Dear Dr. Robin: We have an 81/2-year-old cocker spaniel who is a bit overweight but active and alert. She scratches herself too often. When we pet her on various parts of her body she reacts with sensitivity as if she were ticklish.
Our veterinarian suggested various remedies, including medicated shampoos, conditioners, antihistamines and nutritional additives. Nothing has worked. Any suggestions?
– J.A.
A: Any time a patient has itchy skin, it is important that we first recognize that pruritis (itchiness) can be a very complex problem. Just focusing on treating symptoms is no longer considered appropriate. Most pruritic dogs can get relief from their itching through the use of steroid drugs. These are corticosteroids, not the steroids used illicitly by athletes to bulk up.
Because steroids can cause terrible side effects – causing more problems than they solve – it is important to first get to the underlying issues causing the itching.
Each patient should have a complete metabolic profile, including a complete blood count (CBC), a chemistry panel, thyroid level, fecal evaluation to look for intestinal parasites, and a urinalysis. It is also important to evaluate the skin itself. (Skin scraping or even a biopsy may be in order.) Any underlying diseases should be treated appropriately to eliminate them as causes of itching. If allergies are determined to be the primary problem, specific allergy testing may be needed.
Causes of itchy skin include parasites (fleas, mange, mites, lice); allergies (parasite, inhaled allergens, food, contact, drug, bacterial hypersensitivity); bacteria/fungus; and seborrhea, skin cancer, abnormal immune system function, and behavioral self-trauma.
More than one disease may be at work in a particular individual. It is important to manage all problems simultaneously.
Pruritic patients should be re-evaluated on a very regular basis to make certain that treatment is moving in the right direction.
Above all, it is important to realize that most pruritic patients require multimodal management of their issues and symptoms.
For those patients that do not respond to treatment, an evaluation by a board-certified dermatologist is in order. Fortunately, there are dermatologists available at veterinary teaching hospitals as well as many private specialty practices. These specialists will work closely with the pet’s primary care provider to ensure continuity of care.
Dealing with pruritic pets is often a long-term commitment that may involve a special diet, medications, shampoos and such, depending upon the diagnoses. It is important that all aspects of the treatment plan be carried out as prescribed, and modified as they need to be over time.
Send questions to Robin Downing, DVM, P.O. Box 460, Windsor, CO 80550 or drrobin@windsorvet.com.
