Penn Veterinary Supply, Inc. - Since 1981

If it's summer, it's also “Hot Spot” season!

Hot spots (or acute moist dermatitis), often associated with the summer months, occur where skin trauma provoked by an underlying condition develops a moist bacterial infection. The underlying conditions are typically:

• Allergies
  • Flea atopy (common)
  • Contact irritant
  • Food-related atopy
• Otitis Externa (common)
• Insect bites
  • Flies (more severe cases can present maggots from egg laying)
  • Ticks
  • Mosquitos
• Poorly-kept coat
  • Matting of undercoat not shed properly (common)
  • Lack of ventilation to skin
  • Improper drying of coat due to matting or poor air flow (can be associated with swimming)
• Trauma
  • Scratching
  • Clipper blade irritation or trauma
• Mange (both sarcoptic and demodectic mites)
• Other causes
  • Anal sac disease
  • Ringworm
  • Autoimmune disease
  • Drug reaction
  • Chemical contact irritants

Typical presentation of hot spots

Many owners present their dogs for examination without understanding the potential severity of the problem. The dog presents with a matted, red, crusty and/or oozing lesion that is generally very sensitive to the touch. The area may also have hair loss if inflammation and severe itch have led to excessive scratching. The area may also omit a foul odor, depending on severity.

Hot spots can expand quickly and are often located under the ear (otitis issues) or near the hindquarters (associated with matting or flea allergy dermatitis). They are almost exclusively a dog issue and are rarely seen in cats, predominantly affecting dogs with a thick undercoat such as golden retrievers, Labrador retrievers, German shepherds, and Saint Bernards. Rottweilers also appear prone to hot spots, despite a thinner coat. Spots are more commonly seen in young dogs (<4years old), but both sexes are equally represented.

Initial management of hot spots

The initial examination goal is to understand the severity of the lesion, so proper cleaning and debridement is paramount. However, given the painful nature of the lesion(s), sedation or general anesthesia may be required to properly clip the surrounding hair and thoroughly cleanse the affected area.

Removal of crusts and exudate to allow proper drying of the area is also important. This can usually be done by using a clean, damp washcloth to soak the crusts in order to help facilitate removal, then gently wiping away exudate. Once cleaned, the skin can be rinsed with a mild antiseptic such as a chlorhexidine (or similar) solution.

Treatment of “Hot Spots”

With cleaning completed, the full extent of the trauma can be assessed, and a plan of treatment instituted. Treatment plans often include a combination of the following:

Minimizing the itchiness

Breaking the itch cycle is key to preventing further trauma. Products that help this are:

• Topical steroids
  • Sprays: Help cover a larger area, but try to avoid products containing alcohol, which can sting.
  • Creams: Can be more soothing, but affected areas may need to be protected to give cream time to “vanish,” otherwise, the dog may just lick it off. 
• Topical anesthetics
  • 1.5% lidocaine or 1% pramoxine help minimize itch, but their effects can be short-lived.
• Oral steroids
  • Prednisone can help if used for short period of time (5-10) days.
    • Side effects of oral steroids can be increase hunger, water consumption and frequency of urination. Additionally, some dogs will pant more when taking oral steroids.
• Apoquel® (Oclacitinib) has also been used to break the itch cycle in dogs without the side affects seen with oral steroids.

Topical drying agents

Burrows’s solution or 2% aluminum acetate solution can help decrease oozing of the affected area, thereby reducing further crust formation, which can provide an environment for further infection to propagate.

Topical antibacterial products

Many products contain a combination of an antibacterial agent with a corticosteroid, making it easy for the owner to apply two agents with one treatment.

• Antibiotics: (gentamycin, neomycin, etc.)
• Enzymatic Antibacterial:
  • Given concerns about antibiotic resistance in dogs with recurring lesions, Zymox® topical cream and spray with or without 1% hydrocortisone provides enzymatic antibacterial treatment without fear of potentiating antibiotic resistance. Zymox does not sting when applied.

Oral antibiotics

Depending on the severity of the dermatitis, oral antibiotics may be needed to for 2-3 weeks to help eliminate bacterial infection.

Elizabethan-type collar

An Elizabethan collar can be used to physically prevent the dog from licking or biting a lesion while it heals.

Treating the primary issue

Of course, treating the spot itself is only treating the secondary result of a primary cause. The pet owner should always be advised to monitor the dog and treat any known hot spot-causing issues.

Some of these preventative/maintenance items would include:

• Proper grooming and brushing to eliminate excessive undercoat, especially during times of shedding to help the skin breathe, reduce heat levels, and prevent direct skin irritation.
• Flea and tick control. There are many effective products available to eliminate fleas, ticks and other biting insects, which can cause not only direct irritation, but may induce an allergic reaction.
• Proper ear care. Maintaining a healthy external ear canal will help dogs prone to ear infections stay healthy and reduce infections from scratching or rubbing the ear area. Using a product like Zymox Ear Cleanser weekly helps maintain a natural ear pH, enzymatically reduces bad bacteria, and removes any debris.
• Allergy treatment. If the dog has known allergies, using products such as Apoquel, Cytopoint® and/or hypoallergenic foods, where appropriate will help reduce the dog’s skin irritation.
• Regular veterinary consultations. Many other things could be the primary hot spot culprit, so regular veterinary consultations are recommended to help root out issues before they cause even more problems.

Recurring hot spots need not be a part of every dog’s summer. With proper prevention and a quick response, they can be minimized to keep dogs happy all summer long.

This blog post was created in partnership with PKB Animal Health, the manufacturer of Zymox.

Click here to browse Zymox enzymatic treatment products. 

Click here to view all PKB Animal Health products.