Dermatology

Dermatology

Episodes of itchy skin and sore ears are two of the most common reasons people bring their dogs and cats to see us. It can be frustrating to see your pet so uncomfortable, especially if these episodes keep recurring. There are multiple reasons for these symptoms to occur, and we love doing the veterinary detective work to help get you an answer, and have your pet feeling comfortable and happy again as soon as possible.

How can I tell if my pet has a skin or ear issue?

Skin issues can show in various ways, but common symptoms often noticed by owners are:

• Itchiness, which may be seen as your pet licking their paws a lot, nibbling above their tail, rubbing their tummy or bottom on the ground, or scratching themselves with a paw
• Redness of the skin, with or without raw areas
• Dry flakey skin
• oily, greasy skin or fur
• areas of darkened, thickened skin which weren’t there previously
• fur loss leaving bald patches
• red or pimple-like bumps

Ear issues are commonly noticed by owners, and may cause your pet to:

• shake their head more than usual
• scratch at their ears
• whimper or yelp if they are touched around the head
• have smelly ears
• have abnormal discharge from their ears (may be dark brown or appear more like pus)
• have redness around their ear canals

Why do we talk about skin and ear issues together?

Sometimes, a pet may have either an ear infection or a skin issue. However, many pets can suffer both skin and ear issues if they have underlying allergies causing the problem. Any allergy affecting the surface of the skin may also affect the lining of the ears as well.

Therefore, when we examine your pet during a consultation, we will be carefully checking both their skin and ears, and asking you about any symptoms you have noticed at home.

What causes skin and/or ear issues?

Any pet may suffer a “one-off” skin problem or ear infection. Sometimes it may be as simple as an insect bite or flea infestation that your pet has scratched excessively at, damaging their skin surface and allowing inflammation or infection to develop.

Some breeds are at risk of certain skin or ear issues due to inherited issues, e.g. Spaniels can be at risk of recurrent ear issues due to their long, heavy outer ears preventing good airflow to their ear canals, and differences in their ear lining and ear discharge production.

If you have an at-risk breed, some good general recommendations to help keep their skin and ears healthy are:

• Keeping your pet’s ears clean and dry – try not to let them get water in their ears during bathing or swimming.
• Only bathe your pet if they are smelly or dirty, or if a vet has recommended a special medicated shampoo, as overbathing can disrupt the normal oils and microbes on the skin, which can leave the skin more susceptible to irritation.
• When you do bathe your pet, use a gentle pet shampoo – oatmeal-based ones such as Aloveen are often good.
• Do not routinely clean your pet’s ears unless your vet has advised you to (e.g. if your pet really does produce excessive ear wax). Unnecessary cleaning of ears can change the natural skin balance in the ear canal.
• If you are cleaning your pet’s ears, use a gentle oil-based cleaner – we love the Paw Gentle Ear Cleaner. Alcohol-based cleaners can be too harsh, and will sting if an ear is already irritated!
• Consider adding an omega-3 supplement (e.g. fish oil) to your pet’s diet – feel free to contact our vet or nurse teams for a recommendation on brand and dose for your pet’s size and dietary preferences.
• Plucking hairy ears, e.g. in Poodles, can be a divisive issue. We tend to recommend leaving hairy ears alone unless the hair is becoming matted with discharge, as unnecessary plucking can irritate the canal lining. However, it is OK to have a groomer carefully shave away thick hair from around the underside of the outer ear flap to allow better aeration.

If your pet suffers repeated skin and/or ear irritation, one of the most common reasons is an underlying allergies.

Does my pet have an underlying allergy?

If your pet suffers recurrent skin and/or ear irritations, they may indeed have been born with or developed an allergy that is triggering these issues. There are several types of common allergies that can cause problems:

• Atopy – this is an allergy to airborne dust mites, pollens or moulds. Classically, pets with this allergy will be most irritated around their face, ears, armpits, groin, bottom and feet. These allergies may occur seasonally (e.g. in Spring), or year-round.

If we suspect this allergy in your pet, we can offer specialist dermatology referral for allergy testing, where they can pinpoint exactly what is triggering your pet and then discuss the option of allergy “vaccines”. These involve a long-term course of regular injections that can give an excellent response to reduce the allergy in about 50% of pets, and partially help in another 25% (25% of pets unfortunately won’t show any significant improvement). This treatment is relatively expensive, so is not an option for everyone.

If specialist referral isn’t an option for your pet due to your budget or their temperament, then we can also offer symptomatic management of their allergy at Beach and Bay Vet, to help prevent constant flare-ups of their issues. This can be done via a variety of long-lasting anti-itch injections or daily anti-itch tablets, topical steroid sprays and creams, or medicated shampoos – there is generally an option to suit most situations, and keep your pet comfortable.

• Flea bite allergy – this is an allergy to the saliva of fleas, and causes your pet to have an excessive irritation reaction to even a single flea bite. Pets with this allergy are often most irritated around their lower back and tailbase area, but may also be scratching a lot around their head and belly. This allergy can occur year round, as fleas can survive even through cold weather in the warmth of your house!

This allergy means you should be especially vigilant with year-round flea prevention for all dogs and cats in your household. Please ask us for advice on easy, effective flea control programs for your dog or cat (it is important to treat all dogs and cats in the household), and how to rid your house of any flea infestation. If your pet has very irritated skin, we will also prescribe temporary medications to settle this.

• Food allergy – this allergy occurs when your pet eats certain protein/s. The most common food allergy is to beef (which accounts over 1/3 of food allergies), followed by chicken, lamb and wheat. This allergy will usually occur year-round, and commonly develops after months to years of your pet consuming that particular ingredient, which can make diagnosis tricky. The location of skin irritation is similar to atopy, and mostly concentrated around the face, ears, armpits, groin, bottom and paws. Some pets may also have signs of gastrointestinal upset as part of the allergy.

The best way to diagnose food allergy is to do a hypoallergenic dietary trial for 8-12 weeks. This involves either:

• feeding a commercial hypoallergenic diet containing hydrolysed protein (e.g. Hills z/d) ONLY (no other foods/treats/flavoured medications containing protein or gelatin)
• feeding a home-cooked diet containing a protein the animal has never eaten before, e.g. crocodile meat, ONLY (no other foods/treats/flavoured medications containing protein or gelatin). This can be tricky, as it involves documenting the full dietary history throughout the pet’s lifetime, avoiding any proteins they have ever eaten before.

The majority of animals with food allergy will show an improvement in their symptoms within 8 weeks. Ideally at this point, the animal is then “re-challenged” to confirm the food allergy, involving the owner picking a particular protein every 2 weeks (e.g. beef), and reintroducing this to the animal’s diet to see if their signs recur.

Any animal suspected of allergies should have a hypoallergenic food trial done before any other allergy investigation, as it is safe and relatively easy with veterinary guidance.

Once we know what your animal is allergic to, we can recommend a balanced diet free of this allergen.

• Contact allergy – this allergy is due to direct contact of the skin with an irritant (e.g. a particular cleaning product, grass, perfume etc). Therefore, this allergy most commonly affects the less sparsely furred areas of animals, such as their bare belly/chest, paws, genitalia and muzzle.

If contact allergy is suspected, a good starting point is to house the pet in a different environment for 14 days to see if their signs settle. Then, once the pet is brought back to it’s normal environment, monitor for recurrence of allergy signs, which normally happens within 24 hours. Housing your pet elsewhere depends on what the underlying allergen is suspected to be, e.g. if grass is suspected, your pet may be kept indoors for 14 days, or at the house of someone with only paved outdoor areas, or kept at home but with your pet wearing protective bodysuit and boots whenever they go outside so their skin is covered. If you are unsure of the allergen, consider boarding your pet at an indoors boarding facility so they are completely away from home. It is also sensible to Google lists of common contact allergen plants with pictures, to see if you have any of these in your garden.

If your pet does react positively to the change of environment, one of our vets can give you advice on further patch testing to confirm.

If my animal’s issue is allergies, why do they keep getting skin/ear infections?

Underlying allergies cause inflammation of the skin and/or ears. This inflammation, along with the common issue of pets scratching these irritated areas and damaging the skin further, disrupts the normal protective skin barrier. This allows bacteria and yeasts that are normally present in low numbers to overgrow, causing infection. Infection often makes the problem much worse fairly quickly.

Correct treatment of your pet therefore involves treating these infections, and starting a good management plan for the underlying allergy.

When should I book a consultation for my pet’s skin or ears?

If your is having recurrent skin and/or ear irritations despite the above tips, or if they are having an episode of raw, red, itchy or sore skin or ears, we would recommend a consultation with one our lovely vets. We will discuss what you have noticed at home, how you feed and exercise them, and perform a full physical examination of your pet. We may then proceed with special skin diagnostic testing to help us find the underlying cause of your pet’s issue, such as:

• cytology – collecting material from the surface of your pet’s skin or inside their ear to look at under the microscope, to see if there is evidence of bacterial, yeast or mite infections. It is important to differentiate these different types of infection, as they each require different treatments.
• Skin scrapings – a particular cytology test where we gently scrape away the top layer of skin  (usually over a very small surface area, approx 1x1cm) to look at it under the microscope for skin mites. This sounds like it would be painful, but it is really more just an irritation if done carefully – most pets don’t even notice when they are being given treats and cuddles at the same time! If your pet is particularly wriggly or worried about this test, we will discuss the option of a careful light-moderate sedation to help relax them.
• Skin biopsy – if your pet has unusual lesions, such as skin ulceration or lumps, which could suggest an unusual infection, a skin tumour, or an autoimmune disease, sometimes we will recommend a general anaesthetic for surgical biopsy. We will give you an estimate for this and then book your pet in for a week-day that suits you. Biopsies are often very small, requiring only a few stitches.

So where to from here?

Once we have an idea of what is causing your pet’s skin and/or ear disease, we can make recommendations for treatment, and have a discussion about long-term management options if these issues are repeatedly recurring. We are well-stocked with all common skin and ear treatment options on-site, so we can start treatment for your dog or cat straight away to give them relief as soon as possible! There are often several treatment options for different budgets and pet cooperativeness levels, so we are always happy to discuss these to find what will suit you and your pet best.

If you think your dog or cat has any skin or ear irritation, or for any dermatology issues, please give us a call at Beach and Bay Vet. We’d love to help!