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Friday, November 1, 2013

What's Up With The Skin?

Here's a question from Victoria...

I have a 10 year old pure bred lhasa apsa who seems to be experiencing some kind of dry skin condition on his lower back. I initially brought him to our vet when he presented with what appeared to be cuts on his lower back,to my knowledge he hadnt injured himself so i was concerned. The vet explained he may be hypo glycemic and that can cause thinning of the skin. I.proceeded with the blood test to confirm this and when the test came back negative the vet concluded the dog must have cut himself on something without me knowing. I,thinking that was a totally plausible situation took my boy home and kept an eye on the healing of the cuts. The cuts have now healed but his skin seems to be blackening all on the lower back and almost 'flaking' off. The vet has said it is likely dry skin but hasnt really offered any reasons this skin condition would arise or how i can go about treating it. Any advice or insight you could offer would be much appreciated.

While diabetes can cause skin problems, it's not my first thought when dealing with a dermatology issue, especially if there aren't other symptoms.  The single most common symptom that leads to a diagnosis of diabetes in pets is an increase in drinking and urinating.

Victoria, a full exam and questioning would be necessary for me to give you a good answer, but here are some of the things I would consider in a case like this.  Are there any signs of fleas?  Has he been noticeably scratching or rubbing his skin?  Has he been going under low furniture such as beds, low tables, etc.?  Has he been anywhere new?  Has he been exposed to anything different recently?  Has he ever had any skin problems in the past?

The next thing that I would normally consider would be the trifecta of skin tests:  a skin scraping, skin impression, and fungal culture.  Every dermatologist will do these tests on pretty much every case, even if the referring vet has already done them.  A skin scrape looks for mites, the impression looks for bacteria and yeast, and the culture looks for ringworm.  If none of these are noted then it may be skin irritation or an allergy.  Unfortunately, many disorders can look the same and it make take several tests or treatments to make the proper diagnosis.

When dead skin scabs, it can look black and start to come off.  Also, chronically irritated skin will develop a dark pigment, though the pigment itself is normal and harmless.  Excessive flakiness is not normal and may be related to changes in the skin, nutritional deficiencies, and so on.  If the problem persists it should be further evaluated until appropriate treatment is determined and used.

I would first start with talking to your vet and asking more details.  The vet may actually have other ideas or directions to pursue when it becomes evident that the problem isn't simply some scrapes.  If your vet still doesn't want to look into it further, I'd look for a second opinion.