It was one of the last appointments of the day, and it was with a lovely senior lady who I always enjoyed seeing with her poodle. I was a bit surprised she was coming in, as I had seen her the previous week, and everything seemed to be fine.
“Doctor,” she lamented the moment I entered the room. “You have to help my dog Sandy. My dog is so itchy! I think she has fleas!”
Sandy sat calmly on the table, her tongue hanging out from the right side of her mouth where a few teeth were missing. She seemed completely unconcerned with the examination. From what I could see, Sandy appeared to be in perfect health—just as she had the week before. There were no signs of dandruff, red spots, or rashes, and during the entire half-hour exam, Sandy made no attempt to scratch any part of her body, not even the pink bows in her ears.
Baffled, I pressed further. “How often would you say Sandy is scratching?”
Sandy’s owner stared at me blankly. “She’s not scratching,” she replied, her eyebrows furrowed, as though she thought I was a little off my rocker. Then, as if to clarify, she added, “I have all these red spots on my back and chest. I think they are from Sandy’s fleas.” To emphasize her point, the dear lady promptly removed her shirt to show me the rash she was sure had been caused by the dog.
As it turned out, Sandy was perfectly fine and didn’t have any kind of parasitic infestation. Her owner’s concern stood in stark contrast to that of a farmer who had brought in his collie—completely bald, except for two sad tufts of fur on top of his head. He was worried that there might be something wrong with the dog’s skin.
One of the most common concerns I encounter as a veterinarian during exams is a pet scratching. Interestingly, the severity of a pet’s skin condition when they finally see a veterinarian can vary greatly. Often, we’re seeing pets when their symptoms, like hair loss, are bothering the owner, not the pet.
While it’s pretty obvious when something is wrong with your pet—like if they’re vomiting every 10 minutes or dealing with raging diarrhea—it can be trickier to evaluate skin issues and determine when to intervene with tests or treatments. You can be of great help to your veterinarian by collecting as much information as possible at home about what you’re seeing. In fact, when it comes to skin conditions, an accurate history can go a long way in narrowing down the list of possible diagnoses.
The most obvious thing you can tell your vet is how long the problem has been going on. Has your pet been scratching at its ears, licking its paws, or chewing on its tail? If so, for how long? How many times a day do you notice the behavior? Is it something you can interrupt, or does your pet seem intent on scratching nonstop when they get started?
Be sure to mention what kind of food your pet is eating, including treats and table scraps. 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…). It’s also important to mention any signs of intestinal parasites you may have observed on your pet’s skin, as well as any flea treatments or other products you’ve used.
It can also be helpful for your vet if you can identify any seasonal patterns to the skin changes you’re seeing. Are there any littermates of your pet that also have skin problems? Are other animals or people in the household showing signs of skin issues? Additionally, make sure to tell your vet about any treatments you’ve tried, including baths, antibiotics, steroids, and the doses or frequency of these treatments, if possible.
What Tests Your Veterinarian May Do:
Once your vet has gathered a thorough history of your pet’s skin condition, they will likely recommend some tests. These may include a tape lift to check for topical parasites or a skin scraping to examine for deeper, burrowing bugs. Your vet may also suggest blood work to rule out thyroid or adrenal gland issues, which can affect the skin and coat. Swabs of the skin can help identify bacterial or yeast overgrowth.
Although it may not seem like a “test,” your vet might recommend a prescription food trial. This usually lasts for 6-12 weeks, during which you would feed only the prescribed food. After that, you can reintroduce your regular food. Often, you might see only a small improvement during the food trial, but a noticeable decline once you switch back to regular food. This can indicate that your pet’s skin issue is related to food sensitivity. It’s important to stick strictly to the prescribed food, as any deviations will make it impossible to determine if your pet has a true food allergy—strict adherence to the food trial is the only way to diagnose this.
A biopsy of your pet’s skin may also be recommended to get a clearer picture of the problem. Sometimes multiple conditions are affecting the skin, and a biopsy can help clarify things. Finally, if an environmental allergy is suspected, there are blood tests and skin allergy tests, much like the ones used in people. However, these tests can sometimes be debated in terms of accuracy. Be sure to discuss these options with your veterinarian, as they’ll have insights specific to your pet.
What to Expect from Treatment:
The type of treatment your pet receives will, of course, depend on the disease process your veterinarian diagnoses. There’s an old saying in medicine: skin disease is both good news and bad news. The good news is that most skin conditions are very rarely fatal. The bad news is that many of them are not curable, but instead, manageable through changes in food, lifestyle, environment, and medications. Many of the treatments we use for skin disease require prolonged administration—sometimes for weeks, months, or even years.
As time goes on, you’ll likely become more attuned to recognizing when things aren’t going well with your pet’s skin, which will allow you to intervene earlier and hopefully lessen the severity of flare-ups.
With early, aggressive diagnostics and treatment, most pets with skin conditions can live full, healthy, and normal lives.
