DogTown

by Stefan Bechtel

  Aristotle came to Dogtown with a life-threatening skin condition.

  03

  Aristotle: Extreme Makeover, Canine Edition

  When the little dog named Aristotle was first admitted to the veterinary hospital at Dogtown because of a mysterious illness affecting his entire body, his appearance shocked the staff there. The staff had been forewarned about the little dog’s appearance: He had lost most of his hair, and his skin was pockmarked with scabs and sores, almost too many to count. Photos of him had been sent before he arrived, but they didn’t prepare the Dogtown team for the emotional impact of seeing Aristotle in the flesh. Some said he looked like a raw chicken.

  Actually, he looked considerably worse than that. Except for a handful of white fur on the nape of his neck, the little dog had no hair on his body at all, exposing his pink, paper-thin skin, inflamed and sore ridden. There were scabs all over his face, as if he’d skidded down the street on his smile. In addition, Aristotle could not fully close his eyes—the eyelids had been injured, possibly by some kind of infection, a chemical burn, or even a sunburn. He looked like the victim of a bad face-lift.

  Aristotle hunkered down fearfully when he was first lifted out of his carrying crate upon arrival. Quiet and subdued, Aristotle resembled a naked pink lamb, with bony haunches and a short, stumpy tail. The tips of his ears trembled slightly, perhaps because his hairlessness made him cold, or perhaps because he was scared. But despite his poor health, Aristotle’s soft brown eyes took in his new home, where the dedicated staff at Dogtown would do their best to put hair on his back again.

  Dr. Mike Dix, Dogtown’s head veterinarian, said his best guess was that Aristotle was some sort of terrier mix—possibly a Jack Russell and a fox terrier—although his disfigurement made it difficult to tell. Since Jack Russells are known for bouncing off the ceiling with boundless energy, Aristotle’s quiet demeanor revealed how truly sick he must have felt.

  A CALIFORNIA DOG

  Aristotle came to Dogtown from an animal rescuer who lived in Los Angeles. She knew that Aristotle needed medical attention but lacked the resources to obtain the necessary care and knew that the medical team at Dogtown would be better able to help ease the little dog’s pain. She contacted Best Friends and arranged to transfer him there.

  There wasn’t a whole lot of information available about Aristotle’s life before his rescue. All the Los Angeles rescuer knew about the tiny dog was that he had been surrendered by a suspected animal hoarder (hoarding is a psychological ailment that causes a compulsion in people to collect more animals than they can realistically care for; they subsequently become overwhelmed). The rescuer tried to help relieve the situation in which Aristotle’s owner found himself by removing animals like Aristotle, who appeared to need serious help. What had caused Aristotle’s hair loss, scabs, sores, and wounded eyelids was unknown.

  “HE’S A DOLL!”

  Even in his naked, skinny, scabby shape, Aristotle charmed the staff and volunteers at Dogtown. His sweet, expressive eyes and searching mien seemed a little bit anxious yet begged for human affection. Even though he was so ill, Aristotle reached out to his caregivers as if to show them how much he appreciated all they were doing for him. He put his paws up, on a groomer’s chest or on the edge of the utility sink while he was being washed, as if he were reaching out for help, or perhaps even praying.

  During Dr. Mike’s initial examination of Aristotle, on one of the stainless steel exam tables in the animal clinic, the dog looked up at the doctor apprehensively and gently reached out with the dainty, wet tip of his nose. “He has a very sweet personality—he’s a doll!” Dr. Mike said. “I really felt sorry for the little guy,” he added. “He was such a sweet little dog, but obviously in so much discomfort that he didn’t like being touched at all.”

  To get a closer look at Aristotle’s skin, Dr. Mike gently peeled back a tiny, pink T-shirt, small enough to fit a child’s doll, that the little dog was wearing to protect his skin. As Dr. Mike examined him, Aristotle shied away from his touch, recoiling as though mere physical contact hurt. Little red bumps, a clear sign of an infection, densely dotted his skin. Aristotle’s face and back were covered with sores, some of which were scabbed over, while others were open, raw, and irritated. “Where there are no scabs, his skin is paper thin, like old man’s skin,” observed the vet. He also noted that little Aristotle smelled like yeast.

  “I’ve never seen a case with skin as bad as Aristotle,” Dr. Mike concluded. He and an assistant gently pulled the little T-shirt back onto Ari’s body.

  Did you know…dogs can get sunburned! Dogs with short hair are especially vulnerable. On hot summer days, protect their skin from the sun with a T-shirt, make sure they have plenty of shade (especially at midday), or keep them indoors.

  “You’re going to have to wear that T-shirt to protect your skin, buddy,” he told the dog, who looked up at him dutifully, as though listening for more instructions. Aristotle would also need to be kept in isolation in case the condition—whatever it was—turned out to be contagious.

  After this initial examination, Dr. Mike believed that Aristotle probably had an extremely severe case of mange. (Mange, from the French word meaning “to eat,” is a parasitic infestation of the skin of animals, resulting in hair loss, itching, and inflammation. It’s most commonly found in dogs but also occurs in other domestic and wild animals, such as foxes.) He also thought the former owner may have used medications improperly in trying to manage the problem. If not properly diluted with water, the medication used to treat mange is very caustic. It may have been that this was a clumsy attempt at treatment that instead made the situation dramatically worse, causing chemical burns to Aristotle’s eyelids and face.

  Next, Dr. Mike ordered a battery of tests to begin puzzling out the mystery behind Aristotle’s pain and disfigurement. For the duration of these tests and his treatment, Aristotle would not be medically “cleared” to leave the clinic. So the little dog would be spending his time in Dr. Mike’s office and the clinic laundry room, which could be closed off from the rest of the hospital with a Dutch door.

  PUZZLING OUT THE MYSTERY

  When a devoted owner brings the family dog to a vet, a sheaf of records helps the doctor quickly fill in the animal’s medical backstory. But with Aristotle, and many of the other dogs surrendered to Dogtown, there were no medical records at all. Dr. Mike had to figure out the story from scratch.

  “My approach is to get rid of what’s obvious and see what’s left,” Dr. Mike explained. First he planned to do a skin scrape that would check for the microscopic mites that cause mange. Dr. Mike also wanted to check for ringworm, which essentially is a fungal infection. Another test, called an impression smear, in which a skin sample is viewed under a microscope, checks for the presence of bacteria or yeast. Because Aristotle also had some ear irritation, Dr. Mike took a culture from his ears to find the underlying cause.

  In a normal veterinary clinic, of course, every time one of these tests is ordered, a cash resister goes ka-ching. An impression smear costs about $25, an ear culture about $80. The biopsies and skin sutures Dr. Mike was about to order for Aristotle would run around $500. But at Dogtown, all these tests are covered by the hundreds of thousands of supporters who fund the good works of this remarkable institution and make it possible for homeless animals like Aristotle to get the treatment they need.

  Even without the testing, Dr. Mike had been able to form certain ideas about what might have caused Ari’s condition. The most obvious one was an infestation of Demodex canis, the mite that causes demodectic mange (also called demodicosis or red mange), a common but not terribly contagious problem in dogs. Seen under a microscope, Demodex mites have an elongated, drill-like body that can slip into a hair follicle, as well as weird, waving protuberances emerging from the follicle. When stress, malnutrition, or an impaired immune system kicks in—or, in Ari’s case, a multitude of infections—the mites begin to flourish and spread. They can cause anything fro
m mild irritation and localized hair loss to severe and widespread infection, and even, in rare cases, life-threatening disease.

  Finding the cause of Aristotle’s myriad sores and near-total hair loss proved a challenge to the experienced staff at Dogtown.

  Aristotle’s skin problems also could have been caused by a sarcoptic mange, or canine scabies, which is caused by a highly contagious kind of burrowing mite called Sarcoptes scabiei canis. The skin scrape would help to identify either one of these unpleasant infestations.

  Dr. Mike also tested for ringworm because, even though he had never seen ringworm this bad in a dog, it was still a possibility that needed to be ruled out. On the other hand, the problem might be a very severe allergic reaction, or it could be some other kind of severe skin infection, not mange at all. It was even possible Aristotle had been shaved, for one reason or another, and had gotten sunburned. And then there was the theory of the chemical burn from unknown caustic agents, a theory that had its roots with Aristotle’s rescuer back in L.A. She had located an old, incomplete medical history that included treatment for mange; the medication listed in the chart was the sort that, if improperly diluted, could cause chemical burns similar to the damage seen on Ari’s eyes and skin. At this point, in fact, there was no shortage of theories. But that did not help the little trembling pink lamb of a dog on the examining table.

  Aristotle was in pain—and he was also in danger. His condition was so extreme that Dr. Mike knew it could have fatal consequences. If this was some kind of autoimmune reaction—the body essentially attacking itself—it could affect his internal organs and cause his whole system to shut down. Dr. Mike was also concerned about Aristotle’s delicate, parchmentlike skin, which was so fragile it could impair some of his body’s defensive barriers and make the little dog more prone to potentially lethal infections.

  In recent years there has been a large increase in the number of dogs who suffer from allergies. Some breeds tend to be more prone to them than others.

  If a dog with medical problems this severe were taken to the average animal shelter, he would almost certainly be euthanized. Most shelters are underfunded, overwhelmed, and lacking in the expert veterinary care provided to the rejected dogs and orphans that show up at Dogtown’s door. But even in the loving, high-tech sanctuary of Dogtown, Aristotle’s problems were daunting.

  “If we cannot figure out what is wrong with him, and we can’t make him more comfortable, I have to say that euthanasia is certainly an option for him, down the road,” Dr. Mike said. “It’s not fair to let him keep suffering like this. But we have a lot of steps to cover, a lot of things to try, before we get there.”

  Until the results of all the tests came in, Dr. Mike decided to treat Aristotle with soothing medicated baths and antibacterial and antifungal treatments. “If I can make him comfortable with some easy simple things first, that’s my goal,” he explained. “Based on where we are, we’ll do some more diagnostics or we’ll just keep going where we’re going and try to get to as much of an improvement as we can before we hunt for that underlying condition,” he said. “And then we’ll reassess him in about a month and see where we’re at. But regardless of what’s wrong with Aristotle, we have a pretty long road ahead of us.”

  MYSTERIOUSER AND MYSTERIOUSER

  In his first days and weeks at the clinic, sleeping in a dog bed on the floor of the laundry room, Aristotle acted scared, like a lost child. He spent much of his time curled up in his bed or tiptoeing tentatively around the laundry room, as if the washing machines might attack at any moment. His skin still looked angry, bright pink and scabbed. If the treatments were working, it was not yet apparent.

  When the skin scrape test results came back, Dr. Mike learned, to his surprise, that no mites had been found. (That is, no extreme numbers of mites. A normal, healthy dog is likely to have a few Demodex mites tucked away in his hair follicles; it’s only when the dog is ill, or his immune system is compromised, that there is the population explosion of mites that causes mange.)

  The impression smear, however, showed both yeast and bacteria. And Aristotle had a lot of yeast in his ears. The ringworm culture would be back in a few days.

  “Yeast tends to be an opportunistic infectious agent,” Dr. Mike explained. “Like the mites that cause mange, a healthy dog’s skin and ears harbor small amounts of yeast, but once the defense barriers get broken down by illness, the yeast can flourish and then cause problems of their own.

  “At this point, I don’t have an underlying condition, whether it was secondary to some type of chemical toxic substance, whether it was autoimmune disease, some other congenital defect, I don’t know. I know that he has these infections, but I think that’s a ‘tip of the iceberg’ problem. I think there’s more to it than that. We need to dig deeper once we get the top layer brushed off.”

  In the initial stages of his treatment, Dr. Mike wanted to keep Aristotle in the clinic and in isolation, just in case the ringworm culture came back positive. Aristotle started out getting medicated baths once a week—sparingly, because his skin was so fragile; Dr. Mike didn’t want to cause more harm than healing. Aristotle took his medical baths in a big stainless steel utility sink. It was during the baths that he began to come out of his shell, and a fun-loving side began to emerge. With soapy water dripping off what little fur he had, and his little winsome face looking up at the person bathing him, Aristotle appeared even more lamentable, albeit more comical, than usual, so much so that his handler could only laugh. As much as Aristotle brightened the Dogtown staff’s days, the treatments seemed to brighten his. After each one his behavior turned friskier and more playful, bringing out the bright, happy personality formerly hidden by his illness. His skin looked better, too, so Dr. Mike increased the baths to twice a week.

  A SUPERSTAR

  One day, about a month after the beginning of his treatment, Aristotle was sitting in Dr. Mike’s lap with his paws on the vet’s chest, gently sniffing his shirt. “He seems a lot happier,” Dr. Mike said. “I think the baths make him feel better, and now the antibiotics and antifungals are kicking in. He’s out of his cage more, so that helps, too.”

  Aristotle was looking a little sharper, too. Fur was beginning to grow on his face and back, though it was patchy and uneven. In some ways it made him look even more comical than he did when he first arrived. There were not quite as many scabs, though his face was still unsightly. “I think he’s a superstar,” said Dr. Mike soothingly. “Hi, superstar.” Ari looked up at him, gently sniffing his shirt, blinking his big, questioning eyes.

  Dr. Mike still had not succeeded in figuring out the root cause of the mysterious, disfiguring illness that had brought the little dog here. Over the following month, though, Aristotle continued making progress. Although he spent much of his day in the laundry room, a true terrier personality had begun to emerge. No longer was Ari quiet and shy; he was instead a comedian and a dog with boundless energy. When Ari heard someone coming, he would start jumping up like a little pogo stick to get a peek over the top of the laundry room’s Dutch door. You could see his smiling face appearing above the top of the door, pausing a moment at the top of his jump, dropping out of sight, and appearing again a moment later with the identical expression on his face.

  SEARCHING FOR ANSWERS

  A month or so later, Dr. Mike did another examination of Aristotle’s skin. By this time, he’d been having twice-a-week medicated baths for two months and had been on the antibiotic for almost as long. He had been on the antifungal for about six weeks and an ear medication for about four weeks. And he’d also been getting ointment in his eyes to keep them moist.

  After all this treatment, Aristotle’s skin looked much better, exhibiting hardly any crusting. It was also much less red and inflamed. He was getting some hair growth along his sides and neck, and he was a lot less itchy and smelly. But he was still far from healed. Most of his body still looked as if it had been burned. His small, anxious little face was still disfigured
with scabs. And for terriers, who would be bouncing off the walls if they really felt better, Aristotle still exhibited a more subdued energy level than expected. Dr. Mike was not convinced that the treatments he’d been able to provide were really cutting all the way down to the root of the problem.

  He knew that Aristotle had a skin infection, and that once that was under control, the dog would be noticeably better. Even so, that was not the only thing that was going on here. Dr. Mike was still baffled by the nature of the underlying ailment. He was concerned that, after having “scraped off that top layer and made him a lot more comfortable,” he was still stuck at a level of healing that just would not improve without a definitive answer.

  REACHING OUT FOR HELP

  That’s when Dr. Mike decided to call in a specialist—a veterinary dermatologist named Dr. John Angus. Having a consultation with a specialist is one of the great luxuries of a facility like Dogtown. This is far out of reach of most sanctuaries.

  Dr. Angus was a brawny man in his early 40s. He arrived wearing a suit coat but no tie, considerably more formally dressed than the strictly-for-comfort attire of the Dogtown staff. He was pleasant but businesslike when he came in for his consultation about Aristotle. When Dr. Mike showed him a photograph of the little dog as he’d looked when he was first admitted, Dr. Angus, taken aback, exclaimed, “Oh, my goodness!” with a little gasp.