2 yr old with bald spot that spreads
 

Our 2.5 year old yorkie has a "hot spot" and hair loss that spread, general thinning on the backs of her ears and neck. The hot spot becomes very red and will crust if untreated.


She is on her 3rd round of prednisone/tameril. It clears up and hair begins to grow in while on the meds, but within 3 days the hair at and around that spot falls out again.


In addition, the vet has us giving her melatonin which quickly worked on the ears but not so much the other areas.


Her chip has migrated to just above the hot spot. I am not sure if she's had shots there. Since we travel, she around other people's animals, and in emergencies has to be boarded, she's been fully vaccinated.


The vet indicated we might have to remove the chip which is at the top edge of the hot spot but because we travel, I hope it doesn't come to that.


Any ideas would be greatly appreciated.

Hi and welcome :)!

So, okay...first, we have to clarify a couple things in order to try to be helpful.

When was the chip injected? And when, exactly, did the hot spot later occur? In other words, why is the assumption that one caused the other...for sure...?

A "hot spot" is just a layman's term for an infection that is called pyoderma. Pyoderma is a localized bacterial "infection"/overgrowth (aka hot spot) -OR- a more systemic overgrowth of the skin's normal bacteria (the normal bacteria is called staph intermedius). You CANNOT treat a bacterial infection with prednisone (a steroid) and Temaril-P (an anti-histamine with steroid). Bacteria can ONLY be treated with the appropriate antibiotic.

So, noting the above - what is the reason the vet is giving the pred and TemP...? It makes zero sense to me, clinically. Temaril-P is given to dogs w/ allergies.

Not only that, but this means your poor dog is getting TWO pills that contain steroids - so I'm really *not* surprised she is now losing fur. Medically, giving this much steroid could cause Iatrogenic Cushings Syndrome......

.......and guess what Cushings Syndrome causes....? Fur loss, recurrent infections, and a plethora of many other unrelated symptoms. Read more HERE.

I hope this all isn't super confusing. If it is, the bottom line is this: it's possible that the meds your Vet keeps giving is the very thing that's causing BOTH hair loss and recurrent infections in the skin!

If I were you - first, I'd switch vets asap. Then, I'd get a skin scraping of the "hot spot" to confirm it's bacterial (this is a cheap/easy/quick test). Local spots can be treated with Muciprocin ointment. If there are other areas of pyoderma on the body...then you'd want to treat w/ oral Simplicef x 30 days.

Hair loss
 

Thank you for your reply! Here is a more complete history. Our pup was chipped when she was 5 months old. The chip has migrated down her side about 2 inches and is in the area of the hot spot. I don't know when it moved since we didn't notice until the hair fell out.


The general thinning of her hair began a while ago and was so gradual I thought it might be considered normal. Unfortunately, I can not pinpoint that to a vaccination or other problem (of which she'd had none).


The hot spot appeared 5 months ago with sudden hair loss and crusting. The vet did a scraping and couldn't see anything. We tried the Muciprocin but, while it alleviated the crusting, the hair loss spread and increased pace.


He did a second scrapping and still found nothing. At that point, given the pace of the problem, we asked if we could treat for allergy and infection to slow it down. That is when we started the Cefpodoxime Proxetil and the Temaril. That combination is effective quickly and the hair will begin to grow back in, BUT within a couple of days of completing the series - even by the last day of the Temaril is done (it's tapered very slowly), the spot will begin to fester again right at the original spot.


That is why we suspect irritation/allergy from the chip as a possible source of the problem.


Our vet is the only AKC vet registered in our area and the only practice where you can see the same vet everytime dependably. We have been at the other major vet groups with other pets, and we actually like this vet very much. He is very good with our pup as are the techs. So, while we can get a second opinion possibly, switching is tougher.


I haven't heard of Simplicef but will look into that. If this more complete information sheds any new light, I'd appreciate your feedback. Again, thank you for your response.

Simplicef is what she is on - I just had the generic drug name.

Super helpful reply, awesome :)!

Okay, so, when the 2 skin scrapings were done -- did the vet just look under scope for bacteria, and didn't see anything? That's great for id'ing presence of bacteria; but, a sample should've also been grown out in culture for 10-14 days to note any presence of fungus....*most especially* ringworm, given this hair loss. Has ringworm been discussed? This is a fungus, not a worm, and often appears on dogs in a round-ish shape, and gets larger, and can be discolored, sometimes crusty. The culture would also show any yeast.

And you've given Cefpodoxime Proxetil - this is Simplicef. A couple concerning things here. This is an antibiotic - given for bacterial infections; but your vet said NO bacteria was present - so why did he give it...? Antibiotics should never, ever be given unless there is an infection; giving them when there is *not* an infection present is a huge cause of antibiotic-resistance germs ("superbugs"). This could cause them in your dog too, so please be careful :).

On the Simplicef - how long was it given? 2 weeks? Just as an fyi for future...anytime there is a resistant bacterial skin infection, the gold standard treatment is to give Simplicef x a full 30 days. So if it turns out you do have a bacterial issue happening here, keep that filed away.

If this is ringworm (which can be contagious to humans and other pets, btw), it's treated most often w/ Diflucan x 6wks, then you must re-do the culture grow to see if it's gone, or not.

And then lastly...if this were me and my gut was telling me this really could be the chip, well....heck, I'd just get that thing out of there then, and see what happens. It's possible that something in her body is rejecting that chip for some reason. There is no downside, really, to having it removed -- other than it's going to cost some money to have it removed, and then later you'll have decide if you want to try another one.

You sound like a *super awesome* pet parent, and I know you'll get to the bottom of this, one way or another. Please do keep us posted, this is a unique one and I always like dermatology discussions/learning.

One more thing...although she's awful young for it...she doesn't have symptoms of Cushings, does she? HERE (symptoms about 1/3 down the page)

And, ever had her thyroid checked?

Hair loss
 

The vet did do blood work the very first time to test for underlying disorders. He did comment she was very young to have such, but tested just to be sure.


I will ask about the back up cultures for ringworm/yeast, but my thought is that since she does respond to the antibiotic/prednisone combination it's more likely either a resistant infection or an allergy. Unless ringworm or yeast might respond to those medications in a short window?


I will inquire now to the vet so that before she completes this round of medications so we can explore both continuing the short course of antibiotics or removing the chip since my sense is this problem will return again.


Again, thank you! We love our yorkie and are dedicated to returning her to the picture of health!

Unfortunately, it appears the 30 day antibiotic and prednisone has not solved the problem. She improved greatly, but as soon as the prednisone stopped and just a few days shy of finishing the 30 day round, the hair loss in the bald spot area has resumed at a rapid chunks-falling-out sort of way. So, back to the vet we'll go. Unless he has some miraculous insight, I'm afraid we are looking at removing the chip. We just don't see significant signs of other allergies and it all seems to fall out around the area of the chip. Open to other ideas.