Sam, the West Highland Terrier we previously talked about having had his horrible skin problems ignored was back for a followup visit today. In our April 30 post I had anticipated quick relief for Sam, and he definitely feels and looks much better.
However, his itchiness has not sufficiently resolved, and I was disappointed by that.
His owners and I had discussed the possibility of food allergy at that very first visit, and today we had a review session. We started a food allergy trial with Hills Prescription Diet z/d. Sam is to continue the Hydroxyzine allergy-blocking medication he was already on and we began a new round of Prednisolone at a temporarily-high dose to quell his raging itch.
Poor Sam is typical of allergy patients who are “allergic to life,” as a board-certified veterinary dermatologist friend of mine sometimes says. He is subject to relapses and breakthroughs of his Atopy and Flea Bite Allergies. If he proves to be food-allergic, as we suspect he will, he can have a flareup with even a tiny bite of “regular” dog food, a treat given by a well-meaning neighbor or people food dropped on the floor during meal preparation.
Like all allergy patients, he can present a diagnostic challenge when secondary bacterial, yeast or fungal infections invade.
Other common West Highland Terrier problems, such as hormone excesses and deficiencies may appear later in life, further complicating his clinical picture.
We will be evaluating Sam by phone weekly and seeing him in person monthly as his food allergy trial extends for three to six months.
See you tomorrow, Dr. Randolph.