An 8 year old, male castrated, West Highland White Terrier was referred to Cornell University Hospital for Animals' for increased liver enzymes, specifically alanine aminotransferase (ALT) and alkaline phosphatase (ALP), and skin lesions. He was prescribed amoxicillin clavulanate, and a medicated shampoo (MiconaHex+Triz) for a presumptive skin infection. The owners believed the skin condition began 2 to 3 weeks prior to presentation. On physical exam there were crusts over his face, paw pads, elbows, dorsal, and ventral abdomen. All paw pads were hyperkeratotic with a few exfoliated blisters. There was severe erythema of the inguinal and perineal regions and fissures present on each foot pad. There was also moderate erythema and mild crusting around his eyes and mouth. This report describes a definitive clinical case of Hepatocutaneous Syndrome (HCS) in a West Highland White Terrier with the use of clinical findings, gross pathology, and histopathology as a means of diagnosis.