Hot Spots - 'Tis the Season

By Dr. Dennis Golden

Sam is a beautiful 12 year old male Golden Retriever with the amazing personality that you would expect from the breed. He is “happy go lucky,” loyal, loves attention, and is particularly fond of shamelessly sneaking over and eating his feline roommate's cat food when nobody is watching! Unfortunately, as a Golden Retriever, he also has an increased susceptibility to a common skin condition of dogs commonly known as hot spots. Recently, Sam’s owners discovered a hot spot under his right ear that seemed to develop, literally, overnight.

“Hot spot” is the common name given to a frequent skin condition of dogs that routinely appears very abruptly, often in less than 24 hours, with almost no early warning signs. Hot spots are characterized by a moist, ulcerated superficial skin lesion that is often covered by matted hair that has become stuck to the underlying skin lesion. These lesions can occur in well groomed pets and are not necessarily a sign of neglect because the lesions occur very quickly. Frequently, the lesion will go unnoticed in the early stages until the moist area or matted hair that is covering it is identified or the infection produces an odor, and it is determined that there is a serious skin lesion below the hair covering. As the hot spot lesion progresses, the hair in the central areas of the lesion will fall out, exposing the raw, moist, irritated tissue associated with the disease. The lesions can be very painful and are often associated with intense itching.

Medically, hot spots are classified as a form of “acute moist (exudative) dermatitis.” This name implies that the lesions develop very quickly (acute), are characterized by production of a moist drainage in the early phase of the disease, and results from an inflammation of the superficial layers of the skin (dermatitis). While some lesions can remain relatively small, many are rapidly progressive and can expand to involve very large areas of the body. Since hot spots can be painful and very itchy, they are often made worse by licking, scratching or rubbing. The skin usually becomes infected due to the moisture and trauma on the surface of the skin. Despite the frequency of this disease, the exact cause for hot spots remains unknown. Factors that increase the incidence of hot spots include hot humid weather, underlying allergies (food allergy, flea allergy, and environmental allergies), parasites (fleas, ticks), excessive coat moisture (like swimming), ear infections, and unkempt hair coats. There is a definite increase of this problem in the spring and early summer months.

While any dog can develop hot spots, they occur more commonly in dogs less than 4 years of age and develop more frequently in certain breeds such as Golden Retrievers, Rottweilers, Saint Bernards, and German Shepherds. Hot spots can occur in cats; however, the frequency is very rare.

Sam's owners first noticed that he had a moist matted area of hair under his ear that didn't smell very good, so they made an appointment for Sam to be seen by his primary veterinarian, Dr. Golden. In Sam's case, as in most cases, hot spots can be diagnosed based on the history of the lesion and the characteristic appearance. However, other disease processes can mimic the appearance of hot spots, and a hot spot can be associated with another disease that must also be addressed as part of their treatment and prevention, so any dog suspected of having a hot spot should be examined by a veterinarian. Examination is also important to help determine appropriate therapy, as differences exist in the extent of the treatment necessary based on the severity of the lesion and any potential underlying factors. Typically, the lesion should be clipped to allow access and air flow, and cleaned with antiseptic to reduce infection. Some hot spots are very large or very painful, so some dogs may require sedation in order for us to remove the hair and treat the lesion without causing pain or fear. Once the lesion is clipped, other treatments include topical therapy using an antibiotic/steroid/drying product, and systemic medications such as antibiotics, steroids, or medications to reduce pain or inflammation. Some dogs who are highly motivated to scratch or lick may even require an elizabethan collar for a short time to break the cycle of traumatizing the hot spot. The therapy is dictated by the severity of the lesion, and not every dog will require all the treatment options. For those with recurrent lesions, it is important to try to determine any underlying factors. Fortunately, most hot spots will respond quickly to treatment, but some can take 2-3 weeks to resolve fully.

There are some things that you can try to do to prevent and reduce the incidence of hot spots in your pet and to minimize the severity. Your veterinarian will develop a personalized flea and tick control plan for your dog, which will reduce two major sources of itching that can lead to hot spots. Be certain to dry dogs thoroughly after bathing or swimming. If you have a pet that is prone to ear infections, perform all recommended routine cleaning and treatments, as well as keeping any excess or matted hair trimmed from around the ears. For those pets susceptible to developing hot spots, routine daily examination of the skin and hair coat to detect a lesion in the early stages can lead to earlier treatment and help reduce the severity and recovery time needed for treatment. Because hot spots can progress quickly, if you find an area of moist matted fur, moist red or tender skin, or even a greenish bad-smelling area on the coat or skin, call Animal Hospital of North Asheville for an appointment.

Thanks to Dr. Golden's treatment and the excellent care provided by Sam’s owners, Sam's lesion is on the way to fully recovering. Sam appreciates that he is pain and itch free now, and enjoys the extra attention he gets during “hot spot patrol” checks of his skin by his family!