Small, white, fluffy and with a lot of character, West Highland White Terriers, or Westies, are a popular breed among dog owners. As with all dog breeds, they have their own appeal and quirks, but what are the common West Highland Terrier health problems. Skin problems are frequently associated with Westies, but they can develop other diseases too. So today we will ask whether Westies make good pets, and whether they really do all have bad skin.

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In case you haven’t encountered a Westie before, they are a small size, medium-coat length Terrier breed first bred in the 19th century from terriers in Scotland (hence the name). While we know that personality and behaviour varies wildly between dogs based on genetics and environmental factors, Westies are often considered intelligent, energetic and social, though they can also be protective, stubborn or even grumpy. Originally bred for ratting, they can have a high prey-drive and may chase smaller animals like cats or rodents. On average, most Westies reach 12-13 years old, though some live longer to 16 or more. 

Skin Conditions in Westies 

Unfortunately, the association of Westies with skin disease is not inappropriate, as many Westies do develop skin issues in their lives. Let’s discuss these now. 

Atopic Dermatitis/Allergic Skin Disease in West Highland Terriers

Possibly the most common skin disease of Westies is atopic dermatitis, or allergic skin disease, with as many as a quarter of Westies being affected. Atopic dermatitis is an inappropriate immune response to certain allergens, like pollen, dust mites or food proteins. Atopic dermatitis is likely linked to genetics, meaning the disease may be passed along to offspring.

Primarily, atopy causes pruritus (itching). This itchy feeling means the Westie will want to scratch, rub, bite or otherwise soothe themselves. This leads to skin damage, inflammation, secondary skin infections and pain. These symptoms often cause the dog to want to scratch themselves more, creating a cascade effect. Atopy can present focally, in just one or two places, or generalised over the whole body. It can be seasonal or all-year-round, depending on the cause. Some dogs with atopy will also have gastrointestinal symptoms, such as vomiting or diarrhoea. This is more common with food allergies, but is still fairly rare. 

Diagnosis of allergies can be difficult and complex. We will go into more details in a moment, but generally other skin conditions should be ruled out first. Atopy can be treated in various ways: avoidance of allergens; topical creams, shampoos and moisturisers; oral skin supplements; non-specific medication like prednisolone, oclacitinib or lokivetmab; and specific immunotherapy. Many dogs will require anti-parasitic, anti-fungal or antibiotic drugs to combat secondary infections. It is very difficult to ‘cure’ allergies, and most dogs can only have the disease managed. 

Otitis

Otitis, or inflammation of the ear, is very common in Westies. In many cases, otitis is linked to underlying atopy – the allergy response causes itching within the ear, the dog scratches to try and soothe the discomfort and breaks the skin. The broken skin leads to inflammation of the ear, and allows secondary bacterial or fungal infections. However, otitis can also occur independently, due to excessive hairiness of the ear, dirtiness, swimming, previous ear disease and other factors. 

Otitis often starts as otitis externa, affecting the outer ear canal. This causes pain, shaking of the head, and smelly waxy ears. It can progress to otitis media and otitis interna, which can cause neurological symptoms and problems with balance. 

Many vets will want to take a sample from an ear with otitis, to determine what microbes are lurking there. Sometimes this requires a sedative if the ear is too painful to examine. Once diagnosed, otitis can be treated with topical anti-inflammatories and antimicrobials, and treatment for underlying atopy. 

Hyperplastic Dermatosis 

Hyperplastic dermatosis is a rare skin condition seen only in Westies. This disease is a disorder of skin production, resulting in thick scaly skin and increased susceptibility to fungal skin infections. It causes pruritus, scratching and hair loss. Diagnosis requires sampling the skin for fungi and changes in skin cells. Treatment often requires antifungal drugs, prednisolone and other treatments similar to those used for atopy. Some form of moisturising shampoo is always recommended. One study has also looked into using specific immunotherapy too, with good results. 

Investigation into Westie Skin Disease

Investigating skin disease often requires multiple steps. To start, most vets will take a thorough history from you, asking questions like how long has the skin disease been present, what treatments have been tried, what areas are affected, and so on. They will then perform a full clinical exam to check for underlying health issues; some systemic diseases can affect the skin too. Part of this will be checking your dog’s skin for lesions, signs of parasites, or infection. 

From here, some vets may want to perform skin scrapes, hair plucks or impression smears. These tests involve sampling the skin to reveal parasites, bacteria and certain fungi. These can generally be done consciously, without need for sedation. After this, there are options like testing the blood for environmental allergies, performing a diet trial to identify food allergies, or even taking biopsies of the skin for certain autoimmune conditions. In some cases, general health screens, such as blood, urine and faecal analysis, and imaging, may be performed if systemic disease is suspected. 

Common Health Problems In West Highland Terriers

Idiopathic Pulmonary Fibrosis/Westie Lung

Idiopathic pulmonary fibrosis (IPF), also known as Westie lung, a respiratory condition, is one of the more common West Highland Terrier health problems but can be seen in other breeds and cats too. This condition develops when the stretchy interstitial tissue of the lung is replaced with non-flexible fibrotic tissue. This results in the lungs being less effective at delivering oxygen to the body, leading to low blood oxygen. In Westies, it is believed this occurs due to a problem with collagen formation. IPF tends to develop in middle-aged dogs and gets worse over time.

Westie lung results in a chronic cough, increased respiratory rate, breathlessness, difficulties exercising, blue-tinged gums and even collapse due to lack of oxygenation. On exam, a vet can often hear wheezy, crackly lungs and sometimes a heart murmur. To diagnose IPF, Westies require imaging with x-ray or CT. This shows the fibrous tissue within the lung, and potentially secondary changes like heart disease. Vets may also need to perform other tests, like sampling the lungs, to rule out similar diseases. 

There is no specific treatment for Westie lung, and dogs must be managed on supportive therapy. This includes oral and inhaled steroids, oral and inhaled bronchodilators, cough suppressants, oxygen therapy, immunosuppressive drugs, and treatment for secondary heart disease. There is also some evidence that treatments like laser therapy can help alleviate symptoms. 

Unfortunately, the long term prognosis for IPF is poor, and most dogs sadly have to be put to sleep within a year or two of diagnosis. The prognosis is worse dependent on how damaged the lung tissue already is. 

Craniomandibular Osteopathy/Lion Jaw

Craniomandibular osteopathy is an unusual developmental disease seen more commonly in Westies, but other breeds too. It is characterised by excessive and abnormal bone growth of the jaws, inner ear, jaw joint and rarely other bones. It is a genetic disease seen mainly in puppies, first presenting around 3-8m old. 

Dogs with craniomandibular osteopathy present with swelling of the jaw, pain when eating or barking, reluctance to eat and hypersalivation. These symptoms can lead to weight loss or lack of weight gain, and generalised illness. Some dogs will also have a temperature. The symptoms can wax and wane over time. To diagnose this condition, a vet will take X-rays of the skull, showing the large, dense, swollen bones.

There is no specific treatment for this disease, but most vets will give pain relief to keep the dog comfortable. In most cases the abnormal bone growth slows and eventually stops around a year of age. Sometimes the bones can return to normal, but sometimes there can be permanent damage, resulting in lifelong difficulties eating. In cases where there is permanent damage, particularly if the jaw joint is affected, dogs may have to be put to sleep. 

Because craniomandibular osteopathy is a genetic disease, it is recommended not to breed from any dogs affected. 

Other conditions in West Highland Terriers

As well as the above diseases, Westies can be prone to a number of other conditions. Here are three commonly seen by owners.

Keratoconjunctivitis sicca (KCS)

Also known as dry eye, this is an eye disease where a dog does not produce enough, or good quality, tears. This results in the eye drying out, leaving it prone to damage. This can cause pain, ulceration, chronic scarring and even loss of the eye. Dry eye can be a genetic condition, or caused by trauma or certain drugs. It can sometimes be treated with topical drugs to stimulate tear production, or managed with regular eye lubrication. 

Luxating patella 

This term describes the condition where the groove for the kneecap (the patella) is shallow, meaning the patella can be pulled out of the socket during certain movements, like running. Often this results in a single ‘bunny hop’ gait. In many cases of mild patella luxation, the condition is not painful. However, it can make a dog more prone to cruciate disease or osteoarthritis in later life. More advanced patella luxation can be painful and require orthopaedic surgery to correct. Vets can diagnose luxating patellas based on history, a physical exam and X-rays. 

West Highland Terrier Health Problems: Dental disease, where bacterial build-up in the mouth results in damage to the gums and teeth

This is very common in small-breed dogs like Westies, due to their teeth being more crowded together than larger-breed dogs. Every time a dog eats, food debris and bacteria attach to the teeth and gums. Over time, the bacteria form plaque colonies. This can mineralise into hardened calculus. The bacteria produce chemicals that erode tissue, leading to gingivitis, gum recession, root exposure and eventually loss of the tooth. Dental disease is a very painful condition that has been linked to kidney, heart and other organ damage. Treatment generally requires professional cleaning by a veterinary surgeon. It can be prevented with regular brushing at home, so we encourage owners of all Westies to start brushing habits early.

Summary of West Highland Terrier Health Problems

Overall, we know that while not all Westies have bad skin, a significant number do have allergies that can lead to skin disease, up to a quarter in some studies. This risk may be increased if either parent of the dog had allergies, as it is often genetic. On top of this, Westies can be prone to other skin diseases too, such as otitis and hyperplastic dermatosis. Ensuring your Westie stays clean, dry and parasite-free will reduce the risk of skin issues, but they are common in this breed.

On top of skin disease, as with all dogs, Westies are associated with a number of other health issues, including idiopathic pulmonary fibrosis, craniomandibular osteopathy and dry eye. Thankfully, these conditions are rarer than allergies. 

In summary, despite the common West Highland Terrier health problems we would say that the health of the average Westie, provided they do not develop craniomandibular osteopathy as a puppy, or IPF as an adult, is comparable to other similar sized dogs, and the vast majority do reach good ages. However, many are afflicted with skin or other conditions that can affect their quality of life, and should be addressed if they occur. For a dedicated owner prepared to manage these conditions, we would argue that Westies do make good pets.

Further Reading On Westie Health Problems