Antibiotic-Resistant Hot Spot: Acute Moist Dermatitis—Max’s Story

Acute moist dermatitis, or hot spots, can develop and worsen in a blink of an eye. Contributing factors include moisture, trauma or inflammation.

A dog can develop hot spots in response to

  • allergies
  • matted fur
  • minor wounds
  • insect bites
  • excessive licking
  • contact with an irritating substance

Anything that damages the skin equilibrium can cause a hot spot.

Antibiotic-Resistant Hot Spot: Max's Story

Make no mistake. Not only hot spots look nasty, but acute moist dermatitis is also a painful condition.

Max’s story

Just like our dogs used to, Max loves the country and it has the opportunity to spend time on a farm. He loves to play with his buddy and run through the fields and countryside. Life cannot get any better for a dog.

Usually, Max would arrive home, crash on his bed and fall asleep. This time, after his usual trip and exhausting himself with fun and play, something was different. Max was restless and couldn’t get comfortable. He seemed preoccupied with his neck area.

His mom figured Max might have a wound or foreign body in his ear and she made an evening appointment with their veterinarian.

Two hours later

Just within two hours, by the time they arrived at the clinic, Max developed a large, weeping sore behind his ear. All fur was gone and the skin was red and oozing.

Max was in pain and not happy at all.

Max’s diagnosis was easy—he was sporting a nasty hot spot. It can happen easily on a hot day, particularly in dogs with thick coats such as Golden Retrievers. It can take as little as a minor irritation to trigger a cascade of events that ends with such a nasty sore.

Typically, hot spots are caused by bacteria that normally live on the skin but get out of control when the defenses are down. Warmth and moisture add fuil to the fire, allowing the bacteria to multiply. The toxins the bacteria produce lead to further irritation and a tiny hot spot can blow up in no time.

As the dog’s natural instinct makes them scratch it, it only contributes to the problem.

The treatment

Hot spots usually respond to treatment well and fast.

Max’s veterinarian clipped away fur around the affected area, applied a soothing, antibacterial ointment and prescribed antibiotics. Max was also sentenced to the dreaded e-collar to allow the skin to heal.

Max was in so much pain that he had to be sedated to get his hot spot cleaned. He also received a pain injection. Max should had been feeling much better the next day.

The next day

Bacterial infections like this usually respond to antibiotics very quickly. I have seen it many times. Max should have been doing better but he was not. There was no improvement whatsoever.

What gives?

Fortunately, Max’s veterinarian was fast on his feet. Suspecting something was amiss, he took a swab from the skin and sent it to a lab for culture. At the same time, he changed Max’s antibiotics. He was suspecting a strain of bacteria resistant to the usual antibiotics. Because it was Friday, he didn’t want to take any chances.

The Monday after

When Max came back to the clinic for a follow-up appointment on Monday, he was the happy guy as usually. The skin looked much happier and was no longer tormenting Max.

The laboratory results confirmed the suspicion. Max managed to pick up a combination of two bacteria resistant to standard antibiotics. They did, fortunately, respond to the new medication.

Without Max’s veterinarian’s quick thinking, Max might have ended up in a veterinary ER over the weekend.


Within a week, Max was as good as new.

What triggered the chain of events? Something irritant? A nick from a plant or a bramble? An insect bite? That will have to remain a mystery.

The important thing is that all worked out well and hopefully Max will remain hot spot free for the rest of his life.

Original story:
Max, a one-year-old male Golden Retriever who developed a red sore rash around the back of his neck after a visit to a farm

Related articles:
Acute Moist Dermatitis in Dogs: Symptoms to Watch for in Your Dog—Hot Spots
Before Getting a Second Opinion: Something Not Right? Speak Up

Categories: Dog health advocacy

Jana Rade

I am a graphic designer, dog health advocate, writer, and author. Jasmine, the Rottweiler of my life, was the largest female from her litter. We thought we were getting a healthy dog. Getting a puppy from a backyard breeder was our first mistake. Countless veterinary visits without a diagnosis or useful treatment later, I realized that I had to take Jasmine's health care in my own hands. I learned the hard way that merely seeing a vet is not always enough. There is more to finding a good vet than finding the closest clinic down the street. And, sadly, there is more to advocating for your dog's health than visiting a veterinarian. It should be enough, but it often is not. With Jasmine, it took five years to get a diagnosis. Unfortunately, other problems had snowballed for that in the meantime. Jasmine's health challenges became a crash course in understanding dog health issues and how to go about getting a proper diagnosis and treatment. I had to learn, and I had to learn fast. Helping others through my challenges and experience has become my mission and Jasmine's legacy. I now try to help people how to recognize and understand signs of illness in their dogs, how to work with their veterinarian, and when to seek a second opinion. My goal is to save others the steep curve of having to learn things the hard way as I did. That is the mission behind my blog and behind my writing. That is why I wrote Symptoms to Watch for in Your Dog, which has turned out being an award-winning guide to dog owners. What I'm trying to share encompasses 20 years of experience.

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