By Dr. Elizabeth I Borgmann. Skin issues affect many pets and leave owners terribly frustrated. The problems tend to come back. The vet tries this and that and “nothing works for long”. Costs keep mounting. The owners get frustrated with the numerous visits to the vet office. Fido and Kitty remain uncomfortable.

In the next series of articles we’ll try to address the reasons for some of these issues and try to help you through the long and windy path to the comfortable pet.

Skin can be affected by a huge host of problems: parasites, infections, allergies, autoimmune disease, cancers, nutritional deficiencies, and endocrine (hormonal) problems (to name just a few). Many of these conditions will look very similar. After all, the skin has only a limited number of ways to react to an insult. And many times, more than one problem is present. For this reason skin problems can frustrate owners and veterinarians alike.

To get to the answers and hence fix the problem, there is a pathway to follow. You need to work with your veterinarian to get to the bottom of the problem. It takes perseverance.

One of the most important steps to getting to the bottom of the problem is your pet’s history. It starts with breed and age. Some diseases are more common in certain breeds or at certain ages. The next question will be lifestyle. Needless to say, a Great Pyrenees dog that protects sheep from coyotes is going to have a different set of problems or differentials than the Chihuahua that never leaves the owner’s arms.

Exactly, when did you first notice the problem and what did you see? What changes occurred (if any) in the household around that time? Fabric softener? Shampoo? Carpet cleaning? Any fragrance change? Diet? Introduction of a new pet? Moved? Started doggy day care? Was boarded? Was stressed (eg. family death). This is where it gets challenging! More often than not spouses will give substantially different stories about when the original problem started and what it looked like. There will also be very different stories about the changes in the household. Spouses will even start arguing about the history. As vets we need this history but we have to take it with a grain (pound) of salt.

Is there a seasonal or non-seasonal pattern to the problem? If a dog develops ear infections every fall, it is probably due to an underlying allergy. If the ear infection starts 4 days after grooming that is an important pattern to know. Patterns in time are important. (Hint…keep a diary. Just jot it down on the calendar.) Again, the history received can often be unreliable.

Forget about being perceived as a good/bad owner. Just give us the truth. And if you don’t know or don’t remember, tell us that as well. We are in this together with one goal in mind: making Fido and Kitty feel better.

The next step is a complete physical exam. Why? Because metabolic problems can cause skin problems! And if you have an abdominal tumour, the slightly itchy skin becomes a moot point. We need to know the overall health status of your pet. It also affects which medications we can chose to use on Fido and Kitty.

After doing a general exam, the pattern of skin irritation and problems is noted. Then, the testing starts. It starts with skin impressions and skin scrapes. This is the starting point of most skin exams. (Ok, most, not all). Skin impressions and skin scrapes help identify parasites and infections.

Remember, I said that sometimes more than one thing is going on at a time? Some skin diseases break down the defence mechanisms of the skin and secondary infections (yeast or bacteria) become established. Is the infection the primary or secondary problem? Yeast and bacterial infections can make a dog or cat itchy. We need to treat those first to see what the underlying issue is.

After the secondary issues are identified and a plan is made to remove those issues, your vet will ask for a follow-up exam. Please go to those follow-up examinations. We need to know what your pet’s comfort level is once those issues have resolved. Is your pet 100 percent? What problems remain?

Then we are faced with the next step and this is often where the frustration starts to develop. Based on what is seen your vet may recommend allergy tests, food trials, lab tests or biopsies. He/she is not doing this just for the fun of it! This is the stage where we start to find the answers because we have gotten rid of the initial secondary problems.

Your vet will choose the testing that is most likely to provide an answer based on the history, physical exam, and response to initial treatment. One test may not be enough. If your pet is still itchy but the skin looks great, allergy testing may be next. Food trials need to be well and honestly handled to be of value. Lab tests help to rule out underlying metabolic or hormonal problems. Skin biopsies (on nice clean skin which have the secondary infections resolved) help lead to answers (depending on the skill and interest level of the pathologist). Your vet may want to send the biopsies for a second opinion if the first pathologist report doesn’t meet his expectations. Here is where we start to unearth the real problem.

Skin problems may be resolved after the first visit or they may take up to 6 months to get to an answer. Persevere. That is the best advice I can give you. Skin is challenging. Skin is frustrating. Skin is not easy. Skin problems may be a lifelong management issue. Work with your veterinarian. Ask questions. Be honest.

Remember, your vet is on your side and does want Fido and Kitty to be comfortable. Getting there is not always easy! And once you are there….staying there may not be easy either.

Dr. I Elizabeth Borgmann

Dr. Borgmann has been practicing in the Fraser Valley for over 11 years and can be reached at the Whatcom Road Veterinary Clinic