Hot spots – diagnosis and treatment the natural way

by Dr. Peter Dobias, DVM
Spine and muscle injury can cause hot spots

If you have ever seen a dog dressed in a T-shirt laced up the back or another one looking like a punk with bald spots, shaved all over his body, his owner doesn’t need to be an eccentric dog person. The poor pooch may be dressed or shaven because  of hot spots.

Depending on what hemisphere you are in, summer may be in full swing and hot spots are likely to be a hot topic under the even hotter summer sun. It is also one of the most misunderstood problems under the sun.

Things often are not what they appear to be

For years, I too lived in oblivion, believing that hot spots were the result of hot weather, swimming and scratching,  sometimes fleas may be in the equation.  Frequently, a dog with hot spots is pronounced allergic and put on drugs.  First antibiotics and antihistamines, then steroids which usually unleash the nasty dragon of side-effects, such as liver disease,  obesity, muscle weakness, excessive thirst and urination, adrenal gland problems and believe it or not, usually more itching.



Lets first look at what hot spots are on the surface. They are, in fact, a superficial inflammation and bacterial infection of the top layer of the skin; in medical terms – ‘surface pyoderma’.

At the beginning of my veterinary career, I was prescribing antibiotics and antihistamines and tried to stay clear of steroids. All the books said the same thing.  Hot spots are a form of skin infection that has to be treated with antibiotics and steroids.

Most of the time the problems got better but came back later. That was why I started to look at unique pattern of the skin lesion distribution and realized that these skin lesions usually appeared in very specific areas of their body.

Sometimes around the neck or head, sometimes on the feet or the chest, torso, hind legs and abdomen.

Oftentimes, I observed that in most cases the muscles underlying the hotspot region were sore, suggesting a local muscle injury, sprain or strain.  In other cases, the hot spot location corresponded neurologically to a particular spinal segment that was reactive to touch or immobile.  It appeared that energy stagnation is the main underlying cause of hotspots.

Here are some examples of how the location of hot spot can relate to a spinal location:
  • Cervical spine  =   Fore paw hot spots or licking.

  • Cranial thoracic and mid  thoracic spine  =  Fore arm licking, shoulder and armpit hot spots or scratching.

  • Thoracic spine =  hotspots and skin lesions on the chest.

  • Cranial  lumbar spine =  Abdominal skin lesions.

  • Caudal lumbar  =  Hind legs and groin and genital region.

  • Tail base  =   Anal gland abscesses, anal region.

Why is there such a strong correlation? Because there is a strong relationship between the decreased flow of energy, nerve impulses and blood in the affected area.

Closer look

To simplify this phenomenon, imagine that the tight muscles cause lack of nourishment to the adjacent region. This can be compared to a watering system where one hose gets kinked and there is lack of water flowing to one garden bed. What are the results?  The plants would not thrive.

When it comes to hot spots,  lack of energy and blood flow to the skin makes it more prone to rashes and infections, local muscle pain. Dogs scratch the area and less resistant skin gets inflamed.  Dogs often lick the affected area either because of a pins and needles sensation that radiates from the congested spine or sometimes they simply try to “massage the affected muscles” by licking.

If your dog suffers from  hotspots, go through the following process:
  1. Relate the hotspot location with the related spinal segment and examine the spine first (see relationships of spine and what area it supplies in the green section above).

  2. Push down on both sides of the spine and note any signs of discomfort to touch, heat or skin twitching These are all signals of decreased spinal energy flow, injury or congestion.

  3. In this case, you need to find either a good gentle animal chiropractor, physiotherapist, acupuncturist or IMS (intramuscular needle stimulation) practitioner to treat the area (please contact us if you are looking for someone in the Vancouver area, there are several practitioners that may be suitable).

  4. In severe recurrent hot spot cases, back X-rays may be indicated to determine the degree of bone changes around the vertebrae.

  5. The more chronic changes, the more frequent and longer term the treatment needs to be. The less changes, the better prognosis.

  6. Assess the size and location of the hotspot.

  7. If possible, examine the surrounding muscles for pain, swelling, heat and other signs of injury.

  8. Clip all hair in and around this area if possible. If your pet is too sensitive to touch, use an icepack to numb the region out.

  9. Sometimes a sedation or topical anesthesia may be needed.

  10. If the skin appears sore and very crusty, use a face cloth or gauze to soak and soften the scabbing.  Gently wash the whole scab off and continue doing so for two to three days.

  11. Thick crusty scabs harbour bacteria and delay healing.

  12. Dry the area gently and spray on Healing Solution (available at the webstore) 2 – 3 times daily for 2- 4 days.

  13. Thin scab formation is usually a good sign of healing.

  14. Provide the body with essential supplements and good raw and natural food to ensure good healing.

What to do if the hotspot reoccurs or doesn’t heal?
  • Re-examine the spine and the surrounding muscle

  • Make sure that your dog doesn’t overdo activities like sprinting, swimming, ball retrieving, running behind a bike.  These can be aggravating factors.

  • If the spine continues to be sore, check with your practitioner or ask for a second opinion if unsure.

  • Get back X-rays done to check for chronic changes -  disc disease, arthritis and spondylosis.

  • If they are present, put your dog on mobility and joint support such as Glyco-flex.

  • The more chronic injury is, the longer treatment takes. Some patients need a regular maintenance treatment to prevent hot spot recurrence.

  • Remember that other causes can be at the root of the problem such as hormonal issues, food allergies or fungal disease which are fairly rare.

  • Inappropriate use of collars may also be at cause (see more here).

A word or two about antibiotics in case of hot spots.
  • In most situations, antibiotics are not needed if the underlying cause is addressed.

  • Bacteria on the skin is generally opportunistic and spreads only if the skin in the area is “malnourished” weakened or traumatized by scratching.

  • It is extremely unlikely for hot spot infection to spread systemically.

  • Most of the time, antibiotics improve the situation temporarily but will not resolve the primary cause.

  • In rare cases antibiotics may be needed as a temporary measure.

How about steroids?

These preparations often leave permanent traces of their effect. They reduce the patients “self healing” ability and block the effect of homeopathic remedies. In the long run, they may cause permanent damage and incurable disease.

Steroids like prednisone or topical creams such as Panalog, Surolan or Otomax reduce the inflammation of skin and the injured muscles and give a temporary relief. ( remember the house on fire story )

Topical disinfectants like chlorehexidine or hydrogen peroxide?

I do not recommend these because they are not exactly friendly to the growth of new skin cells and generally slow down the healing process.

You can make a difference

Now when you know what hot spots really mean, you can be the canine ambassador for all those dogs who suffer unnecessarily. If you see the  dog  in a T shirt or shaven like a punk, perhaps stop by and share what you just learned. You can make a whole world of difference.

© Dr. Peter Dobias, DVM

learn about the author


Dr. Dobias is a licensed doctor of veterinary medicine and lives in Vancouver, BC, Canada. He has more than 20 years of practical experience in conventional and holistic veterinary medicine and his big passions are natural healing, dogs and living a healthy lifestyle...

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