Mystery Dog Skin Disease Solved

by Katrina
(The Netherlands)

Reader Question: I need help, my dog has a mysterious seasonal skin disease

Hello,

My Great Dane, spayed female, 7 years old next month, has for her entire life experienced episodes of small hot spots and pustulating rashes. In the first years it started in spring and worsened until the end of summer, but did not get too bad and did not itch.

Four years ago we started needing antibiotics to make it go away, that same year it started itching. Three years ago we needed to also use malaseb shampoo, last year it was an immense struggle to control it and it opened huge pustulating sores all over her body. Finally we got it under control.

THIS year it is not responding to anything the vet throws at it (antibiotics, hypoallergenic diet, anti-itch shampoos, nothing). It is spreading very fast. Over the years we have tried most of the sensitive-skin diets on the market and have been to the vet maybe 20 times about this.

In the last few months she's had a complete allergy blood workup (no allergies found); scrapings and lab tests for bacteria, parasites, and fungi (no fungi, no parasites, bacteria just overgrowth of normal skin population); a complete workup to investigate her hormonal levels, look for cancer, determine internal organ functioning (she has "the blood of a young dog" and no unusual findings turned up). She also had two skin biopsies which revealed only "chronic dermatitis".

As I said it's getting worse fast and starting to seriously affect her quality of life, and we're afraid for what we may have to decide about her future.

I have include a photo of her condition. It was half this bad last week. It spreads under the hair, then the hair falls out (usually in her twice-weekly medicated bath), leaving large areas which crust over and pustulate. It itches a lot despite the anti-itch shampoo from the vet.

What I'm looking for with this letter is any suggestions for things we can ask the vet to try or to investigate. But so far it appears this may end up killing her without ever being fully understood. Any help is appreciated.

Vet suggestions regarding a mysterious dog skin disease

Hello Katrina,

I am so sorry to hear about your dog’s condition. A few things come to mind that would be worth pursuing if you haven’t already.

First, consider making an appointment with a veterinary dermatologist. Get copies of your dog’s records, test results, etc. and send them to the office well before your appointment so the veterinarian has a chance to review them and come up with a tentative plan before seeing you. Then, he or she will be prepared to move forward with a new diagnostic approach.

Board-certified dermatologists are up to date on the latest and most advanced diagnostic tools and treatment options. It’s just not possible for a general practitioner to have all the knowledge that a specialist does.

Secondly, I know you mentioned that your dog’s blood testing for allergies was negative, but these types of tests are not as accurate as are the intradermal allergy tests that are usually performed by dermatologists. Your dog’s symptoms, especially the fact that they were initially seasonal but then progressed, fit very well with an environmental allergy (e.g., to a particular type of pollen or mold). Drugs like prednisone and/or cyclosporine (Atopica) can make a world of difference to dogs with environmental allergies. They are not without potential side-effects of course, but in your dog’s case the benefits might certainly outweigh the risks.

Best of Luck,

Jennifer Coates, DVM