PetMeds^® Blog

It happens all the time: One day your pet has a shiny coat full of luster and the next day there is a large patch of hair loss that is sensitive, moist and oozing. Sometimes the skin is sticky and this can cause your pet to be very uncomfortable. In worse cases, these sticky lesions can also be scratched until they bleed. This common sudden skin change in dogs is often referred to as a “hot spot” which refers to a sudden area of intense skin inflammation as described above.

These areas can emerge anywhere on a pet’s body, but most commonly are seen under the ears or skin folds of the neck, and often down the lower back or flank areas. The causes of these frustrating and often painful eruptions are usually allergy based; either flea bite allergy, inhalant/contact allergy, and/or food allergy. Obviously a thorough flea combing should be done to make sure there is no evidence of flea infestation or recent exposure to fleas. Such pets should be on a good flea preventative program using such products as Frontline Plus or Advantage, or a natural form of flea prevention for clients more holistically oriented. The most first line of treatment in such pets with hot spots is to soothe the skin both topically and through oral medication. Oral antihistamines such as diphenhydramine, chlorpheniramine or clemestine can help break the itch cycle, as well as cleaning the area with a dilute antibacterial soap, and then adequately drying.  Topical anti-inflammatories such as Be Soothed, Excel Hydrocortisone Spray and Miracle Mist Skin Spray can all potentially help in offering the pet relief.

In some cases it is necessary to see a veterinarian who will usually clip the hair from around the area to allow it to heal, and clean and dry the area thoroughly. On occasion it is necessary to sedate the pet, in order to properly treat very sensitive hot spots. If the eruption is severe, oral antibiotics are often prescribed such as Cephalexin and/or short courses of oral Prednisone or Temaril-P, until the lesions dry and heal. With time and patience, most pets are back to normal in a short period of time. In those pets that have repetitive hot spots, it is important to explore the various underlying allergic causes mentioned in this article to cure this tendency long term.

This very common client question unfortunately often has a complex answer, depending upon the individual pet. The first lesson in veterinary dermatology that we learned in veterinary school is to do a skin scraping, looking for scabies or demodex mange mites (more commonly seen in dogs), as well as taking scrapings for overgrowth of yeast or fungi like ringworm.

If these tests are negative the most common cause of scratching is often termed ”allergies.” The three broadest causes of these allergies in dogs and cats, include flea bite allergies, inhalant/contact allergies to molds, grasses, trees, dander, house dust mites, pollens, and food allergies.  Some pets can have multiple factors from these three major groups. These frustrating itchy dogs and itchy cats can often develop secondary bacterial or yeast infections, which must also be addressed if the scratching is to be resolved. Often secondary oral antibiotics or antifungal medications are needed, which can be determined by a veterinary exam and the above testing. In middle aged and older pets, we will sometimes see hormonal disorders as contributing to skin infections and itchy pets.  So, sometimes thyroid and adrenal gland function testing are indicated depending upon the individual pet’s presentation.

One of the first things a veterinarian may do for a very itchy dog is to sometimes treat for hidden scabies mites (which do not often show up on skin scrape) with products like Ivermectin or Revolution, as well as change a pet to a low allergy, novel protein prescription diet for a minimum of a few months. In addition, a veterinarian may treat the secondary bacterial or yeast infections from all of the itching with appropriate antimicrobials and specific shampoos, such as Ketochlor, Oxydex, or Chlorhexidine Shampoo; especially in pets with secondary infections contributing to the scratching. For cats, a low allergy diet is often tried as well.

If there is not adequate improvement in the itching, then veterinary dermatologists will often perform blood and/or skin allergy testing to find out what a pet is allergic to, so that appropriate allergy treatment can be formulated. If a client goes through an entire dermatology workup, costs can climb quickly, especially with the allergy testing and recheck exams, as often up to one year of allergy vaccines are tried before deeming treatment a success or failure.  Average success rates for inhalant/contact allergy dogs and cats (also known as atopic dogs/cats) can range from 60 to 70 percent. For the remainder of the patients, and for those animal guardians who do not go for a complete dermatology workup, symptomatic management with various antihistamines like Diphenhydramine, Chlorpheniramine, and Clemastine can be tried.  When combined with excellent Omega 3 fatty acids like Be Well, Super Omega 3, or Missing Link for Dogs and Missing Link for Cats, and appropriate shampoo therapy, symptoms can often be controlled, but are difficult to cure.

Prescription allergy pet meds like Atopica and Prednisone are needed for extremely itchy, nonresponding pets. Natural supplements like Proanthozone, DMG liquid, or Yucca Intensive may also offer effective alternatives in itchy pets.  I find that no one protocol works best in all pets, and that various combinations from the above groups and various therapeutic trials are needed to find the right combination that works best in a given pet. In addition, all itchy pets should be on some sort of flea preventative product, whether conventional Advantage or Frontline Plus, or natural flea and tick products to eliminate the always potential possibility of flea bite allergies involved.