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Skin Disease

“You’ve got to have skin. All you really need is skin.
Skin’s the thing that, when you’ve got it outside, it helps to keep your insides in!
Yes, you’ve got to have skin.”
--U.C. Davis Veterinary Medicine Class of 1982: Dermatology Final Exam Song

Dermatologists claim that theirs is the best of all specialties, and maybe they’re right. There are no emergencies (Doc, my dog has a rash! Can you meet me at the clinic at midnight?). Everyone can see (and smell) an animal’s skin, so the owner is especially motivated to fix the problem. Finally, skin problems are seldom cured. At best, skin diseases will be controlled or managed, so there’s plenty of repeat business! It really doesn’t sound like such as bad deal - if you’re a dermatologist.

But if you’re not a dermatologist, things don’t look so great. A pet with skin disease is so uncomfortable that pet and pet owner alike are miserable. Itchy dogs scratch and chew themselves for hours, keeping the owners awake at night. Many animals with skin disease have a musty odor, or a greasy coat that is unpleasant to touch and leaves a smelly residue on your hands, or worse, permeates your home. Pet owners are not overjoyed when strangers stare at their bald, itchy pet and ask, “What’s wrong with your dog?”

To make matters worse, diseased skin looks more or less the same. There are only so many things that skin can do when it is sick, and these changes usually indicate the duration rather than the cause of the disease. First, the skin turns red. Then, the hair falls out. Then crusts and flakes accumulate on the skin and coat. Then, the skin turns black. Finally, the skin becomes thick and wrinkled. No matter what is wrong with an animal’s skin, it will generally do one or all of these five things, and do them in the order listed. The point is, no one can look at an animal’s skin and be certain what caused of the problem.

Sick skin itches, a response veterinarians call pruritus. Hence the motto of veterinary dermatologists: Lick pruritus now! This is precisely what pruritic pets do: They lick and chew themselves, often until their skin is wet and discharging a purulent mess. Everyone agrees: Skin diseases are miserable and everyone wants to make them disappear. Nobody wants this more than the pet suffering from pruritus.

What’s a pet owner to do? There are thousands of things that cause skin disease, and it’s difficult to sort out which of these causes have brought about the skin’s five stereotypic manifestations of disease. Discerning the exact cause of a skin disease is the only way to eliminate it!

Dietary allergies are remarkably common and it’s smart to place any pet with skin trouble on a hypoallergenic diet for 30 to 60 days to test whether dietary restriction improves the animal’s problem. It’s amazing how often this helps, or completely resolves the trouble, especially with problem ears. Dogs commonly react to beef, corn, wheat, lamb, rice, and poultry (in cats, fish). Feed obscure combinations of ingredients, things your pet has never eaten (and can’t be allergic to), such as duck and potato, or herring and beets, during the dietary trial.

Think of the hypoallergenic diet as a 30 to 60 day test of your pet’s skin problem vs. food restriction. During the trial, feed only the new diet and water, because even one bite of allergen may cause your pet to react for weeks. Be firm. Don’t let those big brown eyes convince you that “one little bite won’t hurt.” Be careful not to allow well-meaning family members to ruin the test for you. If your pet is dramatically better after a hypoallergenic diet trial, you know your pet suffers from food allergy!

This is where your veterinarian can help. The pattern of skin eruption is a critical clue in determining the cause. Your veterinarian is trained to sort out patterns that indicate parasitism or systemic allergy or self-directed immunity from other causes. The patient’s history provides invaluable clues about what may be – or can’t be – the problem. Your veterinarian’s advice can save you and your pet a lot of suffering.

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