A Tale of Two Dogs, One Skin Problem (and a surprisingly simple answer)

Updated June 6, 2021

Ted and Millie have been seeing us for over six months now. Ted has a joint problem, recently diagnosed and treated, while Millie has mostly just ‘come along for the ride’.  A few weeks ago, however, Millie developed itchy skin associated with pinpoint scabs on the head.

Pyoderma is generally the cause of these scabs, caused by staphylococcal bacteria infecting hair follicles. We call these infections ‘opportunistic’ because they happen when something else is wrong with the skin, and since pyoderma is so itchy, this is usually when we first see the problem.

So if the scabs are a secondary infection, what is happening here? Unfortunately the answer can be anything causing skin inflammation. This is a long list. Millie is up to date with a good flea and mite treatment so at least these were not a concern.

In Millie’s case, a course of antibiotics cleared up the scabs, but the itch remained. Adding a shampoo helped too, but not completely. At this point many dog owners would have said “that’s good enough” but Millie is fortunate to not have “good enough” owners. (By the way, many owners at this point feel embarassed to keep hassling the vet. We say, keep hassling us- if we can’t hack it’s time for a holiday. If you don’t act as your pet’s champion who will?).

So back she comes. It’s time to assume nothing and work through the problem systematically. The list includes parasites (fleas, demodex mites, sarcoptes mites), bacterial, fungal, allergic and inflammatory diseases. And at this point we get very lucky.

Yes, it’s a flea. Hmm.

Despite popular belief, fleas:

  • Are rarely seen on infested dogs and cats, especially allergic ones
  • Have nothing to do with how clean the dog is- Mille is super-clean
  • Are the commonest cause of skin problems
  • Live in, and are caught from the environment, and,

So why does only Millie have the problem? Because she is developing an allergy to flea saliva proteins. Ted is getting bitten too, but his immune system is ignoring the bites

So why was it so hard to diagnose the problem? Millie is on a quality flea control- it could be any of Advocate, Advantage, Frontline, Revolution, or Sentinel. They are all good, and we initially assumed this ruled out a flea problem. Perhaps it’s the use of dog parks, perhaps it’s fleas becoming resistant to these older treatments but we are starting to notice failures.

Fortunately there is a new treatment called spinosad. It is the active ingredient in Comfortis (flea control only) and Panoramis (flea, intestinal worm and heartworm control). We are seeing excellent results.  At risk of this sounding like a sales pitch, Panoramis also works out to also be cheaper than all the other ‘complete’ parasite treatments plus at the moment there is a $10 rebate offer. It does not kill tapeworm, so we give tapewormers to you to make it complete.

But that is not the main message here. The message is:

  1. Every pet living in the real world gets fleas,
  2. Assume nothing, and
  3. Keep bugging your vet!

Visit our Flea Control page to read about many good options to eliminate fleas from dogs. Read more about how bathing can help and how often you can do it.

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By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.