Browsing tag: scratching

Ask a vet online – my dog has skin allergies, how do I help?

Question from Leona Poppleton:

my dog has skin allergies and so gets very dry skin and sometimes scabs that look quite painful is there anything that I can get or do to help this?

Answer: Scabby Skin

Hi Leona, thanks for your question about your dog’s skin. Allergies with skin symptoms are pretty common in dogs, so I’ll briefly discuss allergic disease, then go on to some of the many different treatment options.

What are skin allergies?

The phrase “skin allergies” refers to the itching, scratching and sore skin that allergic dogs get. However, it doesn’t have to be caused by something on the skin – e.g. food allergies (although quite rare in dogs) can lead to skin symptoms – so “allergic skin disease” is a better term.

Essentially what is happening is that the dog’s immune system misidentifies a harmless substance as a dangerous threat, and tries to attack it, causing soreness and itching. Allergic reactions may be triggered by a wide range of substances such as pollen, certain foods, fleas, mites, plants or even some washing powders. In a large number of cases, there’s no specific “allergy” involved, but the dog has a disease called Atopy (or Atopic Dermatitis), where the immune system reacts abnormally to a wide range of different stimuli. Atopy is partially genetic, and is more common in some breeds (e.g. West Highland White Terriers).

How is it diagnosed?

It is important to get allergic skin disease properly diagnosed by your vet because there are many contributing factors and different underlying problems. As a result, diagnosis can be long and exasperating! In addition, diagnosing Atopy requires ruling out all other possible causes.

1) Initially, its vital to make sure that there aren’t any parasites (especially fleas!) on the dog – this is a LOT harder than most people think, and usually requires treatment of the affected dog, all other pets in the house, and the house itself. (A side note here – there are a lot of over-the-counter products available for treating fleas: some work, some don’t work, and some are very dangerous if not used correctly. I would strongly advise talking to your vet for advice, particularly as the most effective treatments are prescription-only medicines, some of which will also act over time to treat the environment as well as killing adult fleas).

2) The next step is to make sure there aren’t any skin infections that could be contributing to the symptoms, or mites burrowing into the skin. This may require skin scrapes to remove a layer of skin (it really doesn’t hurt!) and tape-strip tests to check for yeasts or bacteria.

3) There are a number of allergy tests available – these mostly use blood samples; intradermal tests (injection of test substances into the skin) may be more reliable, but they are expensive and difficult to perform.

4) To rule in or out food allergies, a controlled food trial is essential. This can be done with truly novel food sources, but in general it is more effective and practical to use a hypoallergenic diet from your vet. These diets are formulated so that the proteins are broken down so small that the immune system can’t recognise it. In a food trial, the dog is fed ONLY the controlled diet (no treats or snacks!) for a number of weeks. If the symptoms resolve, you reintroduce the original diet one item at a time, to determine what’s causing the allergy.

But why does it make my dog itch so much?

Itching is what’s called a “summative, threshold” experience. This means that there is a threshold level, below which itching won’t be felt. Anything that stimulates an itch (“pruritic”) response such as a flea bite, an allergy, or a skin infection, raises the level of “itch” until it breaks this threshold and the dog feels itchy. In most allergic dogs, several different factors combine to make the itching overpowering. Unfortunately, actually scratching makes things worse – this is called the “itch/scratch cycle”.

What are the scabs I can sometimes see?

Scabs generally mean one of three things:

1) Flea bites

2) Skin infection

3) MOST COMMONLY – self-inflicted skin damage caused by scratching. The skin is sore because it’s been scratched, and it’s been scratched because its sore etc etc… Scratching also damages the skin and allows infection to become established, which makes the itching worse.

What can I do about it?

The bad news is that most allergies cannot be cured, only managed. However, with good management, most cases of allergic skin disease can be fully controlled the vast majority of the time. There are a number of classes of treatment, which I’ll deal with in turn; however, many cases will require multiple overlapping treatments, so it is essential that you work with your vet to put together a management programme.

1) Disease modifying treatments

These attempt to reduce the underlying allergic response. The most effective are licensed immune-modifying drugs such as ciclosporin*, which when used long term reduces the allergic response. There is great hope for immunotherapy, where the immune system is gradually taught to tolerate certain allergic substances; this must be made up by a lab specifically for your dog’s allergies. Sometimes an allergy can be “cured” by this route, but it is more usually used to reduce the dog’s sensitivity.

2) Relieving symptoms

These act specifically to reduce the sensation of “itch”. There are three main drugs used for this. Firstly, antihistamines; these are not licensed for use in dogs and may have noticeable side effects, but a vet can legally prescribe them under the cascade if necessary. My experience is that they aren’t very reliable in dogs, but may be useful in some cases. There is also a new drug called oclacitinib which works purely to suppress a dog’s itch sensation. Finally, there are steroids. These reduce inflammation, mildly suppress the immune system and are very, very effective at reducing itching. They’re also inexpensive; however, if used long term, they have a wide range of side effects. They’re often best used as a “rescue” treatment, although steroid creams and sprays that can be applied directly to the sore spots on the skin have fewer side effects.

3) Reducing other sources of itching

This category would include products such as antibiotics for skin infections and antifungals for yeast infections (many of which are available as medicated shampoos), and parasite treatments for fleas and mites.

4) Reinforcing the skin barrier

This is a relatively new area, but seems to be a really useful in some cases or in addition to other treatments. There are soothing and hydrating shampoos which work to remove allergic substances from the coat and soothe the skin; as well as oatmeal shampoos which seem to have an anti-itching effect. Finally, there are the ω-3 fatty acids which appear to help many itchy patients; they may be in the diet (particularly in “skin” or “dermatology” diets), added to food as a supplement, or used as a topical spray or spot-on.

Overall, you and your vet need to find the combination of treatments that suit your dog. Managing the allergic pet is a big task, but I hope this has helped, and that you can keep your dog comfortable!

David Harris BVSc MRCVS

* PS – you may notice I’m using generic drug names not brand names in this article. This is because, for legal reasons, I’m not permitted to name specific brands in a blog like this. If you want to know more, check out the government’s Veterinary Medicines Directorate website.

Ask a vet online – ‘My dog keeps shaking his head and scratching his ears’

Question from Amanda Shaw

My dog keeps shaking his head and scratching his ears, they feel a little bit swollen but they are cleaned often so no mites he is lively and not off his food I’m at a loss.

Answer from Shanika Winters MRCVS, online vet

Hi Amanda and thank you for your question about your dog’s ears. It is great that you are cleaning your dog’s ears regularly. I will discuss a list of possible causes for your dog to be shaking his head, scratching his ears and for the swelling followed by some treatment options.

Why is my dog shaking his head and scratching at his ears?

The symptoms you have described could be due to a foreign body e.g. a grass seed down the ear canal, bacterial or yeast infection, skin allergy, parasites e.g. ear mites, polyps or an aural haematoma (blood blister) all of which can be painful.

Grass seeds are a common finding down the ear canal of dogs that go for walks in the countryside. The shape of a dog’s ear canal has an upright tube (vertical canal) and then a 90 degree bend and a sideways tube (horizontal canal) at the end of this is the ear drum (tympanic membrane), this lends itself to getting things lodged inside. A foreign body like a grass seed can usually be seen by your vet with the help of an otoscope (hand held torch with a magnifying lens and a funnel). Grass seeds can usually be removed using a special pair of long grabbing forceps; some dogs will however need sedation or a general anaesthetic to allow the removal and examination to be carried out safely. We often send dogs home with antibiotic and pain relief after foreign body removal to combat any infection and pain.

Bacterial and yeast infections of the ear are conditions that affect the skin that lines the inside of the ear canals. The shape of the ear canal along with the ear flap (pinna) tends to funnel in moisture and trap germs. Dogs with a large floppy pinna such as Spaniels have the added feature of a closed lid over the ear canal all leading to a great environment for germs to breed. Infection may be present on other parts of the body and the whole animal may need treatment not just the ears. If the condition is only affecting the ears then ear cleaning solution and antibiotic drops can be a very effective treatment. If you are new to applying ear cleaner and ear drops then ask your vet or veterinary nurse to show you the best way to use them. If the condition is affecting other areas of skin then injectable or tablet medications may be given so that the drugs can travel in the blood stream to reach more areas of the body. When infections are not clearing up your vet might suggest taking swabs from the area. The swabs are sent to the laboratory for bacteriology and sensitivity. This tells us which bacteria and yeasts are present, and which drugs should be effective against them.

Skin allergy can affect the ears as the ear canals are lined by skin, diagnosis and treatment of skin allergy can involve swabs, biopsy samples and skin scrapes analysed at your vets or sent to a laboratory. Treatment of skin allergy can involve use of low allergy diets, shampoos, desensitisation vaccines, antibiotics, antihistamines and various immunosuppressant drugs.

Parasites including ear mites (Otodectes cynotis) and ticks (Ixodes varieties) can lead to irritation and then bacterial infection of the ears. Ticks are usually visible to the naked eye but ear mites are more easily seen under a microscope. Use of an appropriate antiparasitic treatment and removal of the parasites are the best method of treatment.

Aural haematoma, this is a blood blister usually found on the outer skin of the ear pinna, seen as a swollen area which often causes the ear to droop. The swelling is soft and fluid filled, it is often the result of a trauma such as a dog fight or vigorous ear shaking. The haematoma develops as small blood vessels in the ear burst and the blood leaks under the skin, this separates into a pink tinged fluid and a thicker dark red clot. Some dogs are prone to recurrence of aural haematomas and repeat treatments may be needed. There are two main methods of treatment, draining via a needle or surgical drainage under a general anaesthetic. Antibiotics, steroids or anti-inflammatory drugs may also be given in the form of tablets, injections or directly into the ear.

Ear polyps are growths of different size that occur inside the ear canal, they are usually diagnosed on examination using an otoscope. Polyps are usually not cancerous but if there is any doubt then the polyp can be sent to a laboratory for analysis after removal. Small sized and numbers of polyps may not cause a problem to your dog but if there is irritation they can be removed surgically, in more serious cases removal of part or all of the ear canal may be an option.

In conclusion it is really important to have your dog’s ears examined by your vet so that a correct diagnosis and appropriate treatment can be started. I hope that my answer has been helpful and that your dog has much more comfortable ears as soon as possible.

Shanika Winters VetMB MRCVS (online vet)

If your dog has a problem with its ears please book an appointment to see your vet, or use our online symptom checker

Ask a Vet Online – “My dog gets frontline flee treatment ..”

Question from Tracey Newall

My dog dexter gets frontline flee treatment but recently he seems 2 scratch more i havent found anything but his skin flakey

Answer from Shanika Online Vet

It is good to hear that you are treating Dexter for fleas; fleas are definitely high up on the list of causes for an itchy dog. Dry flaky skin may well be as a result of scratching due to flea infestation but can also be affected by allergies and medical conditions.

It is really important to remember that a pet suffering from a flea allergy or irritation does not need to be full of fleas. All it takes is one flea to bite your pet to set off the allergic reaction cascade that leads to the skin being irritated.

What is a flea?

Ctenocephalides canis or felis (the dog and cat flea) are a small wingless parasitic insect that live on our pets and in the environment.  Fleas can jump but they can’t fly, they need blood feeds to survive and a large proportion of the flea population are in the environment as oppose to on your pet.

Where are the fleas coming from?

Fleas live on animals as well as in the environment. The flea population consists of adult fleas, immature larval stages, dormant pupae and then eggs, as you move down the list the numbers increase significantly which is why we refer to them as a pyramid.

Fleas in the environment, by this we mean anywhere a pet with fleas has been, the warmth of our homes provides a great breeding ground for fleas in carpets, pet bedding and just about any nook and cranny.

Cats can also carry the fleas and they do not even have to be your own cats, for example if a cat comes through your home or garden then the fleas can jump off or deposit eggs as they go. This is why we often advise treating the home environment and in-contact animals also.

So how can you tell if your pet has fleas?

Gently part your pets fur and search through close to the skin, fleas are a reddish/brown colour and quickly move away from the light. It can be easier to find fleas on the underside of your pet as the coat is naturally thinner here. It is often easier to see the flea dirt in your pet’s coat than the actual fleas.

So what is flea dirt and how can you tell if there is any on your pet?

Flea dirt is the waste product produced by fleas and when dry it looks like little black specs, however if you wet it these black specs turn red as they contain digested blood. This brings us to the ‘wet paper test’, we comb through your pets coat and collect the debris onto a piece of wet white paper, if there is flea dirt present there will be small red dots visible where the flea dirt has dissolved in the water. The wet paper test helps to distinguish between flea dirt and just dried mud that may be on your pet’s coat.

Can the fleas live on humans?

You will be relieved to hear that cat and dog fleas don’t tend to live on humans, fleas can however bite humans and cause an irritation at the site of such bites. Commonly humans find flea bites on their ankles, wrists or at their waist band as small itchy raised red areas on the skin.

How to treat the flea problem?

I would recommend using a veterinary flea product either in the form of a spot on (applied to skin at base of neck), impregnated collar or a spray directly on your dog. It is however really important to treat any in-contact animals not just dogs but cats too. Lastly do not forget to treat the environment; this is most easily done by use of an aerosol spray applied to the carpets, skirting boards and soft furnishing. Instructions often advise to vacuum carpets before you spray to help the chemicals to be more effective. Always read the safety information as the chemicals may be harmful to fish or birds and it is important to allow good ventilation after spraying also. In my experience it is best to treat half the house at a time so as to leave somewhere for pets and people to hang out without having to breathe in the spray. The chemicals in the spray are designed to kill or prevent further development of the fleas and their various life stages. The effect of the environmental sprays can last for a year.

Why is my pet still scratching even though I have treated him/her for fleas?

Provided a thorough approach to flea treatment using appropriate products has been undertaken then if your pet continues to scratch there are likely to be other factors contributing. These may include allergies or intolerances to food substances, cleaning products and or an underlying medical condition.

What medical conditions may be causing my pet to scratch?

The skin has its own inbuilt barrier to substances that can cause irritation this however can be weakened in conditions such as Hypothyroidism (under active thyroid gland), Cushing’s disease (over production of natural steroids) and bacterial skin infection.

What should I do if after treating my pet, in-contact animal and the environment my pet is still scratching?

It is likely you will need to discuss further investigations into your pet’s skin condition with your vet, to try and rule out some of the conditions listed above. The investigations may involve blood and or skin tests. There is also the possibility that an exclusion diet or low allergy diet may be suggested if diet is suspected as a contributing factor to the skin problem.

So in conclusion an itchy pet may well need more than flea treatment. That is not to say that fleas are not very high up on the list of things to rule out by taking a thorough approach to flea treatment. If you are in any doubt always talk to your vet as we are here to help you and your pet.

It is good to hear that you are treating Dexter for fleas; fleas are definitely high up on the list of causes for an itchy dog. Dry flaky skin may well be as a result of scratching due to flea infestation but can also be affected by allergies and medical conditions.
It is really important to remember that a pet suffering from a flea allergy or irritation does not need to be full of fleas. All it takes is one flea to bite your pet to set off the allergic reaction cascade that leads to the skin being irritated.
What is a flea?
Ctenocephalides canis or felis (the dog and cat flea) are a small wingless parasitic insect that live on our pets and in the environment.  Fleas can jump but they can’t fly, they need blood feeds to survive and a large proportion of the flea population are in the environment as oppose to on your pet.
Where are the fleas coming from?
Fleas live on animals as well as in the environment. The flea population consists of adult fleas, immature larval stages, dormant pupae and then eggs, as you move down the list the numbers increase significantly which is why we refer to them as a pyramid.
Fleas in the environment, by this we mean anywhere a pet with fleas has been, the warmth of our homes provides a great breeding ground for fleas in carpets, pet bedding and just about any nook and cranny.
Cats can also carry the fleas and they do not even have to be your own cats, for example if a cat comes through your home or garden then the fleas can jump off or deposit eggs as they go. This is why we often advise treating the home environment and in-contact animals also.
So how can you tell if your pet has fleas?
Gently part your pets fur and search through close to the skin, fleas are a reddish/brown colour and quickly move away from the light. It can be easier to find fleas on the underside of your pet as the coat is naturally thinner here. It is often easier to see the flea dirt in your pet’s coat than the actual fleas.
So what is flea dirt and how can you tell if there is any on your pet?
Flea dirt is the waste product produced by fleas and when dry it looks like little black specs, however if you wet it these black specs turn red as they contain digested blood. This brings us to the ‘wet paper test’, we comb through your pets coat and collect the debris onto a piece of wet white paper, if there is flea dirt present there will be small red dots visible where the flea dirt has dissolved in the water. The wet paper test helps to distinguish between flea dirt and just dried mud that may be on your pet’s coat.
Can the fleas live on humans?
You will be relieved to hear that cat and dog fleas don’t tend to live on humans, fleas can however bite humans and cause an irritation at the site of such bites. Commonly humans find flea bites on their ankles, wrists or at their waist band as small itchy raised red areas on the skin.
How to treat the flea problem?
I would recommend using a veterinary flea product either in the form of a spot on (applied to skin at base of neck), impregnated collar or a spray directly on your dog. It is however really important to treat any in-contact animals not just dogs but cats too. Lastly do not forget to treat the environment; this is most easily done by use of an aerosol spray applied to the carpets, skirting boards and soft furnishing. Instructions often advise to vacuum carpets before you spray to help the chemicals to be more effective. Always read the safety information as the chemicals may be harmful to fish or birds and it is important to allow good ventilation after spraying also. In my experience it is best to treat half the house at a time so as to leave somewhere for pets and people to hang out without having to breathe in the spray. The chemicals in the spray are designed to kill or prevent further development of the fleas and their various life stages. The effect of the environmental sprays can last for a year.
Why is my pet still scratching even though I have treated him/her for fleas?
Provided a thorough approach to flea treatment using appropriate products has been undertaken then if your pet continues to scratch there are likely to be other factors contributing. These may include allergies or intolerances to food substances, cleaning products and or an underlying medical condition.
What medical conditions may be causing my pet to scratch?
The skin has its own inbuilt barrier to substances that can cause irritation this however can be weakened in conditions such as Hypothyroidism (under active thyroid gland), Cushing’s disease (over production of natural steroids) and bacterial skin infection.
What should I do if after treating my pet, in-contact animal and the environment my pet is still scratching?
It is likely you will need to discuss further investigations into your pet’s skin condition with your vet, to try and rule out some of the conditions listed above. The investigations may involve blood and or skin tests. There is also the possibility that an exclusion diet or low allergy diet may be suggested if diet is suspected as a contributing factor to the skin problem.
So in conclusion an itchy pet may well need more than flea treatment. That is not to say that fleas are not very high up on the list of things to rule out by taking a thorough approach to flea treatment. If you are in any doubt always talk to your vet as we are here to help you and your pet.

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