Hot spots—those raw, oozing lesions that seem to crop up overnight—are no fun for pet owners or the pet. But even though the clients’ first priority is making the wound go away, it’s important to warn them that another, more pressing issue might be lurking underneath.
“Ninety-nine percent of hot spots are due to allergies,” says Dr. Paul Bloom, DACVD, DABVP, owner of Allergy, Skin and Ear Clinic for Animals in Livonia, Mich., and assistant adjunct professor of dermatology at Michigan State University. “And it’s our job to find out what the allergy is.”
Dr. Bloom recommends a systematic approach to diagnosing the underlying cause of a hot spot, starting with a thorough dermatologic history. It’s important to find out whether the patient has had skin or ear disease in the past, and if so, how it was treated and whether the patient responded to therapy. Also important is identifying a pattern for the onset of clinical signs, such as scratching, biting or licking, to determine whether the animal is uncomfortable year-round or seasonally.
During the physical examination, it’s also crucial to look for other manifestations of allergies, paying close attention to the feet, ears, underside, lip area and chin, neck, dorsal trunk and under the tail. “Because flea allergy is the No. 1 cause of hot spots, the rump area is one of the most common locations for these lesions,” Dr. Bloom says.
Other diagnostic steps may include running a flea comb through the patient’s fur, collecting samples for cytology or performing a skin scraping for mites, specifically Demodex. And once a pattern of allergic flare-ups is identified, further advanced diagnostics, such as a food trial or allergy testing, may be warranted.
But the most important thing to remember, says Dr. Bloom, is that the reason for the pet’s itching must be identified. “If we only treat the symptom, it’s like we’re playing the arcade game Whac-A-Mole,” he says.
“You have to get serious about finding the underlying cause to offer the patient the best chance for lasting relief.”
To download an informational client handout on hot spots, head over to dvm360.com/hotspots.