From Côté: Clinical Veterinary Advisor, 3rd edition. Copyright ©2015 by Mosby, an imprint of Elsevier Inc.

BACKGROUNDPets that consistently scratch can cause damage to their skin and underlying tissues in a short time. Your veterinarian may have di-agnosed a disease that is causing the itching; however, it can take a few days before the treatment provided by your veterinarian will begin providing relief. Allergies, acute moist dermatitis (“hot spots”), mites, fleas, and bacterial and fungal infections of the skin are the most common causes of itchiness, and the medication must be given as directed.

GETTING STARTEDEquipment/materials that may be useful:• Elizabethan collar (E-collar): described separately (see separate

sheet: How to Assemble and Use an Elizabethan Collar)• T-shirt• Duct tape• Socks• Pet “booties”

TROUBLESHOOTING BEFOREHANDPets can become extremely creative at removing items you have placed on them in an attempt to reduce self-inflicted skin damage from scratching. Be sure you can monitor them with the device you have created to prevent them from scratching the area.

When you place an E-collar on your pet, be sure that the collar is long enough to prevent your pet from scratching its head, ears, eyes or neck area.

If your pet has a skin lesion that continues to grow in size, call your veterinarian to schedule an immediate follow-up.

PROCEDUREThe main goals of dealing with incessant scratching are to prevent self-trauma and decrease the itching sensation that is causing the desire to scratch in the first place.

Preventing self-trauma:• Elizabethan collars

E-collars can be purchased at your veterinary hospital or pet store. They function by preventing a dog or cat from scratching a lesion on the face or head with his/her hindpaws, and also by preventing a pet from biting at his/her chest, abdomen, flank, groin, or thigh if the skin lesion is there. E-collars can be cum-bersome, but they provide the major advantage that they do not cover up the affected area of skin (unlike a bandage, for example). This means some very common lesions that can be intensely itchy, such as acute moist dermatitis/“hot spots,” can be left open to the air to dry, reducing bacterial proliferation and accelerating healing.

How to Deal with Incessant Scratching

A correctly-sized E-collar is deeper than the nose is long. This prevents chewing at irritated or itchy skin.

Skin lesions on the back and chest can be protected, but still open to air for healing, with the placement of a T-shirt.

• T-ShirtYou may place an appropriately-sized T-shirt on your pet. Place your pet’s head through the head hole and front legs through the arm holes. This can help prevent your pet from scratching the upper third of his/her body (depending on the size of the shirt and pet). Be sure the T-shirt does not cover the penis in male dogs. You may need to make a narrower waist at the wide end of the T-shirt, depending on where the area of concern is and whether the T-shirt bunches up cranially or lies well ex-tended over the whole trunk. This is not a perfect solution, as many pets can scratch through a shirt, but this idea can be used in a pinch.

From Côté: Clinical Veterinary Advisor, 3rd edition. Copyright ©2015 by Mosby, an imprint of Elsevier Inc.

• SocksYou can put socks on your pet’s feet to reduce the force of scratching when paws contact the itchy skin. Some pets will leave socks on; others will need to have bandaging tape secur-ing the socks (be sure the tape is snug but not overly tight around the leg). The socks have to stay dry and should be changed at least once daily. If your pet must go outside, place a plastic bag over each sock to act as a waterproof bootie and dirt barrier, and then remove the bags immediately once the pet is back indoors.

Child-size socks placed on the paws can reduce the self-inflicted damage caused by scratching.

• Pet bootiesPet specialty and superstores sell dog booties or shoes that can be applied to your pet’s hindpaws to prevent scratching. If your pet has an ongoing or recurrent condition that causes incessant scratching, this may be a good option.

Pet booties.

Decreasing the itching sensation:• Aloe vera cream, vitamin E ointment, and other soothing creams

may be applied once or twice with minimal risk to most areas of itchy skin. Longer-term application (days or more) of any ointment or cream should be guided by the underlying diagno-sis of what is causing the itching. Some bacterial or skin infec-tions will worsen rather than improve with sustained application of certain products, for example. It can be helpful to trim away some of the hair from itchy skin areas if moist exudates are gumming the hair together. Be sure to trim the hair without cutting the skin; use a disposable razor (ideally), or if using scissors, be sure to see exactly where the skin surface is before cutting.

• Cool rinse (bath or hose). Be careful, because inflamed skin can be incredibly sensitive and painful. Even room-temperature tap water can feel icy cold and painful when a very inflamed skin lesion is present. Therefore, cool rinsing should be done only if it appears to be comfortable for your pet, and only if complete drying of the rest of the haircoat is possible immediately after-ward (because a wet coat favors bacterial growth in an already itchy animal, which can degenerate into much worse itchiness).

• Medicated shampoo bath. Some mild, soothing medicated shampoos (like oatmeal shampoo) can be helpful in soothing the skin. They must be rinsed out extremely well after use, because dried soap residue can itself be itchy.

• Specific therapy. Medications aimed at controlling the underly-ing cause of the itchiness are the cornerstone of treatment: they deal with the root of the problem.

AFTERWARDSIt is important to be vigilant when using any of the techniques/devices listed above for preventing self-trauma. Risks from un-monitored use of these devices include exposure of the itchy skin and self-trauma, and ingestion of a piece of the material used in the device, causing intestinal obstruction from this foreign body.

Be sure to rinse out and dry the haircoat very thoroughly if you use any of the rinsing or bathing techniques described above.

If your pet continues to scratch after several days of treatment, call your veterinarian; the risk of further damage to the skin, and pain that can come after excessive scratching, justify an appoint-ment with your veterinarian.

From Côté: Clinical Veterinary Advisor, 3rd edition. Copyright ©2015 by Mosby, an imprint of Elsevier Inc.

the affected area of skin. Often with hot spots, the dog (commonly affected) or cat (rarely affected) will lick and scratch one area. The area becomes sensitive to the touch but very itchy, moist, very inflamed, and the hair is gummed together by the moist exudates from the skin. Contact your veterinarian. The affected area will have to be clipped of hair, and medication will be prescribed to treat the lesion, which almost always turns out to be much larger than was anticipated with hair cover. Do not allow your pet to lick or scratch the area until it has completely healed.

Can I catch what my pet has?Depending on which disease, infection, or parasite is causing the itchiness, it is possible in some cases for you to be infected with the same organism as your pet through contact with the skin le-sion. Fleas, mites, and certain fungi are contagious from animals to people (“zoonotic”). Ask your veterinarian for the specific diag-nosis of the cause of the itchiness, and ask if you can become infected. Always wash your hands after applying medication to your pet.

FREQUENTLY ASKED QUESTIONSIs it normal for my pet to scratch at all?Yes, pets may scratch normally. However, this is usually inappar-ent, and any amount of scratching that captures your attention is likely excessive (especially if scratching consistently involves the same area, and/or produces regions of hair loss). In such cases, you should contact your veterinarian.

How can allergies cause my pet to be itchy?Allergies affect pets differently than they do humans. Pets experi-ence itchy paws, ears, and skin. Allergies in pets can be caused by environmental factors such as grass and pollens or food. If your veterinarian suspects your pet has allergies, he or she may recom-mend that you see a veterinary dermatologist to determine to which allergens your pet is reacting.

What is a “hot spot?”A “hot spot” is a moist red lesion that is itchy. Medically, it is called acute moist dermatitis or pyotraumatic dermatitis. It is due to trap-ping of moisture against the skin, proliferation of bacteria on the skin surface, and exuberant exudative inflammatory response of

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OTHER RELATED INFORMATION SHEET• How to Assemble and Use an Elizabethan Collar