Pip is exhausted.

It shows before he even tries to lie down.

The five-year-old Yorkshire Terrier mix stands inside his shelter medical kennel with his back slightly rounded and his legs positioned carefully beneath him. His eyes slowly close.

His head begins to drop.

For a few seconds, it looks as though Pip may fall asleep exactly where he is standing.

Then his body sways.

He wakes himself.

Pip looks down at the clean pee pad beneath his feet and begins the same careful process again.

His front legs bend.

His chest lowers.

His hindquarters start moving toward the floor.

But the instant the nearly hairless skin along his belly and inner hind legs touches the pad, Pip jerks upright.

He stands again.

His body trembles slightly.

His eyes begin closing almost immediately.

Pip desperately needs to sleep.

But lying down appears to hurt more than remaining on four tired legs.

Almost All the Fur Beneath Pip Is Gone

The skin along his belly is exposed.

So are large areas around his hind legs.

Instead of healthy skin protected by a normal coat, much of the area is red, irritated, and crusted.

Some sections appear dry.

Others look inflamed.

The surface is sensitive enough that even ordinary contact can become difficult.

For Pip, that creates a problem every dog eventually has to solve.

How do you rest when resting requires putting painful skin against something?

At First, He Looks Like He's Simply Hesitating

Pip stands over the pad.

He circles slightly.

Lowers his head.

Moves one paw.

Then another.

A person unfamiliar with his condition might think he simply dislikes the bedding.

But eventually fatigue wins.

Pip tries to lie down.

That is when the problem becomes obvious.

His Belly Barely Makes Contact

He does not have to put his full weight down.

Sometimes only a small section of irritated skin touches the surface.

Pip reacts immediately.

His legs straighten.

His abdomen lifts.

His body rises before he has completed the movement.

Then he stands there again.

He Doesn't Run Away From the Pad

That detail matters.

Pip stays in roughly the same area.

He is not terrified of the object itself.

He does not bark at it.

He does not attack it.

He simply cannot seem to tolerate prolonged contact between the surface and the damaged skin underneath his body.

Severe Dermatitis Can Affect Far More Than Appearance

Hair loss is the easiest thing to notice.

But the missing coat is not necessarily the part causing Pip the most trouble.

Inflamed skin can itch.

It can burn.

It can become tender.

Crusted areas may pull when the body bends.

Open or irritated sections can hurt when pressure or friction is applied.

Secondary bacterial or yeast infections may make discomfort worse.

The exact cause of Pip's skin disease requires veterinary evaluation rather than guesswork.

Many Different Problems Can Produce Severe Skin Disease

Parasites are one possibility.

Allergic disease is another.

Infection can be involved.

Environmental irritation, immune-related conditions, endocrine disease, nutrition, chronic untreated inflammation, and combinations of problems can also contribute depending on the individual dog.

Pip's appearance alone cannot establish the cause.

The important thing is that his skin is painful enough to interfere with one of the body's most basic functions.