Dermatology -- Skin Conditions in Dogs & Cats
Skin conditions in dogs and cats can have multiple causes. If your pet is itching, has dry flaky skin, odor, sores or hair loss, the cause may be fleas, other parasites such as scabies, dry skin, hormone problems, bacterial, fungal (ringworm), behavioral, allergies to food, allergies to airborne particles, autoimmune disorders, cancers and sometimes, idiopathic (unknown).
The cause of skin problems cannot be determined by outward appearance alone; many different causes look the same on the skin. Laboratory tests, trial and error treatments and recheck examinations are necessary to find the cause and appropriate treatment. In order to treat your pet’s skin problem effectively and safely, cooperation between you and your doctor is essential.
At Siena Animal Hospital, we try to treat the problem and not just the symptoms. We often see pets put on lifelong cortisone for scratching (treating the symptom), without trying to treat the problem. Because cortisone has several serious side effects such as diabetes, bladder and kidney infections, other bacterial infections, and water retention and because there are potentially fatal reactions if your pet is suddenly taken off of cortisone, our goal is to use as little cortisone as possible.
Some of the tests your doctor may recommend include:
1. Skin scrapings to check for mites.
2. Flea comb examination.
3. Culture for fungus.
4. Culture for bacteria.
5. Blood tests for hormones.
6. Cytology (microscopic examination of cells).
7. Dietary trials.
8. Skin biopsy and interpretation by a pathologist (probably the most reliable test in recurrent cases).
9. Antibiotic trials.
10. Blood chemistries, blood counts and urinalysis.
11. Allergy testing.
Although all of these tests may not be done on the first visit, they may be recommended during later visits depending on the response to treatment.
As you can see, the correct treatment for your pet’s condition can be complex, but with patience and cooperation between you and your doctor, a lot can be done to solve the problem.
Skin Biopsy
If your pet has not responded to conventional therapy such as antibiotics and medicated shampoos or if your pet has suspicious lesions on the skin, then a skin biopsy may be quite valuable in helping to determine the cause of the problem and the best treatment.
Removal of Skin Tumors
Occasionally, those benign little skin tumors found in various locations on your pet's body can become a nuisance. Your pet may bother these tumors and cause them to ulcerate and bleed, or the tumors may be aesthetically non-pleasing. Removal is then warranted.
It is also possible to test lumps fairly easily with a test called a fine-needle aspirate (FNA) in which cells are removed from the lump and interpreted by a Board-Certified Pathologist in order to determine the type of mass involved. The small sample size is not always 100% however, the determination on how serious the mass is can usually be determined.
Some skin tumors are cancerous, and some are not. A biopsy (histopathology) is required to give an exact diagnosis and prognosis. This can be done by removing part or all of the mass if possible.
Some lumps (smaller than 5mm) can sometimes be removed with a sedative and local anesthesia. Removing larger lumps involve anesthetizing your pet, surgically removing the tumor(s), and placing skin sutures to close the wound.
If spread (metastatic disease) is suspected due to a more aggressive or malignant tumor, x-rays (radiographs) prior to surgery will help detect if there are masses already in the chest. Blood work helps rule out internal organ dysfunction if present as well as making anesthesia safer.
Scabies (Mites, Mange)
Scabies is an infestation of the skin by a mange mite called Sarcoptes in dogs and Notoedres in cats. Humans can get scabies, but dog and cat mites don’t really like people. A few mites (which are usually microscopic) can cause very intense itching.
The treatment involves giving an oral/injectable medication that kills the mite. Although the drug is very effective, it is not without potential side effects. While these side effects are very rare, we feel that it is best to observe your pet and treat for these effects should they occur.
Treatment will consist of an oral or injectable anti-mite medication given every 2 weeks. An average of three treatments every two weeks usually results in successful elimination of the parasite.
Umbilical Hernia
An umbilical hernia is a failure of the midline to close from the umbilical cord. It’s similar to our ‘belly button.’ This is a benign problem since usually it is just fat coming through the hole; however, in some cases, the opening (hernia) may be large enough to contain intestines or other abdominal organs. If the sac is large, there is the potential for intestines to twist or for the sac to be torn and so surgery is needed to repair it. If the sac is small, then the repair can be delayed until the time of neutering/spaying surgery.
Lacerations
Lacerations often require general anesthesia to allow thorough cleaning, clipping and suturing. Small punctures and lacerations can occasionally be treated without anesthesia. If the laceration is old, it needs to be debrided (made fresh) and then sutured (usually). Cost and length of anesthesia and recovery will vary with the severity of the injury. Lacerations are classified as severe when they involve the exposure of tendons or joints, open body cavities, or are extremely large and require reconstructive surgery. These lacerations always require general anesthesia to allow thorough cleaning, clipping and suturing and to minimize pain to the pet.
At times, pets need to be hospitalized and treated with IV fluids and other supportive care if they have other signs of serious injury, internal trauma or shock.
Infection is a concern, therefore antibiotic injections and antibiotics to be given at home are used. A drain tube may be needed to help prevent fluid from accumulating and to help fight infection.
Since pets often chew or lick at sutures, a protective Elizabethan collar or bandage may be needed.
Rechecks and drain and suture removals are part of the important follow-up care for abscesses.
Abscess
An abscess is a pocket of infection that contains pus. They often result from a bite where the skin is broken and hair and bacteria are trapped under the skin. The wound then seals and the abscess develops under the skin. This is usually quite painful and your pet could be less active and have a fever during this time. Surgical treatment is sometimes necessary to drain the abscess, then your pet will be placed on antibiotics. With severe infection, your pet will possibly need to be hospitalized following surgery. Some abscesses also require a drain to be placed under the skin in order to minimize additional fluid and pus accumulation under the skin. It is important to prevent licking or chewing of the drain, incision or sutures, and a medical collar is often prescribed. Due to ‘hidden’ infection, finishing all medications is also important.
Abscesses can often be prevented if puncture wounds are detected and treated within 24 hours of the original injury.
Rechecks and drain and suture removals are part of the important follow-up care for abscesses.
Referral to Board Certified Veterinary Dermatologist
In some cases, your pet may have an unusual or difficult to treat skin condition that needs a specialist to help. You can learn more about Veterinary Dermatologists at American College of Veterinary Dermatologists website.