Her legs have to support her.
Her posture has to remain balanced.
As sleep takes over, that control weakens.
Her head drops first.
Then her body begins swaying.
Eventually, her knees start to buckle.
That should be the moment she lies down.
Instead, contact becomes the thing that wakes her.
Staff Watch Her Fall Asleep Without Ever Reaching the Bed
Late in the evening, Maisie stands near the wall.
Her nose points toward the floor.
Her eyes are closed.
For several seconds, she barely moves.
Then one front knee bends.
Her chest drops slightly.
Her hind legs soften.
Maisie begins sinking.
Suddenly, her eyes open.
She straightens.
The movement is fast compared with everything else she does.
She stands motionless for a few moments.
Then exhaustion starts pulling her downward again.
Sleep and Pain Are Competing for the Same Body
Maisie is not choosing standing because it is comfortable.
Her trembling legs suggest otherwise.
She is choosing—or perhaps simply defaulting to—the position that keeps the most painful skin away from contact.
That creates an impossible tradeoff.
Standing protects her skin.
Lying down allows her muscles to rest.
Right now, she cannot comfortably have both.
The Wall May Be Helping Her Stay Upright
Maisie often positions herself close to it.
Sometimes her head is only inches away.
At other times, part of her shoulder lightly contacts the surface.
The wall may provide orientation or a little physical support as fatigue increases.
But caregivers also have to make sure she is not rubbing inflamed skin against it.
Anything Maisie uses for support can become another source of friction.
Her Skin Condition Needs a Cause, Not Just a Description
“Severe dermatitis” describes what is happening to Maisie’s skin.
It does not explain why.
Dogs can develop widespread skin disease for many reasons.
Allergic disease may be involved.
Parasites can cause intense irritation and hair loss.
Bacterial or yeast infections may occur alone or as secondary complications.
Endocrine and other systemic disorders can affect the skin and coat.
Several problems can also exist simultaneously.
Maisie’s appearance cannot determine the underlying cause by itself.
The Crusts and Redness Are Important Clues
The veterinary team needs to evaluate the pattern of hair loss, inflammation, lesions, odor, discharge, crusting, and other findings.
Testing may be appropriate depending on the examination.
The goal is not simply to make the redness look better.
It is to identify and control whatever continues driving the inflammation.
Otherwise, temporary improvement may not last.
The Itch-Pain Cycle Can Make Everything Worse
Maisie may scratch or lick because the skin itches.
That self-trauma damages the skin further.
Damaged skin becomes more inflamed.
Inflamed skin may become more painful and susceptible to secondary infection.
Then the discomfort produces more licking or scratching.
Eventually, a dog can reach the point where the skin both itches and hurts.