyone has had success with the other companies which have now started producing "malaseb formula" shampoos or with the original produt? Is it effective or recommended for mildly yeasty dogs? Best bet on finding these products online or in stores at a good price?



Thanks.

[Gina Spadafori]

Christopher, I might have an answer for you tomorrow, if I ever stop playing tag with the derm pal and we meet for coffee as planned.

[Dr. Sarah]

What do you do when the bugs that you are washing off become resistant to the anti-bacterial shampoo? You wash off all the protective oils at the same time....doesn't this stress the skin out more? I get that we are washing away allergens and bad bugs, but in the end...Aren't we creating more problems this way?



Just questions wandering around my head, hoping that someone plunks down an answer.



I am super interested in all the research that is currently being done on the area of skin barrier defects and lipid defects (fillagrin) in humans and how this relates to allergic skin disease in dogs, and how treatments are being designed towards improving the skin barrier in animals that have compromised cell layers...like this article:



http://www.ncbi.nlm.nih.gov/pubmed/21181301



Is there anything out there that improves the skin barrier?

[Liz Palika]

Susan: A long coated collie would never get dry!

[Alison]

Christie:

With regard to the Duoxo. Am I right in assuming she's recommending the Chlorhexadine shampoo & not the Seborhhea shampoo ?

[Susan Fox]

Liz, I'll see your winter-coat Aussie and raise you a big-coated rough collie ;0).



I'd do it if that was what it took, but frankly, I don't think Niki would never be totally dry again for more than a few hours. I guess shaving him would be an option, but I think it would be pretty devastating for his self-image. Srsly.



Fortunately, all I've ever had to deal with are a hot spot here and there. Cortisone cream cleared them up very quickly. I'm sure glad to have this information though, just in case.

[Christie Keith]

Alison, I'm sure she was, as the context was products for bacterial infections. The notes were on a CD so I promise I'll dig out a comprehensive product list!

[Liz Palika]

I like the idea of baths. It makes sense to me.



But were there any suggestions for coated dogs? An Aussie in winter coat could take all day to air dry or an hour under a blow dryer. Although I suppose the dog could be shaved. It wouldn't be my first choice but if it came down to a case of 'druthers.'

[Cindy Steinle]

Um yeah where can I get a copy of said CD? We have a MAJOR issue with one of the sanctuary dogs here.

[Gina Spadafori]

Said CD for the conference proceedings is $75. We're trying to get it comped for media use to access the powerpoints and references for reporting. We'll keep you posted!

[Carol V]

Although I never have had to deal with this..it does remind me of something hubby learned in his surgery rotation a few years back.."the solution to pollution is dilution"...of course you are supposed to say it like it is a jingle....

[Laurie Haight Keenan]

All of Duoxo's shampoos except the "Maintenance" contain phytospingosine, which restructures the lipid barrier of the skin and as such is both antibacterial and antifungal, since phytospingosine rebuilds the barrier against pathogens--or so my veterinary dermatologist explained. We tried all the Duoxo products on our rescue Duncan who had elephant skin and horribly infected (actually rotting) skin, and the Duoxo top spot product was more helpful than the shampoo, in my estimation. Daily shampooing sounds great until you actually have to do it, especially with a dog whose skin is deeply grooved from thickening. You have to take a dryer and dry out each fold, one by one, or else you're opening the door to more fungal infections. The whole process takes hours. The Duoxo top spot (along with desensitization injections) made it possible for us to normalize this dog in about two years, and he even got hair back on all but one section of one leg. Even so, we were bathing him twice a week for most of that time, to keep him from getting smelly. I found alternating shampoos worked best--after a while, each one would fail, so yes, the pathogens do eventually become resistant, or so it seemed to me. We also did an antiyeast diet with him, with antiyeast supplements, which really helped. Long road for this little guy, but it was so nice when he was no longer chewing on himself all the time and had no more raw open sores, and (from laser treatments) finally had totally soft skin.

[Laurie Haight Keenan]

Sorry--left out one letter: it's phytosphingosine.

[LBD]

I have a dog with allergies, have seen three different dermatologist and minimal (if any) relief unless it was steroid-based. I have tried a Duoxo emulsion spray a couple of years back and do have a trio of the Zymox products that I haven't put a good effort into trying. I just worry about his skin becoming too dry with daily baths.



Would love a follow up post if you are seeing positive results.

[Christie Keith]

LBD, if it's atopy and not a resistant skin infection, you can do the baths twice a week, with topicals in between...

[Linda H]

Does this mean daily bathing for the rest of their lives or is there a point at which the bathing is less frequent?

[Linda H]

I suggest you make a tag for allergies under medical. It took me a very long time to find this post again and it's an important topic. I'm currently following the protocol and it seems to be helping. I combined it with the body suit made for allergies at www.k9topcoat.com which keeps him from chewing on himself without having to wear an elizabethan collar. The bodysuit covers almost all of him and seems to be very comfortable for him to wear.

[Linda H]

I suggest you make a tag for allergies under medical. It took me a very long time to find this post again and it's an important topic. I'm currently following the protocol and it seems to be helping. I combined it with the body suit made for allergies at www.k9topcoat.com which keeps him from chewing on himself without having to wear an elizabethan collar. The bodysuit covers almost all of him and seems to be very comfortable for him to wear. BTW, I have no affiliation with K9topcoat. In fact, the first time I saw one I couldn't imagine why anyone would want o use one. Little did I know :-). I've now used them with three different dogs for three different reasons.

[Char L]

I wanted to let you know that my new adopted dog developed some skin allergy late last fall. It came on suddenly and he suffered with the scratching and biting most of the winter. While searching for updated articles on Staph Resistant Bacteria for my blog(my other dog had MRSP of the bladder), I came across the the article about Dr. Fadok. I had already started using a shampoo with 2% Chloroxylenol and tried a cream rinse that would hydrate his skin. While it stopped the itching, he soon returned to scratching. I used the Douxo after reading the article about Dr. Fadok's solution of bathing and changed to Epi-Soothe Cream Rinse and gave him a bath each week. His scratching is just about non existant. I had a 90% improvement after the first bath. According to Dr. Fadok, dogs will eventually improve their barrier to the point that they will develop new protection and not need them as frequently anymore. I am also passing this on to Bella Moss Foundaion and to MRSA and MRSP patients I help counsel.

[Margie]

thank you so much for all this information. My dog is suffering with so many skin issues and terrible urges to bite himself, which, of course, makes for more infections.
It seems that when I bathe him, it's a big improvement, so I'm going to try it for 30 days and see how he does. Fingers crossed.

[Louise]

I've been dealing with skin problems with my havanese for years and treating him with antibiotics and cortisone pills. It doesn't really help that much and it comes back immediately after he stops the meds.
After reading this article, I started bathing him with the medical shampoo and a special spray from the vet to put on him 3 times a day and after 21 days of washing him every day, he is 90% better for the first time ever and with no meds. I'm in shock and wish I would have done this for the past years of his life. He's not itchy and not biting himself and causing more infections. Thank you so much. I want to know after the 30 days, do I still wash him every day or is there a maintenance program with a few baths a week? If my dog could talk, he would say thank you!!!!! Oh, also, I had his hair cut real short so the shampoo could really do it's magic on his skin.
Thank you. It's so great not to be giving him meds constantly!!!!