One of the most common conditions veterinarians see in practice is skin and ear diseases.  Many dogs are plagued by chronically itchy skin with secondary infections.  Long standing skin and ear problems can be very frustrating and difficult to deal with and are challenging for the veterinarian.  

 

There are many different causes of skin and ear disease, ranging from simple problems such as flea allergies to complicated metabolic, endocrine or immune disease.  Many of the conditions can look exactly the same but unless the cause is diagnosed, treatment cannot be successful.

 

 

The first part of a dermatologic exam is a thorough medical history.  It is important to know what type of flea and tick control is being used, the type of diet the pet is given, the numbers and types of other pets in the household, the physical environment the pet is in such as an outdoor kennel or a fenced in grass yard, frequency of bathing and grooming, what type of shampoo, how often and so on.  

 

We discuss how long the problem has occurred - is it seasonal or year round, has there been treatment for the condition in the past, and if so, what was used and was it successful.  If your pet has had ear infections in the past how have they been diagnosed and treated?  Did the treatment work?  How old was your pet when the condition began, has it been their entire life or only recently.  Have you and your pet ever lived in other parts of the country and did the condition exist then?  

 

We also ask if the problem is localized to one area usually or is it over the entire body. Are both ears usually affected or not at all?  Is one ear affected more so than the other?  Does your pet have other problems when the skin condition gets worse such as decreased appetite, vomiting or diarrhea, sneezing or coughing?

 

Do you take your pet swimming in the ocean or in lakes, ponds or streams and do they receive a bath afterwards? Does your pet have a fecal exam done at least twice a year?

 

These are examples of the types of questions needed for a dermatologic history.

 

 

Once the history is completed, a thorough physical exam is conducted.  The entire animal is examined not just the skin and ears since there can be other clues in other body systems that can help identify the cause of a skin problem.    

 

The skin exam includes a comb-through for external parasites such as fleas, ticks or lice, dandruff, crusty and scaly lesions.  Cytology of any open sores or areas with discharge may be done to look for abnormal cells.  Cytology of ear discharge is conducted to look for bacterial versus yeast infections.  Ear cultures may be needed if a bacterial infection is present so that the proper antibiotic can be selected.  Ear smears are made to check for ear mites.  Skin scrapes may be done on areas with hair loss to check for skin mites such as demodex or scabies.  Depending on the physical appearance of lesions, we sometimes need to do fungal cultures for ringworm.  

 

 

To check for metabolic or endocrine disease, baseline lab tests are done to identify conditions such as hypothyroidism, Cushing’s, diabetes, liver or renal disease which all can manifest as skin conditions.   If all of the above is negative, skin biopsies are needed to rule out immune mediated skin disease such as lupus or pemphigus.  

 

Food allergies may be diagnosed with blood tests but a more accurate way is to try a food trial with a hypoallergenic diet.  These diets are specifically made and cannot be bought in a pet store or on-line.  The proper one will be recommended based on your pet’s history and clinical presentation.  

 

Atopy (environmental allergies to plants, pollen, dust, molds, mites, trees, weeds, grasses and plants) is diagnosed with blood tests.  If these results are positive for antigens, a specific immunotherapy product is produced for your pet and a schedule is made for injections at a regular interval.  You will be taught how to do these injections on a regular basis.  Many dogs benefit from this time of treatment.  

 

Based on the results of the above diagnostic tests, a treatment plan is made specifically for your pet’s needs.  This may include medicated baths and ear cleansers, oral medications such as antibiotics and/or antifungal drugs, ear medications, medications for underlying metabolic or endocrine disease.

 

We also teach clients how to properly clean and treat their pet’s ears if they have an infection.  The dog’s ear canal anatomy is quite different from a person so we educate clients about this so they can have a better understanding of how to clean and medicate ears.                

 

Regular grooming is a very important part of your pet’s care and many people have a misconception about how frequently a dog can have a bath.  As long as the shampoo is rinsed off very thoroughly, a dog can have a bath numerous times a week.  It does not dry their coat out as many people think.  Conversely, it keeps their skin healthy because clean skin is healthy skin.

 

We hope this has helped to explain our dermatology service.  Please feel free to call us to schedule a dermatology exam so your pet can feel better and look better!