Hot Spots, Rashes & Infections: Holistic skin and coat care

One of the most common medical complaint in dogs is the notorious “Hot Spot,” also called “acute moist dermatitis.” There are dozens of causes of hot spots, including allergies, parasites, or just licking and chewing, but the common factor is infection, whether bacterial or fungal or yeast. And hot spots can appear anywhere on the body: Hind leg, feet, rump area, neck, etc. The bottom line for your dog is that there is an infection and intense itching, regardless of how it got that way. Sometimes hot spots seem to appear out of thin air. For example, many dogs are very sensitive to simple lawn grasses. These animals are physically and nutritionally normal, but show signs of inflamed skin and hair loss. Or, a skin lesion can occur as a result of moisture on the skin surface from rain, pond or lake water. Minute scratches on the skin from, for example, a clipper blade, may trigger other cases. Moist eczema is one example of a hot spot type. If the coat is dense or allowed to become matted, moisture on the skin may remain long enough to allow superficial bacteria to reproduce and create an infection. Some cases of moist eczema will spread very rapidly and require rather aggressive therapy to correct.

Rashes and Skin Infections (Infectious Dermatitis)
Bacterial, fungal and yeast organisms are notoriously obnoxious skin and coat pathogens. They can cause skin infections, rashes and other problems in otherwise healthy dogs. Bacterial dermatitis rarely occurs spontaneously. Normal healthy skin has tremendous numbers of a variety of bacteria present all the time. If something upsets the normal balance, such as antibiotics eliminating one or two types, the remaining types proliferate. Any contact with grass, plastic, an abrasion or moisture, or parasitic invasion can bring down the skin’s defensive barriers and opportunistic bacteria then have their way. Fungal infections first appear as one or more small areas of hair loss that may be reddened or inflamed. As infection progresses, crusts may form on the area of hair loss, the patches increase in number and size, and large portions of skin may become involved. Yeast, a type of fungus, can irritate an already diseased skin surface. Yeast infections typically create greasy, odorous and inflamed skin in affected dogs. Symptoms may include blackening of the skin, dry flaky skin or greasy type grit on the skin. As the condition worsens, a bad yeasty smell or odor may accompany this, and the dog will experience severe itching, leading to endless biting, chewing and hair loss.

Parasites and Mange

Skin Problems Caused by Parasites (Fleas, Ticks, Mange Mites and More) A parasite is an organism (a flea, for example) that spends a significant portion of its life in or on the living tissue of a host organism (your pet) and which causes harm to the host without immediately killing it. Some parasites are relatively innocuous, some are not, and some can cause serious skin problems. Fleas, Flies, Chiggers, Ticks, and Gnats When a pet parent sees her dog scratching and biting at itself, the first thing she thinks is “Oh no! Fleas!” Chiggers, deer flies, and gnats (sometimes called No-See-Ums) can be considered nuisances and generally do not create remarkable systemic skin problems. But repeated exposure to fleas can trigger a hypersensitivity to the bite of even a single flea, leading to an allergic response, and ultimately to hot spots or worse. Tick bites seldom trigger an allergic reaction, but can leave a slow-healing lesion.

Mighty Mites and MangeMites are microscopic creatures resembling tiny spiders. Among the species that attack animals are members of the Sarcoptic mange mites (family Sarcoptidae), which burrow under the skin. Demodex mites (family Demodicidae) are parasites that live in or near the hair follicles of mammals, including humans. Cheyletiella mites look like tiny spiders under a magnifying glass and are often called “Walking Dandruff” because upon close inspection it seems like little flakes of dry skin are actually moving about. Sarcoptic mites are very nasty critters. Called scabies or red mange, infestations of these mites are highly contagious and produce intense itching, reddening of the skin, thinning of the hair (alopecia) and development of crusts and scabs. Bacterial skin infections commonly occur in the inflamed, irritated skin. Sarcoptic mite infestation, or mange, is frequently misdiagnosed as allergic dermatitis by even very competent and experienced veterinarians. The mites burrow right down into the skin where they are virtually undetectable by skin scrapings. Sarcoptic mites prefer skin with little hair, so they are most numerous on the ears, elbows, abdomen and hocks. As the disease spreads, hair is lost and eventually the mites occupy large areas of skin. Sadly, many dogs are treated with cortisone or prednisone for a supposed allergic dermatitis when in fact these Sarcoptic mites are the cause of the pruritic or inflamed skin, and the unnecessary cortisone eventually makes the condition worse.Then there are Demodectic (or Demodex) mites, which cause another kind of mange. These mites are found in small numbers in the hair follicles of normal pets. In stressful situations, however, they proliferate, and large numbers inhabit the skin and hair follicles. The good news is that Demodex mites can easily be seen on a skin scraping viewed under the microscope. The less good news is that generalized demodicosis is serious and often difficult to treat. Large areas of the body may be affected, and often the affected areas are also infected by bacteria. In these cases, the skin is red, crusty and warm, and has many pustules. It may bleed easily and has a strong, rancid odor.

Why Not Steroids?

Corticosteroid drugs, called "steroids" for short, are potent chemical substances that can reduce swelling and inflammation quickly. Common corticosteroid drugs used to treat skin issues in dogs include cortisone, hydrocortisone, prednisolone and prednisone. These compounds reduce itching by reducing inflammation. In other words, these drugs treat the symptom of itching, but can do nothing about the underlying cause of the itch. Unfortunately, they also affect every organ in the body. Prednisone is the most potent anti - inflammatory and anti-itch steroid and is often used for treating allergies in dogs. It is usually reserved for dogs with moderate to severe skin allergies, or skin diseases that are difficult to diagnose. These medications are often over prescribed without a positive diagnosis and without careful monitoring, and the pet owner can be unaware of the potential seriousness of the side-effects.

Whether a dog has hot spots or mange or allergies, often it’s the secondary infections that cause the worst itching. If steroids are given to treat the symptoms of itching, the bacterial or fungal secondary infections will be given a boost, and will get much worse very quickly. The reason for this is that cortisones depress lymphocytes, a type of white blood cell, making it easier for bacterial infections to occur and then to proliferate unchecked. In other words, steroids can compromise, or crash, your pet’s natural immune system. When this happens, your dog will lose hair and his skin will become black with a terrible odor and insane itching. Traditional medicine can no longer help him when the disease reaches this stage, and your vet is likely to recommend euthanasia. Even holistic, naturopathic veterinarians may recommend treatment with small amounts of corticosteroids to give some affected pets relief during the flea season. However, these treatments may be dangerous to your pet if prolonged and only offer temporary relief of symptoms at best.

These treatments may include topical medications, soothing baths, ointments and sprays, oral antihistamines, or steroids. Caution: If you are sent home with a prescription for cortisone, or your dog has been given “a cortisone shot to stop the itching”, your dog may ultimately be worse off than before if the true diagnosis happens to be an unrecognized case of Sarcoptic mites!

We carry at our on-line store a holistic series of products coming from a company called DER Magic. I have tried their products and experienced success with both, our cats as well as our dogs, this stuff really works. You know I don’t like to advertise the products we carry at the on-line store. But sometimes I just can’t help it and feel, if in general it really helps your companions, why not passing on a recommendation. Other stores do it too, even vets make their very specific recommendations when it comes to food, treats and remedies and illness cure. Coming back to DER Magic Skin & Coat Care: This company, as so many within the holistic circle of pet food, treat and supplement suppliers, was started because it’s founder, Dr. Adelie Ritchie, also proud owner of a couple Shih Tzus, tried to figure out how she could help her pups, who often were in need of a quick fix for bug bites, rashes, hot spots or other dermal boo-boos. The doctor’s original prototype product was formulated many years ago, back when Dr. Ritchie was breeding and showing Yorkshire Terriers and teaching organic chemistry at a community college in Florida. At the time, her prize show dog developed a serious skin disease and then progressively got worse under standard veterinary treatments, to the point where her vet suggested euthanasia to put the dog out of her misery. Shenanigan was her name and she had thick black skin by this time, smelled horrible and cried constantly. Back then, as is still the case today, there just weren't any good choices out there for veterinary treatments that weren't loaded with cortisone, steroids, antibiotics or strong chemicals, and even those treatments were not effective enough to save Shenanigan's life. This is when Dr. Ritchie got to work on formulating an effective topical treatment with natural, herbal and organic ingredients. Shenanigan got dunked, slathered, gooped, and drenched in potions, all somewhat effective, but not quite enough. Finally, after a few trials, the prototype DERMagic Hot Spot Lotion was born, and Shenanigan's relief was visible and immediate. She stopped crying and scratching, and her hair was sprouting again within 48 hours of the first treatment. Within six months, she was again in full coat and was parading herself proudly around the show ring. Over the years, Dr. Ritchie used her formulations to treat dogs and cats and horses belonging to family members, friends, and her colleagues in the dog show business, but it was not until much later that a good friend challenged her to make her great products available to every pet owner facing skin problems with their beloved companion animals.
Today, Dr. Ritchie offers a well rounded program of just a few, but extremely effective holistic skin and coat care products. All of them constantly receive very positive recognition in the pet oriented and related media including for example Animal Wellness Magazine to name just one. The line includes a complete 4 step skin care system, a hot spot salve, lotions, soap bars, Dead Sea aromatherapy bath salts and of course shampoos and conditioners.

Besides the very powerful fact that they simply work, what I like the most about Dr. Ritchie’s products is that she enables me to offer yet another effective solution within a well rounded holistic program, from food and treats to supplements and skin & coat care, all together designed to successfully help our customers in their efforts to get rid of their pet’s allergy problems.

Related to today’s comment, here is how Dr. Ritchie (who also by large contributed today’s comment) addresses the task on hand: DER Magic products stop infections associated with parasitic infestations, and kill certain parasites outright. They kill bacteria, yeast and most types of fungus, fast, and are the first line of defense against hot spots. Aside from being immediately effective at relieving itch, fighting fungal and bacterial infestations and promoting healing of affected areas, these products are safe and free from corticosteroids.

EPA scrutinizing Flea and Tick Products

According to June’s issue of the Veterinary Practice News (VPN), the US Environmental Protection Agency (EPA) is currently intensifying its evaluation of whether further restrictions on the use of spot-on flea and tick control pesticides are in order. With the measurement the agency aims to better protect our pets. Under review are both, veterinary as well as over the counter products.

The magazine reports that according to an EPA spokesman this all comes because of the recent increase in reported incidents: In 2008 44,000 plus potential incident cases with registered products were reported. By federal law, all EPA registrants are required to submit reports of possible adverse reactions if they are possibly related to the use of the registrant’s products. These reports are to be submitted regardless of whether the product was or was not used according to manufacturer’s instructions.

Flea and tick products are available in a variety of application media, such as spot-on’s, sprays, collars and shampoos, however, according to VPN, most EPA reported incidents are based on spot-on products, which is what the evaluation seems to be focused on.

Active ingredients in those products include amitraz, cyphenothris, dimotefuron, etofenprox, fipronilimidicloprid, metaflumizon, permethrin, pyriproxyfen and S-methoprene. The EPA according to the magazine claims, that the adverse reactions reported ranged from skin irritations to seizures and unfortunately in some cases were even fatal.
VPN further reports that the evaluation started out at mid April of this year with a few products from about 7 different manufacturers, but by now was by the EPA extended to include all EPA registered spot-on flea and tick products. The EPA on its website provides a complete list of all registered products.

I visited the agency’s website and apparently “Since the chart previously located on this page reflected only a portion of the numerous pet spot-on products available, EPA felt that pet owners and consumers might be led to believe that only those products listed were the focus of concern. In fact, EPA is intensifying its evaluation of all spot-on products and is providing a more comprehensive list of these products.”

At this point I feel that it is also important to reiterate that “EPA is not initiating a product recall of these products nor is the Agency suggesting that the products not be used. EPA recognizes the importance of the products in effective flea and tick control. EPA’s objective at this stage is simply to advise consumers and pet owners to exercise caution when using the products and to monitor pet behavior following their use, as some animals have experienced adverse reactions following treatment.”

Here is the agency’s view on all of this:
“Pets may experience adverse reactions from flea and tick control products, including spot-on treatments, sprays, collars and shampoos. However, the majority of reports to EPA are related to flea and tick treatments with EPA-registered spot-on products. Spot-on products are generally sold in tubes or vials and are applied to one or more localized areas on the body of the pet, such as in between the shoulders or in a stripe along the back.
Flea and tick products can be appropriate treatments for protecting your pets and your family’s health because fleas and ticks can transmit disease. While many people use the products with no harm to their pets, EPA recommends that pet owners take precautions when using these products. People should carefully follow label directions and monitor their pets for any signs of an adverse reaction after application, particularly when using these products for the first time. Also, before use of these products on weak, aged, medicated, sick, pregnant or nursing pets, or on pets that have previously shown signs of sensitivity to pesticide products, EPA recommends that a veterinarian be consulted.”

Additional safety tips are available for taking care of fleas and ticks on your pet.

As VPN writes, it is all a “Matter of Perspective: One needs to temper the 44,000 potential incidents with the available units for sale in the field, said Mark Newberg, director of corporate affairs at Central Life Sciences of Schaumburg, Ill. In that context, he said, the number of adverse reactions turns out to be very small.
“And of those 44,000, I’m going to guess that the lion’s share are mild or moderate reactions,” he said.
Newberg said he believes that many of the reports involve consumers applying the product incorrectly. For example, he said, because of the ailing economy, some consumers buy a product for a larger animal and mete it out over several months instead of buying the proper dose.
“It may sound like something that everybody is preaching, but (it comes down to) the label directions,” Newberg said. “Nowhere on the label directions do you see, ‘Split up doses.’ It says very clearly, ‘Do not use these products on cats’ when they are designed for dogs. I don’t know how much clearer you can be.”
What more can be done?
“That’s exactly what the EPA meeting is for,” Newberg said. “Once we put the cards on the table, we will have the opportunity to look at the adverse reactions. Maybe there will be a sub-meeting or subgroup that puts together a task force to look at labeling. … They may come back after the meeting and say these instructions are very clear and maybe change the way adverse incidents are reported, so that numbers don’t skew one way or another.”
Whatever the result, Newberg said he is anxious to work with the EPA on this issue.”

Here are some reactions coming from the manufacturers mentioned in the VPN article: “Common misuses include pet owners applying a spot-on product dose that is inappropriate for the pet’s size and applying a product designed for a dog on a cat and vice versa, said Hal Little, DVM, director of field veterinary services for Merial Ltd. of Duluth, Ga. That is why following instructions and working with a veterinarian are so important, he added.
“The veterinarian is a very important gatekeeper,” Dr. Little said. “Clients should be working with their veterinarian, asking questions, talking about directions and about the products.”
Merial maintains that while the EPA noted a “sharp increase” in the number of reported adverse events associated with spot-ons, company records do not indicate such a case for Frontline.
“The number of adverse events reported per volume of sales has remained consistently low since the introduction of Frontline in 1996,” Little said. “Over 1 billion doses of Frontline have been sold, so there is extensive experience with the product in marketed use.”
Merial and other spot-on product manufacturers are working with the EPA. A meeting was to be held in May in conjunction with the Canadian health department, which has identified similar concerns.
Fort Dodge Animal Health of Overland Park, Kan., is working closely with the EPA to identify and resolve any issues related to ProMeris for dogs, spokes-man Ryan Noonan said.
“Before ProMeris for dogs was released to the market in 2007, it went through extensive clinical testing,” Noonan said. “Because ProMeris is a new product, there may be more questions related to its use, as compared to other available spot-on products that have been on the market for a number of years.”
Mark Levin, vice president of technical affairs at Sergeant’s of Omaha, Neb., said he thinks the increased number of reports can be tied to the fact that products traditionally sold through the veterinary channel are being sold over the counter.
“The one item we feel we at least need to get on the table … is that when (veterinary products) are sold to a consumer and the consumer has an issue with that product, they take it and the animal back to the vet,” Levin said. “The vets don’t necessarily report those adverse events back to the manufacturer. Whereas for our over-the-counter products, if a consumer has a problem with our product, they call us directly and we respond with those numbers to the EPA.”
In regard to reports of incidents involving Sergeant’s products, Levin said those numbers are low.
“We don’t feel good about even one case, and we constantly look at any opportunity that we can to improve our products across the board,” he said.
For example, Levin said the company has found cases in which consumers used the wrong size product or used the product on the wrong species. Levin said the company also found cases in which household pets licked each other shortly after application.
Melinda Fernyhough, DVM, Ph.D., manager of Scientific Affairs for Hartz of Secaucus, N.J., agrees that reading the label carefully is important.
“Hartz wholeheartedly en-dorses the EPA advisory’s call to action to pet owners regarding the importance of carefully following label directions and making informed decisions when selecting and using spot-on flea and tick pesticides,” Dr. Fernyhough said. “As the EPA states: ‘The pesticide label is your guide to using pesticides safely and effectively.’”
Fernyhough said that EPA-reported adverse effects for Hartz UltraGuard products for cats decreased in 2008 from 2007 and those for Hartz UltraGuard for dogs maintained the same low ratio of reported incidents to sales.”

While I was browsing around at the EPA’s website I followed the link “Taking care of fleas and ticks on your pet “ , where among other advice the agency makes a point of how to properly use flea and tick control products:

“To help minimize incidents that may be caused by product misuse, EPA is reminding consumers to always carefully read and follow all instructions on the label for these products and these Safety tips for pet owners:
Consult your veterinarian:
Before use on weak, aged, medicated, sick, pregnant, or nursing pets, or on pets that have previously shown signs of sensitivity to pesticide products; and
If your pet experiences an adverse effect.
If you use a spot-on product or any other pesticide on your pet, carefully read and follow the product label.
Use flea and tick control products only on the animal specified by the product label, for example, dog products for dogs only and cat products for cats only.
Follow any label prohibitions against use on weak, aged, medicated, sick, pregnant, or nursing pets, or on pets that have previously shown sensitivity to pesticide products.
Apply only the amount indicated for the size of the animal being treated.
Do not apply to kittens or puppies unless the product label specifically allows this treatment. Pay attention to the age restrictions for puppies and kittens on the label.
Monitor your pet for side effects or signs of sensitivity after applying the product, particularly when using the product on your pet for the first time. Do not apply spot-on’s to pets known to be sensitive to pesticide products.
If your pet experiences an adverse reaction, immediately bathe the pet with mild soap and rinse with large amounts of water.
Keep the package with the product container (such as individual applicator tubes). Also keep the package after treatment in case adverse effects occur. You will want to have the instructions at hand, as well as contact information for the manufacturer.
Besides spot-on’s, there are other pesticides registered for flea and tick control on pets. These include shampoos, collars, dust, and sprays. Consumers should apply the same precautions when using these products as recommended for spot-on’s. Pet owners may also wish to consult their veterinarian for advice and recommendations.”

Advice for Reporting Incidents
Keep the package with the product container (such as individual applicator tubes). Also keep the package after treatment in case adverse effects occur. The package contains the product label, which includes important information such as the EPA registration number and contact information for the manufacturer.
Report any adverse effects to the manufacturer, who is required by law to report it to EPA. Contact information can be found on the product label. In addition, you may report the incident to the National Pesticide Information Center (NPIC), 1-800-858-7378
Encourage your veterinarian to use NPIC’s Veterinary Pesticide Adverse Effects Reporting portal at http://npic.orst.edu/vet to report any incidents. This portal is not for use by the public.”

Updated information on the agency’s progress is frequently being made available at http://www.epa.gov/pesticides/health/flea-tick-control.html