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Stretchy, Saggy, Painful Skin in Dogs

Cutaneous Asthenia in Dogs

Cutaneous asthenia, also known as Ehlers-Danlos syndrome, is a hereditary disorder that affects dogs, characterized by excessively stretchy and saggy skin. This condition stems from a genetic mutation passed from parents to offspring, resulting in deficient levels of collagen, the essential protein responsible for providing strength and elasticity to the skin and ligaments.

Dogs with cutaneous asthenia experience painful joint dislocations due to the instability of ligament fibers that connect the bones. The ligaments lack the necessary elasticity to return to their original form after stretching, leading to persistent joint instability and discomfort.

Furthermore, the structural integrity of the skin is compromised due to the lack of collagen. The skin fails to retract properly after being stretched, resulting in pronounced sagging. Additionally, the weakened skin is more susceptible to injuries, tears, bruises, and scarring.

Although cutaneous asthenia is rare, it poses significant challenges for affected dogs, often diagnosed at a young age. Identifying this condition relies on observation rather than skin and tissue samples, making it essential for pet owners and veterinarians to recognize its symptoms and provide appropriate care.

This disorder affects both dogs and cats, albeit infrequently, underscoring the importance of early detection and management strategies to mitigate its impact on affected animals.

Symptoms and Types

The symptoms of cutaneous asthenia typically manifest as loose, saggy skin with excessive folds, exhibiting a soft and delicate texture with minimal elasticity. The skin is prone to tearing easily, often resulting in wide, fish-mouth type wounds that bleed minimally but gradually widen into scars over time. Additionally, unexplained scars may be present on the skin. Swelling beneath the skin around the elbows may occur due to pressure from bones during rest, accompanied by bruising and hematoma formation under the skin, particularly around the elbows and elsewhere on the body. Lacerations commonly appear on the back and head, while internally, low collagen levels increase the risk of ruptures and internal bleeding.

In dogs, this condition frequently leads to joint laxity, ranging from mild to severe. Mobility may be compromised due to slight joint looseness, or joints may be so loose that dislocations occur, affecting various parts of the body connected by joints, including the legs and hips. Additionally, a rare effect of this condition in dogs is the dislocation of the eye lens, attributed to insufficient collagen affecting the ligaments that support the lens.

Cutaneous asthenia is observed in the following breeds:

  • Beagles
  • Boxers
  • Dachshunds (both miniature and standard)
  • English Setters
  • English Springer Spaniels
  • German Shepherds
  • Greyhounds
  • Irish Setters
  • Keeshonds
  • Manchester Terriers
  • Poodles
  • Red Kelpies
  • Springer Spaniels
  • St. Bernards
  • Welsh Corgis


The primary cause of this medical condition is heredity, stemming from a genetic mutation transmitted from parent to offspring. It can manifest in either a dominant or recessive form. In the dominant form, both parents carry the mutated gene without exhibiting symptoms. In contrast, the recessive form may involve only one parent being a carrier, also without symptoms. In both scenarios, it’s typically recommended to refrain from breeding the parents of an affected animal and to consider withholding breeding of the affected animal’s siblings as well.


To diagnose the condition, veterinarians conduct an examination to assess the skin’s extensibility. This involves stretching the skin to its full capacity while observing the dog for any signs of discomfort. The extent of skin stretchiness is measured using the Skin Extensibility Index (SEI), which quantifies the stretched skin (typically using the dorsal skin on the back) divided by the length of the dog from the back crest of the skull to the base of the tail. The numerical value obtained from this calculation indicates the severity of the condition. Typically, an index exceeding 14.5 percent is considered within the expected range.


Treatment for cutaneous asthenia is challenging as the condition is incurable, and the prognosis is generally poor. Many dog owners opt for euthanasia due to the chronic pain experienced by the dog and the extensive time required for managing chronic wounds. Additionally, considerations regarding household dynamics, including the presence of other pets or children, often influence this decision. Affected pets must be segregated from situations that could lead to injury, as even innocent play with other animals or vigorous petting from children can result in skin tears.

For those who choose to keep their pet, precautions must be taken to ensure their safety. This includes isolating the affected dog from other pets and maintaining a hazard-free environment with padded sleeping and resting areas to prevent elbow swelling. Careful handling and restraint are necessary to prevent large skin tears, and visitors should be informed of the dog’s condition to avoid accidental injuries.

Neutering the animal is recommended not only to prevent the transmission of the mutated gene but also to mitigate the risk of injury during mating, as the inherent lack of collagen renders pregnancy impossible.

Living and Management

Living and managing a dog with cutaneous asthenia requires vigilant care. Lacerations and even minor cuts should be promptly repaired to prevent the risk of infection. Keep antibiotics on hand, both for topical application and oral administration, to address any infections that may arise in your pet.

Recent evidence suggests that Vitamin C may be beneficial in improving skin health for dogs with this condition. Therefore, it is now recommended for owners who have chosen to manage their pet’s disease to incorporate Vitamin C supplementation into their pet’s care regimen.

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