Severe scratching is one of the most common problems seen in the dogs and cats I treat in my practice. Commonly referred to as skin allergy, hypersensitivity reaction and subsequent scratching can be triggered by ingredients in a pet’s diet or by inhalant or contact allergens, such as house mite dust, pollen, and detergent residues in bedding, to name a few. Allergic reactions in dogs can manifest as uncomfortable skin breakouts such as hives, pimples and pustules, skin peeling, and secondary skin infections due to excessive licking, chewing, or scratching.
Such symptoms, however, can herald other health problems that do not stem from the skin itself. For example, pets often chew or scratch at the skin overlaying painful areas of their bodies or experience phantom sensations they perceive as itchy skin. This article discusses some common pet health problems unrelated to allergies that can lead to severe scratching.
As our dogs and cats age, they may experience degenerative problems affecting spinal discs and connective tissue. Most pets, if physically able, try to remedy their joint pain by massaging the areas of skin they perceive as the source of stressful sensations. Digging or chewing at the sore area often leads to painful hot spots, lick granulomas, and skin infections. Some patients are able to use their hind legs to dig at parts of the back and cause lesions similar in appearance to allergy-induced skin rash.
Other clues that a lesion is not an allergic reaction include a progressive decline in the pet’s stamina, a reluctance to jump up on furniture, or an avoidance of stairs. Arthritic pain tends to be inconsistent and varies in intensity based on the location and severity of the joint injury, frequency of re-injury, and temperament or sensitivity of the patient. It usually responds well to physical therapy, anti-inflammatory medications, and other means of pain control. Just like with true skin allergies, self-induced secondary skin lesions might require additional treatments, such as topical care or oral antibiotic.
Pets experiencing anxiety or physiological stress such as dehydration, persistent joint pain, or chronic infections will often suffer from indigestion, heartburn, or acid reflux disease, as well. These digestive disorders may cause an unpleasant burning sensation in the chest or throat, which often leads to chewing paws, licking the inner forearms, and using hind legs to scratch at the chest, neck, or under the jaw. Again, overzealous scratching may result in secondary skin infections often mistaken for allergic breakouts.
Owners typically report excess panting and drinking, ravenous appetite, coughing or dry heave, tongue rolling, and ingestion of grass or other non-food items. This type of apparent skin discomfort often responds well to feeding bland, easily digestible, and moist diets or administering gut-coating agents and medications designed to reduce stomach acid production. Stress factors such as pain and infections may also need to be addressed.
Dental pain can be mistaken for allergies as it often presents as skin lesions caused by pawing at the side or bottom of the jaw, vigorous muzzle rubbing after meals, or digging at the ears. Owners also often report head shaking, changes in eating and chewing habits, and a strong mouth odor, all signs that their dogs may have dental problems. Many of my canine patients present for treatment of corneal ulcers and ear canal infections caused by ardent pawing at the side of the face and incidental eye or ear injury.
Although young pets can damage their teeth, the incidence of dental disease increases with age. Many cats and toy breed dogs, however, may be affected by periodontal disease caused by malocclusion or misaligned or overcrowded teeth and suffer from subsequent dental infections early in life. Dental pain and the secondary skin lesions it can cause usually respond well to antibiotics, pain medications, or extraction of damaged teeth under general anesthesia.
Since the term “skin allergy” has become synonymous with all types of scratching, I find it important to consider all of your pet’s unusual behaviors in order to paint an accurate clinical picture of the cause. Chewing on feet, inner thighs, rump/tail base, digging at ears, chin rubbing, and other expressions of discomfort can have roots far below the skin surface.
A thorough discussion of all symptoms will allow your veterinarian to make a correct diagnosis and prescribe a proper course of treatment to resolve the true cause of skin disease.
Dr. Adam Piaseczny received his veterinary degree from Cornell University in 2000 and Veterinary Acupuncture certification from Chi Institute in 2006. He and his partner, one-year-old daughter Sofia, two dogs, and four chickens have made San Francisco their home for the past nine years. Dr. Adam owns and operates Healthy Pets Veterinary Hospital (sfhealthypets.com), a three-doctor integrative practice in West Portal that he built in 2010.
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