Is Your Dog’s Itchy Skin Driving You Crazy?

Lisa Feinstein DVM MPH


If your dog is scratching and itching himself, there are a lot of great medications that can help give your dog (and you) relief. Itching, licking and biting can cause damage to the skin and should be managed. The cause of the itch may be parasites (fleas, mites, lice, fungus), allergies (to environmental triggers like grass or pollen or to food reaction), bacterial/yeast infection, immune disease (like lupus), or psychological/habit (like lick granuloma sores). It is important for the pet to be examined to check for these since if the cause of the itching is not treated, then it will persist despite medicines to control it.

An itchy dog deserves a full skin examination. His coat will be thoroughly combed for evidence of fleas or flea dirt (essentially flea feces which are black coiled fragments that turn red with water). Even if you can’t find fleas or flea dirt, your dog can still be biting from prior flea bites- and you may need to comb your other animals since some dogs are so good at removing fleas (and evidence) that you can’t find them during your exam. If there are hair loss spots, the skin will be scraped and and examined under a microscope for mites and lice. A sample of skin or hair may also be pulled for fungal testing.

If there is evidence of bacterial or yeast infection, your dog will be treated with appropriate medications to treat these infections. Staph bacteria can colonize the skin and creates characteristic crust circles (“collarettes”). Yeast makes yellowish flakes that smell oily and musty. A sample of the crust should be examined under a microscope to see the bacteria and or yeast. Appropriate antibiotics should be used until skin completely resolved, which sometimes takes a few weeks.

Allergies and immune disease can manifest in the skin with chronic licking and scratching. Ideally testing would be done to identify what the dog is allergic too (through blood serum or skin testing) and a food elimination trial. However, testing can be expensive and the veterinarian may try some medications to relieve the itch without necessarily knowing the source of the allergy. Hypoallergenic foods (either novel “never been fed” protein or hydrolyzed protein) can be tried, but only are worthwhile if they are used exclusively (with no treats or sneaks from the other dog or cat’s bowl).

In the old days, veterinarians used to give a steroid shot to itchy dogs giving them temporary relief. However, now a days there are a lot better and safer alternatives. We still use a short course of Prednisone to stop the inflammation and allergic symptoms, but we have a lot better drugs for long term use for itching. Cyclosporine (Atopica) is an immune modulating drug that blocks the body’s overactive immune reaction to allergies. And my favorite, Apoquel is a JAK inhibitor that essentially blocks the skin’s signals of allergies and triggers. It’s safe enough to use every day long term and requires no weaning off. And Apoquel has no side effects like Prednisone which makes your dog eat and drink more, pant and urinate more.

In addition to Apoquel, my favorite pill for itchy dogs, there’s a new injection called Cytopoint. Cytopoint is dog monoclonal antibody, which means its immunotherapy to target the dog’s allergic signals his body is sending. It has no major side effects and no weaning off and can last 4 to 8 weeks. Typically the veterinarian gives an injection once a month for 3 months, then every 3 to 6 months thereafter. So far I have seen good results with the 3 dogs that have had the injections.