Veterinary Referral & Outpatient Service

01473 555 072

Menu

Dermatology

We understand the commitment needed to care for a pet with skin disease, as well as the difficulties that may be encountered.

At NVRS we offer a dermatology service for the investigation and management of acute and longstanding skin conditions in dogs and cats, including intradermal skin testing for allergic disease. In addition, we also provide a service for the investigation and treatment of ear infections (otitis externa and otitis media), particularly longstanding cases where we can use video-otoscopy and advanced CT imaging to fully evaluate the ear canal.

Skin disease can be challenging to diagnose and manage. The skin can only react to disease in limited ways, so many different conditions may appear similar. These are further complicated by secondary changes from scratching and opportunist infections, as well as skin thickening from longstanding inflammation. Many skin complaints are long term conditions, meaning ongoing management is required to maintain initial improvements. We do our utmost to support our clients, and tailor our patients’ treatment regimes to ensure they are as comfortable as possible.

The best outcomes for these conditions will be gained through: a careful and thorough approach to allow an accurate diagnosis, followed by a structured treatment programme, and ongoing management strategies which are adjusted according to the patient’s response.

The dermatology service includes:

  • Dedicated extended dermatology consultations, allowing time for a thorough history to be taken and subsequent investigation of the condition, with further testing as appropriate
  • In-house laboratory testing for rapid results, including blood testing, skin scrapes, hair plucks, tape strips, skin and ear cytology
    Investigation and management of allergic skin disease including:
    • Intradermal skin testing (IDST)
    • Serum allergy testing
    • Immunotherapy
  • Management of acute and recurrent ear infections:
    • Video-otoscopy
    • Advanced CT imaging of the external ear canal and middle ear
    • Skin biopsies (including sebaceous adenitis screening)
    • Regular follow-up appointments to assess progress and provide support for ongoing cases

Some of the conditions we regularly investigate and treat include:

This group of conditions is very common and accounts for a significant proportion of skin cases.

The classic sign of allergic dermatitis is itching, followed by inflammation and often secondary infection. The three most common presentations are flea allergy dermatitis, food hypersensitivity and atopic dermatitis, which is hypersensitivity to environmental allergens such as house dust mites, grass pollens, fungal spores etc.

The presentation of allergic disease may be persistent or seasonal, and affect multiple body areas or only one area (e.g. the ears) and be simply itchy, or complicated by scratching, licking and secondary infections. It is vital with these cases to address the presenting problem of itch and inflammation, whilst at the same time investigating the underlying cause in order to manage the allergy, as otherwise the symptoms will only recur time after time, often worsening with each flare.

Treatment of allergic skin disease centres around several key areas:

  • Allergen identification and avoidance
  • Improvement of skin barrier function to resist allergens and infections
  • Targeted medication to reduce the allergic response, such as immunotherapy injections
  • Symptomatic relief of irritation with anti-inflammatory medications, antihistamines etc

Treatment usually involves several simultaneous therapies, and can be required for life in some cases.

Alopecia occurs as a symptom in multiple groups of skin diseases. Hairs can be damaged or lost through infection, or scratching due to irritating conditions. Hair loss without infection or self trauma can indicate hormonal imbalances such as hypothyroidism, but also more uncommon hereditary or spontaneous conditions.

Specific investigation would usually involve initial samples for microscopy and culture, followed by blood tests, and possibly skin biopsies if indicated by the preliminary findings.

The ear is very prone to infection (especially in dogs) due to its shape and tendency to produce wax, so any skin abnormality is usually amplified by the moist warm environment of the ear canal.

Recurrent ear infections are usually a sign of underlying allergic disease, and can progress to chronic ear disease, possibly with deeper middle ear infection. Repeated head shaking, redness of the ear canal, ear discharge or abnormal odour warrant prompt investigation.

The investigation and treatment of ear disease involves addressing the ear itself, which may need visualising and flushing under general anaesthetic using video-otoscopy, and may require imaging with CT to assess middle ear and bony involvement in some cases. However it is also vital to investigate for underlying disease and manage this concurrently, otherwise recurrence will be highly likely.

Advanced cases may need referral to our surgical team for assessment, as surgical removal of the ear canal (total ear canal ablation, or ‘TECA’) is sometimes the only solution in advanced or longstanding cases.

Infections are most commonly bacterial or fungal, but they can be viral or parasitic. Ear infections described above are related to infections of the skin lining the ear canal. Careful evaluation is required to identify the causal organisms using hair plucks, skin scrapes, tape strips, cytology of any discharges, culture and sensitivity testing of bacterial samples. Recurrent infections are usually a sign of underlying disease, which needs to be investigated and addressed otherwise the problem will continue and often deteriorate.

This varied group of skin conditions is caused by an abnormal response by the body’s immune system, targeting elements of the skin. The severity of immune-mediated skin disorders can be anything from mild (requiring only monitoring or simple topical treatment) through to very aggressive and sometimes even fatal.

Diagnosis is usually based on clinical presentation and results of investigations including cytology and skin biopsy. As with most skin conditions, early recognition and treatment will give the best results.

These can be secondary to other skin diseases such as allergies and skin infections. Investigation will focus on identifying any primary problem and treating or managing this. If our investigation identified that scaling or ‘dandruff’ is a primary problem, a skin biopsy will be performed to confirm this.

Small skin masses can be secondary to skin infection or inflammation. If this is suspected, initial investigation will be the same as for allergic skin disease and infections. Primary skin masses that are not caused by another problem will usually be investigated by performing a fine needle aspiration to look at the cells involved or biopsy where appropriate. If skin cancer is confirmed or suspected, we will work alongside our oncology unit to achieve the best outcome.