Attack of the Face Eating Thing

Hi Dr. H,

My beautiful, crazy, Grand dog, Ginger, developed the most horrific, runny, itchy, gooey, face eating, thing on her cheek and our local vet called it a Hot Spot. In all my years, I have never seen anything like it. She is on oral antibiotics, and Gentocin Topical Spray. The spray seems to really burn. She is miserable and has convinced Boudreaux and Coco (our other two dogs)to constantly lick it, so I have tried to separate them, but that’s not working out. We started the meds two days ago and it may be a little bit better today, but not much. Are we on the right course?

Mary R.

Yup - sounds like you're on the right course. Hot spots are areas of moist skin infection. They usually come up suddenly. There may be a bite/sting/scratch that starts it. The area gets wet, infection starts to go wild, and within 12 hours they can turn from a small spot to a huge, wet, stinky, sticky, nasty, red, itchy mess. Really impressive. They also hurt like the dickens.

Key to these guys is clipping them up, cleaning, and getting them to air out. At the same time we use antibiotics to control the infection and then usually a steroid - either by mouth or topically. Antihistamines like Benadryl are usually helpful, but not strong enough to help an active hot spot feel better. The more common antibiotics to use are cephalexin or cefpodoxime (Simplicef). Topical medications commonly used include NeoPredef powder, gentamycin/betamethasone (Gentocin, Gentaved), and a newer product called Calm Gel (part of the Douxo line by Sogeval - very nice stuff!). The goal is to get the nasty thing to calm down.

I'll typically have an owner clean them gently with warm soapy water twice daily and then gently blot dry. In the summer time you MUST MUST MUST not let these wounds go untreated and have the dogs outside much - especially when the wounds are fresh. Hot spots are a favorite of flies and you'll get maggots in the wound nearly immediately. Make sure these get clipped up and cleaned right away. Hot spots smell badly enough without being full of maggots.

Good news is that they usually heal up about as fast as they come on. It'll take a week or two to look normal, but the majority of the pain, discharge, moisture should resolve in the first couple of days.

These type of wounds are common in dogs with seasonal allergies. Their skin is already inflamed and is "ripe" for bacterial overgrowth. Additionally, they are usually scratching and chewing. That combination makes a moist dermatitis easy to flair up.

AMH