Saturday, December 10, 2016

An 8-year-old female spayed Maltese hides in a corner and keeps scratching for past 3 months

Sunday Dec 11, 2016

TP 46489
Referral from the owner's friend on Dec 8, 2016.

This Maltese had skin disease for the last 3 months. The owner had consulted 2 vets who prescribed medication, prescription skin diet and said no mite infestation. But the skin disease and scratching persisted. His friend referred him to me.

Neck hairless and red. All 4 paws red. Ears painful. No scales or dry skin. The owner applied Chinese medicated oil to the paws to prevent licking.

After clipping bald, the whole body is filled with rashes and pustules. I call it generalised pustular dermatitis, usually caused by bacteria. Ultraviolet light negative fluorescence, so probably no ringworm. Oily skin could be due to yeast infection. 

Blood test showed low platelet count, with platelet clumping noted. High blood urea and low creatinine. High AST.

FOLLOW UP ON Sunday Dec 11, 2016
"After the first 2 days, the skin is better, not red," the owner said. "The dog now stops hiding in the corner and comes out to play."

"Why does she hide in the corner?" I asked.
"I don't know."
"Is she afraid that you put the Chinese oil onto her paws to prevent biting?" I asked as the platelet count was low and indicated toxicity in the blood.
"She could have licked the oil, I had applied for the last 7 days," the owner said. "She could be hiding to lick her paws!"

It is important for the owner that the dog feels better and come out to play. She eats better too. Will need to wait one month to review. In the meantime, no dog treats, Chinese oil application, no pet shop creams etc. Just home-cooked food as this dog could be allergic to dry dog food.

This dog had 2 episodes of itchness in the past and had recovered. But the past 3 months were the worst.

Chronic and severe skin disease is a costly disease to treat and follow ups are very important. Many Singapore owners do not follow up with the same vet.

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