Hi Barb,

Thanks for the question.

It sounds like you’ve done a great job getting this issue under control. There are some additional treatments that may help further.

It’s best to treat allergies with multiple strategies. Vanectyl-P is a medication that has both a steroid and an antihistamine in it. The antihistamine is safe and has few side effects, whereas the steroid can certainly cause undesirable side effects over time and it’s best to reduce your reliance on it as much as possible. Let me first say that the amount of Vanectyl-P you’re using is modest. For the average size Shih Tzu, 1/2 a tablet of Vanectyl-P a day is unlikely to cause significant problems even if it’s used over years, but having said that, it would be great to reduce it’s use further if possible.

It sounds like you and your veterinarian have done a good job trying to find a diet that reduces the food allergy component your dog may have. Here’s a few ideas:

1. Consider a skin scraping. If there is a lot of paw licking, I would suggest you perform a skin scraping if it hasn’t already been done. There may be an infectious agent, such as yeast, that could be contributing to the itching and it could be eliminated if found.

2. Consider giving Buddy omega-3 fatty acids as a supplement. You can give this orally, but also ask your veterinarian for a topical omega-3 fatty acid that you apply to the skin. I’ve seen amazing results from some of these products. The fatty acids are applied along the top of the back in small amounts, then they will be absorbed and they can mediate the inflammatory process throughout the skin.

3. Consider shampoos. By using a medicated shampoo, such as one that is anti-itch, it could reduce the symptoms – ask your veterinarian about the products they have. By lathering it on and letting it sit on the skin for 10-15 minutes before rinsing, it can help a great deal. Just put some towels down in the bathroom and let him walk around before rinsing it off. You can do this once a week and seeing if it helps, then increase or decrease the frequency based on the response.

4. Consider an additional antihistamine. Please look at our article ‘Antihistamine Therapy for Your Dog‘ and it describes how to use them. Keep in mind that dogs can respond incredibly well to one antihistamine over another, so this articles describes how to try different ones and their dosages. Always consult your veterinarian before starting.

5. You could consider allergy testing to determine a more appropriate diet. There is allergy blood testing and intradermal or skin testing. Veterinarians can easily perform an allergy blood test but it tends to be expensive and some specialists disagree about how valuable the results can be. I’ve seen many cases where it has made a strong positive impact, but others where it was less useful.

Hopefully these thoughts are helpful as a next step for you and Buddy. Thanks for your support and your question.

Dr. Clayton Greenway