1.5yo, FE, Border Terrier, 6.3kgPatient History:Hair loss of post MC & MT past few months.No other medical issues. Was being fed hills puppy, then science diet from 1yo. changed to Hills derm defense food recently.Since noticed, stricter on treats.Bravecto given 3 months ago and second Bravecto given recently.Owners report dog not itchy at all unless when wearing harness, rarely seen licking feet.Clinical Examination:Healthy dog, TPR WNL.Alopecia palmer metacarpals and plantar metatarsals. small amount of sparse hairs. reddish, flakey skin in these areas.coat otherwise full, slightly greasy on dorsum- no lesions. no infection.not itchy when assessed.Differentials:Atopy, demodicosis, FIAD, seasonal allergies, contact allergies/reactions, behavioural?Laboratory investigations:Skin scrapes - negativeCytology- malassezia yeasts negativeHair plucks- under microscope hair has chewed ends. (normal telogan/anagen hairs)Final Diagnosis:Low Grade Itch- hairs under the microscope have jagged ends- possibly only licking/biting at feet when alone.Plan:Cytopoint injection to relieve atopyStart Malaseb feet washes bid 10-14ddepending on response;consider food trial?could be seasonal (summer?)Review:Feet seem to be responding - skin looking much less red, flakey and hairs starting to grow back.continue monthly cytopoint injections & derm defense food.
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