Skin allergies, sensitivity to fleas and foods, skin bacterial infections, mange, yeast, and fungal infections can make a pet miserable. Really miserable. And smelly and gross. And irritable and restless.
Treatment can often be frustratingly ineffective.
So often, pets with sensitive skin are suffering from not one but several things all at once. For example: A single pet may be extra sensitive to fleas. And reactive to several different food groups. And allergic to dust mites and pollens. And because this pet's skin is chronically inflammed and irritated, it might also suffer from both bacterial and yeast infections. If a vet misses just one of these problems, the pet continues to itch and itch and itch.
This page is devoted to outlining "What To Expect When You Go To The Vet" for skin disease in general. This should give you a broad understanding of what the vet is looking for and how involved getting a good diagnosis and treatment plan can be for skin diseases.
On other pages, listed on your left are more detailed descriptions and useful comments about specific skin diseases.
As usual, there may be a few jokes, political, historical, and miscellaneous comments scattered about just for fun or interest.
Remember that this information is intended not as a guide for home treatment but to impress on you how complicated a safe and successful treatment can be: for good results you need to go to your vet. And with skin disease being as frustrating as it often is, you may need to make several visits in order to finally get everything under control.
Notice I said control and not cure. It's just a fact of medical life ... at least for the present ... that there is no actual cure for many of our skin diseases. But with diligence and an armory of some fairly effective medications, we can usually make your pet comfortable, happy, sweet smelling, and nice to have around again.
There's quite a bit of new information here, so enjoy.
Roger Ross, DVM
"What To Expect When You Go To The Vet" When Your Pet Has Skin Problems
(Of course, your vet may do things a little differently)
A good history and Exam: In addition to our normal head to toe exam, we'll be paying special attention to: where on the body the skin problem first started, whether or not the problem seems to be seasonal, diet, the location and type of lesions on the skin, the presence of fleas, ticks, mites, & lice, and whether previous treatments have helped much. We'll also want to know if other pets or people in the household are affected. We need to know if a female dog has been in heat recently or pregnant.
An experienced vet can often get a pretty accurate diagnosis with just a good exam and history and may recommend a course of treatment without the expense and trouble of further testing...but this is method often fails...not because the vet is wrong but rather because something was missed:
Much of the time there are at least 2 or 3 problems going on at the same time. A very typical case might involve a dog with skin allergies. But because the skin and the underlying glands are irritated by the allergies, the skin changes texture, the pores clog with sebum and the skin becomes infected with not only bacteria but also yeast organism. Unless all 3 parts of the problem are detected and treated, the skin doesn't improve much.
So, if you and your vet decide to treat based upon exam and history alone, just beware that if your pet is not improving soon, to should return for a more aggressive follow up visit.
Here's a list of tests that may need to be done:
Microscopic skin scrapings: to rule out mange mites and to see what the hair follicles look like which are clues to hormone related problems
Microscopic ear wax smears to rule out the ears as a source of infection, mites, and yeast.
Fungal Ringworm Culture: Surprise; often positive when not strongly suspected.
Cytology: This is where we stain samples of scrapings from the skin and ears. It's probably the best and easiest way to identify malassezia (yeast) infections which are quite frequently part of the problem. This same test will also tell us if heavy loads of bacteria are present and give us a good clue as to what type of bacteria they are. (The vast majority are staph intermedius and show up as easily identified cocci in the microscope.) This helps us choose an appropriate antibiotic if needed.
Bacterial Culture: I don't find skin cultures worth the cost and trouble in typical cases of suspected skin infections, but there are exceptions when they are very useful. One example would be if it turns out in the cytology that the bacteria are rod shaped instead of cocci, then we would suspect a pathogen different from the usual staph and would probably do better with a different antibiotic. Frequently such bacteria turns out to be pseudomonas which can require long term, expensive antibiotics.
Thyroid testing for thyroid disease: This is usually a disease of middle age and older dogs. It's a fairly common underlying cause of skin problems and your vet may recommend this blood test.
CBC & Chemistry: another underlying cause of skin problems, especially in middle age and older pets are metabolic problems such as Cushings Disease, Addison's Disease, and Diabetes. Your vet may recommend blood work to rule these problems out. Doing general blood work has other merits too; it helps flag problems with the liver and kidney...something we need to know when we're prescribing medications, and because the old axiom is often true; visible disease on the outside (skin) may be a result of hidden disease on the inside.
Skin biopsy: Because of the expense and trouble of this test, it isn't frequently done unless the skin problem is hard to resolve or remains undiagnosed after doing other less expensive testing. But biopsy is the test of choice for many auto-immune diseases and "deep" skin diseases.
A trial of Hypoallergenic diet: Food allergies are frequently at least a part of the problem and switching foods can lead to a big improvement in about 1 out of 5 skin cases. But it's important to do this trial test right; not just switch from one brand to another. (More information on the page about food allergies)
Allergy Testing and Desensitization: I'm not very impressed with the blood tests and skin testing kits available to general practioners for this purpose, and I don't think most vets recommend such testing until other less expensive tests and treatments have been attempted. But, for those allergic pets who aren't responding well or safely to other forms of treatment, this option, especially in the hands of a specialist, may identify exactly what your pet is allergic too and if desensitized, may allow your pet to live a more normal and comfortable life.
Some of the tests above are quite inexpensive or included in the normal exam fee and are done routinely to help us get a firm diagnosis. On the other hand, some of the tests are somewhat or very expensive and you and your vet will typically discuss the potential wisdom of doing these tests based on the individual patient, the severity of the problem, and so forth.
Sometimes we'll start by treating any obvious problems detected such as bacteria and yeast infections and once that's under control recheck the patient to see what problems might be remaining. Be prepared; it may take multiple visits to get a bad skin problem under control.
Treatment of Skin Disease:
If you've read everything above, you know by now that there are multiple things that might be causing your dog or cat to have smelly, itchy, or otherwise damaged skin. Treatment, of course will depend on which problem ... or problems ... are detected.
I live in a rural area where we have our fair share of "hicks", also known as "good 'ol country people" and they'll say things like "my dog has got the mange" ... an expression they use for any type of ugly looking skin problem even though the problem usually isn't actually mange but rather allergies and fleas and malnutrition with secondary bacteria.
No matter, as long as you understand that there are quite a few potential causes of skin disease, they more often than not, there's more than one problem involved, and finally that effective treatment means you first need to figure out which problems are affecting your pet.
I've outlined treatment options in detail on other pages for each of the more common skin problems: Please go to the list above to your left and click on the disease you're interested in.
Thanks and good luck making your pet much more comfortable. Roger Ross. DVM
On This Page
Introduction To Skin Diseases
What To Expect When You Go To The Vet with a pet suffering from skin disease
On Other Pages
Atopy: Irritated, itchy skin caused by pollens, molds, dust mites and other allergens. (very common)
Skin Allergies Caused by Food
Fleas, Ticks,Flea Sensitivity, FBD, & Flea Bite Dermatitis
Hormonal Skin Diseases
Anal Gland Problems
Immune mediated Dermatoses
Feline Symmetrical Hair Loss (Alopecia)
We vets have to euthanize a lot of pets that could be saved.
They are "put down" mainly because the owners are over extended and can't pay the $400 - $1200 vet bill needed to save their pet.
Please don't be put in this situation: get Pet Insurance before your pet gets sick or injured.
I’ve written this web site mostly to share my love of my profession … taking care of the medical and behavioral problems of pets.
But I have three other desires:
To help animal lovers make sense out of the details and confusion of veterinary care
To encourage pet owners to be more responsible in the care of their pets
And I was really hoping to somehow raise money to keep our No Kill Pet Shelter running.
Our shelter is staffed 100% by volunteers and has been successful at finding homes for 200-300 pets a year that would otherwise be euthanized.
We take pets that are often filthy, full of parasites, suffering from diarrhea or colds or injuries.
We clean them up, test and treat for heartworms, intestinal parasites, and leukemia. Our pets are socialized, vaccinated, spayed or castrated, and treated with love and compassion until we can place them in a suitable home.
Please help us.
Thank you so much. Your help is much appreciated and your donations will be used wisely, effectively, and with compassion.