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Alopecia and coat loss in the Keeshond

by Jane Saunders

In a coated breed most owners strive to ensure their dogs have that perfect coat. Today with more emphasis than ever on the amount of coat dogs have it is of concern to owners when their dogs suddenly start to loose coat and even develop patches of alopecia.

Most Keeshond owners are aware of cases of dogs and bitches loosing areas of coat from the thighs. I can remember over 30 years ago being told that the "cure all" was Bob Grass Skincure. This traditional product contains amongst other ingredients sulphur, known for its beneficial effect on skin disorders. There have also been other traditional suggestions such as castrating a dog or allowing a bitch to have a litter. If the coat problem resolved people concluded the "treatment" had resulted in the improvement to coat. There have however been cases of dogs re-growing areas of alopecia with no treatment via surgery or medication.

It is generally understood that coat condition and growth in an otherwise healthy dog is due to some kind of hormone imbalance but it is not fully understood why. There appears to be a greater tendency in certain Spitz breeds. Many owners will immediately think of thyroid deficiency and may request their vet to carry out a simple test for thyroid function. If the result is within the normal range the owner and vet are often left wondering what to do next.

Typical symptoms are thinning of hair or total alopecia in certain parts of the dog’s body. Alopecia is generally bilateral (appearing equally on both sides of the body) and affecting the lateral neck, (area on both sides of the throat), rump, area near root of tail and along the area of the second thigh on back legs. The areas of coat loss around the neck are often thought to be due to friction from a badly fitting collar, as they appear to be where the collar lies. In fact the collar generally has nothing to do with the problem. Coat texture in these areas is often harsher than the remainder of the body and has a tendency to break readily when brushed. There is generally no sign of pruritus (itching) or lesions of the skin of affected dogs.

The skin in these areas tends to become hyperpigmented and darkens in colour from grey pink to black. In Keeshonds this type of coat loss appears to be more common in males although bitches can show the same symptoms.

There have been cases where an affected dog has, for no apparent reason regrown hair on the areas of alopecia and where this has occurred the hyperpigmentation appears to resolve itself. Alopecia may or may not reoccur.
In 1998 a study was commenced by, veterinary surgeons working in the Department of Dermatology at the Royal Veterinary College. The study set out to look at patterns of coat loss in Spitz breeds and sought to gain help from breed clubs of Chows, Samoyeds, Pomeranians and Keeshonds. A number of breeds appear to be susceptible to patterns of coat loss and the department has also carried out studies with Irish Water Spaniels and Miniature Poodles. Breed Clubs were invited to become involved and individual owners requested to submit dogs showing patterns of coat loss or poor coat growth to the department of dermatology at the RVC North Mymms site.

The Survey Methods

Owners of dogs participating in the survey were asked to complete a questionnaire explaining when the coat loss commenced and any links to times of year etc. An outline of a Spitz was provided to illustrate the areas of coat loss. Where possible owners were also requested to send photos to illustrate the dogs coat loss. Some owners visited the Royal Veterinary College with their dogs to enable a range of tests be carried out and others were tested by their own vets using the set protocol provided by the survey. Blood samples were taken and a standard haematology and biochemistry assay completed.
An ACTH test was also carried out testing for cortisol and 17 OHP pre and post stimulation. Dogs were tested for thyroid function with T4 and TSH. Several skin sections were collected both from areas affected by the alopecia and hyperpigmentation and also from an unaffected area to act as a control.
A series of urine samples were subsequently collected by owners and sent to a specialist laboratory for analysis.
During the latter part of 2000 a food study was carried out on a number of dogs as diet has been found to have an effect in others breeds, notably the Irish Water Spaniel. Wafcol provided supplies of their fish and corn complete diet for owners to take part in a fixed period food trial.


Oestradiol (oestrogen) levels were well above the normal reference range in all dogs. Testosterone was within normal range although there was a considerable variation. The TSH levels within these samples were also within normal ranges. T4 levels were within the normal reference range for most. No dogs were hypothyroid.
Urine analysis showed no abnormalities.
All the tested dogs showed elevated 17 OHP levels post stimulation.
The food trial showed a slight improvement in some dogs but none in others. Some owners reported their dogs being unenthusiastic about eating a complete food. One owner has since changed over to the Wafcol Salmon and Potato food and reported significant improvement with the dog now sporting a profuse coat with no signs of alopecia.


The condition is referred to as Alopecia X. (Adrenal Hyperplasia Syndrome) Onset has been found to occur at any age and does appear to be more common in ”plush-coated” breeds such as the Spitz breeds.

It was concluded that the hormonal results of all the dogs showed an increased level of 17 OHP post ACTH stimulation and an increased level of oestradiol (oestrogen). This is a common finding in dogs with this disease. This type of coat loss is now thought to be due to abnormal steroidogenesis (a slightly abnormal adrenal gland function in the pathway of steroid formation such as cortisol). It is not known to what extent the condition in the different breeds is caused by the same hormonal imbalances as the tests showed different patterns in the breeds within the survey. There appears to be a difference between the hormonal imbalance in the Keeshonds and that of other breeds. It is possible that Keeshonds have a mild form of the alopecia that affects Irish Water Spaniels, Miniature Poodles and Pomeranians.

It is likely that coat loss in the Keeshond is affected by a variety of factors including diet and hormones.

Where do we go next?

A drug thought to be suitable for correcting this imbalance has been identified and received its UK licence last year. Trilostane is licensed for use in Cushings disease but has also shown encouraging results when used as a therapy for coat loss.

The drug is considered to be extremely safe to use and to date trials have been carried out on Pomeranians and Miniature Poodles. Results have been encouraging with 90% efficacy in the trial (Cerundolo, personal communication). The drug needs to be balanced carefully and it can take several months to obtain the optimal balance. The initial investigations were funded via a Kennel Club grant to the RVC and this has now ceased. The drug company provided medication for the trial on Pomeranians and Miniature Poodles. For the time being at least, any continuation of the study is “on hold”. It is hoped that it will be possible to recommence work with Keeshonds at some time.

In the meantime it is important to remember that this disease is purely cosmetic and affected dogs are healthy in every other respect.


I would like to thank Prof. David Lloyd BVetMed, PhD, FRCVS, Dip ECVD and Rosario Cerundolo D.V.M. Cert. VD, Dip ECVD, MRCVS for involving Keeshonds in the Alopecia X study. I am also grateful to Rosario for his advice and support in the writing of this article.

David Lloyd is Professor of Veterinary Dermatology in the Department of Veterinary Clinical Sciences at the Royal Veterinary College, University of London and Rosario Cerundolo is currently Assistant Professor of Veterinary Dermatology in the Department of Dermatology at the University of Pennsylvania School of Veterinary Medicine.

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Cerundolo R, (1999) "Symmetrical alopecia in the dog": In Practice,21: p 350 – 359

Cerundolo R, (2000) )"Alopecia associated with abnormal steriodogenesis in dogs", Continuing Professional Development - Veterinary Medicine2: p 100-104,

Cerundolo R, Lloyd D.H, Pidduck H.G (1999) "Studies on the inheritance of hair loss in the Irish Water Spaniel" The Veterinary Record. Nov 6; 145(19): p 542- 4

Cerundolo R , Lloyd D.H., McNeil P.H., Evans H, (2000) "An analysis of factors underlying hypotrichosis and alopecia in Irish Water Spaniels in the United Kingdom" Vet Dermatology;11: p 107-122

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I lived with Keeshonds for 46 years and Show and exhibit and judge in England.

I hold a post graduate advanced diploma in companion animal behaviour counselling and am a member of the Keeshond Club, the North of England Keeshond Club and the Deutscher Spitz Club of Belgium.

I have a particular interest in health and work with several veterinary contacts to further the knowledge of health problems within the breed. I am the health co-ordinator of the Keeshond Club.

© Jane Saunders - August 2002

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