Cheshire Veterinary Dermatology

11/06/2026

Earlier this week we shared a post about our approach to ear cytology. Today, meet the patient behind that slide: little Milo.
Milo was referred to us for chronic right sided otitis. On presentation he was extremely painful – too sore to allow even a basic otoscopic exam. He was shaking his head, yelping on touch, and clearly distressed. Given the severity, he was admitted for a CBCT scan and video otoscopy.
The imaging and otoscopy findings explained everything. The ear canal was swollen and ulcerated, with active discharge and a slimy, adherent exudate coating the walls. The tympanic membrane was not visible initially due to inflammation and debris, once clean we could see that it was intact. Cytology confirmed Malassezia within a biofilm – a key contributor to recurrent, treatment resistant flare ups.
A few interesting points from Milo’s case:
• Biofilm involvement likely contributed to his rapid relapse as biofilms can protect organisms from topical therapy.
• His CBCT showed no middle ear involvement, reinforcing the value of advanced imaging in differentiating external canal disease from otitis media.
• The degree of ulceration seen on video otoscopy highlights how easily chronic otitis can progress when flare ups aren’t fully resolved.
• Pain on presentation was a useful clinical indicator of deeper pathology – a reminder that behavioural signs often correlate strongly with canal pathology.
Milo has now started a targeted treatment plan based on his cytology and endoscopic findings. We’ll be reviewing him in two weeks to monitor healing, reassess comfort, and ensure we’re preventing further chronic change.

10/06/2026

Our approach to ear cytology.
Earlier this week we saw a lovely allergic patient for her recheck. She’s a dog who struggles with chronic ear flare ups, and after a swim earlier this month her ear became uncomfortable again, prompting her owner to book an appointment.
Cytology is one of the most important tools we use when managing ongoing ear disease. In this case, the sample we collected had taken up a lot of stain, which immediately suggests that infection is likely to be present.
Under the microscope, the cytology showed Malassezia sitting within a biofilm. This combination can make infections more stubborn and explains why flare ups can happen so quickly. A look down her ear confirmed what we were seeing: redness, inflammation and a slimy layer of infected material coating the canal.
Now that we know exactly what we’re dealing with, we’ve started a targeted treatment plan to get this flare under control. We’ll see her again in two weeks to monitor her progress and make sure her ears are heading back in the right direction.
If your dog is shaking their head, scratching, or has smelly or waxy ears, early assessment makes a big difference. You can always reach out for advice.

09/06/2026

🐾 Wilbur’s Wonderful Healing.
In today’s photos we’re showing a before and after of our CO2 laser treatment for pododermatitis. Many of you will remember Wilbur, our gentle giant who came to us with painful interdigital cysts on his front feet.
We’re delighted to share that his lovely owners have sent us an updated photo — and his foot is now completely healed. It’s always so rewarding to see the end result, especially after such a dedicated treatment plan and careful aftercare at home.

08/06/2026

Meet the beautiful Romeo 💙
Romeo was referred to us for investigation of chronic ear disease affecting his right ear. His previous cytology had shown a Pseudomonas infection, which can be a particularly stubborn and uncomfortable cause of ear disease. Because this type of bacteria can progress quickly, it was important that we assessed him without delay.
As part of his work up, we performed a CBCT scan, which showed thickening of the right ear canal. This helps us understand how long the disease has been present and how much the canal has been affected, allowing us to plan the most appropriate treatment.
On his initial examination, Romeo’s ear canal was very inflamed with a noticeable build up of discharge. The swelling and debris made it difficult for air to circulate and created exactly the kind of environment where infection thrives.
After treatment and careful cleaning, his follow up image shows a much healthier picture. The canal looks cleaner, the swelling has reduced, and we can now properly visualise the deeper structures to guide his ongoing care. This gives Romeo a far better chance of responding well to his tailored treatment plan.
He was such a gentle, patient boy throughout his visit, and we’re really pleased with the progress so far. We’ll keep you updated as he continues his journey back to comfortable, healthy ears.

06/06/2026

05/06/2026

Earlier in the week we shared a photo of Duke, who visited us for a check up on his ear tip vasculitis.
Have you ever wondered what a biopsy sample looks like once it’s been processed for histopathology? Thanks to David Shearer MRCVS at Cytopath and Vetcutis, we’re able to show you exactly that — he’s very kindly allowed us to share these fascinating micro images.
These samples help us understand what’s happening at a microscopic level. In cases of vasculitis ( these are not from Duke ) the biopsy shows:
• microhaemorrhage – tiny spots of bleeding within the tissue.
• epidermal vesicles – small fluid filled pockets forming within the skin layers.
• inflamed blood vessel walls – a key feature of vasculitis, where the immune system targets the small vessels at the ear tips.
These findings support a diagnosis of pinnal tip vasculitis, a condition that can cause crusting, ulceration and discomfort at the edges of the ears. With the right treatment and monitoring, many dogs do very well — just like Duke.
A huge thank you again to David Shearer MRCVS for sharing these images and for his expert dermatopathology support.

04/06/2026

Meet E Li, who was referred to us yesterday alongside his very dedicated mum, Mouse.
He has a history of intermittent skin and nail disease, with periods of improvement followed by recurrent flares. At yesterday’s visit he presented with ulceration and crusting around his eyes, prompting further investigation.
Cytology revealed intracellular cocci despite the fact he was currently receiving a course of antibiotics. A bacterial culture has been submitted so we can ensure he’s on the most appropriate antimicrobial therapy before considering next diagnostic steps.
Once we have the culture and sensitivity results, we’ll review his response and determine whether biopsies are indicated to further characterise the underlying disease process.

03/06/2026

Meet Duke and Louis — the most handsome, well behaved duo who brightened up the clinic yesterday !
Duke came in for a check up on his vasculitis, a condition that affects the small blood vessels in the skin. For Duke, it shows up on his ear tips, causing inflammation, crusting, and occasional soreness. With the right treatment and regular monitoring, most dogs manage this really well — and Duke is doing brilliantly.
Louis, of course, came along for moral support and to charm the whole team.
Always a pleasure to see these two lovely boys.

02/06/2026

🐾 Meet Leo 🐾
Leo visited us yesterday after his family were referred for a dermatology opinion on the loss of pigmentation around his lips. His vet had already taken biopsies, which confirmed a condition called vitiligo. Our role was to review the findings, ensure the diagnosis was correct, and discuss whether any treatment was needed.
Vitiligo occurs when the pigment producing cells in the skin slow down or stop working, leading to pale or white patches. It’s a cosmetic condition only — it doesn’t cause discomfort, itching or pain, and dogs with vitiligo remain completely happy and healthy.
Because areas with reduced pigment are more sensitive to sunlight, we recommended using a pet safe sunscreen on the pale patches during brighter weather to protect the skin.
Leo was a little star for his appointment, and we were pleased to reassure his family that no treatment is required beyond simple sun protection. Just a very handsome boy with some unique markings.
If you ever notice colour changes, new patches or anything unusual on your pet’s skin, we’re always here to help guide you through what might need checking.

01/06/2026

Understanding Lilo’s Ear Journey..
Thank you to everyone who joined in and guessed — well done to all of you who picked Lilo the cat as the real patient! She was referred to us earlier this month for investigation of her ear disease, and she’s been such a lovely little patient throughout.
The video attached shows what her ears looked like during her initial scope, before we carried out a full ear flush. Her CBCT scan showed normal middle ears, which is always reassuring and helps us focus on what’s happening in the outer ear canal.
We’re really pleased to share that Lilo is doing well. At her revisit, her ears remained clean and comfortable, and we’ve now started looking into the underlying issues that may have contributed to her flare up. Understanding the cause is an important step in preventing future problems.
Ear disease in cats can be surprisingly subtle. Many cats hide discomfort well, and early signs can be easy to miss — things like occasional head shaking, scratching, a change in smell, or sensitivity when their ears are touched. Causes can include allergies, inflammation, wax build up, infections, or even tiny parasites.
A proper examination and a thorough clean are often the first steps in helping us understand what’s going on. Once the ears are comfortable again, we can begin investigating what might be driving the problem so we can keep them feeling their best.