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My pom has just starting to loose her hair in spots her skin…

Customer Question
My pom has just...

My pom has just starting to loose her hair in spots her skin is raw where the hair is coming out is there any thing that I can get over the counter to help her

Veterinarian's Assistant: I'm sorry to hear that. What sort of animal are we talking about?

A pomeranian

Veterinarian's Assistant: OK. What is the Pomeranian's name and age?

Kesia she is about 8 years old

Submitted: 5 months ago.Category: Dog Veterinary
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Answered in 14 minutes by:
11/13/2017
Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago
Dr. Meghan Denney
Dr. Meghan Denney, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 1,984
Experience: Veterinarian at Kingsland Blvd Animal Clinic
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Hi I am Dr. Denney. I am currently reviewing your post now. Please give me a few minutes to type my response. Thank you for trusting us with your question. This service is used for general information only and is no substitute for a veterinarian patient relationship by examination.

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago

Does Kesia have any pre existing medical conditions?

Is she on flea prevention ?

Can you send me a picture so I can see what we are dealing with and what home remedy options may work?

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago

Pomeranians can get a few metabolic diseases like Cushings disease that can cause these symptoms and is very common in the breed.

The reason I am asking about flea prevention is that even a bite from one or two fleas can cause an allergic reaction and cause the fur to fall out and as fleas only spend about 20% of their lives on the pet we rarely see them unless there is a heavy infestation.

Some Pomeranians also can have their hair fall out and not grow back form a specific genetic condition called Alopecia Gene X which melatonin supplements once a day can help in about 40% of cases to get the hair growing back

If this is a bacterial skin infection from allergies or another unknown cause then she may need antibiotics to clear it.

There are some over the counter remedies but I need to see what is going on to be able to tell you if any of those will work or if she needs to see her veterinarian

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago

Hello are you there?

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Customer reply replied 5 months ago
where do I need to send a picture of the place on her back
Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago

There is a paperclip icon here on the site that you can use to attach a picture

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago

I can also give you my email if you cannot figure out how to send one since I know it can be complicated sometimes

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Customer reply replied 5 months ago
Please send me your email address
Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago

Let me know when it is sent so I can start checking my email

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago

The picture that I received is really blurry and I cannot make anything out. Would you be able to send a clearer picture with better lighting ?

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago

Ok just got home.

The picture is still not very clear and the skin looks more white than raw (may just be the picture quality)

I would make sure she is on flea prevention

If the skin is truly raw she probably has a secondary bacterial skin infection and will need antibiotics from your regular veterinarian along with topical therapies to help it heal.

If the skin is not really raw and is just bald now this may be the genetic condition I was talking about earlier the Alopecia Gene X that this breed can get commonly and starts like this presentation ( like Kesia)

Feeding 3mg of melatonin once a day for 2-3 months or getting a melatonin implant from your veterinarian injected into her skin can help jump start the hair follicles and start new growth of the hair, however it does not work in every dog, but give it 2-3 months before you call it working or now.

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago

Alopecia X

Alopecia is the medical term for baldness. A particular type of baldness has been described in the Nordic or double-coated breeds whereby the dog develops symmetrical coat loss on the trunk as well as darkly pigmented skin in the bald areas. This pattern of baldness is commonly called "endocrine alopecia" as it is common in several types of hormone imbalances (in particular, hypothyroidism.)

The condition we call alopecia X, however, is not associated with the hormone imbalances that normally create endocrine alopecia. Its causes remain mysterious hence the name alopecia X. Given that there are numerous therapies that work for some cases and not for others, and that many of these therapies seem to be in complete opposition, it may be that alopecia X is not one disease but several and we simply do not know how to distinguish them.

Alopecia X goes by many names:

  • Black skin disease
  • Growth hormone-responsive alopecia
  • Castration-responsive alopecia
  • The coat funk
  • Pseudo-Cushing syndrome
  • Biopsy-responsive alopecia
  • Follicular dysplasia of the Siberian husky
  • Adrenal sex hormone alopecia
  • Hair cycle arrest

The following is what is currently believed about this confusing condition.

The Typical Patient

The typical Alopecia X patient is a Spitz or Nordic breed such as an American Eskimo, Chow Chow, Pomeranian, Alaskan Malamute, Elkhound, or similar. Poodles have also been over-represented. Hair loss begins in early adulthood, usually by age 3 years. First the long primary hairs go, leaving a fuzzy, puppy-like coat but eventually that goes, too. The bald skin pigments are not itchy, and usually do not get infected.

Step One: Diagnostic Testing

Part of the problem is that all hormone-based hair losses can look exactly like this, so some testing is needed to determine which of several conditions are occurring.

Expect your veterinarian to begin with:

  • A blood panel
  • A urinalysis
  • Some kind of thyroid testing
  • Some kind of adrenal hormone testing
  • A skin biopsy

The purpose of this rather broad testing is to rule out diseases that look like Alopecia X but for which well-defined treatment protocols exist. This means that two conditions must absolutely be ruled out before proceeding with the trial and error process of Alopecia X treatment.

  • Cushing's disease
  • Hypothyroidism

Step Two: Sterilization

Alopecia X seems to be a sex hormone imbalance in at least some cases and didn’t earn the name “castration responsive alopecia" for nothing. For this reason, the first step in treatment is to sterilize the patient; unspayed females should be spayed, intact males should be neutered. There are health benefits to sterilization regardless of whether or not there is a hair loss issue, and many animals will grow their hair back (though possibly not permanently) so this is where we start rather than investing in complex and confusing diagnostics.

Step Two for Animals Already Sterilized

What if the pet is already neutered or if several months have gone by after altering and no hair has regrown? The next simple therapy to try is oral melatonin.

Melatonin can be obtained in 3 mg tablets at most health food stores or vitamin retail outlets. Approximately 50% of dogs will show some response within 6 to 8 weeks. You give the medication for at least 2 or 3 months before giving up but if hair regrowth occurs, you continue the medication until hair growth seems to have plateaued. After maximal hair regrowth has been achieved, the dose is gradually tapered down to a weekly dose over several months. Some dogs can ultimately discontinue medication though it is important to realize that if you discontinue the medication and the hair falls out again, the condition may not be responsive to melatonin a second time.

  • Melatonin has been used as a sleep aide. Some owners find the sedating side effect to be unacceptable. Consider giving it at bedtime so that drowsiness is less noticeable.
  • Melantonin should not be used in diabetic patients as it has been found to create insulin resistance.
  • Beware of melatonin brands containing xylitol. Xylitol is an innocuous sugar substitute for people but is a poison for dogs.
  • Since melatonin is a nutritional supplement, rather than a prescription medication, the FDA does not insist on the same quality control it does for drugs. There may be tremendous differences in the amount of melatonin contained in pills between brands. Nature's Bounty® brand has been the preferred brand but any major supplement brand should be acceptable.

If neither sterilization nor melatonin has been fruitful and we know the dog does not have Cushing's disease or hypothyroidism, then you should realize that the therapies left to still try have potential harmful side effects.

Consider this: Alopecia X is a cosmetic condition. It may make the dog look funny, but it does not cause harm.

You will need to weigh the potential side effects of therapy against the appearance of the pet. That said, there are other therapies that can be attempted.

The University of Tennessee Hormone Profile

One option in the pursuit of effective alopecia X therapy is the adrenal sex hormone panel available at the University of Tennessee. This test is done by drawing a baseline blood panel, administering a pituitary hormone called ACTH, and drawing a second blood sample an hour later to compare. Samples are shipped to Tennessee for evaluation for numerous adrenal sex hormones. The results show not only what hormones respond abnormally but the university will make suggestions as to which therapy might be likely to work.

Testing is not inexpensive and results can take several weeks to obtain but may help in selecting what therapy makes sense to try next.

Other Alternatives: Lysodren and Trilostane

Lysodren (also called mitotane or OP'ddd) is normally used to treat Cushing's disease, which is an excess production of cortisone-type hormones by the adrenal gland. Lysodren acts by eroding the outer layers of the adrenal gland to control cortisone produced by these layers. If the adrenal gland is over-eroded, problems with electrolyte imbalance can occur and potentially these problems can be permanent, though they are treatable. Lysodren helps with Alopecia X because the adrenal gland also produces sex hormones and Lysodren is able to stop the production of these hormones by eroding the part of the adrenal gland that produces them.

It is important to realize that dogs with alopecia X do not have Cushing's disease and thus do not have an excess of cortisone. Treating these dogs with Lysodren can lead to a cortisone deficiency or, more seriously, the adrenal steroid deficiency called Addison's disease. Signs of Lysodren reaction include: listlessness, vomiting, and diarrhea. Expect periodic blood testing to monitor the cortisone levels being maintained by the patient on Lysodren.

Trilostane is another medication used in the treatment of Cushing's disease. It has also been successful in treating alopecia X if the adrenal gland called hyperplasia is present. Again, this medication has potential to create a dangerous deficiency in adrenal steroids. It is not without risk even though it has been effective in causing hair regrowth in some patients.

Growth Hormone

There was a time when this condition was believed to represent a deficiency of growth hormone. Growth hormone is not effective unless given as an injection. It is a genetically engineered product that is often not commercially available but may be obtained through academic sources. Administration can cause diabetes, so blood sugars must be monitored. A 6-week course of therapy may produce results that last several years.

There are other drugs that have influence on adrenal hormones and they have been used in the treatment of Alopecia X with mixed results. These other options include: ketoconazole, leuprolide, and cimetidine. Alopecia X is a frustrating condition and will remain frustrating for years to come. Research is on-going and progress comes gradually.

I would also recommend the testing for cushings disease ( body makes too much cortisol and it causes slow hair regrowth and baldness)

I would recommend testing for hypothyroidism as well ( low thyroid ) as this disease can also cause these symptoms

Both diseases are treatable but we have to diagnose if one of them is occurring in Kesia.

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago

Good luck with Kesia

If this was helpful I would be most appreciative if you could take the time to rate my assistance so the site will credit me with helping you

Without a rating (the stars at the top) the site will not compensate me for helping you.

I am also here for additional questions you may have just reach out to me here and I will be more than happy to assist you.

Kind regards,

Dr. Meghan Denney

This Content is not intended to be a substitute for a professional veterinary exam, diagnostics, diagnosis, or treatment. Always seek the advice of your attending veterinarian with any questions you may have regarding a medical condition of a pet.

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