It was one of the last appointments of the day and was with a lovely senior lady who I loved to see with her poodle. I was a little surprised she was coming to see me, as I had seen her the previous week and all seemed to be well.
“Doctor,” she lamented the second I entered the room, “you have to help my dog Sandy. My dog is so itchy! I think she has fleas!”
Sandy sat on the table placidly, tongue hanging out the right side of her mouth where she was missing teeth, utterly unconcerned with the proceedings of the examination. As far as I could see, she looked exactly as she had the week before: perfect health. There was no sign of dandruff, red spots or rashes and, throughout the half hour exam, Sandy made no attempt to scratch at any part of her body, including the pink bows in her ears.Baffled, I questioned Sandy’s owner further. “How often would you say that Sandy is scratching?”
Sandy’s owner stared at me blankly. “She’s not scratching,” she said, eyebrows furrowed as though she thought I were a little off my nut. Then, by way of explanation, she clarified, “I have all these red spots on my back and chest. I think they are from Sandy’s fleas.” To drive home the point, the dear lady promptly whipped off her shirt to show me the rash she was sure had been dog induced.
As it turned out, Sandy was fine and had no infestation of any parasite. Her owner’s concern stood in sharp contrast to a farmer, who presented to me his collie, who was completely bald, save two lonely tufts of bedraggled fur on the crest of his head, voicing his suspicions that there may be something wrong with his dog’s skin.
One of the most common concerns presented to me as a veterinarian during an examination is that a pet has been scratching. Interestingly, how severe a pet’s skin condition is by the time they see a veterinarian can have a wide range. We often see animals when their symptoms, such as hair loss, are bothering the owner, not the pets themselves.
What you should be able to tell your veterinarian:
While it can be pretty obvious there is something wrong with your pet when he or she has raging diarrhea or is vomiting every 10 minutes, it can be more difficult to evaluate with a skin condition how quickly to intervene with tests or treatment. You can be of great help to your veterinarian if you are able to collect some information at home about the signs you are seeing. In fact, in skin conditions, an accurate history of your pet’s symptoms can go a long ways towards narrowing the field of prospective skin diseases
your pet may have.
The most obvious thing you should be able to tell your vet is how long the problem has been going on. Has your pet been scratching at his ears, licking at his paws or chewing at his tail? If so, for how many weeks, and how many times a day would you catch him or her scratching? Can you distract him from scratching at his ears, or is it a full time project when he starts going after them?
Make sure you can tell your vet what kind of food your pet is eating, including treats and table scraps. And yes, leftovers from your fridge DO count, as do rawhides and whatever your dog finds in the cat litter box (I know, gross, but true…). You should also report any signs of parasites you may have seen on your pet’s skin and report any products you may have used to treat fleas or other parasites.
It can be helpful to your vet if you can tell him or her if there is any seasonal pattern to the skin changes you are seeing. Do you know of any littermates of your pet that also have skin problems? And are the other animals and people in the household showing any signs of skin problems? Make sure you can tell your veterinarian what other treatments have been tried, including baths, antibiotics and steroids, and the doses and frequency of these treatments, if possible.
What tests your veterinarian may do:
Once your vet has gotten a thorough history of your pet’s skin problem, they will likely recommend some testing. These may include a tape lifting to check for topical parasites or a skin scraping to check for more deeply burrowing bugs. Your vet may also recommend blood work to rule out thyroid or adrenal gland problems which can affect the skin and coat. Swabs of the skin can show overgrowths of bacteria or yeast.
Although it may not seem like a test, your vet may recommend a prescription food trial. These usually are done for 6-12 weeks during which ONLY the prescription food is fed, then your start feeding your regular food again. Often you may see only a small improvement while you are on the food trial, but see a substantial deterioration once you switch back to your regular food. This would indicate that at least some of your pet’s skin problem can be improved with the proper foods. It is important to remember that cheating on a food trial will prevent you from being clearly able to see if your pet truly has a food allergy, as a strict food trial is the ONLY way to diagnose a food allergy.
A biopsy of your pet’s skin can shed more light on your pet’s problem. There is sometimes more than one condition affecting the skin, and a biopsy can help sort out multiple conditions. Finally, if an environmental allergy is suspected, there are blood tests and skin allergy tests, much the same as in people, which we can use in pets. There is, unfortunately, some debate about these tests as to how accurate these tests are. Talk to your veterinarian about their recommendations regarding your specific patient.
What to expect from treatment:
The type of treatment your pet undergoes is, of course, dependant on the disease process that you veterinarian has diagnosed. There is a saying in medicine that skin disease is good news and bad news. The good news is that most skin diseases are only very rarely fatal. The bad news is that we are often not dealing with diseases we can cure, but diseases we manage with food, lifestyle, environment changes and medications. Many of the treatments we use for skin disease must be administered over prolonged periods of time, from weeks to months and, sometimes, for years. As time goes on, you will find that you will recognize the signs in your pet that things are not going as well, and you should be able to intervene earlier in the disease process, hopefully making the episodes less severe as time goes on.
With early and aggressive diagnostics and treatment for your pet’s skin disease, they are usually able to live full, healthy, normal lives.
