LOOKING LIKE AN OLD HAG

"The doctor used to do house-calls to treat my dog. It has skin disease now," said Mr Tan Ah Long.  Make a house-call, charge $50, treat and prescribe some drugs. This would have been an easy job since the client lived a 5-minute drive away and house calls could be made anytime.

Skin diseases form a large number of clinical cases for Singapore veterinary surgeons. Many Singapore dog owners believe in injections and some tablets as a cure for many skin diseases. 

Having been in practice for over 30 years, the silver-haired Dr Foo had the intuitive feeling of that this case would not be a few rashes easily cured by injections and medication in one house-call.

When you have not seen the dog owner  or the dog for the past four years, you could guess that the skin disease of the dog would be severe, otherwise you would not be called.  One house-call would not solve the problem and the owner would be unhappy with more house call charges.

You could not bring your microscope to check out the fungal infection of the hairs, for example. Or look for the microscopic skin mites causing mange in dogs.

The dog could bite you or even disappear when you tried to scrape its skin for hair samples to bring back to the Surgery for microscopic examination. Some owners even wanted the vet to catch the dog when it escaped. 

Aren't veterinarians supermen who are fearless and dog catchers too? There will no payment since the dog is not caught. After all, the vet has not treated the escapee!

Dr Foo knew it would not be in the dog's interest as skin diseases have many causes. Mongrels do suffer from skin diseases too but usually they are not treated as they are kept as guard dogs by the factory owner. 

Mr Tan did not want to pay for the dog transport from one of those pet taxis. Several days later, he had a company van to bring in the dog to the clinic.

The female neutered dog certainly was haggard looking.  Simply dry skin, hair lost in large numbers and numerous white flakes.  A casualty of the World War Two? 

"No response from all the sulphur baths I gave to this dog," said Mr Tan. His other mongrel of the same age had a full coat. "Could sulphur-dips be so strong as to dry up the skin?" he asked.  Sulphur was used as a cure for skin diseases and since he lived in a house near the forest, he had use the same sulphur powder to deter snakes from entering the house as treatment for his dog.   

You don't see emaciated pet dogs in Singapore, a developed nation in the year 1999.   The dog was clipped, bathed, given antibiotics and hormone replacement therapy.

In less than 7 days, there was a great difference.  She was re-examined on the table.   The hairless cross-bred with the brightest eyes did not want to make eye contact with Dr Foo, as if embarrassed at her personal appearance. She was only 4 years old or in human age, 28 years old. Yet, she looked ancient.

"Well Dr Foo, I see that the dog wouldn't look at you because she was not in her Sunday best?" Dr Melissa Chua teased. Dr Foo's lady clients always dress in their finest silks whenever they have an appointment with him. Their dogs would be wearing the latest designer coats and they also look forward to greeting him too, in the canine manner, by tail wagging.

It was already 7 days after treatment.  But the new patient just put her head down all the time when Dr Foo tried to examine her.  She didn't bite or growl. She just looked away every time he tried to check her femoral pulse, to take the temperature, to take a skin scraping of the wrinkled hyperpigmented skin, full of dry scales.  It was as she was in deep depression.

Will this gentle mongrel be put to sleep?  Mongrel ownership does not confer prestige to the owner.  Nursing care would take weeks and costs money.  Euthanasia was an option since the cost of treatment would be high. It was only 4 years old and life has just begun.

This spayed bitch responded very well to hormone replacement therapy as you can see from the images below.  Some skin diseases of sterilized female dogs are caused by a lack of female hormones.  The coat becomes dry and itchy, starting from the back legs and backside.  Response to replacement hormones is generally very good. 

However, will the owner bother to continue with the long term replacement as he travels frequently to her factories in Malaysia and Thailand?  There is a need for a follow up assessment, but most owners of cross-breds guard dogs will not bother to do so.  They can always find another puppy, a healthy one with no skin problems.

Will the long term use of female hormones cause cancer, as believed to do so in the menopausal women?  This is seldom an issue in the animal world.  The important issue is to let the dog live a comfortable itch-free life and in this case, it means hormone replacement throughout the life span of the dog.

There are laboratory tests in some countries to confirm the low levels of female hormone levels in the dog, but such facilities are not available for dogs in Singapore. 

Emaciated, non-stop itch, depressed, wrinkles, dry skin.
Dandruff all over the body.

Tentative diagnosis: Generalised dermatitis -
one of the many causes may be hormone deficiency.