What is a Hot Spot?
“The spot came up on my dog overnight, and now they won’t leave it alone!” This is usually how the conversation goes with panic-stricken clients that have just noticed the huge, bald sore that is red and oozing. After telling them it looks or sounds like they are describing a hot spot, the next question is typically, “What is a hot spot?!”
Hot spots, or acute moist superficial pyoderma or pyotraumatic dermatitis, are rapidly developing skin infections where the naturally occurring bacteria on the skin invade through damaged skin. The initial inciting factor can be from many sources. Anything that leads the dog or cat to start itching in a particular location can begin the cycle. The most common reasons for itching are fleas or external parasites, food allergies, seasonal allergies, matted hair, and insect bites or stings. Once the itching and scratching begins, skin abrasions develop which allow the normal Staphylococcal bacteria on the skin to set up an infection.
These infections normally progress very rapidly and can become large and very painful in a matter of hours. Once the infection takes hold, the itching and scratching is accelerated- so that the pet constantly licking, biting, or scratching which then makes the lesion worse. The sore becomes moist, oozes pus, and loses hair. Usually the hot spot actually extends into the haired areas as well, and we don’t realize how large it is until we begin to shave the surrounding hair. It is more common to see these in the hot, humid times of the year; but they can occur year round.
So how do we treat this?
Although hot spots look terrible and are very uncomfortable for the pet, fortunately the treatment is straightforward. We may still have to search for the underlying cause to prevent the animal from having recurrent problems, but treatment for the hot spot will still be the same. The first thing I do is shave the entire area, which is usually much larger than it initially appeared. This allows me to visualize the extent of the hot spot, scrub the entire area with an antiseptic, and allows more fresh air to reach the wound. Our goal is to start drying the wound so it will scab over and to avoid anything that will keep the wound wet (like greasy ointments). In severe cases, the animal may have to be sedated to completely shave and clean the area.
Once the area is sufficiently cleaned; there are many different topical, oral, and injectable products or combination thereof that can be effective in treating the infection. Every veterinarian has their favorite products that we reach for first; but those can include antibiotics, a steroid for itching and inflammation, NSAIDs for pain, and Elizabethan collars to prevent further scratching. For very large and painful hot spots, topical therapy alone may not be sufficient. To choose the appropriate antibiotic, a skin cytology or skin culture may be needed. Therapy will need to be continued until the hot spot is completely healed, and the pet will need to be reassessed by the veterinarian to determine when the medications can be discontinued.
The thing to remember is that you are not a bad pet owner if your dog or cat develops a hot spot. This a very common skin condition that can become severe before you even notice that it is an issue. Please bring your pet in to see your veterinarian as soon as you notice that there appears to be problem, especially if your pet is prone to get recurrent skin infections. You may even want to place a wrap or cover the affected area until you can get to the vet to keep further damage from being caused from continuous licking or biting. The sooner treatment is initiated by your veterinarian, the faster your pet can be comfortable and on the road to recovery.