Using Chlorhexadine for Your Dog (Answers to Common Questions)

March 2, 2020
Chihuahua with Bandage on his Head

​It can be so upsetting to see your dog suffering! Whether the cause is a skin abrasion, rash, cavity, infection or some other health issue, you just want your precious pup to feel better fast.

After all, until your dog feels better, you won't feel better either.

If you are caring for a dog for the first time, the word "chlorhexidine" may be a new one for you. What is chlorhexidine? How does it work? Is it safe for dogs? How do you use it?

Chlorhexidine is not just used on dogs, by the way. It is also commonly used on people!

In some cases, your canine veterinarian may prescribe chlorhexidine, either as chlorhexidine gluconate or as chlorhexidine diacetate. The latter is usually stronger than the former so be sure you are clear on which type you have before using it.

In either case, it is important to follow your veterinarian's instructions for use, even if those instructions conflict with the manufacturer recommendations.

You can also purchase canine chlorhexidine over the counter in many stores and online. Here again, it is vital to understand what this antiseptic is designed to do, how it works and how to use it, as well as warning signs to watch for.

You will learn about using chlorhexidine for your dog in this article. But remember, if you have any questions, your canine veterinarian should always have the final word!

What Is Chlorhexidine for Dogs?

​Chlorhexidine is an antiseptic (disinfectant or cleansing agent) with a number of useful properties. For instance, it is a known anti-fungal, anti-bacterial and anti-viral.

For this reason, chlorhexidine is commonly used to treat each of the following types of health issues in dogs:

  • Fungal infections
  • Bacterial infections
  • Yeast infections
  • Viral infections

It is important to note that chlorhexidine is not designed for use in treating parasites and pests (worms, ticks, mites, fleas).

According to Veterinary Practice News, veterinary surgeons often use chlorhexidine to prepare canine patients for surgery.

Chlorhexidine is often prescribed to treat these types of health issues in dogs:

  • Ear infections: acute/chronic otitis externa
  • Dental health issues: gingivitis, periodontal disease
  • Skin infections and conditions: hot spots, yeast infections
  • Wound treatment: easing inflammation, reducing infection risk.

But chlorhexidine can also be used to prevent your dog from getting an infection or developing dental issues. You can also use it to help prevent your dog from getting an infection in the first place.

Why Would You Use Chlorhexidine for Dogs?

​You now know that chlorhexidine is a common antiseptic. Just hearing this, you are probably already starting to get a clearer picture of why you might want to use chlorhexidine with your dog.

Dogs will be dogs, after all! An active pup can get into all kinds of things and you may never know where that mysterious scratch or purple rash came from.

As well, some of the places where dogs can get hurt or develop infections can be pretty difficult to isolate and protect.

Inside the mouth, inside the ears, on the paw pads - these are just some of the places where it might come in handy to have a long-lasting antiseptic as your healing ally.

As we briefly mentioned in the introduction here, chlorhexidine can be obtained in two ways:

  1. Over the counter or online.
  2. By prescription through your veterinarian.

Chlorhexidine is sold in a variety of formats. These are four of the most common:

  1. Aqueous (water-based) liquid solution
  2. Wipes
  3. Spray
  4. Shampoo

Chlorhexidine comes in different preparations (strengths), including these:

  • 0.4 (four percent)
  • 0.3 (three percent)
  • 0.2 (two percent)
  • 0.1 (one percent)

And chlorhexidine may be used alone or in combination with other ingredients. These additional ingredients may be active or inactive.

Before choosing a non-prescription chlorhexidine with added ingredients, always be sure you know what those ingredients are designed to do.

These are some (but not all) of the additional active ingredients that are often used in combination with chlorhexidine or chlorhexidine gluconate:

  • Ketoconazole (anti-fungal agent)
  • Climbazole (anti-bacterial and anti-fungal agent)
  • Miconazole (anti-fungal agent)
  • Zinc gluconate (nutritional additive)
  • Benzalklonium chloride (another antiseptic agent)
  • Malic acid (breaks down wax)

Here are some of the common inactive ingredients used in some chlorhexidine preparations:

  • Alcohol
  • Fragrance
  • Essential fatty acids
  • Aloe Vera
  • Essential oils
  • Herbal additives (chamomile, et al)
  • Preservatives
  • Dyes
  • PH stabilizers
  • Foaming agents
  • Water
  • Moisturizers
  • Deodorizers
  • Glycerin
  • Panthenol
  • Flavoring agents
  • Sorbitol (sugar alcohol)

Here, it is important to remember that just because an ingredient is regarded as "inactive," this doesn't necessarily mean it won't bother or irritate your dog.

For example, essential oils, perfumes and dyes can all be potentially bothersome for dogs who have skin allergies.

For your dog's safety and your peace of mind, if you decide to use any non-prescription chlorhexidine product that includes added ingredients you are not familiar with or have not used before, it is always smart to talk with your dog's veterinarian first.

How Do You Dilute Chlorhexidine for Dogs?

​You probably noticed that chlorhexidine comes in a variety of strengths ranging from 0.1 (one percent) up to 0.4 (four percent).

It is extremely important to dilute the product in specific ways based on how you need to use it.

Drugs.com recommends the following dilution strengths for canine use:

  • Dilute two tablespoons (one ounce) of chlorhexidine into one gallon of water.

It is very important to avoid getting any of this solution in your dog's eyes or mucous membranes. If this happens, flush the area with pure clean water right away.

Different dilution strengths may be recommended based on the type of health issue your dog is battling.

In some cases, the chlorhexidine product you are using may already be diluted. Always read the instructions for use carefully before doing any additional dilution to avoid cancelling out the positive effects of the treatment.

Here is a basic overview of how to use or dilute chlorhexidine for use on different areas of your dog's body.

Dental/Mouth Use

Your Pet Dentist recommends using a solution of chlorhexidine that ranges from 0.12 to 0.2.

If you go any higher than two percent concentration, you risk irritation of the sensitive mouth tissues and mucous membranes.

In many cases, dental solutions are already pre-diluted and may contain additional ingredients for use as a rinse.

The most common reason to use chlorhexidine on your dog's mouth or teeth is to prevent plaque or to treat gingivitis and periodontal disease.

Your Pet Dentist also points out that ongoing use of chlorhexidine may cause some tooth staining. However, any discoloration should come off when you have your dog's next tooth cleaning.

A study published by the Journal of Veterinary Dentistry reported that use of a 0.2 (two percent) chlorhexidine dental chew had any measurable impact on the amount of plaque that formed on the dogs' teeth.

Even better, a study published in the Journal of Small Animal Practice stated that a 0.5 (five percent) gel solution used directly on the teeth of Beagle dogs made a significant impact on the amount of calculus and plaque that formed after treatment began.

However, the same study showed that previous calculus was not reduced at all. This points to use of chlorhexidine as a preventative agent for your dog's dental health.

What these studies reveal is that chlorhexidine use may be another potential way to help keep your dog's teeth and mouth healthier and prevent gingivitis and periodontal disease. It may also help to reduce the frequency of dental cleanings.

Topical (Spot) Skin Use

As Preventative Vet points out, using a too-strong solution of chlorhexidine will not only risk irritating your dog's skin but may also actually kill off the helpful cells that are trying to heal the area.

Preventative Vet recommends using a solution of chlorhexidine diacetate, although in most of the literature chlorhexidine gluconate is the most common type used.

When using chlorhexidine to spot-treat areas on your dog's body that may be inflamed, infected or wounded, you want to stay away from products designed to scrub. Rather, what you want is flushing products.

Wipes or liquid solutions are both great choices. If you are using chlorhexidine diacetate, aim for no higher than a 0.05 percent dilution of chlorhexidine to additional ingredients.

If you are using chlorhexidine gluconate, you can go as high as 0.2 (two percent) dilution as long as you don't see any signs of skin irritation after use.

If you need help calculating the correct dilution of chlorhexidine to water, always ask your dog's veterinarian. You can also use this handy free dilution calculator.

VCA Animal Hospital points out that it is generally not recommended to use any type of flushing solution with an open wound.

However, there are times when your veterinarian may suggest using a chlorhexidine solution to keep an open wound clean, such as after minor skin surgery or dental surgery.

Another common use for chlorhexidine on the skin is when your dog has had an injury and you need to clean out some dirt or debris. In this case, chlorhexidine solution is often the right choice to achieve this.

Shampoo Use

Shampoos that contain chlorhexidine often contain other active ingredients as well.

This means it is especially important to either talk with your dog's veterinarian or simply screen the ingredients carefully before choosing a chlorhexidine shampoo for your dog.

The good news here is, Veterinary Dermatology performed a study to investigate the effectiveness of chlorhexidine shampoos versus antibiotics and found that the former performed just as well as the latter.

So chlorhexidine shampoo for canine dermatology issues really can be a great solution when used properly.

The Veterinary Dermatology study used a shampoo containing 0.4 (four percent) chlorhexidine digluconate. The dogs received a shampoo treatment twice per week.

The dogs were also treated separately with a 0.4 (four percent) chlorhexidine digluconate solution (liquid flush). The solution was applied once per day.

The treatment period lasted for four weeks. At the end of the study, the dogs that had received the chlorhexidine treatments were completely free of staphylococcus and pyoderma after the four weeks was over.

A presentation on Topical Therapies in Veterinary Dermatology recommended using a preparation with concentration of chlorhexidine gluconate at between 0.2 (two percent) and 0.4 (four percent).

The presenting veterinarian also recommended leave-in products and/or a longer contact time of up to 10 minutes to experience the best results. In addition to chlorhexidine shampoos, you can also use sprays, wipes and flushes (liquid solutions).

One of the reasons that chlorhexidine shampoo can work so well to treat canine skin conditions is because the contact results (the amount of time the solution stays active on your dog's skin) is as long as two days.

Ear Use

We will cover how to use chlorhexidine to clean your dog's ears in the next section here.

How Do I Use Chlorhexidine for Cleaning My Dog's Ears?

​The Journal of Progress in Veterinary Neurology states that a solution of up to 0.2 (two percent) can be safely used to clean and flush a dog's ears without risk of ill effect such as irritation.

For this particular study, chlorhexidine acetate (a form of chlorhexidine diacetate) was used. The dogs that participated in the study did not experience any irritation even after three weeks of treatment.

Vets Now recommends using a solution containing chlorhexidine in 0.15 to 0.2 concentration and no higher.

This is important to avoid what veterinarians cause "ototoxicity." Ototoxicity can manifest in a variety of ways, including temporary or permanent loss of hearing. It can also damage the sensitive membranes of the outer and inner ear.

So how should you use chlorhexidine to clean your dog's ears? The way you use chlorhexidine can differ depending on whether you are using it for preventative or treatment purposes.

Always ask your veterinarian about the frequency and strength of the chlorhexidine product you plan to use. Alternately, follow the manufacturer's instructions for your particular product.

Start with the lowest level of usage and work your way up as needed. For example, if the instructions are to flush your dog's ears once to twice per week as needed, start with once per week and see how your dog responds.

If your dog is very wiggly or squirmy or hates having their ears touched or handled, you may find that using a chlorhexidine spray is a lot easier than trying to administer a liquid or use wipes.

Dog getting a bath

Can I Wash My Dog With Chlorhexidine?

​You can use a chlorhexidine shampoo to wash your dog. Chlorhexidine shampoos can be effective against bacterial infections, fungal infections and similar non-parasitic skin conditions.

You may already be quite familiar with the process of giving your dog a bath. But the process of giving your dog a medicated bath can be quite different.

Whereas with a normal shampoo your goal is probably just to get rid of excess dirt, hair and grime, with a medicated shampoo your goal is going to be to make sure the shampoo contacts the affected areas and stays in contact for a minimum of 10 minutes.

This may mean you are shampooing certain parts of your dog's body, ears, paw pads, belly or wherever the irritated or infected patches reside. You don't want to skimp on shampoo - rather, be sure you get the area well covered with chlorhexidine shampoo.

Also, where you may normally be accustomed to doing a quick shampoo and rinse for your dog just to get the dirt off, with a medicated shampoo it is common to let the shampoo sit on your dog's skin for a period of time before you rinse.

This YouTube video offers a helpful how-to guide for giving your dog a medicated shampoo.

The shampoo is done by a veterinarian in a clinical setting so you'll get a good look at exactly how and how long to leave the shampoo on, as well as warning signs to look for.

At the end of the video, the veterinarian emphasizes how important it is to leave the shampoo on for an adequate period of time for the type of infection you are treating.

And if your dog seems itchy or bothered after the shampoo, this may be a sign that the shampoo itself is causing discomfort or irritation. Be sure to watch for signs that your dog is licking or biting the area more than normal after the shampoo.

Because some dogs have a very real sensitivity to chlorhexidine, it is important to try a wash-off shampoo the first time you treat your dog. Then watch for signs of skin irritation or allergic reaction.

If you don't see any warning signs and your dog seems to tolerate the shampoo well, you may want to try a leave-in chlorhexidine shampoo.

Today's Veterinary Practice reports that using leave-in medicated shampoos can not only make medicated baths easier on you and your dog, but the extended contact may also help ensure your dog finds relief faster.

Today's Veterinary Practice further states that chlorhexidine shampoos at 0.2 to 0.4 strength are best for treating skin issues that are resistant to other forms of treatment. Bathing frequently is also an important part of treatment success.

Is Chlorhexidine Safe for Dogs?

Veterinary Practice News emphasizes that solutions of chlorhexidine up to 0.2 (two percent) are generally safe for use with canine patients.

In fact, chlorhexidine is very commonly used as part of the process to sterilize areas before surgery.

But this does not means that chlorhexidine is benign. While there are many chlorhexidine-based products for dogs that are sold without a prescription, it is important to remember that chlorhexidine is still a medication.

For this reason, the very best approach is to ask your veterinarian first before choosing to use any product containing chlorhexidine in any of its forms on your dog.

It is also important to be sure you are purchasing your chlorhexidine products from a reputable manufacturer. Now that we live in a global economy, it may not always be obvious where the canine chlorhexidine product you are considering comes from.

Different countries maintain different standards for sourcing and manufacturing pet products. By taking some time to research the manufacturer, you can usually find out where the product is actually made and if there have been any customer complaints.

In cases where you are not sure, it is always smart to select a chlorhexidine manufacturer that prints "made in the U.S.A." on the packaging. This way, at least you know the Food and Drug Administration (FDA) maintains oversight over pet products.

What Are the Side Effects of Using Chlorhexidine Shampoo for Dogs?

​Dogs, like people, can potentially experience sensitivity to chlorhexidine.

As the Committee of Veterinary Medicinal Products states, chlorhexidine binds very strongly to the skin, which can be irritating for some dogs.

This is especially true if the solution comes in contact with your dog's eyes or sensitive mucous membranes and tissues.

However, chlorhexidine has been in use since its discovery in 1950, which makes it one of the best-known and studied medicines for both people and pets. Overall, a low dose of chlorhexidine has low toxicity and poor absorption in the gut if swallowed.

A 2014 ResearchGate study issued the recommendation that chlorhexidine be used more frequently in veterinary medicine precisely because it is so well known and seems to be well tolerated by most dogs.

However, animal subject research studies have shown the danger increases when the dosage increases. Many studies showed that concentrations of chlorhexidine above 0.2 (2 percent) were more irritating to dogs, especially in dogs that had sensitive skin to start with.

One of the biggest concerns with a skin-adhering treatment like chlorhexidine is always going to be to keep your dog from licking it off. While studies prove that chlorhexidine is poorly absorbed in the gut, it could cause irritation in the lungs and bronchial tubes.

Summary

​If you are caring for an intact dog that will be used in a breeding program, always talk with your veterinarian before using any medicated treatment, including chlorhexidine.

While studies have not shown that there is a big risk to the fetus in low doses, at higher doses there can be low birth weight, greasy coat and additional health problems.

All medications, whether prescription or over-the-counter, topical or ingested, deserve our respect and careful research.

This is especially the case when you are caring for a different species, even if the medication in question, like chlorhexidine, is used on both people and dogs.

By taking the guidance of your dog's veterinarian and researching chlorhexidine products carefully, you can have the best chance of reaping the preventative and treatment results you just read about in the studies cited here.

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