I recently saw a challenging dermatology case involving a 14-month-old Shar Pei bitch. She presented, as a second opinion, with facial and pedal alopecia, patchy erythema and a moderate level of pruritus and discomfort – poor soul.
I took multiple hair plucks, but could I see any Demodex mites on microscopy? No. None at all – and with the level of clinical signs you might expect these to be present in abundance.
Then I remembered Shar Pei’s are special, and it is very possible that such patients may well have demodicosis despite a lack of evidence from skin scraping or microscopy.
There are quite a few other differentials as well – particularly at this age, with these signs – so my top tip would be to biopsy Shar Pei skin when they do not respond rationally to [previous] treatment.
Our friend is coming in for cytology and a skin biopsy tomorrow…