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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 24424
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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7 yr old cocker male suffering from black crusty nipples and

Customer Question

7 yr old cocker male suffering from black crusty nipples and black crusty spots on other parts of the body. Have tried washes, baths with medications from Vet but nothing seems to work. They go away and come back
Submitted: 1 year ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 1 year ago.
Aloha! You're speaking with Dr. Michael Salkin
The recurrent nature of Mochi's dermatopathy suggests seborrhea in an American Cocker spaniel. This is a hereditary disorder of keratinization (skin maturation). Clinical symptoms initially might appear during puppyhood and may be mild at first but worsen with age. Symptoms may become apparent or worsen as an adult if underlying concurrent diseases develop.
Clinical signs may include a dull, dry, lusterless hair coat, excessive scaling (dandruff), follicular casts, scaly and crusty seborrheic patches and plaques as you mentioned, and greasy, malodorous skin. Most of the body is involved to some degree, with interdigital areas, perineum, face, axillae, ventral neck, abdomen, and skin folds usually most severely affected. Pruritis (itchiness) is mild to intense, and ceruminous otitis externa (oily external ear canal inflammation) is common. Secondary skin and ear infections with bacteria and Malassezia (yeast) are often present.
I can appreciate how frustrating Mochi's care must be for you. I don't know everything you've tried so I'll list a primer for treatment and prognosis for you to peruse. You also have the option of having Mochi see a specialist veterinary dermatologist as can be found here: www.acvd.org.
1) Ensure good nutrition. A commercially balanced dog food that meets AAFCO requirements should be fed. You should find the AAFCO statement on the food label.
2) Any secondary bacterial and Malassezia skin and ear infection should be treated with appropriate topical and systemic therapies. Periodic treatments or long-term, low-dose maintenance therapy may be needed because these dogs are susceptible to recurring infection.
3) For symptomatic control of ceruminous otitis, long-term maintenance ear care is necessary. Ear treatments with a multimodal therapy (consult with Mochi's vet) or ear cleaner should be administered to both ears every 1-7 days to control cerumen (wax) accumulation.
4) For symptomatic control of seborrhea, antiseborrheic shampoos and emollients may be used every 2-7 days until the skin condition is improved (~2-3 weeks), then, bathing frequency should be decreased to every 1-2 weeks or as needed for maintenance. Antiseborrheic shampoos contain some combination of sulfur, salicyclic acid, tar, benzoyl peroxide, and phytosphingosine.
5) Daily oral fatty acid supplementation may be helpful as an adjunct therapy (180mg EPA/10lbs). EPA is thought to be the most antiinflammatory of the essential omega-3 fatty acids. It's plentiful in fish oil supplements. You should be able to find the amount of EPA on your fish oil product.
6) Vitamin A 8000-10,000 IU per 20lbs orally administered with a fatty meal every 24 hours. Improvement should be seen within 4-6 weeks.
7) For dogs with severe, greasy, malodorous, pruritic (itchy) seborrhea, treatment with systemic corticosteroids may be helpful. Acitretin (a retinoid) may be helpful in some dogs. Calcitriol (a form of vitamin D) may be helpful in other cases.
The prognosis is variable, depending on the severity of the seborrhea. This is an incurable condition that requires lifelong therapy for control. Please respond with further questions or concerns if you wish.