Skin Diseases Archives - Page 3 of 3 - Chappelle Veterinary Clinic

Feline hyperthyroidism is the most common endocrine disorder in middle-aged and older cats. It occurs in about 10 percent of feline patients over 10 years of age.
Hyperthyroidism is a disease caused by an overactive thyroid gland that secretes excess thyroid hormone. Cats typically have two thyroid glands, one gland on each side of the neck. One or both glands may be affected. The excess thyroid hormone causes an overactive metabolism that stresses the heart, digestive tract, and many other organ systems.
If your veterinarian diagnoses your cat with hyperthyroidism, your cat should receive some form of treatment to control the clinical signs. Many cats that are diagnosed early can be treated successfully. When hyperthyroidism goes untreated, clinical signs will progress leading to marked weight loss and serious complications due to damage to the cat’s heart, kidneys, and other organ systems.
CLINICAL SIGNS
If you observe any of the following behaviors or problems in your cat, contact your veterinarian because the information may alert them to the possibility that your cat has hyperthyroidism.

weight loss despite a normal or increased appetite
increased urination, more urine in the litter box
increased drinking or thirst
defecation outside of the litter box
increased vocalization
restlessness, increased activity
vomiting
diarrhea
rarely, lethargy and a lack of appetite
poor hair coat, unkempt fur

DIAGNOSIS
Twice yearly examinations of your cat may allow early detection of hyperthyroidism, as well as other age related diseases. During the physical examination, your veterinarian may discover increased heart and respiratory rates, hypertension, a palpable thyroid gland, and loss of muscle mass. Routine screening of laboratory tests and blood pressure may detect abnormalities before clinical signs (bulleted list to left) are advanced. Blood testing can reveal elevation of thyroid hormones to establish a diagnosis of hyperthyroidism. Occasionally, additional diagnostics may be required to confirm the diagnosis. Because hyperthyroidism can occur along with other medical conditions, and it affects other organs, a comprehensive screening of your cat’s heart, kidneys, and other organ systems is imperative.

MANAGEMENT AND TREATMENT OPTIONS
If your veterinarian diagnoses your cat with hyperthyroidism, he or she will discuss and recommend treatment options for your cat. Four common treatments for feline hyperthyroidism are available and each has advantages and disadvantages. The choice of therapy can depend on factors such as the cat’s age, other disease conditions, treatment cost, availability of treatment options, and your veterinarian’s recommendation.

Radioiodine therapy – commonly called I-131 by your veterinarian. This treatment consists of administering a small dose of radioactive iodine which only overactive thyroid tissue will absorb. The radiation destroys the abnormal cells while the normal thyroid tissue continues to function. Even though this radiation exposure carries minimal risks for you and your cat, special facilities are required for treatment, and specific isolation protocols need to be followed after discharge. The advantages of I-131 treatment are that it can be curative and there is no anesthesia, surgery, or risk of drug reaction. The disadvantage is that few facilities provide this therapy and referral to a specialized treatment center is often necessary.

Medical therapy – anti-thyroid medications will control the disease and block the excess production of the thyroid hormone; however because this medication does not cure the disease, your cat must take it for its entire life. Your cat may also receive the drug as a short-term measure, prior to surgery or anesthesia, or if radioiodine therapy is not available right away. Advantages of medical
therapy are a low initial cost, readily available treatment, and no hospitalization. Disadvantages include the need for medication, potential for adverse drug effects, and long-term costs of treatment.

Thyroidectomy – a surgical technique which removes all or part of the thyroid gland. The advantage of surgery is that it can be curative and eliminate the need for life-long medication. The disadvantages of surgery are that your cat requires general anesthesia and not all cats are good surgical candidates. Additionally, varying complications of surgery may occur including damage to nerves and blood vessels of the neck, damage to the parathyroid gland function, and recurrence of hyperthyroidism as unrecognized tissue can be left behind by even the best surgeon.
Nutritional therapy – involves feeding a special diet restricted in iodine content to control the production of thyroid hormones, which may manage some cases of feline hyperthyroidism. Advantages of dietary therapy include low initial costs and ease of treatment. Disadvantages include complicating factors if the cat has other diseases or conditions, takes other medications or supplements, or does not find the taste appealing; also long-term costs of feeding a prescription diet, and the challenges of
feeding this diet in multi-cat households.

MANAGEMENT GOALS
In general, all cats with hyperthyroidism need to be treated. The goal of therapy is to restore normal thyroid function and minimize side effects of treatment without creating lower than normal levels of thyroid hormones (referred to as hypothyroidism). On-going monitoring of your cat after any treatment is very important, as well as routine veterinary checkups with your veterinarian. If you have any additional questions, concerns, or notice any sudden changes with your cat, please contact your veterinarian immediately.

For more information on feline hyperthyroidism, visit www.catvets.com/fht

Blog source: https://catvets.com/guidelines/client-brochures#cattovet

There are 3 major types of allergy that can affect your dog or cat:

Environmental allergy (atopic dermatitis): allergy to indoor or outdoor environmental substances such as pollen, dust mites, molds, feathers and hair. This is the most common allergy in most parts of Canada.
Food allergy (cutaneous adverse food reaction): allergy to ingredients in food, including occasionally ingested ingredients. It is much less common than environmental allergy.
Flea allergy (flea bite hypersensitivity): fleas are a common cause of allergy around the world, though they are rare problem in places with harsh winters like Quebec and the Prairie provinces.

In this document, we will discuss environmental allergy and food allergy, as their clinical signs are often identical.

What is an allergy and what are allergens?

Allergy is an abnormal reaction of the body to the presence of a substance, usually a protein, which is normally harmless. This substance is called an “allergen”.

Allergens are quite varied in nature. House dust mites, grass, tree or weed pollens, environmental molds (fungi), feathers, and food proteins are all harmless substances capable of causing allergic reactions in allergic pets. Interestingly, environmental allergens are primarily absorbed through the skin in pets, rather than by inhalation, although both forms of allergen exposure may contribute to symptoms in the allergic pet.

The significant overlap in symptoms associated with various allergies and their secondary infections lead to making allergy a complicated condition. Additionally, an individual animal is rarely allergic to one thing.

An allergen is a substance that can induce, or trigger, an allergic reaction in an allergic pet. The allergic pet over-reacts to an allergen present in its environment or food, whereas non-allergic pets do not react to these substances.

Allergic pets are usually sensitive to multiple allergens! One individual may be allergic to a variety of pollens, another may be allergic to pollens and house dust mites, while another may be allergic to house dust mites and a dietary ingredient. Various combinations are possible. All such combinations of potential allergens leads to the common allergy symptom of itchiness (pruritus) in dogs and cats! Fortunately, it is not always necessary to identify all the allergens involved or to treat all the allergy complications at the same time. It is sometimes enough to eliminate the major causes of itchiness so that the patient improves, and becomes comfortable.

The main symptom of environmental and food allergy is itchiness which can mainly result in scratching, licking, biting, rubbing, over-grooming, and head shaking. The allergic dog is typically itchy at the paws, belly, neck, ears and face. Subsequently, due to self-inflicted trauma, there may be hair loss, redness, and crusts.

Most allergies (particularly environmental allergy) begin in young adults. However, they can begin at any age. There are sometimes additional clues in the patient history that help the veterinarian to differentiate between environmental allergy or food allergy:

Environmental allergy (atopic dermatitis) is a familial disease and the presence of similar symptoms in parents can be an important clue. There is a long list of breeds that are predisposed to developing environmental allergy, but this disease may affect an individual from any breed.
An environmental allergy may also be associated with eye and/or respiratory problems.

Some itchy cats may not scratch but instead groom themselves excessively, leading to hair loss. The allergic cat may have crusty dermatitis, or red, oozing, raised plaques on skin. Scratching, head shaking, paw biting may also be noted.

The symptoms of environmental allergy can be seasonal (for example, grass & weed pollen causing summer allergic symptoms) although year-round problems are also commonly associated with environmental allergy.
Food allergy can be accompanied by digestive symptoms (for example diarrhea, excessive gas, and frequent bowel movements).
A sudden allergic flare after eating a specific food is suggestive of food allergy. Despite some suggestive signs that help differentiate food and environmental allergy, it is very difficult to distinguish these two diseases in most allergic pets. Moreover, both environmental and food allergy may affect a proportion of allergic patients, thus diagnosing one condition will not rule out the other.

Secondary infections in the allergic patient

Skin allergies almost always result in a disturbance of the fragile balance that characterizes healthy skin. Affected skin and ears are more susceptible to infection by microorganisms that are naturally present on the skin in low numbers. On an allergic pet, these organisms can proliferate and give rise to secondary infections. These infections are caused by bacteria (usually Staphylococcus spp.), a yeast (fungus) called Malassezia, or both. Secondary infections of the skin and/or ears can greatly aggravate allergic symptoms and add to the pet’s discomfort and suffering. Infection identification and control are essential when treating an allergic patient.

How to approach allergies in pets

If your veterinarian suspects that your pet is suffering from an allergy, a stepwise plan is usually suggested. In many pets, the initial stage involves investigating the major causes of itching that can closely mimic allergies. Parasitic itching (fleas and other ectoparasites) should be excluded. This can involve a trial treatment even if parasites are not seen on your pet, as they can be very hard to find. Another step will be to recognize and treat secondary infections, often based on microscopic examination (cytology) of material collected from the skin or ears. If an infection is present, topical and/or oral antimicrobial treatment will be prescribed.

The next stage is usually work up for food allergy, if the pet’s signs are present year-round. The only way to diagnose or rule out a food allergy is with an 8-week “elimination diet trial” followed by a diet re-exposure challenge. It is important to complete the elimination diet trial under the supervision of a veterinarian for best results. Every patient is an individual, and it can take some time to find a diet that works best for your pet. Switching between various pet store diets is unlikely to work. Unfortunately, the available tests that utilize blood, hair, or saliva to diagnose food allergies are highly inaccurate and have been disproven by many studies. Pets that do not improve within the 8-week elimination diet trial very likely suffer from environmental allergy. Identification of the culprit environmental allergens for your pet can be undertaken using intradermal or blood allergy testing. Allergy testing is not used to confirm or rule out environmental allergies, as that diagnosis is obtained by ruling out other possibilities, not by relying on test results. The results obtained from allergy testing are used to formulate an immunotherapy vaccine to desensitize your pet to the allergens causing the symptoms, making the environmental allergy easier to manage long-term.

Conclusion

Although food and environmental allergy have similar clinical signs, their diagnosis and management plans are quite different. A specific dietary change (elimination diet) helps control food allergy in affected pets, while also helping with ruling out a food allergy in pets affected with other conditions such as environmental allergy. Allergy testing and allergy immunotherapy are used to help manage environmental allergy after your pet’s veterinarian has ruled out other possibilities.
There are many treatment combinations available for the management of allergies. An individualized treatment plan is needed for every patient, thus it may sometimes take time to find one that is best for your pet. Successful management of allergies involves close follow-up with your veterinarian.

While both environmental allergy and food allergy are lifelong diseases that are not curable, both can be effectively managed with appropriate treatment in order to help your pet live comfortably and with a very good quality of life.

Source: w w w . c a v d . c a

Elimination diet trials can be tough! We’re here to help. The Canadian Academy of Veterinary Dermatology would like to share some information and tips about this
very important diagnostic step. Your veterinarian has reason to believe that a “cutaneous adverse food reaction” – which we will simply call a “food allergy” – might be playing a role in your dog’s skin or ear problems. By addressing this allergy, you can help your dog feel much better. That’s the good news! The bad news is that there is no accurate skin or laboratory test for food allergies in pets. And a dog with a food allergy looks just like one with environmental allergies and might, in fact, have both.

Currently, the only way to diagnose a food allergy is using an elimination diet trial. The elimination diet trial (also called a “hypoallergenic” diet trial) is an 8-week test period when your dog can eat one thing, and one thing only: the food recommended by your veterinarian. Any other food, even a tiny treat, can affect the results of the trial. To give your dog the best chance of responding, you must be 100% strict with the trial for the full 8 weeks. We know that this is easier said than done!

What happens during those 8 weeks? If your dog has a food allergy, you will see a gradual 50% to 100% improvement in his condition, depending on whether other allergies are present. After 8 weeks, your veterinarian may ask you to return to your dog’s regular food and treats to see if his symptoms return. This step is called a dietary challenge, and is only done after your veterinarian has reassessed your dog. The challenge is recommended because many other factors (medications, season changes) can contribute to your dog’s improvement during those 8 weeks.

We’re often asked the following questions:

I haven’t changed the food recently and my dog’s poops are perfect; could he still have a food allergy? Yes! In fact, most dogs with food allergy have eaten their food 2 years or longer. And it’s very common for the allergy to affect only the skin or ears. How common are food allergies? Estimates vary, but about 20% of dogs with allergic skin disease have a food allergy. What could my dog be allergic to? Almost anything! Food allergy is an inappropriate reaction of the immune system against a normal – and perfectly safe – food ingredient called an “allergen”. The most common allergens are proteins in food, which are abundant in meats but also found in grains, fruit, and vegetables. Common allergens for dogs include beef, dairy, chicken, and wheat. But there are many others!

What is an Elimination Diet?
Simply put, it’s any food that we think doesn’t contain the ingredients that your dog may be allergic to. Elimination diets, also called “hypoallergenic” diets, fall into two categories: novel
ingredient diets and hydrolyzed diets. A novel ingredient diet is made from foods that your dog has never eaten. This makes the ingredients new, or “novel”, to his immune system. The immune system usually tolerates these ingredients because there hasn’t been time for an allergy to develop. A novel ingredient diet can be veterinary kibble or wet food, or a home-prepared food, based
on your veterinarian’s recommendation and your preference.

Although they can be very effective, there are a couple of drawbacks to novel ingredient diets. It can be difficult to
find ingredients that are truly novel if a dog has already “eaten everything on the Ark”. And we suspect that in some cases, dogs can cross-react to ingredients that they have
never eaten. For example, some dogs allergic to beef may show symptoms when fed lamb or venison, even if they have never eaten these meats. A hydrolyzed diet is made with ingredients that are broken down (hydrolyzed) in a way to make them very small. These tiny fragments are so different from the full-sized protein that they are much less likely to trigger an allergy. So even if your dog as an allergy to soy, he might safely be able to eat a food made from hydrolyzed soy. Hydrolyzed diets can be a good choice in dogs that have eaten a wide variety of foods and treats.

In addition to being hypoallergenic for your dog, the food must also be one that he digests well and eats happily for 8 weeks. Each dog is different, so sometimes we have to try a few different foods before we get it right! What treats can I give during a diet trial? None, unless they are specifically made to accompany the recommended food. Don’t assume that treats with a hypoallergenic label will be suitable. Even the tiniest amount counts: the flavouring in a single monthly heartworm pill is enough to set off an allergy. Think of a child with a peanut allergy. Would you give them “just one” peanut? Want to show your dog some love during the diet trial? See the Tips for Elimination Diet Trials below.

Can I feed fruit or vegetables?
Fruit and vegetables can sometimes cause allergic reactions too. Don’t assume they will be OK.
Set your dog up for success by being as strict as possible!

Can I use a pet store food to diagnose a food allergy? How about a grain-free or raw diet?
We recommend using veterinary diets or home-prepared foods for the elimination diet trial. Studies show that some store-bought foods can contain small amounts of ingredients not listed
on pet food labels, making them unsuitable for the 8-week elimination diet trial period. Grain-free diets are not effective for elimination diet trials unless your dog only has a known
grain allergy. And because we rarely know what your dog is allergic to when we start the diet trial, we would miss many food allergies by simply switching to a grain-free diet.
Raw foods are not recommended for diet trials. They don’t work any better than their cooked counterparts, and pose health risks to your dog and your family.

Will I need to feed the recommended diet forever?

In most cases, no. Even if your dog has a food allergy, your veterinarian can often recommend foods other than the trial diet that will work for long-term feeding. And of course, if your dog does not improve by 8 weeks, there is no reason to continue the food.

Why is the diet trial so long?

It takes a long time for the skin to normalize after a food allergen is removed. A diet trial lasting 8 weeks will diagnose about 95% of food allergic dogs. On the other hand, a trial lasting 4 weeks will diagnose only about half.

How can I find out exactly what my dog is allergic to?

If your dog reacts to his previous food or treats, you might wish to find out exactly which ingredients caused the problem. Your veterinarian can guide you through a sequential process (provocation) that involves adding individual suspected food allergens to the diet for up to two weeks at a time.

Tips for Elimination Diet Trials

Tough love. You will need to be strong when confronted with those big brown eyes asking for a treat. Think of the possible health benefits for your dog. Or imagine a peanut-allergic
child asking for a peanut butter cookie!
Take it slow. Don’t switch to the new food overnight. It’s a recipe for refusal and stomach upset. Take at least one week (or longer) to make the transition, starting with a very small amount of the new food on day one. Start the 8-week countdown on the first day you feed only the elimination diet.

Don’t give up. Though we always recommend a food that we think is best for your dog, what your dog actually thinks matters most. Call your veterinary team if you encounter food refusal, diarrhea, or any other problems. Veterinary diets are guaranteed, so the food can be returned and replaced with another if your dog doesn’t like it.
“Good dog!” Make the food into a treat by putting it into your dog’s cookie jar and using it as a reward. If your dog gets food from the kitchen counter or table, have a stash of the
food at these locations. You can even hide it in a food-dispensing toy to make it more fun for your dog. As your veterinary team for other tips on rewarding your dog.
No stealing! Feed your dog separately from other pets to make sure he doesn’t sneak into their bowls.
Don’t mix and match. Stick to one type of food during the trial. For example, don’t add a venison canned food with a hydrolyzed dry food. No one food is 100% hypoallergenic for every dog, o
feeding more than one type increases the chance of “missing” a food allergy.
Oh no, pills? If you struggle to give oral medications to your pet, ask your veterinarian about alternatives such as injections or topically applied treatments, or even delaying the diet trial.
Let your pack know. Your dog may have an entourage: children, neighbours, dog walkers, dog daycare staff, pet store staff, and members of your family. They need to know about the diet trial!
Plan ahead. Purchase the food well in advance of when you will run out.
Stay clean. Keep the food in its original packaging, or thoroughly wash the container you use for storing the food.
Keep track. Keeping a calendar of your pet’s symptoms, medications, and food can really help us figure out what’s working, and what’s not.
Don’t panic! If you make a mistake, it’s OK. Record it on the calendar and keep going with the diet trial.
Stay strong. For the sake of your dog’s health, do your best to stick with the trial for the whole 8 weeks. Call your veterinary team with questions, or to ask for help.

Every dog is different. We know it takes patience and effort to complete an elimination diet trial. But if your dog has a food allergy, your persistence can make a world of difference to his quality of life. Hang in there!

Canadian Academy of Veterinary Dermatology
Promoting the advancement of veterinary dermatology in Canada

Source: at www.cavd.ca

ABOUT THE DIAGNOSIS

“Hot spots,” also called acute moist dermatitis, are rapidly developing skin sores under the haircoat. They are common in thick-coated or long-haired dogs, less so in cats. They most often develop in areas where the haircoat is heavy, such as the back, tail base, and side of the thigh, neck, or face. Hot spots tend to occur more frequently in hot, humid weather. The dog often will scratch or chew at the area, although it can be quite painful (the condition is also called pyotraumatic dermatitis for this reason). When the hair is parted, the skin is seen to be moist and reddened. A pus-like discharge coats the skin and the base of the hairs.

Hot spots begin with a superficial skin injury that causes some moisture to be caught under the haircoat. Bacteria grow in the fluid, causing more skin inflammation, and the affected area rapidly expands as more fluid oozes from the skin, promoting more bacterial growth. The speed of onset of hot spots is often striking, and a large and painful lesion can develop from previously normal skin in a few hours. Fortunately, other than being uncomfortable, hot spots are not life-threatening and they tend to heal very well.

LIVING WITH THE DIAGNOSIS

Several skin conditions may be underlying causes of hot spots. Anything that causes skin injury or encourages the dog to scratch or chew its skin may start the disease process. Skin parasites such as fleas, ticks, or mange mites; allergies; hair mats; or foreign material caught in the coat are common inciting factors. Preventing reoccurrence of hot spots involves controlling (and, ideally, eliminating) these conditions.

TREATMENT

The most important step in treatment is to clip away the hair in the area and then clean the skin of all discharge with a mild antiseptic. The hair should be clipped for at least 1 inch (2-3 cm) beyond the edge of the visible lesion or sore. This is best done with electric animal hair clippers, since scissors often damage or cut the skin of dogs with acute moist dermatitis—avoid doing this hair clipping at home. Your veterinarian may need to sedate your pet for this step if the area is painful, because the skin may be excruciatingly sensitive. After the area is clean, an astringent (drying agent) may be used on the inflamed skin. Preparations containing an antibiotic or antiseptic are applied directly to the area to stop bacterial growth; these topical medications also often contain an analgesic or corticosteroid to alleviate pain. Spray-on products are preferred over ointments. Most hot spots heal rapidly (days) since the infection is only on the surface of the skin.

Some hot spots are associated with a deeper skin infection. In these cases, red, raised bumps often are found scattered in the healthy skin surrounding the hot spot. Golden retrievers seem more prone to this form than other breeds. Antibiotics given by mouth every day for 2 weeks or more are needed to cure this type of hot spot, in addition to the treatment mentioned above

DOs

Keep your pet free of skin parasites, especially fleas.
Groom long- or thick-coated pets regularly; remove foreign bodies such as plant material from the haircoat, so these do not cause mats nor penetrate the skin directly.
Treat underlying skin diseases, such as allergies, if present.
If a hot spot develops, have it treated immediately and use medications as directed.
Expect that over the first 48 hours of beginning treatment, the hot spot will look “quieter”: less red, with less fluid oozing from its surface, and it should be less painful. Scabbing and return of normal skin usually occur over a 7-10–day period after that.
Consult with a veterinarian specialized in skin disorders (veterinary dermatologist; see www.acvd.org) if acute moist dermatitis is a recurrent or severe problem. These specialists are best able to identify triggering causes and to prescribe the best treatments

DON’Ts

Do not touch the hot spot directly with your fingers except to apply medication (and then, use disposable latex medical gloves). Touching a fresh hot spot can be painful and can carry bacteria into it, causing an infection.
Do not apply medication to the sore without first clipping and cleaning the area.
Do not cut the hair over a new hot spot using scissors, as this is a common cause of severe skin injury (the scissors cut the skin) in dogs.

WHEN TO CALL YOUR VETERINARIAN

After treatment, if the area still looks red after 48 hours, or if the problem is spreading to new areas of skin

SIGNS TO WATCH FOR

Intense scratching or chewing at an area, sometimes accompanied with whimpering

ABOUT THE DIAGNOSIS

Acral lick dermatitis, also known as lick granuloma, is a self-induced skin lesion. The term acral refers to the legs and feet. Acral lick dermatitis mainly is a problem of dogs, rarely cats. The dog continually licks at one area of the leg, producing hair loss, sores, and thickening of the skin. Typical appearance is a raised, red, hairless, oval patch of skin or skin lump found over the front surface of one leg. Occasionally, more than one leg may be affected. The most common locations are over or near the carpus (“wrist”) of the front paw or just below or above the hock on the rear leg. Breeds most likely to develop acral lick dermatitis include the Doberman pinscher, Great Dane, Labrador retriever, Irish setter, golden retriever, and German shepherd, but any breed of dog can be affected.

Males are affected twice as often as females. The condition may appear at any age; however, most dogs are over 5 years of age when presented for treatment. Although several conditions that cause discomfort of the skin can cause persistent licking (see Diagnosis below), in many dogs with acral lick dermatitis no underlying problem can be found. In these cases, acral lick dermatitis is considered a psychogenic disease; that is, it is caused by a behavioral disorder. For example, sometimes excessive licking or chewing can result from boredom or can be used as attention-seeking behavior; sometimes anxiety is the stimulus for stereotypic behaviors like repetitive licking.

Stereotypic behaviors are excessive, repetitive behaviors engaged in to relieve psychological distress such as boredom or anxiety.

Diagnosis:

Several other skin conditions may appear similar to acral lick dermatitis. These include skin tumors, granulomas (masses due to chronic inflammation), and deep bacterial or fungal infections. In addition, several conditions that cause pain or itching can be involved in the development of lick granulomas, since dogs will lick areas where they feel tingling or discomfort. Depending upon the appearance of the skin lesion and your pet’s history, your veterinarian may need to run several tests to check for similar conditions and underlying disorders, including skin scrapings, bacterial or fungal cultures, and skin biopsies.

In some cases, x-rays may be warranted to look for joint or bone disease, such as arthritis, or bone infections that can cause pain and therefore cause a dog to lick over the painful area incessantly. A history of trauma or surgery in the area might indicate possible nerve damage as a source of discomfort. A variety of conditions that cause itching can contribute to the development of acral lick dermatitis; these include allergies, skin infections, and skin parasites (fleas, mange, etc.).

If no underlying disease can be found, then by exclusion, psychogenic factors are assumed to be the cause of the dog’s constant licking. Therefore the first step in evaluating a dog thought to have acral lick dermatitis is to perform basic tests to assess for other contributory medical and skin conditions (above). Once acral lick dermatitis is confirmed to be the problem, a very valuable form of evaluation is consultation with a veterinary behaviorist. These are veterinarians who specialize in assessment and treatment of behavioral disorders such as acral lick dermatitis. While animal behaviorists are sometimes derided, they are specialty-trained veterinarians whose focus of practice is entirely animal behavior, and their input and recommendations can be lifesaving.

The American Association of Veterinary Behaviorists is a nonprofit veterinary medical association. It regroups the specialty-trained veterinarians around the world who are experts in behavioral problems of dogs and cats (see “For the Public” → “Find a Board Certified Veterinary Behaviorist” at www.dacvb.org). Your veterinarian should be able to refer you to one of these Diplomates in your area, or by telephone, to better identify and correct the psychological/behavioral trigger that is leading to the incessant licking.

LIVING WITH THE DIAGNOSIS

Acral lick dermatitis can be challenging to treat. Medications may help, either for direct application or, in the case of behavior-modifying medications, as oral tablets. Often the visible skin lesion is only the surface of the problem, and the root cause is psychological or behavioral. Therefore, the frustration of dealing with a dog that is compulsively licking needs to be met with an understanding that some sort of underlying trigger may exist and that dealing with that trigger is critical to solving the problem.

Response to treatment depends upon correction of the underlying cause. Many cases require long-term care at home and adjustment of treatments when the lesion reappears. It is worth remembering that stressful changes in your pet’s life may precipitate reoccurrence of the problem.

TREATMENT

There are many approaches to treating acral lick dermatitis, nd some trial and error is usually needed to find the best treatment for an individual dog. Since deep bacterial infections of the skin usually are present as well (secondary problem due to the damage of licking), antibiotic pills are usually given for several weeks. The affected skin area can be treated directly with a variety of medications, including topical treatments and injections. Bitter-tasting topical solutions are sometimes applied to discourage licking. Most treatments that are applied to the lesion are aimed at altering the sensation in the skin. Agents used include corticosteroids, dimethyl sulfoxide DMSO), capsaicin, antiinflammatory drugs, and antihistamines. Additional treatments aimed at reducing itching or painful sensations include acupuncture, laser surgery, or cryosurgery.

Removal of the lesion with conventional surgery, laser surgery, or cryosurgery is also advocated by some veterinarians. Some degree of relief can also sometimes be brought about by frequently bandaging the leg and/ or placing an Elizabethan collar on the dog to break the cycle of licking-itching. Behavioral components of the condition also need to be addressed. Boredom can be alleviated by increasing playtime, introducing another animal as a playmate, reducing confinement time, or keeping the pet occupied with toys such as those with openings for treats (e.g., Kong-type toys). Several behavioral modification training techniques can be used. Stressful conditions should be eliminated, when possible. Antidepressant and antianxiety drugs may also be helpful in some dogs, and these can be prescribed by your veterinarian or a veterinarian specialized in behavioral medicine.

DOs

Be diligent and persistent with treatment. Hair regrowth and reduced compulsion to lick happen very slowly (weeks to months).

DON’Ts

Avoid blaming or acting exasperated with a dog with acral lick dermatitis. Unfortunately, compulsive licking can truly be exasperating, but yelling at or punishing dogs for doing this simply does not register with them and often can make them more compulsive, which worsens the problem. In other words, harsh words and punishment for licking behaviors tend to be totally counterproductive. Acral ick Dermatitis
Don’t assume that the problem is entirely in the skin, or entirely in the dog’s mind. Oftentimes, a combination of behavioral factors and skin factors is to blame for acral lick dermatitis.

SIGNS TO WATCH FOR

Persistent licking or chewing at one area on the paw or leg.
Hair loss, irritated skin, and eventually a raised, completely hairless, shiny, reddened area of skin.

ROUTINE FOLLOW-UP

Because determining the best treatment of acral lick dermatitis often requires trial and error, several visits may be necessary to determine the optimal combination of treatments for your dog.
Once the right treatment is found, the visits become much less frequent—generally just routine checkups.

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CLASSIC LIST

Feline Hyperthyroidism

Allergies in The dog and the cat

What is an allergy and what are allergens?

Secondary infections in the allergic patient

How to approach allergies in pets

Conclusion

Diagnosing Food Allergies in Dogs: Elimination Diet Trials

Acute Moist Dermatitis (“Hot Spots”)

ABOUT THE DIAGNOSIS

LIVING WITH THE DIAGNOSIS

TREATMENT

DOs

DON’Ts

WHEN TO CALL YOUR VETERINARIAN

SIGNS TO WATCH FOR

Acral Lick Dermatitis

ABOUT THE DIAGNOSIS

Diagnosis:

LIVING WITH THE DIAGNOSIS

TREATMENT

DOs

DON’Ts

SIGNS TO WATCH FOR

ROUTINE FOLLOW-UP

Dermatophytosis

Eosinophilic Granuloma Complex

Flea Bite Allergy

Food Allergy

Mammary Gland Neoplasia

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