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The skin (as you may have learned while playing Trivial Pursuit) is the largest organ of the body, yet somehow, it’s still uniformly underappreciated by the casual observer. It is always at the front lines of any conflict, from cat scratches to car crashes, and everything in between. Unassuming as it may be, skin plays a central role in a surprisingly large proportion of veterinary visits. That must be because it’s one of the easiest parts of your pet to see and feel.
Despite its location on the exterior of the body, pet skin can get up to some serious mischief on the sly. Animals with thick fur can develop mats, flea and tick infestations, open sores, even—sorry!—maggot communities under the cover of their coat. Furthermore, dogs and cats have a lot of nooks and crannies. Can you recall when you last spread apart your cat’s foot pads, peeked under your dog’s tail, stretched out the wrinkles under his eyes? Ear canals are not visible at all without the proper instrument, but they too are composed of skin.
Skin does an exemplary job of protecting us from external dangers, but it can be somewhat uncooperative and difficult to work with, frustrating for the person who is financially responsible for its medical care. On visual inspection, most skin problems look quite similar prior to extra laboratory testing. The treatment plan, therefore, can never be guaranteed in advance and virtually always needs be tailored, over time, to the individual patient. For example, your doctor might feel that the skin’s appearance suggests infection and send you home with antibiotics. If the microscopic menace here is a yeast, however, your pet will need antifungal pills instead, or possibly both at the same time. Sometimes the adversary is, in fact, a bacterium, but it doesn’t happen to be vulnerable to the first-choice antibiotic. Laboratory testing often sheds some light on the situation, but it is an additional expense and unfortunately still does not provide a totally reliable road map to follow.
Many dermatologic issues have inflammation—and not organisms, per se—at their origin. It could be something as mundane as an allergic reaction to microscopic particles in the pet’s environment or diet. In such cases, the skin won’t heal until the allergen is identified and removed, or else the inflammation itself is extinguished by medicine. Identification of allergen particles requires referral to a veterinary dermatologist and/or a lengthy, specialized diet trial. A somewhat shorter test period is usually needed for exploring the different inflammation blockers, but meticulous care must be taken to recheck routinely and consistently (which is to say, you’re better off seeing the same doctor for each visit). These problems are almost never solved with one appointment, I’m afraid.
Skin concerns are very common in dogs and cats, but their commonness doesn’t make them any less challenging. Even the worst ones can be alleviated—at least in part—at your regular vet, but you will need to go in with realistic expectations, an open line of communication with your doctor, and a generous dose of patience.
Dr M.S. Regan