A complete guide to hot spots in dogs

Healing hot spots naturally without antibiotics, steroids and other harmful chemicals

Article Summary:

1. Introduction to hot spots
2. How do hot spots start?
3. The conventional view of hot spots
4. Surprising connection between hotspots, spine and muscle health, and hormonal imbalance
5. Hot spot locations and their relationship to spinal segments
6. Why you need to beware of some commonly used conventional treatments of hotspots
7. A step-by-step plan for the natural treatment of hotspots in dogs

Introduction to hot spots

If you have ever seen a dog with patches of missing hair dressed in a T-shirt or sporting the familiar “cone of shame,” it may be because this pup is suffering from hot spots. 

The medical term for hot spots is surface pyoderma, a painful, itchy, and uncomfortable condition mainly affecting the top layer.

This condition is more common in the spring and summer, which leads many people to mistakenly believe that the hot spots are primarily related to heat, moisture, and perhaps allergies.

But this is only partially correct.

In the early years of my veterinary practice, I obediently followed treatment protocols commonly presented in veterinary textbooks. 

I saw hundreds of dogs going through regular cycles of hot spot flare-ups, steroids, antibiotics, and special diets. However, there was a missing piece in the hot spot puzzle.

My curiosity (and also a good dose of frustration) made me look outside of the box of conventional medical explanations for hot spots. Luckily, this allowed me to see things differently and find a natural and very reliable approach to treating hot spots.

I am happy to report that it has helped thousands of dogs since!

This article aims to share what I discovered and empower you to use safer, more effective, and natural treatments for hot spots.

This comprehensive guide includes knowledge and tools to help your dog heal and prevent future flare-ups.

How do hot spots start?

Surface pyoderma usually starts as a microtrauma of the top layer of the skin caused by scratching and rubbing. Still, it can also result from weakening the skin in the area, which I will explain in detail later.

Skin trauma and weakened skin create ideal conditions for pathogenic bacteria bacteria to harbor and multiply.

The opportunistic pathogenic bacteria take advantage of “the situation” and cause pain, inflammation, swelling, hair loss, and oozing purulent discharge.

The most common locations of hot spots are the neck, head, feet, chest, torso, hind legs, and abdomen, but also in the folds of certain dog breeds such as pugs, bulldogs, boxers, and other breeds with short noses or excessive skin.

The conventional view of hot spots

Conventional medicine often sees hot spots as a result of local skin trauma, too much swimming, environmental and dietary allergies, flea infestation, yeast infections, or hormonal issues such as Cushing's disease.

The most commonly used treatments are topical antibiotic creams with corticosteroids, sometimes antifungal medication, systemic antibiotics, and antibacterial soap washes.

While this treatment appears to work for some time, it never addresses the key causes of hotspots, which often remain undetected.

A surprising connection between hotspots, spine, muscle health, and hormonal imbalance

It took me some time to discover that there is much more to the origin of hotspots than what most vets are taught at vet schools.

It may surprise you to learn about the connection between hot spots and undetected injuries, over-exercise, sprained muscles, back problems, and hormonal issues caused by conventional neutering and spaying.

The connection between hot spots, the back and muscles

When treating many dogs with hot spots, I noticed the affected skin patch was in the same sprained or sore muscles beneath the segment of affected skin.

In other cases, I would find nothing locally, but when I trailed the nerve line (or energy meridian) from the hot spot area to the spine, I saw that a particular spinal segment was tight, inflamed, and injured. 

This finding led me to understand that many hot spots start with a back or spine injury and a consecutive decrease in blood and nerve flow to a particular skin segment.

Also, injured possibly backs and spines sometimes lead to abnormal sensations similar to “pins and needles” or numbing, identical to humans.

When this happens, dogs start chewing, licking, and scratching, which causes skin microtrauma.

Such a situation creates the perfect conditions for bacterial growth and surface pyoderma – the dreaded hot spot! 

To summarize, an injury to the spine or tight muscles decreases blood and nerve flow to the adjacent region of the skin. 

Refer to the chart below for more clarity on this principle.

Note: In some instances, a hot spot is closely related to a local injury unrelated to the back, such as a sprain or bruising.

I have been using this principle in treating hot spots for many years now, and most dogs heal surprisingly quickly when their muscles and back injuries are treated.

Hot spot locations and their relationship to spinal segments

The following segment outlines the locations of spinal segments and their relationship with adjacent regions of the body. 

• Hot Spots around the head, neck, ears, and eyes are closely connected with the upper and mid-cervical spine and the tightness of chewing muscles.

IMPORTANT: If your dog pulls on the leash, is on a retractable leash, or loves to chew on bones or toys, hot spots often appear on the head, around the ears, and in the eyes.

Also, dogs with tight cervical and jaw muscles often scratch and traumatize their neck and head, which can result in hot spots. 

• Hot Spots on the forelegs and front paws is connected to the nerves running from the neck and the two upper thoracic vertebrae.
• Hotspots in the armpits, forearms, and front chest relate to the lower neck spine and inter-scapular region.
• The skin of the abdomen relates to the caudal (rear) portion of the thoracic spine and the front portion of the lumbar spine.
• The groin, flanks, and upper thighs are closely connected to the spine's rear (caudal) portion.
• The metatarsal bones (the shins), the heels, and the hind feet are related to the caudal and the lumbar regions.
• The sacral-lumbar area of the spine supplies hips, the tail, and the area around the anus.

Here are practical examples of the above-described connections:

• Cervical spine => Forepaw hot spots or licking.
• Cranial thoracic and mid-thoracic spine => Forearm licking, shoulder and armpit hot spots or scratching.
• Thoracic spine => Hot spots and skin lesions on the chest.
• Cranial lumbar spine => Abdominal skin lesions and licking.
• Caudal lumbar => Hind legs and groin and genital region.
• Tail base => Anal gland abscesses, anal region.

REMEMBER: A local muscle injury or skin irritation may also cause hot spots and must be ruled out before assuming a back injury is the primary cause of hotspots.

To say this, sometimes a primary local injury can also be reflected in the spine.

Why you need to beware of some commonly used conventional treatments of hotspots

Antibiotic ointments and creams

A large majority of people reach for an antibiotic cream when they have a cut or a wound.

This is an ingrained habit, and most people do not realize that they are putting a crude oil-based chemical, such as petroleum jelly, directly on the wound, which is the base for most antibiotic ointments.

Also, the overuse of antibiotics has led to the propagation of resistant bacteria and superbugs, which is a severe and sometimes life-threatening problem. 

Dogs love to lick creams, and ointments are a problem.

Even if we used the most natural creams, most dogs would lick the greasy cream off, which would cause additional trauma to the wound and a prolonged healing process.

Is it ok to treat hot spots without antibiotics?

In my experience, antibiotics are unnecessary, especially in most situations, if the underlying cause of hot spots is addressed.

Bacteria surrounding hot spots are primarily opportunistic pathogens that spread only if the skin is scratched or weakened by decreased blood and nerve flow due to a local or spinal injury.

It is improbable that hot spot infections would spread systemically. 

Antibiotics are rarely needed to treat hot spots with evidence of severe non-responsive bacterial infection.

Should you use chlorhexidine-based soap to treat hotspots?

Chlorohexidine has many commercial names; hence, you should read the ingredient label when using any disinfectant solution.

According to the safety data sheet, chlorhexidine is very hazardous when ingested. It is a respiratory irritant and a toxic skin, eyes, and respiratory tract irritant.

Evidence shows that repeated or prolonged exposure to chlorhexidine soap can cause organ damage, which is especially a concern in dogs as they often lick their incisions and wounds. 

It is hard to believe this toxic substance is frequently used in mouthwashes and rinses for humans and dogs.

Why I don't use corticosteroids for hot spots

Corticosteroids are frequently added to antibiotic creams and ointments. The most common brand names are Panalog, Surolan, or Otomax.

Putting dogs with chronic recurrent hot spots and scratching on oral corticosteroids is standard practice.  

While such medication may appear miraculous, topical and oral corticosteroid preparations have a severe negative effect on health, especially on the adrenal glands and the immune system. In other words, the body's ability to defend itself against pathogens and hotspots is decreased,

Even one course of corticosteroids renders the patient more prone to repeated, chronic, and hard-to-treat conditions. The body seems to lose its ability to heal, and the immune system starts acting erratic and inefficiently.

Even topical corticosteroids are absorbed through the body's skin, negatively affecting the adrenal glands and the whole body.

Steroids could be compared to “a credit card loan with high interest”; they deliver a quick fix with a high price to pay!

The most common side effects are liver disease, obesity, muscle weakness, excessive thirst and urination, adrenal gland problems, and more itching in the long run. 

Why do antibiotics and steroids work temporarily?

The reason is that there is a secondary bacterial infection after the skin gets scratched, and the inflammation gets suppressed with steroids.

Unfortunately, such an approach only gives us the illusion of recovery and doesn't address hotspots' core cause.

The overuse of antibiotics also leads to an increase in antibiotic-resistant superbugs.

A step-by-step plan for the natural treatment of hotspots in dogs.

PHASE 1 – First Aid

1. Assess the size and location of the hot spot.
2. Unless the area is susceptible, examine the surrounding muscles for pain, swelling, heat, and other signs of injury. If the area is sensitive, focus on helping the skin in the first phase of the treatment.
3. Clip all hair in and around this area. Be gentle and ensure all hair is clipped to the skin to prevent a thick scab formation, bacterial overgrowth, and deeper infection.
4. If your pet is too sensitive to touch, first numb the region with an ice pack. In some cases, sedation or topical anesthesia may be needed.
5. If the skin appears sore and 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. Thick, crusty scabs harbor bacteria, delay healing, and cause deeper scars.
6. Dry the area gently with gauze and use herbal SkinSpray 3 -5 times daily for two to four days.
7. Clean and soak the scabs for three to five days until a fragile scab forms. Thin scab formation is usually a good sign of healing; continuous oozing and discharge may indicate that a visit to your veterinarian is necessary.

To prevent your dog from licking and making the problem worse, put a T-shirt on your dog or use the Elizabethan or inflatable protection collar to avoid licking and more severe problems. 

PHASE 2 – preventing hot spots from coming back

When the acute hot spot is healed, the next important step is preventing them from returning.

1. Examine your dog's spine and look for inflammation and tightness in a particular area. Use your thumbs to press on both sides of the spine and note signs of discomfort, heat, or skin twitching.
2. You must apply significant pressure to see the different reactions between a healthy and an inflamed spinal segment.
3. Use the chart below to confirm if a “twitchy” and tight spinal segment is neurologically related to the region where the hot spot occurs.
4. To address the concern, schedule a visit with a chiropractor, physical therapist, acupuncturist, rehabilitation expert, or veterinarian with a background in these disciplines.
5. Examine the musculature, skin, and joints beneath and surrounding a hot spot area.
6. Ensure your dog has no collar injury, which can also lead to hot spots.  Use a harness instead of a collar, here is a link to a harness I use for my dog, Pax
7. Make sure that your dog doesn't overdo activities like sprinting, swimming, ball retrieving, or running behind a bike. These can be aggravating factors. Read more here.

PHASE 3 – DIET AND SUPPLEMENTS

1. To ensure your dog heals well, use FeelGood Omega, which contains high-potency Omega 3 fatty acids that reduce inflammation and promote skin healing.
2. To prevent hotspots from recurrence, start your dog on the FAB4 essentials.
3. If your dog is on kibble and your budget allows it, consider switching to natural homemade food. The book Forever Dog Life by Rodney Habib and Dr. Karen Becker is one of the best resources for homemade diets for dogs.

Click the button below to receive complimentary access to our Natural Diet Course for dogs. 

PHASE 4 – Hormonal Health

The latest research studies by Dr. Michelle Kutzler, a board-certified reproduction specialist, suggest that neutered and spayed dogs are affected by the absence of sex hormones.

Several studies confirm that removing the gonads leads to severe Luteinizing Hormone (LH) elevation. The excess LH affects glands, ligaments, bones, muscles, the brain, and the skin and causes inflammation that can also, among other conditions, lead to hotspots.

If your dog has been neutered and suffers from repeated unexplained hot spots, ask your veterinarian to refer you to Dr. Kutzler's studies and consider hormone therapy for your dog. Click here for more references.

Click here for more information on Skin Spray and Fab4 essential supplements for robust, long-lasting health.