Category Archives: Skin

Heart Failure

Heart Failure
By Dr. Karen Burgess

What does heart failure mean?
The heart is a muscular organ that contains four separate blood holding chambers.  The heart muscle functions to push or pump blood held in these chambers through the body’s blood vessels.  When the heart is unable to push blood forward at a rate that keeps up with the body’s demand it is considered heart failure.  Heart failure typically leads to fluid backing up into the lungs.

What causes heart failure?
There are a variety of diseases that can lead to heart failure.  Pets with a heart murmur, or leaky heart valve account for 80% of heart failure cases in dogs.   In some cases the heart muscle is abnormal, either too thick or too thin.  Lung disease can also put added stress on heart muscle.

What is the significance of heart failure?
Heart failure can be chronic disease with symptoms waxing and waning or acute in nature leading to sudden death.  When blood flow to the body is affected energy level, organ function, and the ability to breathe can all be affected.  Owners may also notice an enlarged belly (from fluid buildup), gums that are blue or paler than usual, and weight loss.

What are symptoms of heart failure?
Pets experiencing heart failure are often first seen for coughing, in particular after exertion of first thing in the morning.  Other signs include exercise intolerance, reluctance to go for walks, and change in sleep pattern or position.

What tests are indicated if heart failure is suspected?
If a pet is experiencing collapse or severe breathing issue from heart failure it may be life-threatening within minutes to hours and immediate medical attention is necessary.   Hospitalization and oxygen support along with medications may be required in these situations.  Radiographs (x-rays) are often used to evaluate for heart failure which will often produce an enlarged heart shape of evidence of fluid buildup in the lungs.  Blood pressure, EKG evaluation, and blood tests are often recommended to further evaluate the impact of heart failure on the rest of the body.  Ultimately an echocardiogram (ultrasound of the heart) allows a veterinarian to understand the specific disease affecting the heart.

What is involved with treatment for heart failure?
Often pets with heart failure are able to be managed with oral medications for some time period after diagnosis allowing them to live a relatively normal quality of life.   It is helpful in managing heart failure patients to monitor their breathing rate while sleeping; changes in this number may indicate that a pet is having more troubles related to their heart function.

Is heart failure the same as a heart attack?
Heart attacks are common in humans and occur when blood flow to the heart muscle is interrupted thus leading to death of the heart muscle known as a myocardial infarct.  This is not a common cause of death or heart disease in cats and dogs.


By Dr. Karen Burgess

What is pyoderma?
Pyoderma is another way of saying bacterial skin infection.  Skin has bacteria present naturally, but when allowed to overgrow skin infection develops.

What causes pyoderma?
Pyoderma is an overgrowth or invasion of the hair follicle with bacteria.  Typically pyoderma is secondary to some other cause.  Examples include allergic skin disease (atopy), food allergy, matted hair, self-trauma, and underlying metabolic disease (hypothyroidism, Cushing’s).

What are the signs of pyoderma?
Superficial pyoderma affecting only the outer skin layers often appears as red bumpy areas that have crusts present.  Hair loss or rough hair in the area may also be present.  Deeper pyoderma can cause significant hairloss and open wound like lesions.  In either case pets are often itchy and may paw or lick excessively at effected areas.

How is pyoderma diagnosed?
Visualization of lesions, history, and cytology of affected sites looking for bacteria are all involved in the diagnosis of pyoderma.  In severe or chronic cases additional testing to rule out underlying medical conditions may be indicated.

How is pyoderma treated?
Mild localized cases of pyoderma can often be treated with medicated sprays or shampoos.  More severe instances often require oral antibiotics until well beyond resolution of lesions.  An Elizabethean collar is often essential in treatment to prevent pets from further self mutilation while medications are taking effect.  Treatment of underlying medical conditions (ex. allergies, parasites) that predispose to pyoderma is also necessary.


By Dr. Karen Burgess

What is atopy?
Atopy is another way of saying airborne allergies or environmental allergies.  In people atopy would be known as asthma or “hay fever”.   Allergens are found in the environment and may be inhaled or come in direct contact with the skin.

What are signs of atopy in pets?
The most typical presentation is itchy skin, secondary skin infections, and ear infections or inflammation.  Symptoms may be seasonal in nature or year round depending on the underlying allergen.  All areas of the body can be affected, but in dogs the face, armpits, abdomen, feet, and legs are often predominant.  Dome pets may have a red color to their fur from licking (saliva contains a pigment that thus stains the fur).  Cats can have lesions anywhere on their body.  Ears are a continuation of the skin inside so infections are common secondary to atopic inflammation of the ears.  Respiratory signs can occur in pets but are much less common.  Symptoms often start between 1 and 3 years of age and will usually get worse over time not better thus making treatment essential.

What causes atopy?
Just like in humans, allergies are an inappropriate and excessive response of the immune system.  Essentially instead of ignoring an allergen such as dust or mold, the immune system becomes overly excited at any exposure leading to inflammation of the skin for pets.  Genetics also play a part with certain breeds having a higher incidence of atopy.

How is atopy diagnosed?
Clinical signs and history are very helpful in identifying atopy as a cause of chronic itching or skin disease.  The first step is ruling out other causes of itchy skin, in particular parasites (mites, fleas, lice), secondary bacterial or yeast infections, and systemic diseases (hormonal diseases, cancer).  The next step is determining whether food allergies may be a factor.  Pets can experience both food allergies and atopy and symptoms for both overlap, but their treatment is very different.  Once all other possible causes of chronic itching/skin disease have been ruled out then atopy is the most likely diagnosis and definitive testing can be performed.  Skin (intradermal) testing has for years been considered the gold standard.  Similar to in humans, an area of skin (typically on the side of the body that has been shaved) is pricked with a variety of potential allergens and the subsequent response is measured.  This information is then used to create injections that are used for treatment.  Prior to testing steroid and antihistamine therapy must be discontinued for a period of time.  Sedation is necessary for skin testing.  Blood allergy testing has become more reliable; this method measures the pet’s antibody levels toward a particular allergen.

How is atopy treated?
There are many ways to manage or treat atopy.  A few are listed here.

  1.  Minimize exposure– Avoidance or removal of specific allergens (washing feet after going outside, frequent baths)
  2. Hyposensitization (“allergy shots”)- Information obtained from allergy testing can be used to design specific immunotherapy.  By giving small doses of allergens at a regular interval, the pet hopefully develops tolerance to them and thus reacts less when encountered in the environment.  Unlike in humans, pets do not outgrow allergies like some humans.  These injections are typically given by owners at home and are found to be effective in 75% of treated dogs.
  3. Immune modulators– Atopica (cyclosporine) is a non-steroidal medication that alters how the immune system responds to an allergen.  While safe and effective, this product can be expensive particularly for larger dogs.  Corticosteroids (such as pred) act as an anti-inflammatory and immunosuppressive agent.  While very effective at controlling symptoms and inexpensive, steroids have a myriad of negative side effect and are not a safe chronic long-term solution.
  4. Antibacterial/antifungals– It is common for pets with allergies to develop secondary bacterial or fungal injections.  In essence pets with allergies have “sick skin”.  While bacteria and yeast are found naturally on the skin, it is easy for their numbers to get out of control for pets with allergies.  For severe infections or overgrowth, oral antibiotics or antifungals may be necessary.  In milder cases topical products may be sufficient.
  5. Antihistamines– Commonly used to control allergy symptoms in humans, antihistamines such as Benadryl are far less effective in dogs and cats.  The mechanism of action is to block the chemicals causing the itch (typically histamine).  Any particular antihistamine may help only 10-15% of pets.  Trial and error is necessary to determine which if any might be beneficial for an individual pet.  Overall antihistamines offer a safe and inexpensive adjunct to atopy treatment.
  6. Omega 3 supplementation– Often referred to as fatty acid or fish oil supplements, Omega 3s overtime can decrease the inflammation associated with atop.  DHA and EPA are the common fish origin omega 3 fatty acids.  When determining a dose the sum total of DHA and EPA is used with a target of 70 mg/kg/day (range 50-100 mg/kg/day).  Fish oil supplements are a supplement and thus not well regulated.  Reliable brands include Nordic Naturals (online human product) and Welactin (veterinary product).
  7. Topical treatments– Shampoos, conditioners/lotions, and sprays can all be very useful in controlling allergic skin disease.  Medicated shampoos need to be used frequently (two to three times weekly) and allowed to stay in contact with the skin for 10-15 minutes before rinsing.  While for some clients this is not the most convenient therapy, it allows a relatively inexpensive at home treatment option that is safe and does not involve systemic (oral) medication.  Sprays and lotions are used for specific or isolated areas.  Steroid sprays allow the potent anti-itch effect without the same negative side effects of oral steroids.
  8. Flea and tick preventative– Year round prevention of parasites is recommended to avoid this complication for the already itchy atopic pet.

Acne, Feline

Feline Chin Acne
By Dr. Karen Burgess

What is feline chin acne?
Feline chin acne is a condition affecting the hair follicles on the chin of cats which often resembles a dirty chin.  When this “dirt” is removed and on closer inspection, small raw or bloody bumps are often discovered.  Technically chin acne is a follicular disease where too much keratin (protective protein made by skin) is produced, trapped in the hair follicles thus leading to what are commonly referred to as blackheads.  These plugged follicles can then become infected forming pustules (otherwise known as pimples).

Why do cats get chin acne?
There is no one cause for chin acne. Contributing factors may include poor grooming habits of the cat, genetic tendency to produce too much sebum (a naturally produced oil produced by the skin glands), improper shedding of the hair thus leading to clogged follicles, or abnormal keratin production.

How do I tell if my cat has chin acne?
When looking at your cat’s chin it should be smooth and clean in appearance under the fur. If bumps, scabs, or a dirt-like substance are noticed then your cat may have chin acne. The chin may be painful and in severe cases fairly swollen. Chin acne may also affect the upper lip.

How does my veterinarian diagnose chin acne?
Often the clinical appearance is enough to diagnose chin acne. Additional testing of the skin for specific bacteria, parasites, or cancer may also be necessary.

How is chin acne commonly treated?
Better hygiene is typically the basis of treatment. Cleaning the debris off the chin allows for better penetration of medication which is often benzoyl peroxide based. In some cases clipping of the fur is also necessary. Medicated shampoos, pledgets, or ointments are often prescribed for use at home.  It often helps to first hold a warm moistened wash cloth against the area for a couple minutes to help open affected pores. In severe cases oral medications may also be necessary.  Removal of any plastic bowls is also recommended as there is some association between plastic exposure and chin acne. Prognosis for control or recover is good overall.

Abcess, Feline

Cat Bite Wounds & Abscesses
By Dr. Karen Burgess

Cats are highly territorial and often fight when they meet outside or, less commonly, within the household. During fights, cats inflict deep bite wounds that inject bacteria from the mouth into the internal tissues. Cat bite wounds frequently become infected and abscessed. An abscess is a pocket of infection that the body has walled off.

Signs of Abscesses
If you know your cat has been in a fight, it is a good idea to examine him carefully for signs of injury. Bite wounds may leave only tiny puncture holes on the skin. Veterinary care is always recommended for cat bite wounds. More often, you will not know that your cat has been fighting until an abscess forms. Signs of an abscess include fever, lethargy, loss of appetite, pain and the appearance of a swollen area. Hair may be lost in the area, and the skin may rupture, leaking foul-swelling pus onto the fur. The most common areas for bite wounds and abscesses are the face, legs, and the base of the tail.

What is an Abscesses
An infected bite or claw wound is a common infectious disease for cats. The wounds occur when deep punctures through the skin are inoculated with bacteria or foreign material and subsequently lack drainage. A decrease in oxygen tension allows growth of anaerobic bacteria. Aerobic, mixed, and fungal infections may also occur in the wound sites. The most frequently inoculated organism is Pasteurella multocida, an aerobic gram-negative bacterium commonly found in the mouth of cats. Fusobacterium, Prevotella, E. coli, and Clostridium spp. are among a number of other possible bacterial agents.

How Abscesses are Diagnosed
Your veterinarian can usually diagnose the abscess based on a physical exam. It may be necessary to shave hair from parts of the body to look for bite wounds.

Abscess Treatment
Cats typically require anesthesia for initial drainage and cleansing of the infected area. All of the pus and dead tissue will be removed. The wound is encouraged to heal without trapping bacteria under the skin again. This usually means that the wound is left open so that the internal tissues heal first, before the skin. Drains may be placed temporarily under the skin. In addition to giving oral medications, it may be necessary for you to administer topical antiseptics or antibiotics directly to the wound area. Hot packing the area with a warm, wet washcloth for 5-10 minutes twice daily is also beneficial. Most cats heal well with proper treatment.

Even though an untreated abscess usually ruptures and drains on its own, recurrence is extremely common without professional care. Cats with abscesses can also get sick enough to stop eating and become severely dehydrated. Prompt medical attention is a must for all cat bite wounds and abscesses.

Biting is the most common means by which some serious cat diseases are spread. Feline Leukemia Virus (FeLV), Feline Immunodeficiency Virus (FIV), and Rabies can all be spread by bites. If your cat goes outside he should be vaccinated against FeLV and Rabies. Your veterinarian may also advise testing for exposure to FeLV and FIV after a bite.

Preventing Abscesses
The main mechanism for preventing abscesses is keeping cats indoors, where they are less likely to fight. Routinely checking your cat for injuries is also a good idea.