QUARTERLY BEAT / JULY 2024
THE ITCHY DOG: HOW TO IMPLEMENT A PRACTICAL, STEP-BY-STEP APPROACH AND BECOME A DERM ROCKSTAR
DR. JULIA E. MILLER DACVD
In this VETgirl veterinary technician webinar “The Itchy Dog: How to Implement a Practical, Step-by-Step Approach and Become a Derm Rockstar” on April 7, 2024, Dr. Julia E. Miller, DACVD reviews all you need to know about becoming a derm rockstar! In case you missed the webinar, watch it again HERE or read the cliff notes below!
In both general and specialty practice, itchy dogs make up a large portion of what we see every day. This is why it is incredibly important that practitioners are equipped with a repeatable, step-by-step diagnostic workup for these cases. By developing a methodology, frustration can be minimized, successes may be achieved, and derm really can be fun! WHY SO SCRATCHY? When it comes to dermatology, especially when working up pruritic patients, thorough, derm-specific history questions are a must as they will guide the prioritization of differentials. Skilled nurses and assistants are an invaluable asset in collecting the necessary information to guide the diagnostic workup. Educating the team on the approach to pruritic patients will increase success and efficiency. Another important aspect of the itchy dog workup is a thorough derm PE – truly a nose-to-tail examination. Part the fur and use a flea comb to look for evidence of fleas. If the patient is licking its paws, get up close and personal with the claw folds to look for dermatitis or discharge. If the patient is scooting, do a rectal examination to evaluate the anal sacs, and don’t forget to
check the perivulvar skin in female animals. Thorough derm PEs ensure that causes of pruritus are not missed and guide what diagnostics are warranted.
REMEMBER: ATOPY IS A DIAGNOSIS OF EXCLUSION Not every itchy dog is allergic, and many allergic dogs also have secondary, complicating factors. Before diagnosing a patient with environmental allergies (atopy), it is imperative to rule out ALL other causes of pruritus with derm-specific history taking, a thorough PE, derm diagnostics (cytologies, skin scrapes, etc.), and by assessing response to treatments. Allergy testing (serum or intradermal) should NOT be used to diagnose atopy as false positives are possible and may lead you down the wrong path.
ROCKSTAR TIP:
Rule out ectoparasites in every single itchy dog! Isoxazolines are a fantastic way to do this.
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