Spanky, a 12-year-old neutered male Cocker Spaniel, came to our Dermatology Service with a five-week history of sores all over, but mostly on his back and ears. He was very itchy and smelled none too pleasant. He didn’t feel very good at all. Since many conditions produce a similar appearance, Spanky needed several different diagnostic tests to determine what was wrong. A cytology gave us a look at the skin cells under a crust, and some cells suggested Spanky’s problem might be autoimmune. We took a culture and several different bacteria grew. We started Spanky on antibiotics based on culture results, but the lesions remained. Finally, Dr. Delger and Spanky’s owner decided to do a biopsy despite the lack of ideal lesions. We made a diagnosis! Spanky did indeed have an autoimmune disease called “Pemphigus.” His immune system was destroying the connections between skin cells causing pimples to form within the skin, which then became crusts. We treated Spanky with medication to suppress his immune system so it would stop attacking his skin. A couple of months later, most of the crusts were gone, and Spanky was a brand new dog!