"Super-hive" mystery solved

FINALLY! I know what's causing Dozer's insane hive outbreaks.

Two weeks ago, I took Dozer to the regular vet to treat staph lesions that were popping up here and there. The weekly baths and occasional Zyrtec just weren't cutting it. The vet prescribed a standard round of prednisone (to stop the itch) and cephalexin (to stop the staph).

Today, as soon as I saw the telltale pinpricks of oncoming urticarial vasculitis, ("super hives") I called the dermatology/allergy vet. (Well, first I screamed "NOOOOOOOOOOOOoooooooooooo!!!" and then I called the vet.)

What urticarial vasculitis looks like in the first few hours.

After looking back through his files, the derm vet confirmed what we'd already suspected but now seemed pretty conclusive: cephalexin allergy.

Ironically, today, after I reviewed some historical blog posts about Dozer's hives (like this one in 2009, this one in 2010 and this one earlier this year), I saw that he'd been taking cephalexin, an antibiotic, in every case.

Why wasn't the allergy deduced years ago? Because the hives never happened at the beginning of a cephalexin course—only at or near the end. Dozer could go two weeks on cephalexin and completely finish the course without a reaction, only to break out in hives a few days later, while taking no medications at all.

This mystery was also solved today, because the derm vet noted that Dozer usually gets prednisone or a cortisone shot at the same time that he's given the cephalexin. Although the point of the steroid is to cut down the itching from the staph, these steroids stop all allergic reactions. Period. Including the reaction to the cephalexin. After the short steroid course tapers down, there's nothing stopping the hives anymore. Thus the delayed reaction.

Six hours later--not looking too bad this time!

Prednisone and a much larger dose of Zyrtec were the order of the day. I'm loving the Zyrtec (over the Benadryl we used to give) because it knocks Dozer right out. I know the D is loving it, too, because he goes right to sleep. No itching, whining, panting, tummy upset, or any discomfort.

Sleeping soundly... with his face inches from the space heater.

Well, as they say, hindsight is 20/20.

First thing tomorrow morning, I'm calling the regular vet to ask them to flag this allergy in his file. No more cephalexin!!

Urticarial Vasculitis

Thank you very much for your well wishes sent to Dozer!

He is doing much better today, and today we have a fancy name for his crazy allergic reaction: urticarial vasculitis.

"Rhymes with treat!"

We went in today and the dermatology vet got her first look at Dozer after his hive attack.

The hives themselves are pretty much gone. Dozer looks totally normal when he's standing around.

Clearly feeling fine today.

The derm vet glanced him over and noticed the smaller bumps on his rear leg and said "Okay, so these are the hives?" Translation: "I don't get it. Why are you here?"

I said, "Those are some leftover hives, but you really should look at his stomach." We got Big D to lie down and stretch out, and I spread his rear legs for the full effect.

Day 3. Now looking rather like poison ivy or ringworm.

The redness is not quite as purple today, but it has spread so that you can see it all the way down his legs, even through his fur.

For the first time ever, I heard a vet say "Jesus Christ!" Followed by a lot of "Oh wow... Wow... Wow... This is so red... wow...."

I said, "This is day three. It looks different every day. I have photos of the last two days on my flash drive."

"I... wow... Oh my gosh..." It went on like this for a while as she and her assistant stared at the train wreck that was my dog.

After she had gotten past the shock and awe, the vet asked if she could take Dozer in the back and show him to the interns. She also took my flash drive and copied the photos, evidently wanting to use them in her lectures.

Which was all fine and good, but I really wanted to know what the heck my dog was suffering from.

Other than goofy-adorable syndrome, of course.

Anyway, after she brought Dozer and my flash drive back, and after consulting with interns and a few other vets, the derm vet said that Dozer had an episode of urticarial vasculitis.

Basically, urticaria is a serious case of hives, and vasculitis is when the blood vessels get inflamed and leak blood and fluid into the skin. In other words: Dozer's hives were so massive that they caused extensive bruising. Vasculitis also explains why the redness expands and turns interesting shades of purple, green, and brown over a period of days--the same way a bruise does.

Why and what to do about it are the harder questions to answer. The derm vet said that it could have been caused by a bug bite, a drug (like the cephalexin), or food allergy. Since D is on the rabbit-based food only, we don't think it's food. It could be a reaction to cephalexin, so we've decided to stop giving that.

But the most likely culprit is a bug sting, of any kind, from tiny fire ant to big red wasp. A bug sting would explain all of the previous hive outbreaks that Dozer has had, because he has always developed the hives after going outside for a potty break.

No matter what caused it, the vet has recommended that we try giving Dozer a daily antihistamine. That should put a damper on his daily allergies, and also stop these hives before they have the chance to go nuclear.

Most dogs would get Benadryl, but we are going to try hydroxyzine. You would not like Dozer on Benadryl. Nobody likes Dozer on Benadryl.

Hives(?) Photos, Day 2

Today I touched base with Dozer's regular vet over the phone, to update him on Dozer's progress after yesterday's hive outbreak: less itching, but the rash is spreading out and darkening.

Much to my dismay, our seasoned vet admitted that he has really not seen any dog with hives that present quite like this. He told me that he definitely wanted Dozer's dermatology vet to see this particular reaction. Perhaps it really won't impress the dermatology vet, he said, but it definitely left an impression on him.

Not quite what I wanted to hear from a very experienced guy that rarely seems fazed by anything.

The dermatology vet has never seen Big D's hives, or the aftermath. She has always told us to go to the regular vet. And after talking to the regular vet today, I realized the derm vet was probably passing us off because I keep calling this event "hives"—normal, boring, highly treatable, common old hives—which is a little different from "freakish burning red-purple lumpy rash covering his entire body," thus leaving her with the wrong impression about this event.

Anyway, here is day 2 of the "hives" (or whatever this is)—12 hours after Benadryl and cortisone injections. Note the worst areas, where the skin has turned a disturbing green-gray. Do any of you know why it would turn that color? I'm very curious about what is happening under the skin to make it such a sickly color.

Doesn't he look downright contagious? My mom came over and she was scared to touch him because she thought he had a communicable disease.

I'm sure it's an allergic reaction; I'm just not sure why it's so... gross.

"But it's Dozer we're talking about."

Dozer's allergies had been under control for the last several months. A little staph lesion here and there, but nothing major. High fives all around.

A few weeks ago, the itching started. The staph multiplied a bit. We went to the dermatology vet and got some cephalexin (antibiotic) to treat the staph.

The itching got worse. Dozer licked and scratched at hot spots. The derm vet prescribed prednisone and suggested increasing to three baths per week. Over the long Memorial Day weekend we dutifully administered his meds and bathed him twice. He developed a red "pinprick" rash across his stomach and chest.

And this morning, despite everything, he exploded in hives.

Covered head to toe in dark red wheals. Feet and legs puffy like marshmallows. So itchy he couldn't hold still for more than a minute at a time. He ran around the house with ants in his pants all morning.

We went to the regular vet. The thing about these hives is that they grow quickly and merge together into one massive uber-hive, so when you glance at Dozer, you don't really notice anything at first. It's only after you look at his purple-red stomach and run your hands over his puffy, lumpy sides that you realize it's not a layer of fat: he's actually covered in enormous wheals.

So the office staff, the vet techs, and even the vet didn't really understand why I was there. "You want a cortisone shot for him?" Look of confusion. "He has a little rash or something?"

And then I do the big reveal, pulling his rear leg back for a clear shot of his angry red stomach. The vet's jaw drops and he comes a little closer to get a better look, which is the only way to really see the extent of the problem.

As of today, three vets have now seen him in the midst of a hive attack, and all of them have had the same reaction: "Gosh... These are... so inflamed... Wow... Wow..." Leaves them speechless.

Today I asked if it could possibly be a reaction to medication he's taking, like the cephalexin—since these hives, which started as the rash, seemed to crop up soon after D started cephalexin.

The vet rubbed his chin. "That type of allergy is pretty unusual. But then again, it's Dozer we're talking about."

A shot of cortisone and a Benadryl injection, plus the stress of the vet visit, have knocked Big D out for the afternoon. Should offer some temporary relief while we try to figure out what caused this. What a setback!

Star's weekend adventure included a trip to the newly built garage.

Step 1. Walk up to the garage door and peek in.

Step 2. Walk inside and look. Stay close to doorway for fast exit.

Step 3. Scary as hell! Run back to back door and look pitiful until someone lets you in the house.

She's getting a little bit better—as long as the nail guns aren't popping. When the garage becomes the new destination for car rides and hanging out with Daddy, I think she'll come around.

Hives and staph and allergies, oh my!

Dozer has allergies. (If you follow this blog, this is not new.)

They were once seasonal and a simple cortisone shot could get him through the worst of it, but for the last couple years, the allergies have been year-round.

Dozer's third and most recent bout of staph sent us to a specialist. Who knew there were canine dermatologists? And that there was a good one just around the corner from my house?

So off we went to the dermatologist. Her office was fancy. I think the level of office fanciness is a big clue that you're now in Specialist Land, because Dozer's orthopedic specialist had a similarly swanky pad. We're talking polished concrete floors, vaulted ceilings with cedar beams, a plethora of looming tropical indoor plants, huge windows gazing out into greenbelt. Nothing resembling the cheap white tile and plain white walls of the regular vet.

The new strategy is a food allergy trial, meaning a restricted diet. Dozer eats nothing but a special rabbit-and-potato kibble for the next six weeks or more. He can't eat anything with artificial flavors, meaning he has to have ivermectin instead of the standard beef-flavored heartworm medicine. A few natural vegetables, like carrots and pumpkin, are okay.

Dozer HATES his special food. I think it smells awful, so I sympathize. I mix canned pumpkin into the food and it becomes magically delicious. Go figure.

Dozer also got a four-week course of cephalexin to treat the staph infection. Those pills go into a spoonful of pumpkin twice a day.

Just when I thought, hey, we might get this stuff under control after all... HIVES. The worst case of hives he's ever had.

I have no idea what set him off, but when he came up to me on Monday morning looking unhappy, I noticed the raised red weals all over his stomach. Blotchy, but not horrible. Yet.

Day 1

When they didn't disappear in a few hours, I called the dermatologist. The dermatologist advised giving him four Benadryl every eight hours. Now, I know Benadryl is the popular solution for many histamine reactions like hives, and it does work well for some dogs, but for whatever reason, Dozer has never really responded to Benadryl. But then again, four Benadryl sounded like a mega-dose that nothing could stand up to, so I decided to try it.

Hello? Benadryl? You working?

By the next morning, Dozer was one giant hive. His stomach was red as a tomato (and turning purple and even brown in places), his feet were puffy like marshmallows, and the hives had moved into the areas where the staph was already a problem, so he basically looked horribly diseased. Through another phone consultation, the dermatologist agreed I should take him to our regular vet for some serious intervention.

At the regular vet (who said, without batting an eye, "Wow, his skin is really inflamed"), Dozer got a cortisone shot, and some take-home prednisone pills for the next week.


Day 2




The dark spots aren't freckles--they are uber-hives.
Dozer's stomach is usually uniformly pale.

 It took another 24 hours for the swelling to go down. Dozer gets two cephalexin and a prednisone pill twice a day. Here we are four days after the initial event, and he still has blotches and scabby spots.

Sure wish I knew what happened so I could get rid of whatever it is/was.

Anyway, I'm still hopeful we can get a handle on his allergies, despite this ridiculous setback. We may resume allergy shots if the food trial turns up negative for food allergies.

Here is a totally off-topic closing quip for your enjoyment.

Text message exchange between me and my sister:

Me: i wanna put my recycling in your receptacle

Sister: dirty

Season of Joy

I thought it might be a good idea to post a bit about the great things happening, since previous posts might have implied that I'm really sad or discouraged. :)

It is crazy around here (Dozer), and stressful (Dozer!), but believe it or not, I'm having the best time of my life. My educational websites are performing satisfactorily, and my volunteer activities (fostering, etc.) are time-consuming but very rewarding. My job is kick-ass awesome; I get told daily how great my work is, and that feels really good. And my home life is certainly not boring.

Daisy's mom is very sweet; she's worried about Dozer's most recent mishap (that I Tweeted about), so I thought I'd update.

Yesterday I got home from work and noticed Dozer itching a lot. So I got a closer look and he was covered in blotches all over his stomach. In an hour this went from blotches to lumps, and in three hours when he started looking like a marshmallow, Byrd and I packed him over to the emergency vet.

At the emergency vet, they gave him three injections (two cortisone and one Benadryl) and sent me home with Prednisone and orders to give him 4 capsules of Benadryl twice a day as well.

We don't have any idea how this reaction happened or what caused it. It's supposed to clear up in a few days. The drugs have made Dozer very sleepy, so it's peaceful around here right now. :)

I've been told that this incident won't interfere with his surgery for the torn meniscus, which is scheduled for December 23.

Sigh. Dear God, I would like the random surprise disasters to stop now, please. Sincerely, Jennifer.


For my rather large extended family, the period between Thanksgiving and New Years' is a time for reflection, thanks-giving, good food and good company, goal-setting, and reminiscing.

Here is my earnest wish for the coming year. It is my hope that everyone will take up a volunteer role of some sort. Even a very small role, or a short-term one. Every volunteer minute is a valuable one, and many organizations are in desperate need. (For those who are already volunteering or donating in some way--thank you so much!)

And of course, I wish the best for you, my readers, and your families and friends in 2010.