• Skin and ear parasites – diagnostics and treatment;
• Itching/ Pruritus – diagnostics and treatment;
• Skin infections – diagnostics and treatment;
• Ear infections – diagnostics and treatment – outer, middle, and inner ear inflammations;
• Ear procedures – foreign body removal, sample taking, outer and middle ear irrigation;
• Allergy diagnostics and treatment, including treatment of atopy, allergy shots specifically developed on the basis of allergy tests (allergen-specific immunotherapy);
• Hair loss without itching – diagnostics and treatment;
• Autoimmune skin diseases – diagnostics and treatment;
• Dermatological manifestations of internal systemic diseases (e.g. endocrine system disorder, such as hypothyroidism, overactive adrenal glands, etc.) – diagnostics and treatment;
• Changes in hair and nail condition.

Dermatological problems are relatively common in cats and dogs. According to some statistical data, approximately 17–25% of all visits to the animal clinic are related to skin or ear problems. Every day, a dermatologist has to deal with problems like toe licking, abdominal skin infections, armpit redness and itchiness, hair loss from the back and abdomen in cats, ear scratching, head shaking, and unpleasantly smelling discharge or non-itchy hairless areas.

During a visit to a dermatologist, a detailed medical history is composed describing the peculiarities of the diet, lifestyle, and previous treatment. This detailed interview may be rather time-consuming. The animal should be accompanied by the family member who is best informed about the pet’s health issues and treatment. We additionally recommend to prepare for the visit at home and take notes about the food and treats the animal consumes, and their composition, external parasite control methods used, medications administered and their efficiency (e.g. ear drops, shampoos, medications: name, quantity, length of treatment).

During the visit, a sample of the skin and from the ear are taken, to confirm or eliminate the presence of the parasites and/ or infection. 
A lamp with a special light spectrum is used and samples are taken to be studied under the microscope and inoculated in the laboratory from cats with dermatophytosis.
In case of chronic and/ or reoccurring bacterial skin/ ear infections, it may be necessary to take microbiological samples (for bacteriological analysis) to determine the pathogen (bacterium) and its sensitivity to antibiotics.
For final diagnosis of various skin formations and abscesses, needle samples (fine needle aspirations) are taken to study the cells under the microscope. In case of several skin diseases, it is necessary to take a tissue sample (biopsy) and study it in the laboratory (histological examination). 

General blood haematology is performed to evaluate overall health condition before starting continuous oral treatment or during its course to monitor the patient’s health.  Hormone tests may be necessary to diagnose endocrine system disorders (e.g. hypothyroidism in dogs) or to monitor the course of treatment (e.g. increase/ decrease medication dosage). In order to prepare an individual allergy medication (immune serum or the so-called allergy shot), it is required to perform haematology to determine allergen specific antibodies. All the above mentioned procedures and commonly painless and are conducted during a regular visit to the clinic. However, if your pet is really restless and nervous, light sedation may be performed. Deeper sedation is needed to take skin samples for biopsy, ear diagnostic imaging (see below), deep ear irrigation, or broken nail removal. These procedures are usually planned and scheduled after primary examination. 

Itching is an unpleasant feeling and the most frequent (25–45%) cause of the visit to a dermatologist. Pruritus may be induced by parasites (e.g. mange), allergies (e.g. food, dust mites, pollen), or secondary skin infections (e.g. certain skin tumours). 
Pruritus diagnostics has to be gradual and systemic. Therefore, it may be time-consuming and you have to be patient: it is a lengthy process, but it is possible to find the exact cause of the disease! Depending on the medical history, the veterinarian will explain to you in detail what diagnostic procedures are necessary (e.g. external parasite control, exclusion diet).
Pruritus may be accompanied or cause reddening of skin, hair loss, scabs and/ or purulent small abscesses, etc. If the disease is chronic, fair skin may become darker and thicker (the so called ’elephant skin’ condition). Thus, skin diseases that have developed due to pruritus of different causes may eventually have a similar clinical picture!
When the diagnosis is clear, the veterinarian will suggest treatment plans suitable for your pet.

It is often believed that ear problems are a separate type of disorders, but actually, ears are also covered with skin, and the problems are considered dermatological. The causes of external ear infections are often (though not always) the same as in case of pruritus or skin infections.
The inflammation may start in the outer ear (i.e. until the eardrum) but develop/ spread further into the middle and inner ear. The most common cause of middle ear infection in dogs is chronic outer ear infection, which, in its turn, is often caused by (undiagnosed/ untreated) allergies.
Auditory canal and eardrum are examined using an otoscope (a cone lamp equipped with magnifying lenses and light).
This procedure is not commonly painful, but sometimes the ears may be so infected (swollen, painful, reddened, and excessive discharge) that their examination and medication administration may not be possible.

In this case, the veterinarian may first prescribe a course of oral medications, for example pills, and only when the condition has improved and the pet is more comfortable with its ears being touched, cleaning and irrigation procedures, as well as administration of the ear drops may be continued. In case of chronic ear disorders, diagnostic imaging may be necessary (e.g. radiology, MRI, and CT examinations) to determine the spread of the disease, presence of middle/ inner ears inflammation, and irrigation possibility/ necessity. All these procedures are performed under anaesthesia. 

The treatment of ear infections is successful if the primary cause of inflammation is determined (e.g. pollen allergy), secondary infection (e.g. bacterial otitis) is treated, chronic changes in the ears are under control (e.g. earwax producing glands are significantly enlarged, auditory canals are constricted), and possible predisposing factors are avoided (e.g. frequent cleaning of the ear, the use of unsuitable cleaning methods).

There exist numerous diseases that are not accompanied by pruritus, but are characterised by hair loss. There may be hairless spots or larger symmetric areas on the body. The process may start at a young, middle, or old age and be either accompanied or not by other symptoms signalling deterioration of the overall health condition (e.g. excessive water consumption/ urination, inexplicable weight loss, lethargy). One has to be particularly careful when diagnosing hair loss in cats, as the process is not frequently spontaneous, but self-inflicted, which means cats excessively lick themselves and induce hair loss! As the causes of hair loss without itching are numerous and treatment possibilities are different (e.g. Demodex mites, endocrine system disorders), a visit to a dermatologist and careful examination may help find the solution. 

1. When coming to the clinic, make sure you have enough time to carefully examine your pet, find the cause of the skin/ ear disease, and be able to treat it! The first visit to a dermatologist usually lasts 90 and a re-check visit – 60 minutes. NB! If you are more than 15 minutes late for the visit, in order to offer you the services of the highest quality, we would ask you to schedule another appointment.  
2. If possible, we recommend that the animal is brought to the clinic by the family member who is best informed about the pet’s lifestyle, diet, and medications.
3. It is also advisable to do your homework – e.g. gather information on the food and treats (name and composition) the pet has consumed or continues consuming, on the medications and care products administered and used (shampoos, oral medications, ear drops, etc.); on the type flea/ tick repellents applied.
4. 4If your pet suffers from re-occurring skin problems and you have previously consulted a dermatologist outside Small Animal Clinic of Estonian University of Life Sciences, we recommend to take with you or send via e-mail (to loomakliinik@emu.ee marking „Dermatology“ as the topic, your pet’s and your names) your pet’s medical record.  It may help better plan the visit, save your time and probably money (e.g. it may not be necessary to repeat recently performed blood tests).
5. Do not wash your pet, clean its ears, or use ear drops before your appointment with dermatologist! For the test results to be reliable, it is not recommended to perform any of those procedure during up to 48 hours before the appointment. Do not stop administering any prescribed oral medication, however. 
6. Sedation is normally unnecessary to perform routine dermatological procedures. However, some particularly restless animals may be sedated to perform routine and/ or more complicated procedures, such as deep ear irrigation, diagnostic imaging, biopsy sampling, removal of detached nails (or some other diagnostic procedures and tests). Therefore, if your pet is scheduled for any of the above mentioned procedures that are performed under sedation/ anaesthesia, or if you think that your animal may be restless and nervous, please do not feed it at least 8 – 12 hours before the appointment. The animal may still consume water  in normal quantities
7. We would also like to draw your attention to the fact that one of the main peculiarities of our clinic is participation of veterinary medicine students (including international students) in our daily work: they may job-shadow your veterinarian being present during the visit, but do not independently 
8. In our clinic, we have a veterinarian specialising in dermatological problems of (small) rodents, birds, reptiles, and other exotic animals. 

Phone +372 503 3878.

Regular working hours: E–R 9.00–20.00.
Address: Kreutzwaldi 62, 51014, Tartu.
E-mail: loomakliinik@emu.ee (to be used for general inquiries and feedback, it is not possible to book, reschedule or cancel the appointment via email)