Bailey
Bailey, a 5.5-year-old Beagle, first visited us in August 2025 with severe itching (10/10 pruritus). She was already on apoquel for itch control and thyroid supplements for her hypothyroidism.
Her main areas of concern were the neck, groin, ears, and limbs.
Cytology revealed cocci and rod-shaped bacteria across multiple sites (ears, paws, neck, groin) along with yeast in the ears and neck, indicating a superficial pyoderma with a mixed infection.
We initiated treatment with:
- Oral amoxicillin-clavulanate
- Ciclosporine and a Cytopoint injection for better itch control
- Gentamicin + miconazole ear drops for the ear infection
At her 2-week recheck, Bailey showed encouraging improvement.
However, by the 4-week visit, she developed a severe flare-up in the groin area with erythema, intense pruritus, scaling, and crusting. Cytology showed severe inflammation with streaming cocci, indicating a persistent secondary bacterial infection.
We adjusted the treatment plan and introduced:
- Topical clindamycin
- Propylene glycol for scaling and crusting
When improvement remained limited, we increased the dose and duration of amoxicillin-clavulanate, added chlorhexidine baths three times a week, and started an anti-seborrheic foam to address the scaling.
Two weeks later, Bailey finally showed significant clinical improvement, with marked reduction in bacterial load on cytology and visible healing of the lesions.
Today, Bailey is stable and maintained on:
- Cytopoint for itch control
- Weekly chlorhexidine baths
- Topical clindamycin three times a week on problem areas
This was a very tricky case, but with consistent monitoring and treatment adjustments, Bailey is finally comfortable again. 🐾
Comment 01
By Oliver Williams
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