Recognizing the Itch: Common Signs and Symptoms

Atopic dermatitis (AD) causes a range of symptoms. While some dogs will only have one or two symptoms, others will have all of them. And some dogs get symptoms more mildly. Let’s take a look at the symptoms that affect dogs with atopy.

Click or tap ‘play’ to listen to an audio recording of one of our vets discussing the ‘classic’ case of AD.

So that’s the ‘classic’ case, according to Dr Woodnutt. Now let’s take a look at the other symptoms, and what studies say about how common they are.

Click on each tab to read more about the symptoms. They are in approximate order of how common they are.

Recurrent ear infections

One study found that nearly half of atopic cases were diagnosed after an ear infection. It’s thought that nearly 90% of dogs with atopy have a history of ear infections (otitis externa). This manifests as itching, head shaking, and change in ear position, with dogs often becoming very distressed. If a dog has more than two ear infections without an obvious cause, it’s worth investigating atopic dermatitis as an underlying cause.

When a dog has an ear infection as a symptom of their atopy, the ear infection will need treatment too. This normally means ear drops, but oral medication or a cleaning under sedation are also sometimes warranted. Once a dog’s atopy is under control, their flare-ups of otitis reduce, but some dogs will still have the occasional infection.

Chewing and/or licking feet

One of the most common signs of atopic dermatitis, itchy paws, causes chewing and licking of the feet. This happens in 85-100% of dogs with atopy, with some dogs more affected than others.

Itchy face

If your dog has an itchy face, you might see them rubbing their face along the floor, scratching at their face, or even burrowing their face into blankets. This is sometimes seen alongside signs of a sore face, but just because you can’t see redness or swelling doesn’t rule out atopy.

Itchy tummy

Dogs with atopy often have itchy bellies, especially in the hairless areas towards the back and under their legs. This might be because of increased allergen exposure (eg to weeds ‘rubbing’ their tummy on a walk) but may also be because this warm, moist area is prone to yeast overgrowth in dogs with a dysregulated skin immune system.

Pink fur on feet (if usually white)

Dogs with white feet might get pink-orange fur from the constant licking. This is called ‘saliva staining’ and happens because of the pigments in saliva being deposited on the fur. You might see this saliva staining just between the toes, or it might cover the feet and part of the legs as well. It’s likely to be on more than one foot, and even on all four.

Hair loss

Dogs with allergies are prone to hair loss. They might have thinner hair, due to inflammation of the skin, or they might have areas of hair loss from constant licking/scratching. A recent study suggests this affects 55% of allergic dogs.

Change in skin colour and texture

A change in skin colour from pale to pink or even black suggests ongoing inflammation in the skin, which can be triggered by allergies. Skin may also become very thickened. According to a recent study, 63% of dogs with allergies had reddened skin, 26% had darkened skin, 31% had rough/scaly skin, and 13% had thickened skin.

Itchy bottom, scooting, and blocked anal glands

Anal itching, usually seen as scooting, is common in dogs with allergies, with studies suggesting around 50% of dogs with allergies will have itchy bottoms. In the early stages, it might seem like dogs have anal gland problems. But, much like with ear infections, after a couple of recurrences your vet might start to suspect allergies are the root cause.

Coat changes – dry, poor coat; dandruff; crusts; or greasy, bad smelling coat

Dogs with allergies often have secondary seborrhea, a condition where the body produces too much or too little keratin. This causes the coat to become dry and poor or smelly and greasy.

Sore eyes and conjunctivitis

Hair loss around the eyes is common in atopic dogs, but dogs with allergies can also have red eyes and conjunctivitis. This happens in around 60% of dogs with allergies.

Dogs might have red or swollen conjunctiva (the pink part of the eye) and small amounts of discharge.

Recurrent hot spots

‘Hot spots’ (aka ‘wet eczema’ or ‘acute moist dermatitis’) are areas of skin that suddenly turn intensely itchy and ooze thanks to a localised bacterial infection (‘pyoderma’).

Skin infections

Allergies are the most common underlying cause of recurrent skin infections (aka pyoderma), with one study finding that over 60% of cases were due to an allergy.

Sneezing

Dogs with allergies might also be prone to sneezing. A 2019 study suggests about 20% of dogs with allergies have this symptom. 9% of allergic dogs have a runny nose.

Seasonality

Depending on the trigger for your dog’s allergies, you may notice a seasonal pattern to their symptoms. For example, grass and weed pollen allergies will be worse in the summer, while dust mite allergies cause problems year-round, but they might get worse in the winter when dogs are inside more.

To do:

Try to plot your dog’s symptoms weekly, noting whether they’re ‘as bad as they get’ or ‘a bit better’. This is a good way to spot seasonality or whether the itch is related to another trigger, like a particular walk. You’ll also be able to track improvements after treatment has started.

Similar conditions

While these signs are classic for atopic dermatitis, they actually overlap with several other skin conditions, including other allergies (food allergies), skin infections, and parasites. It’s crucial to rule out these other diseases when your dog is first diagnosed. Your vet will also need to rule out these other similar conditions every time your dog has a flare up, to rule out a secondary problem.

Classic problem areas

This image shows the classic problem areas in an atopic dog.

Move the slider to see the problem areas appear

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Summary

Atopic dermatitis often causes ear infections, itchy feet, and hair loss. There are lots of other symptoms of atopy in dogs and they vary between dogs too. Some dogs will have a seasonal pattern to their allergy, while others have the problem year-round. Tracking this seasonality can help you to work out the triggers.

Key Takeaway

Atopic dermatitis can look different in different pets, depending on their triggers and their individual response to the allergens.