One Big Hot Spot

 D. E. Larsen, DVM

The early morning air was warm and unusually humid as I loaded into my truck to head to the clinic. This was going to be a hot day, and I just hoped I wouldn’t have some dog with a heat stroke today.

“The good news is there isn’t much going on this afternoon,” Judy said when I leaned over the front counter to look at the appointment book. “We should be able to leave early before the day warms up.”

When Dixie came through the front door, her immediate concern was the daily schedule.

“I’m hoping we have an easy afternoon,” Dixie said to Judy.

“I am trying to keep things open,” Judy said. “They say it will be a hot day, and you know how hot it gets in this clinic.”

“Yes, I am going to get the backdoor open and start the sprinkler on the roof,” Dixie said. “That will keep things cool until two or three this afternoon.”

Dixie opened the garage door in the back of the clinic. With the front door open, it provided a nice cool breeze through the clinic. The sprinkle on the roof kept the clinic from heating up until later in the afternoon. The water running off the roof was hot already.

“I didn’t schedule any surgeries today,” Judy said. “That way, we won’t be stuck here recovering a patient in this hot weather, and we can fill those hours with any clients that call this morning.”

The morning was busy, and Judy did a good job fitting the entire day into the morning.

“I think we will be out of here at one if we work through the lunch hour,” Dixie said. “That will be great. I have plenty to do this afternoon.”

I was finishing the last appointment at twelve-thirty when Georgia came through the door with her Saint Bernard, Nana.

“I know I don’t have an appointment, but something is terribly wrong with Nana,” Georgia said. “I am hoping you can see her.

“We are just finishing up for the day, but I think the doctor has time to look at her,” Judy said.

Dixie showed Georgia and Nana into an exam room. “Something doesn’t smell good with Nana,” Dixie said. “How long has she had a problem?”

“I noticed her smelling this morning,” Georgia said. “I was so hot yesterday, and she suffers in the heat anyway. I just assumed she was just hot when she was scratching yesterday.”

Nana’s odor had filled the room by the time I stepped into the exam room. I took a deep breath.

“Nana is an interesting name,” I said. “Where did you come up with it?” 

“Nana was the family Saint Bernard in the Peter Pan movies,” Georgia said.

“Let’s see if we can find where this odor is coming from,” I said. “How long has she had a problem?”

“I noticed her scratching a little yesterday,” Georgia said. “I just figured it was the heat, but this morning she really smells.”

I knelt down to look at Nana. She was far too large to lift onto the exam table for just an exam. I ran my hands down her back, and her skin was moist over her shoulder blades. 

“I think I have found the problem,” I said as I parted her hair to look at the skin. A large area of infected skin was on the middle of her back. “I think we need to clip some hair to get a better look at things.”

“I hate to have her hair clipped,” Georgia said. “Are you sure that needs to be done?”

“What is going on with Nana is a moist skin infection,” I said. “The hair mats down a little, and the infection just grows. We need to remove the hair and clean up the area. Then with some antibiotics and other medication, things heal up pretty fast in most cases.”

We started clipping Nana’s hair in the middle of her back. The skin was painful, sore, and covered by a thick layer of yellow pus. We extended the area of the clip, looking for the edge infection. Nana was an excellent patient. She never complained through the whole process.

“Look at the size of this hot spot,” Dixie said as she finally reached the edge of the infection, almost up to Nana’s neck and back to the middle of her back. “I don’t think I have seen anything this large.”

“And it looks like it extends down her sides,” I said. “It looks like someone poured a bucket of pus on the middle of her back.”

When we finally finished clipping hair, the area covered looked like the area that a saddle would cover. Several strips of infection extended Nana’s sides, almost to the bottom of her rib cage and down the sides of her legs.

We scrubbed the area with Betadine Scrub. Then after a rinse, we applied some Furacin Ointment and hydrocortisone cream. 

“We are going to send you home with some antibiotics and prednisone. I expect this to heal rapidly, although there are a few spots where the infection is pretty deep, and they might scab over.”

“What caused all of this, Doctor?” Georgia asked. “Was it something that she ate?”

“I could be a food allergy, but the dermatologists say that food allergies are real rather rare, unlike what the dog food companies try to say,” I said. This often starts from a reaction to something, and maybe just a flea bite. Controlling fleas this time of the year is just about impossible. I hear new medications are on the horizon that will help with flea control.”

“How can a flea bite cause something like this?” Georgia asked.

“It is not just a simple flea bite. It is the allergic reaction to the bite,” I said. “Or the reaction to some other allergen, the dog scratches a bite, the skin oozes some moisture, that mats the hair down. A skin infection quickly follows in this heat, and the lesion just grows. This is by far the largest hot spot I have ever seen.”

“So she is going to be okay,” Georgia asked.

“Yes, I think she will feel much better in the morning,” I said. “We should plan to check Nana on Monday, just to make sure everything is coming along okay. Then it is just growing some hair back.”

Nana’s tail was wagging as she went out the door.

“I was so glad we didn’t have to sedate her,” Dixie said. “I could just see our free afternoon melting away.”

“I turned the phone over to the answering service,” Judy said. “I hope everyone has a good weekend. It is supposed to be cooler by Monday.”


Nana was a different dog when she came through on Monday afternoon. Bouncing in the door, tail wagging and nuzzling Dixie, she led her and Georgia back to the exam room.

“I think she knows you guys helped her,” Georgia said. “She feels so much better, and there is only one small scab on her back.”

“Looks like we are home free,” I said as I looked at Nana’s skin. “The inflammation is mostly resolved. There is nothing more to do now except finish the medication, and then Nana can grow some hair.”

Photo by Olga Dudareva on Unsplash. 

Published by d.e.larsen.dvm

Country vet for over 40 years in Sweet Home Oregon. I graduated from Colorado State University in 1975. I practiced in Enumclaw Washington for a year and a half before moving to Sweet Home to start a practice.

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