Extreme Face Scratching - 30 Days on Atopica and No Relief - YorkieTalk.com Forums

Siron · 10-18-2015, 08:50 PM

I would like to introduce Rocky to the YorkieTalk forums. My little guy has been having chronic scratching issues that have been progressively worsening to the point of him being in constant discomfort. He is a neutered male, was born January 18th, 2014, and currently weighs 4.6lbs (2.1kgs) and throughout the past year his scratching has went from bad to worse.

We started off with an elimination diet at the suggestion of the vet - went to a Blue Buffalo restricted ingredient lamb and eliminated all forms of treats with the exception of fresh fruits (blueberries, apples, banana) and an apple and pumpkin treat from the vets office. After 60 days on this and still no signs of improvement we changed from Blue Buffalo to IAMS Veterinary Formula Kangaroo at the suggestion of the vet and eliminated all treats except fresh fruits. Again, after another 60 days on the Kangaroo still no sign of improvement.

At this point we started using Virbac Epi-Soothe shampoo once per week and started a treatment of Atopica. One 10mg capsule once every 24 hours. In addition to the Atopica we were prescribed an antibiotic.

After 30 days on Atopica and an antibiotic with the IAMS Veterinary Formula Kangaroo and zero treats of any kind (except the fresh fruits) the condition has shown no improvements. At the most recent vet appointment Rocky was checked for the possibility of mites around his muzzle causing him to scratch - came back negative.

He has been wearing a cone for almost 3 months now 24/7 with the exception of when we go on walks or when he is sitting with me. As long as he is within eyesight of me he is pretty good about not scratching, but given the chance the scratching and licking starts. When the cone is first removed in the morning after waking up it appears as though the itchiness builds up to the point of him needing a release and he violently scratches with both paws around his muzzle to the point of drawing blood and scratching the fur off his nose. Most recently his symptoms have progressed from the scratching to non-stop licking of his nose - like lapping at the air. Additionally, it seems he now has extreme sensitivity to his lower jaw, and will cry if its rubbed - it also seems swollen, red and irritated. The other symptoms to note include: snoring, sneezing, drooling (causing the lapping), greasy hair, and bad breath.

There has been no changes in eating or drinking and no weight gain or weight loss. His activity level has decreased dramatically however since he seems to be very uncomfortable and has no interest outside of trying to sleep.

We are waiting for a vet dermatologist to help direct us in the right direction, but they are booking 6 months out. Any possible advice or direction would be greatly appreciated.

Wylie's Mom · 10-19-2015, 03:58 AM

Hi and welcome to YT

. I'm so sorry it's under these circumstances - you're poor little baby

! I feel so bad for him.

So he doesn't chew/lick his paws or anything - it's just the muzzle he goes after? If so, that in itself is a little odd since almost ALL dogs w/ allergies will chew/lick their paws bc of the histamine reaction affecting their paws.

So, was a skin scraping of his muzzle done? Also, was it grown out in culture for 10 days to see if it was fungal?

Ya know, for some reason I feel like there could be something nerve related going on here bc it almost seems like EVERYthing (all of his symptoms) are focused along a certain pathway...all in the same main area (air licking, drooling, muzzle issues, nose licking etc). If a dog, for example, had some sort of tingling nerve pain, I would think the dog would try to itch at it to make it go away, ya know? So I do have to wonder about this. Ie, is something pinched from up in the neck area or something...? An xray may help.

Snoring: this could be a stand alone thing -or- could be signs of nasal structure issues, allergies, GERD (read this), elongated soft palate, irritated nasal passages. One has to wonder if they should scope his nose to see if there is anything stuck up there too...? Something up the nose could cause nasal issues, scratching/pawing, nose licking, sneezing, drooling, stress.

Teeth/breath: the bad breath could easily mean there could be a rotting tooth issue going on. This could cause drooling, bad breath, extreme pain/stress, sneezing, swelling, pawing/scratching at muzzle. It could also lead to an oral-nasal fistula -- which would cause further symptoms and can be quite severe and painful. I would look into this as something to at least rule out as a factor. Most def put him under to get a dental done and all bad teeth removed ASAP.

Has Apoquel been tried yet for the itching? This is another miracle allergy drug, similar to Atopica. If you try Apoquel and it also doesn't work - then what that would tell me is that the itching is NOT related to the histamine/immune system reacting - and therefore, that's why neither drug could alleviate symptoms.

So, those are the things that came to the top of my mind. Don't know if any of that is helpful. I sure feel bad for both you and your precious little one!

sandy simpson · 10-19-2015, 05:17 AM

My friends Yorkie is scratching her side and rear area. I put green tea bag soaked in water solution on her hot spots. Then rub coconut oil on her itching areas. She is on a special hills zd diet and takes benedryl. Now when she is at her home she really scratches. She comes here and gets better. We think dust mites. The rug will be out . I have tile. I do hope you can help bring relief to your yorkie.

MzLynnC · 10-19-2015, 05:41 AM

Welcome to YT !
Sorry don't have anything to contribute but from the pic, can just imagine his pain and your concerns.

Please keep us all updated on what the findings are for him and what helps him.

Good Luck to both of you. Also as far as the dermo - you might want to check out a little further and see if you can get him in. I also ask to be put on the cancel list if anyone calls and cancel an appointment to call me so that I can get in quicker.

Maximo · 10-19-2015, 12:34 PM

Poor little guy. He is adorable. I'm sorry he is having so much trouble and I hope the doctors and you can figure it out soon.

I agree with Ann about checking into his dental situation. Dental pain can lead to head rubbing and scratching.

Buster Brown · 10-19-2015, 01:20 PM

Buster was also rubbing his face and licking his paws. I tested him for allergies and he had some environmental and food so I thought that was causing him to rub his face. but when I brought him in for his dental I found out he had cracked the crown off of two teeth from chewing on Bully sticks.

The teeth were exposed so they had to be pulled. He not longer paws at his face...we are still dealing with the food allergies and the occasional flea bite but his symptoms there are more chewing on the paws and rump area. Your baby has such a sweet face and it's so sad he is so miserable with scratching. I hope you can find out the answer.
There is also a saliva allergy test for dogs that can be used to help with elimination diets. It has not been thoroughly reviewed and it is a bit expensive but it can provide a reference for foods that may be trigger foods. It is less invasive than the blood tests and I found out after I got the blood test on Buster that the blood test sometimes gives incorrect readings on food allergies and is better at determining environmental allergies. NutriScan Food Sensitivity and Intolerance Test for Cats and Dogs - Dr. Dodds

Siron · 10-19-2015, 08:33 PM

Thank you for the responses and support.

When Rocky was neutered on May 10th, 2015 we also had his four retained deciduous teeth (Baby Teeth) removed that hadn't fallen out yet. The face scratching started prior to being neutered, but was significantly less violent and less frequent. I actually had a feeling that his teeth were causing the scratching back then, but the vet said it shouldn't. Following the procedure, after about a week his breath became unbearably bad and I had to return to have some stitches removed that hadn't dissolved properly and had his mouth cleaned.

To answer your question regarding a skin scraping, yes, we did have a scraping done. However it wasn't left to culture and it wasn't from the area around his muzzle, it was from some small bumps (pimples) on his head and back which were noticed on one of the visits to the vet for the scratching issue. The sample was on a slide and under the microscope in less than ten minutes and found to not be a yeast. We were issued a prescription of Clavaseptin 50/62.5mg (Amoxicillin) which was administered by half pill dosage every 12 hours. Cleared up the bumps nicely but didn't have any effect on anything else. Some hairs were pulled from his muzzle and put on a slide to check for mites on two separate vet visits, but neither of those came up with any indication of mites.

If left without his cone and unsupervised he will do some paw licking, but the licking is constant and not necessarily directed at just his paws. If he is being held he will constantly lick the nearest hand, if he is wearing the cone he will lick the cone or lap at the air.

I rescheduled another vet visit for tomorrow and am going to inquire on the possibility of a tooth or mouth related issue causing the pawing of his face, constant lapping and licking, and breath issues. I also scheduled another vet visit with a doctor that specializes in skin related issues (not a vet derm, but the next best thing). I will also mention Apoquel to the vet tomorrow and see if that would be an option. I will be seeing about pushing for an xray and dental exam as number one priority.

This morning was probably one of the worst mornings for the little guy, as he was in visible pain and actually crying in attempts to reach his face.

Wylie's Mom · 10-20-2015, 03:09 AM

Quote:

Originally Posted by Siron

Thank you for the responses and support.

When Rocky was neutered on May 10th, 2015 we also had his four retained deciduous teeth (Baby Teeth) removed that hadn't fallen out yet. The face scratching started prior to being neutered, but was significantly less violent and less frequent. I actually had a feeling that his teeth were causing the scratching back then, but the vet said it shouldn't. Following the procedure, after about a week his breath became unbearably bad and I had to return to have some stitches removed that hadn't dissolved properly and had his mouth cleaned.

To answer your question regarding a skin scraping, yes, we did have a scraping done. However it wasn't left to culture and it wasn't from the area around his muzzle, it was from some small bumps (pimples) on his head and back which were noticed on one of the visits to the vet for the scratching issue. The sample was on a slide and under the microscope in less than ten minutes and found to not be a yeast. We were issued a prescription of Clavaseptin 50/62.5mg (Amoxicillin) which was administered by half pill dosage every 12 hours. Cleared up the bumps nicely but didn't have any effect on anything else. Some hairs were pulled from his muzzle and put on a slide to check for mites on two separate vet visits, but neither of those came up with any indication of mites.

If left without his cone and unsupervised he will do some paw licking, but the licking is constant and not necessarily directed at just his paws. If he is being held he will constantly lick the nearest hand, if he is wearing the cone he will lick the cone or lap at the air.

I rescheduled another vet visit for tomorrow and am going to inquire on the possibility of a tooth or mouth related issue causing the pawing of his face, constant lapping and licking, and breath issues. I also scheduled another vet visit with a doctor that specializes in skin related issues (not a vet derm, but the next best thing). I will also mention Apoquel to the vet tomorrow and see if that would be an option. I will be seeing about pushing for an xray and dental exam as number one priority.

This morning was probably one of the worst mornings for the little guy, as he was in visible pain and actually crying in attempts to reach his face.

Gosh, I truly just feel horrible for you and your precious little man, I really do. I can't *imagine* watching my baby go through this day in, day out - and feeling helpless in fixing it. So sorry

.

There is something so very wrong here, and yet nothing seems obvious as to what it is. I do wonder if something happened during his tooth removal during his neuter - perhaps nerve damage?

I would definitely ask the vet what you could try / use for medication if this was suspected to be nerve related - bc it'd be worth a try.

The muzzle area doesn't blister spontaneously or anything does it, btw? If it does, I'd be wondering too about the rare-to-diagnose puppy strangles.

I SO hope for some relief for this poor little man. Have you asked his breeder about this at all?

maxmom · 10-20-2015, 06:33 AM

I dont know if he has any other symptoms but this is just a thought, What is the bowl you are feeding him from made off? My Sophie developed a rash on her face when we first got her, she was eating and drinking for a beautiful set of plastic bowls.I tried changing foods, shampoos,and nothing worked. Once I changed to a set of not so pretty Pirex glass, the scratching and rash begin to fade and she has had no more issues. Hope your baby gets better soon.

Maximo · 10-20-2015, 12:59 PM

Quote:

Originally Posted by Siron

This morning was probably one of the worst mornings for the little guy, as he was in visible pain and actually crying in attempts to reach his face.

My heart goes out to your baby and you. Praying that the doctors will have some answers for you over the next couple days and will be able to give your sweet boy some relief.

Buster Brown · 10-20-2015, 03:05 PM

Good luck with the Vet visit I hope there is some relief for poor Rocky. He is so sweet, that picture of him with the cone looking out the window is adorable. Sending prayers and best wishes.

Siron · 10-20-2015, 07:06 PM

Had the vet visit today. The vet took Rocky's temperature - no fever and all normal, checked his lymph nodes - they were normal and not swollen, checked his teeth and gums - all seemed fine there. They then drew some blood and got a urine sample. We will know tomorrow if the blood comes back with a high t-cell count indicating an infection or not.

He still has extreme face sensitivity and violently tries to paw his face and chin which has created more swelling. Again more crying this morning.

The vet prescribed 4 doses of Metacam (non-steroidal anti-inflammatory drug) in .15ml to be administered once daily and also Clavaseptin tabs for another week.

Rocky threw up four times today before the vet visit, but seemed perfectly fine before and after the vomiting spell. Not sure what if anything triggered that and the vet didn't think it was related. He is still eating, drinking, and going to the bathroom completely normally.

I inquired on Apoquel and to my surprise the drug is currently not available in Canada. The nearest vet dermatologist in the USA would be located in Montana (roughly 6 to 8 hour drive depending on where in Montana)....but I am seriously considering making the drive to see if Apoquel would be the solution.

In regards to the food dishes, he has only been fed from stainless water and food dishes so I don't see that being the problem in this case.

Thanks again for the support and I will update what we find out tomorrow.

107barney · 10-20-2015, 07:35 PM

I would try a hydrolyzed food like Royal Canin hypoallergenic or Purina HA. My dog takes around 6-8 weeks to respond to Atopica. We also must use simplicef and fluconazole to treat bacterial and skin infections. We use therapeutic dosing of omega 3 salmon oil and bathe weekly in malaseb. My dog eats home cooked food.
Your dog needs a board certified vet dermatologist - I see that you may not have one in the area. The above is the protocol ours has had my dog on for the past 10 years.

sandy simpson · 10-21-2015, 04:56 PM

Praying for sweet rocky to get better. That poor fella must be miserable itching.I hope healing comes soon

Siron · 10-21-2015, 08:59 PM

Got the results back from the vet today. For the most part everything looks good and normal. The urine test was good - concentrated and no indication of any kidney issues. The blood work was also all spot on with the exception of the new SDMA (kidney disease) test. Rocky's number was 15 which should be at 14 - so one point high. They said it really was nothing to be concerned with at this point as he is still a young dog and the urine test was good.

Tomorrow I have a one hour long consult with a new vet that specializes in skin conditions - not a vet derm, but the next best thing I have locally. Depending on how tomorrow turns out, I will most likely be taking an 8 hour drive down into Montana to a vet derm and hoping to get my hands on some Apoquel. The journey continues...

10-19-2015, 03:58 AM	#2
Wylie's Mom Furbutts = LOVE Donating Member Moderator Join Date: Jan 2005 Location: Phoenix, AZ Posts: 35,889 Blog Entries: 2	Hi and welcome to YT . I'm so sorry it's under these circumstances - you're poor little baby ! I feel so bad for him. So he doesn't chew/lick his paws or anything - it's just the muzzle he goes after? If so, that in itself is a little odd since almost ALL dogs w/ allergies will chew/lick their paws bc of the histamine reaction affecting their paws. So, was a skin scraping of his muzzle done? Also, was it grown out in culture for 10 days to see if it was fungal? Ya know, for some reason I feel like there could be something nerve related going on here bc it almost seems like EVERYthing (all of his symptoms) are focused along a certain pathway...all in the same main area (air licking, drooling, muzzle issues, nose licking etc). If a dog, for example, had some sort of tingling nerve pain, I would think the dog would try to itch at it to make it go away, ya know? So I do have to wonder about this. Ie, is something pinched from up in the neck area or something...? An xray may help. Snoring: this could be a stand alone thing -or- could be signs of nasal structure issues, allergies, GERD (read this), elongated soft palate, irritated nasal passages. One has to wonder if they should scope his nose to see if there is anything stuck up there too...? Something up the nose could cause nasal issues, scratching/pawing, nose licking, sneezing, drooling, stress. Teeth/breath: the bad breath could easily mean there could be a rotting tooth issue going on. This could cause drooling, bad breath, extreme pain/stress, sneezing, swelling, pawing/scratching at muzzle. It could also lead to an oral-nasal fistula -- which would cause further symptoms and can be quite severe and painful. I would look into this as something to at least rule out as a factor. Most def put him under to get a dental done and all bad teeth removed ASAP. Has Apoquel been tried yet for the itching? This is another miracle allergy drug, similar to Atopica. If you try Apoquel and it also doesn't work - then what that would tell me is that the itching is NOT related to the histamine/immune system reacting - and therefore, that's why neither drug could alleviate symptoms. So, those are the things that came to the top of my mind. Don't know if any of that is helpful. I sure feel bad for both you and your precious little one! __________________ ~ A friend told me I was delusional. I nearly fell off my unicorn. ~ °¨¨¨°ºOº°¨¨¨° Ann \| Pfeiffer \| Marcel Verdel Purcell \| Wylie \| Artie °¨¨¨°ºOº°¨¨¨°

10-19-2015, 05:17 AM	#3
sandy simpson YT 2000 Club Member Join Date: Jun 2012 Location: santee, california Posts: 2,123 Blog Entries: 1	dog My friends Yorkie is scratching her side and rear area. I put green tea bag soaked in water solution on her hot spots. Then rub coconut oil on her itching areas. She is on a special hills zd diet and takes benedryl. Now when she is at her home she really scratches. She comes here and gets better. We think dust mites. The rug will be out . I have tile. I do hope you can help bring relief to your yorkie.

10-19-2015, 05:41 AM	#4
MzLynnC Donating Senior Yorkie Talker Join Date: Jun 2013 Location: SC Posts: 256 Blog Entries: 1	Welcome to YT ! Sorry don't have anything to contribute but from the pic, can just imagine his pain and your concerns. Please keep us all updated on what the findings are for him and what helps him. Good Luck to both of you. Also as far as the dermo - you might want to check out a little further and see if you can get him in. I also ask to be put on the cancel list if anyone calls and cancel an appointment to call me so that I can get in quicker. __________________ Lynn - Cricket , Damit, Dixie, Gracie , Daisy , Luke and Lily

10-19-2015, 12:34 PM	#5
Maximo ♥ Maximo and Teddy Donating Member Join Date: Jun 2009 Location: Northern Virginia Posts: 25,041	Poor little guy. He is adorable. I'm sorry he is having so much trouble and I hope the doctors and you can figure it out soon. I agree with Ann about checking into his dental situation. Dental pain can lead to head rubbing and scratching. __________________ Kristin, Max and Teddy

10-19-2015, 01:20 PM	#6
Buster Brown Donating YT 1000 Club Member Join Date: Oct 2009 Location: Toluca Lake, CA Posts: 5,491	Buster was also rubbing his face and licking his paws. I tested him for allergies and he had some environmental and food so I thought that was causing him to rub his face. but when I brought him in for his dental I found out he had cracked the crown off of two teeth from chewing on Bully sticks. The teeth were exposed so they had to be pulled. He not longer paws at his face...we are still dealing with the food allergies and the occasional flea bite but his symptoms there are more chewing on the paws and rump area. Your baby has such a sweet face and it's so sad he is so miserable with scratching. I hope you can find out the answer. There is also a saliva allergy test for dogs that can be used to help with elimination diets. It has not been thoroughly reviewed and it is a bit expensive but it can provide a reference for foods that may be trigger foods. It is less invasive than the blood tests and I found out after I got the blood test on Buster that the blood test sometimes gives incorrect readings on food allergies and is better at determining environmental allergies. NutriScan Food Sensitivity and Intolerance Test for Cats and Dogs - Dr. Dodds __________________ CarolynBuster Brown "The happiest people don't have the best of everything, they just make the best of everything."

10-19-2015, 08:33 PM	#7
Siron YorkieTalk Newbie! Join Date: Oct 2015 Location: Calgary, Alberta, Canada Posts: 6	Thank you for the responses and support. When Rocky was neutered on May 10th, 2015 we also had his four retained deciduous teeth (Baby Teeth) removed that hadn't fallen out yet. The face scratching started prior to being neutered, but was significantly less violent and less frequent. I actually had a feeling that his teeth were causing the scratching back then, but the vet said it shouldn't. Following the procedure, after about a week his breath became unbearably bad and I had to return to have some stitches removed that hadn't dissolved properly and had his mouth cleaned. To answer your question regarding a skin scraping, yes, we did have a scraping done. However it wasn't left to culture and it wasn't from the area around his muzzle, it was from some small bumps (pimples) on his head and back which were noticed on one of the visits to the vet for the scratching issue. The sample was on a slide and under the microscope in less than ten minutes and found to not be a yeast. We were issued a prescription of Clavaseptin 50/62.5mg (Amoxicillin) which was administered by half pill dosage every 12 hours. Cleared up the bumps nicely but didn't have any effect on anything else. Some hairs were pulled from his muzzle and put on a slide to check for mites on two separate vet visits, but neither of those came up with any indication of mites. If left without his cone and unsupervised he will do some paw licking, but the licking is constant and not necessarily directed at just his paws. If he is being held he will constantly lick the nearest hand, if he is wearing the cone he will lick the cone or lap at the air. I rescheduled another vet visit for tomorrow and am going to inquire on the possibility of a tooth or mouth related issue causing the pawing of his face, constant lapping and licking, and breath issues. I also scheduled another vet visit with a doctor that specializes in skin related issues (not a vet derm, but the next best thing). I will also mention Apoquel to the vet tomorrow and see if that would be an option. I will be seeing about pushing for an xray and dental exam as number one priority. This morning was probably one of the worst mornings for the little guy, as he was in visible pain and actually crying in attempts to reach his face.

10-20-2015, 06:33 AM	#9
maxmom Donating YT 1000 Club Member Join Date: Apr 2008 Location: South Florida Posts: 2,307 Blog Entries: 1	I dont know if he has any other symptoms but this is just a thought, What is the bowl you are feeding him from made off? My Sophie developed a rash on her face when we first got her, she was eating and drinking for a beautiful set of plastic bowls.I tried changing foods, shampoos,and nothing worked. Once I changed to a set of not so pretty Pirex glass, the scratching and rash begin to fade and she has had no more issues. Hope your baby gets better soon. __________________ maxmom My belongs to Max and Sophie Mei

10-20-2015, 03:05 PM	#11
Buster Brown Donating YT 1000 Club Member Join Date: Oct 2009 Location: Toluca Lake, CA Posts: 5,491	Good luck with the Vet visit I hope there is some relief for poor Rocky. He is so sweet, that picture of him with the cone looking out the window is adorable. Sending prayers and best wishes. __________________ CarolynBuster Brown "The happiest people don't have the best of everything, they just make the best of everything."

10-20-2015, 07:06 PM	#12
Siron YorkieTalk Newbie! Join Date: Oct 2015 Location: Calgary, Alberta, Canada Posts: 6	Had the vet visit today. The vet took Rocky's temperature - no fever and all normal, checked his lymph nodes - they were normal and not swollen, checked his teeth and gums - all seemed fine there. They then drew some blood and got a urine sample. We will know tomorrow if the blood comes back with a high t-cell count indicating an infection or not. He still has extreme face sensitivity and violently tries to paw his face and chin which has created more swelling. Again more crying this morning. The vet prescribed 4 doses of Metacam (non-steroidal anti-inflammatory drug) in .15ml to be administered once daily and also Clavaseptin tabs for another week. Rocky threw up four times today before the vet visit, but seemed perfectly fine before and after the vomiting spell. Not sure what if anything triggered that and the vet didn't think it was related. He is still eating, drinking, and going to the bathroom completely normally. I inquired on Apoquel and to my surprise the drug is currently not available in Canada. The nearest vet dermatologist in the USA would be located in Montana (roughly 6 to 8 hour drive depending on where in Montana)....but I am seriously considering making the drive to see if Apoquel would be the solution. In regards to the food dishes, he has only been fed from stainless water and food dishes so I don't see that being the problem in this case. Thanks again for the support and I will update what we find out tomorrow.

10-20-2015, 07:35 PM	#13
107barney T. Bumpkins & Co. Donating YT Member Join Date: Dec 2008 Location: New England Posts: 9,816	I would try a hydrolyzed food like Royal Canin hypoallergenic or Purina HA. My dog takes around 6-8 weeks to respond to Atopica. We also must use simplicef and fluconazole to treat bacterial and skin infections. We use therapeutic dosing of omega 3 salmon oil and bathe weekly in malaseb. My dog eats home cooked food. Your dog needs a board certified vet dermatologist - I see that you may not have one in the area. The above is the protocol ours has had my dog on for the past 10 years. __________________ T. Bumpkins & Co. Washable Doggie Pee Pads (Save 10% Enter YTSAVE10 at checkout) Cathy, Teddy, Winston and Baby Clyde...RIP angels Barney and Daisy

10-21-2015, 04:56 PM	#14
sandy simpson YT 2000 Club Member Join Date: Jun 2012 Location: santee, california Posts: 2,123 Blog Entries: 1	dog Praying for sweet rocky to get better. That poor fella must be miserable itching.I hope healing comes soon

10-21-2015, 08:59 PM	#15
Siron YorkieTalk Newbie! Join Date: Oct 2015 Location: Calgary, Alberta, Canada Posts: 6	Got the results back from the vet today. For the most part everything looks good and normal. The urine test was good - concentrated and no indication of any kidney issues. The blood work was also all spot on with the exception of the new SDMA (kidney disease) test. Rocky's number was 15 which should be at 14 - so one point high. They said it really was nothing to be concerned with at this point as he is still a young dog and the urine test was good. Tomorrow I have a one hour long consult with a new vet that specializes in skin conditions - not a vet derm, but the next best thing I have locally. Depending on how tomorrow turns out, I will most likely be taking an 8 hour drive down into Montana to a vet derm and hoping to get my hands on some Apoquel. The journey continues...