Dermatomyositis may occur at the age of 4 to 6 months, and is frequently misdiagnosed by general practice veterinarians as sarcoptic or demodectic mange. The disease manifests itself as alopecia on the top of the head, supra- and suborbital area and forearms as well as the tip of the tail. If the disease progresses to its more damaging form, it could affect the autonomic nervous system and the dog may have to be euthanised. This disease is genetically transmitted and recessive, with breeders having no clear methodology for screening except clear bloodline records. Deep tissue biopsies are required to definitively diagnose dermatomyositis. Lay assessment of end-stage dermatomyositis is observed difficulty or inability to swallow, even water.