What are the best next steps for flank alopecia in a Pomeranian?

RE: What are the best next steps for flank alopecia in a Pomeranian?

Pippa Swan — Wed, 01 May 2024 20:17:14 GMT

If the dog's skin is not itchy/uncomfortable, you've currently ruled out Hypothyroidism and it's otherwise well then I think no further investigations are warranted. If anything changes then perhaps more is required. Doesn't sound like there is a welfare problem here and you could be creating one by subjecting her to more testing.

RE: What are the best next steps for flank alopecia in a Pomeranian?

Marianne Thomas — Wed, 01 May 2024 17:37:28 GMT

Based on your headline, first thoughts were alopecia x, Cushing's or thyroid.

Bloods seem to support your suspicion that it's not HAC/T4, though Cushing's can sneak up on you so a first morning urine cortisol:creatinine would be worth offering if client keen.

I have a similar case in a larger breed- lethargy& weight gain the only signs except alopecia. Was sure it'd be thyroid, but T4 was 30. Skin biopsies suggestive alopecia X but not ruling out Cushing's. Left visible scars. Abdo scan, UC:C, repeat biochemistry all normal. Everything points to alopecia x except the lethargy.

That's the worry, isn't it? You don't want to miss something serious, and it's a diagnosis of exclusion. But in a pom, if it's not adrenal, surely it's X? Good luck with your case

RE: Flank Alopecia in a Pomeranian

Rob Loxley — Wed, 01 May 2024 07:16:48 GMT

Had it been to the groomers - post clipping alopecia in poms can be pretty dramatic (and long lasting)? Otherwise alopecia X - once you've reasonably ruled out other causes of hairloss. I'd probably use something a bit better than advocate to be happy I've ruled out demodex. Then it's often a case of managing client expectations...
Maybe worth a nsaid trial to see if that improves walking, but sounds like this may be unrelated to the skin.

RE: Flank Alopecia in a Pomeranian

janine redman — Tue, 30 Apr 2024 21:33:52 GMT

Discuss with owner as to how far they want to take diagnosis but biopsy more informative than skin scrapes

RE: Flank Alopecia in a Pomeranian

Beats — Tue, 30 Apr 2024 13:36:42 GMT

The hair might regrown after the punch bipsies, but i would have assumed alopecia X in a Pom that appeared well at this age and if not pruritic then unless it is getting cold (wear a coat) I would not consider a need to do anything at this point.

There was a wacky paper on rolling with a microneedling device a few years ago.

There are no end of blood tests you can do (complete hormonal panels pre and post ACTH administration etc etc - I simply wouldn't recommend them.

A Bravecto is good advice for flea prevention anyway and I would happily do this.

Topical therapy as appropraite sounds fine.

I wouldn't personally biopsy or scrape from sounds of things.