This patient, like many that I see daily, is licking its paws. This dog has already been diagnosed with atopy or environmental allergies and is on allergy vaccines for desensitization. She was pretty stable with her allergies up until 6 weeks ago when she started to get itchier than usual. The itchiness or licking of the paws has now caused enough trauma that she has a bacterial infection of her feet.

It is not uncommon for a pet with environmental allergies that are on immunotherapy to still have a flare up. It doesn’t necessarily mean that the allergy vaccines are not working.

Allergy vaccines are not a cure for environmental allergies. A pet will still likely have a flare up. But we do want those flare ups to be less intense than prior and less frequent. Keep in mind that environmental allergies are forever, this is not going away. A pet with this allergy needs constant care and maintenance therapies.

With that said, this dog is also on Cytopoint to manage its allergies and its last injection was 4 months ago. Instead of using Cytopoint as needed, it may have benefited this patient to be on a more consistent use of Cytopoint, like every 2 months.

I advise general practitioners to do frequent follow-ups on your atopic patients. Think of it as preventative care for their allergies. At the start of immunotherapy, we are seeing these atopic patients every few months to make sure everything is going well with their allergy vaccines. After a year of immunotherapy and they are stable, it really depends on the patient how often we see them back. For example, it may happen every 3-4 months, especially the atopic patients with otitis problems. We like to check on these pets often because many times clients miss the signs of an ear infection.

Preventative care visits for your atopic patients will keep their allergies better controlled because you will catch things sooner than later. Don’t wait until they get bad.

#preventativecare #dogpaws #westie #westiesofinstagram #veterinarymedicine #petdermatology #atopy #veterinarians #vetschool #miamivetderm
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Through the sponsorship from Royal Canin, last night I had the pleasure of presenting a lecture along with Dr. Cherlene Delgado, ophthalmologist, and Dr Jose Villamil, oncologist, to our local referring veterinarians. It was a great night of learning and socializing that had been sorely missed since the pandemic began.

It is reported that 5% of veterinarians in the United States are Hispanic. I will make a joke here that I think practically all of that 5% is in Miami. 😊 When I read this statistic a few years back, I was shocked. I truly live in a bubble because most of my colleagues here in Miami are Hispanic. We have a nice diversity of veterinarians from many Latin countries.

So last night as I was listening to the interesting lectures, I was left wondering how much of that 5% are specialists. I imagine a very low percent. And it reminded me of the need for more representation of Hispanic veterinary specialist in our profession.

Living in Miami, a city where many citizens primarily speak Spanish, I can tell you it makes a significant difference to be able to speak Spanish and explain to pet owners about diseases in a language and terms that they can understand. Trust and compliance increase when a client can relate to you.
With all this said, secretly when I post here on Instagram I am also hoping to influence a young Hispanic pre-vet or vet student to consider specialty medicine. You can do this!

If there are any students out there with questions, please DM me.

Proud to be a Latina!

#latinxvets #veterinarioslatinos #hispanic #hispanicvets miamivetderm #gotitchypet #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedicine #veterinarian #prevet #vetschool #vettech #medicinaveterinaria #petdermatologist
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It’s procedure day Monday! 💃🏽💃🏽

Here we are again doing video otoscopy and flushing another set of ears with chronic infection.

It is almost hard to believe that a dog could be so sweet and good tempered with ears like this.

(Note: client rescued this dog already with ear infections and is doing everything possible to get her better).

#dogearinfections #dogsofinstagram #videootoscopy #yuck
#miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedicine #veterinarian #prevet #vetschool #vettech #medicinaveterinaria #petdermatologist
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I know what you are thinking… these are hives on a dog’s skin. Urticaria or hives are red raised welts on the skin.

When hives occur on haired areas of pet’s skin, especially in short, coated dogs, it will appear as raised tufts of hair.

Hives are commonly caused by an allergic reaction to anything like pollen allergy, food allergy or insect bite. Sometimes it is hard to find the cause.

A bacterial skin infection can also look like hives, and it is important to make the distinction as the treatment for hives is different from a bacterial skin infection.

Hives typically last 24 hours but may last longer. Since urticarial lesions are due to vasodilation, the hives should disappear on diascopy (pressing a microscope slide on the skin and the skin blanches). Therefore, you can use diascopy to differentiate the lesions.

If the raised tuft of hair has a pustule, papule, or crust beneath it then it is most likely a bacterial infection. Do a cytology to confirm or culture it!

The dog in this video had a bacterial infection secondary to his atopic disease. The bumps were not hives.

#hives #bacterialinfection #bullybreed #dogsofinstagram #miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedicine #veterinarian #prevet #vetschool #vettech #medicinaveterinaria #petdermatologist
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What is a crust?

Crusts on a pet’s skin are an accumulation of dried exudate, skin cells, pus, serum, and blood.

Most often the crusts you will see on a dog’s skin are secondary lesions, due to pyoderma. However, these crusts have a primary cause. It is important to get a good medical history and thorough physical exam (what is the distribution of these crusts) to find that primary cause.

Make sure to rule out ectoparasites, like fleas, and mites, like demodex and sarcoptes. Also, it is important to look for infections like dermatophytes.

If the pet is pruritic, then the most common underlying or primary causes are allergies, like food or environmental. If there is no pruritus, then disorders like endocrine and metabolic diseases are important to rule out. Remember that disorders like Cushing’s can cause a dog to get recurrent pyodermas. Should the pet continue to develop crust lesions, then biopsy of the skin is necessary to rule out disorders like primary keratinization disorders, nutritional disorders, autoimmune and neoplastic causes.

The picture here is of a 11-year-old M/N German Shepherd with an approximate one-year history of these crust lesions developing on the skin associated with minimal pruritus. There was no prior history of skin issues throughout this pet’s life. No endocrine disorder was present on bloodwork. The referring veterinarian treated for pyoderma and allergies with no complete resolution. 

We took biopsies of the skin and histopathology revealed pemphigus foliaceus, an autoimmune skin disorder. Pemphigus can be variably pruritic and can confuse a general practitioner with pyoderma and allergies. One key finding on exam for this pet was subtle crusting on the pinna and muzzle, not common in allergies. In pemphigus, the primary lesion is a pustule that is usually transient, the pustule progresses to an erosion and then crusts, that can have a yellow color.

The purpose of this post is to show that crusts on the skin can be more than just a pyoderma. And should you find yourself with crust lesions on a patient that are not going away, then consider a biopsy.

#pemphigusfoliaceus #germanshepherd #dogsofinstagram #vetdermatology
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How do I feel about antihistamines for allergies?

Since antihistamines are inexpensive and readily available clients will often ask about their use for pets.

Antihistamines provide small benefit as a sole therapy in reducing itchiness associated with allergies, particularly environmental allergies. In a mildly allergic patient, antihistamines may help, but I find that in moderately to severely allergic dogs it makes no difference and it just isn’t enough to control the pruritus.

Keep in mind that antihistamines only block histamine. The pathobiology of atopy is more than just histamine and this may help you understand why antihistamines are rarely by themselves enough. There are so many players in the cascade of itchiness at the immunological level that many environmental allergic dogs need “stronger” allergy medications.

Should you want to prescribe antihistamines, it works best if given before the allergy signs start. Best if used as a preventative. If an antihistamine works, then I ask clients to continue on it and not to stop.

There are many different antihistamines and if a client is interested in using one, I will have them try one over a 7–14-day period to see if it works. If it doesn’t in that time frame, then I have them move onto another antihistamine.

Short acting antihistamines, like Diphenhydramine and Hydroxyzine, need to be given more often, up to three times a day, to be effective. As opposed to, Loratadine, that is a longer acting antihistamine and doesn’t need to be given as often.

Depending on the case, I may use antihistamines as an adjunct to other allergy medications.

Antihistamines can work synergistically with fatty acids, therefore consider this combination use.

#dogallergies #benadryl #antihistamine
#miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedicine #veterinarian #prevet #vetschool #vettech #medicinaveterinaria #petdermatologist
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Today I had a visit with a human dermatologist to remove a bump on my head. It was neat to see her approach: she used a 4 mm punch biopsy to make a small opening in my scalp and open the cyst capsule. Then she applied pressure to push out the cyst contents. She then removed the cyst capsule and sutured me up.

Not like our patients that must wait until sutures are removed to get a bath, thankfully my doctor said I could wash my hair in 24 hours. Just in time for the holidays! LOL.

#drpimplepopper #scalpcystremoval #dermatology #popaholic
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It is hard to tell from far away that this dog has a dermatological problem.

Part the hair and you can now see hair loss, thinning of the coat and dark scaley to crust lesions on the body.

This dog has non pruritic or non-itchy hair loss. This is a Pomeranian so we may immediately think of Alopecia X. But you still want to do a good work up of other causes like mites, dermatophyte, bacterial infections, and endocrine disorders.

Vets: during your physical exam on these plush coated dogs take some time to sift through and part the hair to look for signs of skin or coat problems.

Pet owners: when you are petting and loving your pets take some time to part through the coat and look for bald spots and skin lesions.

#pomeranian #petskincare #plushdog #miamivetderm #gotitchypet #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmedicine #veterinarian #prevet #vettech #medicinaveterinaria #petdermatologist
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Every specialty in veterinary medicine has equipment or instruments they can’t do without.

The microscope is an essential equipment for a veterinary dermatologist. Just about every patient we see needs cytology diagnostics done on their skin and/or ears. A good microscope is important for us to see what is affecting the skin or ears and guide proper treatment.

It was only a matter of time that our clinic moved to get a microscope with a monitor. This is a great teaching microscope, not only for the client but also for staff.

#microscope #mynewtoy #cytology #miamivetderm #gotitchypet #vetdermatology #dermatologiaveterinaria #vet #veterinarymedicine #vetmedicine #veterinarian #prevet #vettech #medicinaveterinaria #petdermatologist
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When a dog has repeated ear infections, there are three things that pet owners need to be concerned about.
 
1) The on and off again exposure to topical ear medications, specifically ones with antibiotics, can potentially lead to resistant infections in the ear. To this point, left over ear medications should not be used as needed or without the approval of a veterinarian. One of my biggest pet peeves is hearing a client say they been using left over ear medication when they see their dog’s ears get red or smell funny. This is a NO NO!
 
The bacteria I commonly see that is resistant and difficult to treat is Pseudomonas. If this bacterium is present in the ear, it adds another level of complication to that ear problem.
 
2) Ear infections start in the external ear canal. After repeated infections, the ear drum can break and the infection then goes into the middle ear. Middle ear infections require a middle ear flush- a procedure done under general anesthesia. It is not until the infection in the middle ear cavity is removed that the ear infection can begin to resolve.
 
3) Lastly, repeated insults to the ear canal can lead to what I like to describe as chronic scarring changes to the ear canal. The ear canal is no longer an open smooth tube, it is bumpy lumpy, and the lumen is narrowed to obliterated.  It is not a normal tissue. Due to these changes, topical medicines or ear cleaners do not work well because they cannot get down or go through the closed ear canal. The ear canal swelling can sometimes be temporary due to the existing infection. But for some dogs it is a permanent change which complicates the ear problem. Some of these pets need their ear canals surgically removed. 
 
It is not normal for a dog to get repeated ear infections. The primary cause needs to be addressed so that complicating factors as described above do not occur.
 
#learnoninstagram #letsdobetter
#miamivetderm #gotitchypet #vetdermatology #petowner #vet #veterinarymedicine #veterinarian #prevet #vetschool #vettech #petdermatologist
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Why does a dog get recurrent ear infections?

If you are a pet owner and you find yourself in a repetitive cycle of your dog getting an ear infection, your pet receives treatment for the infection, your dog gets better but within a few weeks to months the infection comes back. Read this…

The main reason a dog gets recurrent ear infections is because the underlying or primary cause has not been addressed.

The most common primary cause is allergies to either food or environmentals.

There are a few other factors that can cause a dog to have chronic or continuous ear infections in addition to the underlying or primary cause.

These factors are middle ear infection (extension of infection from the external ear), resistant bacterial infections in the ear (i.e., Pseudomonas), and closed, swollen, scarred ear canals. What do these additional factors mean? They complicate the ear problem irrelevant of the primary cause. As a general practitioner it’s important to keep these in mind when evaluating an otitis case.

Key in understanding ear infection in dogs: Bacteria and yeast infections are secondary causes.

To end the cycle of continuous ear problems in a dog, the primary cause needs to be addressed.

As stated, the most common primary cause is allergies. However, there are other causes like endocrine disorders, polyps or tumors (typically a unilateral ear infection), foreign body or mites in the ear.

Make sure to take your dog to a veterinarian when you see an ear infection and follow the steps with your veterinarian to address the primary cause of the ear infection.

#dogear #otitis #allergies#vetdermatology #petowner #vet #veterinarymedicine #vetmed #vetmedicine #veterinarian #prevet #vettech #petdermatologist
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This is a 1-year Female Frenchie that has been excessively licking its paws. On exam, all the paws were red and brown stained, the bottom part of the paw was especially affected from the chewing and licking. For general practitioners this may be a common case scenario.

My work up plan: Skin cytology to rule out secondary infections. Skin scrapes to rule out mites. See an itchy paw, rule out demodex mites. Results of the diagnostics showed yeast and bacteria on the skin, and no mites.

What is the underlying cause of the paw itchiness? With mites ruled out the only other cause for the paw itchiness in this patient was allergies. Allergies to either food or environmentals are making this dog’s paws itchy.

What is the treatment and future follow up plan for this dog? It is important to treat the infection on the paws because it is contributing significantly to the pruritus. Treatment with oral and topical antibiotics and antifungal medications will bring relief to this pet. The follow up plan: start the pet on a diet trial to rule out food allergy.

If I start the diet trial and do not treat the infected paws, the client will not see improvement on the diet trial food. Infection causes itchiness, it is important when assessing if a diet trial is working or not, that the pet’s skin is not infected. This is key!

When I talk to clients about their pet’s skin problems, I often divide it into primary and secondary causes. For the case I am discussing here, the primary cause is allergies. The primary cause has led to a significant secondary bacterial and yeast infection.

Sometimes after the secondary infection has been resolved, the pet looks so much better that the client thinks the pet is cured! No, it is not. Something made the infection appear in the first place. The allergy needs to be addressed if not the pet will relapse with infection and the client will find themselves in a cycle. I am sure this scenario sounds familiar to pet owners with pets with skin problems.

It is important to do follow ups with your vet to find the root cause of your pet’s itchiness.

#howmanyhands #allergies #vetderm #petowner #vetmedicine #veterinarian #petdermatologist
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A patient signalment (species, sex, breed and age) is often used to assist in diagnosis of conditions, as certain conditions may, for example, be age specific.

It was a surprise to see that this patient, a 3 1/2 year old female spayed Frenchie, who presented for evaluation of these nodular lesions on her face turned out to have skin cancer. The nodules or tumors were due to epitheliotropic T cell lymphoma verified thru immunohistochemistry. This type of skin cancer is not something commonly seen in young dogs. It is much more common in older dogs.

Bad diseases can happen in young dogs too, and just something to keep in mind when the clinical lesions fit a disease but the signalment does not. This was a very sad diagnosis.

#cancersucks #petswithcancer #skincancer #miamivetderm #gotitchypet #vetdermatology #dermatologiaveterinaria #vet #veterinarymedicine #vetmedicine #veterinarian #prevet #vetschool #vettechlife #vettech #medicinaveterinaria #petdermatologist
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Repost from last year.

It never fails that the week after thanksgiving our office is taking calls from pet owners whose dog ate some of the thanksgiving meal and now are pruritic.

If you have a dog with a known food allergy or on a diet trial please be extra careful this week. Keep your dog in a separate area of the home so it doesn’t have access to the thanksgiving dinner table, the trash or worse yet, a relative or friend that can’t resist those begging eyes that dogs know how to do so well.

Happy Thanksgiving!!!

#thanksgiving2022 #thanksgivingdinner #miamivetderm #gotitchypet #foodallergies #vetdermatology #petowner #vet #veterinarymedicine #vetmed #veterinarian #prevet #vettech #medicinaveterinaria #petdermatologist
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The ear canal of a Chihuahua is a different length from the ear canal of a Great Dane. Practitioners, when dispensing medications for an otitis case it is important to keep this in mind as the volume will depend on the particular breed of dog.

When I see patients with ear infections that are not resolving, a subset of them is not responding to medications because the right volume of medicine is not being applied.

A dog like a Chihuahua could get about four to six drops of medication into their ear. A Great Dane would need twenty or more drops into its ear.

We want the medication to fill the ear and reach deep down into the ear canal so that we are treating the entire ear properly.

With ear cleaners, we want to make sure we are about flooding the ear canal with the cleaner so that it can dissolve all the debris in the ear. Applying a few drops of a cleanser into the ear will not dissolve or dislodge the discharge in the ear well.

#letsdothisright #dogear #dogearinfections #miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedworld #vetmedicine #veterinarian #prevet #vetschool #vettechlife #vettech #medicinaveterinaria #petdermatologist
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A common mistake I see pet owners do is give flea medicine only when they see a flea on their pet.

It may seem “safer” or less expensive to apply/give the flea product only when there is a flea, but this is not a good method to keep fleas away from your pet long term.

This method will kill the flea on the pet, but what you may not realize is that that flea has already laid eggs in your home and environment and more fleas are waiting to develop.

When you see a flea on your pet it is unlikely that flea just got on your pet!Chances are the flea has been there for days. I know this is a hard one to swallow but it’s true.

When a flea gets on a pet, it quickly takes a blood meal and then the flea will begin to reproduce and lay eggs.  They say a flea lays 40-50 eggs a day.

The eggs will fall off the pet into your home/environment and these will be new fleas that will emerge in 3-4 weeks. Therefore, more fleas will be getting on your pet and the cycle continues.

My favorite flea preventatives are the isoxazolines. Since these are oral they do not get washed off like the topical flea products.

Flea baths/ shampoos don’t work because there is no residual effect. These work only the day you use it.

The point of flea medications: to kill a flea fast enough that it doesn’t reproduce and therefore not cause some degree of infestation in your home and environment. 

Flea preventatives need to be used long term, not just when you see a flea.

#letsdoitright #fleas #learnoninstagram #miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedworld #vetmedicine #veterinarian #prevet #vetschool #vettechlife #vettech #medicinaveterinaria #petdermatologist
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Omega fatty acids for the skin

Fatty acids provide a small benefit in reducing the itchiness associated with atopy. 

By itself fatty acids are rarely enough to control the itchiness or clinical signs associated with atopy in dogs and cats.  Therefore, it should not be used as the sole therapy for managing an atopic pet’s symptoms.  It should never be used for acute pruritus (itchiness), there are other allergy medications available that work faster and better.  
 
If a client is interested in therapies to support the skin of their atopic dog, I will recommend omega 3 fatty acids as an ADJUNCT therapy to manage their allergies. 

Omega fatty acids provides its benefit by incorporating itself onto the skin and therefore the inflammatory mediators produced are anti-inflammatory.  Their benefit can also come from improvement of the quality of the coat and may affect superficial skin lipids, therefore improving the skin barrier. A strong skin barrier means less water loss from the skin and less penetration of microbes and allergens into the skin.

You can find fatty acids in oral supplements (like the product in this picture), enriched in diets or topicals.

What has been your experience with fatty acids for atopic pets?

#fattyacids #fishoils #omegafattyacids #linoleicacid #supplements #supplementsfordogs #miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedworld #vetmedicine #veterinarian #prevet #vetschool #vettechlife #vettech #medicinaveterinaria #petdermatologist
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Don’t forget to look under the tail in a dog or cat with rear end itchiness.

The trauma from chewing, licking or scooting can cause secondary infections like bacteria and malassezia.

Look at the skin under this dog’s tail: it’s become lichenified (elephant like skin) from chronic trauma. It will take weeks to get this skin to look normal by treating the infection and stopping the itchiness.

We can stop the itchiness with medicines like Apoquel and Cytopoint. But these medications will only be bandaids if we don’t look for the underlying cause of the itchiness.

Number one cause of rear end itchiness is fleas! But food allergy and atopy can be causes too.

Full anal glands can also cause a dog to scoot and itch back there, but if the glands are expressed frequently it should never get to a point that the tail looks like this. Don’t blame all scooting on anal glands!

#scooting #itchydog #miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedworld #vetmedicine #veterinarian #prevet #vetschool #vettechlife #vettech #medicinaveterinaria #petdermatologist
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There is a misconception that pet’s eating starchy foods, like potatoes, will cause yeast infections of the skin or ears. This myth comes from the belief that Candida overgrowth in people is caused by a diet high in white flour and sugars. Therefore, removing these types of foods from the diet resolves the Candida. Even if the latter were true in people, Candida is different from Malassezia. Malassezia is the species of yeast that primarily causes skin and ear infections in dogs (and sometimes cats).

Malassezia is primarily triggered by allergies. Allergies causes inflammation of the skin and the trauma from licking, chewing, scratching creates an environment for Malassezia to flourish. When Malassezia is present it makes the pet even more itchy, more itchiness means more trauma and inflammation to the skin, which then leads to more Malassezia, and the cycle continues.

A dog can have a food allergy that is making the skin itchy and leading to secondary Malassezia, but it is not the food that is causing the Malassezia, it is the itchiness and inflammation on the skin.

Can other conditions cause yeast? Yes, I have seen Malassezia in dogs with mites, hormonal disorders, like hypothyroidism, and nutritional disorders.

If your pet has been diagnosed with a yeast infection, make sure the underlying cause is being addressed.

#mythbusting #candida #malassezia #mythvsfact #miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedworld #vetmedicine #veterinarian #prevet #vetschool #vettechlife #vettech #medicinaveterinaria #petdermatologist
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For your enjoyment, because I know you can’t get enough of these ear videos…. another scary and yucky looking ear. It’s hard to imagine a dog has been living with this for the last 1-2 years.

Happy Halloween 🎃

#hallloween #happyhalloween #miamivetderm #gotitchypet #otitis #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedworld #vetmedicine #veterinarian #prevet #vetschool #vettechlife #vettech #medicinaveterinaria #petdermatologist
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This is a 6-year-old male Labrador that I recently saw with severe pododermatitis and several draining tract lesions on its body.

Please take note that lesions like these are indicative of a deep infection.

This patient had been on and off antibiotics without resolution and worsening as the weeks went by.

When a patient is presented to me with these types of lesions and a long medical history of antibiotic use, cultures of the skin are necessary. In this pet, I did not want to blindly guess on an antibiotic that would or would not work.

Culture! Culture!

For this pet, we proceeded with skin cultures. Since the infection was deep, I took biopsies of the skin and submitted the infected tissue to the lab for analysis.

The cultures of the skin grew a methicillin resistant staphylococcus infection, or MRSP.

Deep infections require minimum 6-8 weeks of antibiotics. This is minimum, so it may be longer.

Do not forget to look for the underlying cause!

I also took tissue biopsies for pathology. Anytime I see severe pododermatitis like this I want to rule out demodex, and this pet had not been on any flea preventative like an isoxazoline. It is hard to do skin scrapes on inflamed paws like this and therefore biopsies are necessary. No mites seen on biopsy.

Cause- likely allergies to food or environmentals. It is hard to believe that an allergy can cause a pet to get this bad, but it can when you have severe secondary infection. Sometimes the infection can be worse than the disease!

#dogpaws #MRSP #miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedworld #vetmedicine #veterinarian #prevet #vetschool #vettechlife #vettech #medicinaveterinaria #petdermatologist
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Paw licking is often confused with grooming or behavioral issues.

Many pet owners do not realize that paw licking is a sign that their dog is itchy of it’s feet.

Just as the pet’s body can be itchy due to allergies, the paw licking can also be part of the allergy presentation as well.

#dogsofinstagram #dogpaws #pawlicking #dogownersofinstagram #miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedworld #vetmedicine #veterinarian #prevet #vetschool #vettechlife #vettech #medicinaveterinaria #petdermatologist
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Surrounded here by my team. ❤️

I am a small business with a small work group.

I have two full time vet techs & one part time vet tech.

As much as I honor our vet techs this week and I know this week is for them, I’d be remiss to not acknowledge the entire staff this week as well.

So in essence, vet tech week for us turns into staff appreciation week.

Because we are a small group, on some days, especially the crazy busy days (you all know what I mean), my receptionist, my manager and even my scribe have to fill in the vet tech role. Therefore it’s hard for me not to honor everyone this week.

I am grateful for my team. ❤️

#vettechappreciationweek #vettechweek #myteam #werock #miamivetderm #gotitchypet #staffappreciation #thisishowwedoit
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Little dark spots on a dog’s skin. What can these be?

Make sure its not a flea or tick, or flea dirt.

Focal brown/black crusty lesions may be a sign of bacterial or fungal skin infection.

Hyperpigmentation (or darkening) of the skin can be age spots, however, mites (like demodex) or endocrine (hormonal) disorders can cause the skin to darken.

Raised dark spots may be a skin growth or viral lesions (pigmented plaques).

Best to see a veterinarian to assess the cause.

#dogskin #darkspots #miamivetderm #gotitchypet #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedworld #vetmedicine #veterinarian #prevet #vetschool #vettechlife #vettech #medicinaveterinaria #petdermatologist
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When we think of dermatophyte or ringworm infection, Microsporum canis often comes to mind as the most common cause. However, another dermatophyte to keep in mind is Trichophyton mentagrophytes.

A few things about this species of dermatophyte, as it can be easily missed and confused with other skin disorders:

T. mentag rarely fluoresces under UV light. Therefore, a Wood’s lamp is unlikely to detect this dermatophyte.

T. mentag can cause lesions that mimic autoimmune conditions, like pemphigus foliaceus. Lesions include alopecia (can be generalized), erythema, crusts and scales. The skin can become hyperpigmented and scaley. The alopecia with this infection can be quite scarring and dramatic. Dogs can be itchy as well, often due to secondary bacterial infection.

Not too long ago I posted about Yorkies being predisposed to dermatophyte infection. It is important when seeing a Yorkie with skin problems that you keep this fungal infection in mind and consider performing a dermatophyte culture or dermatophyte PCR (w/reflex culture).

Don’t forget that dermatophytes are contagious. Ask the pet owner if they have skin lesions. It so happens that the human family this Yorkie lives with had a ringworm infection diagnosed by their medical doctor.

#yorkies #yorkiesofinstagram ##yorkielovers #dermatophyte #ringworm #miamivetderm #gotitchypet #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedworld #vetmedicine #veterinarian #prevet #vetschool #vettechlife #vettech #medicinaveterinaria #petdermatologist
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When do I start worrying that a pet’s skin lesions could be a sign of skin cancer ….

When I see depigmentation on the skin and nose.

When I see loss of cobblestone texture to the nose.

Ulcers or erosions on the skin.

Crusting of the foot pads.

Pet overall feeling ill.

All the above and oral lesions.

There is a low probability that these lesions on the skin are due to allergies.

These types of lesions warrant biopsies of the skin to confirm the diagnosis.

#cancersucks #dogskinproblems #miamivetderm #gotitchypet #vetdermatology #petowner #notallergies #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedworld #vetmedicine #veterinarian #prevet #vetschool #vettechlife #vettech #medicinaveterinaria #petdermatologist
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I wanted to share with you a unique case of Nodular Dermatofibrosis.

This is an 8-year-old M/N Mixed breed dog that for the last 4 years has had these growths throughout its entire body. On exam, dozens of these growths were on the head, trunk, and extremities.

Closer look you can see that these growths were raised firm cutaneous nodules of varying sizes. On the dorsal trunk the growths caused the hairs to tuft up that from a distance “appeared” as hives. This begs the importance of parting the hair and looking to see what is under those raised tufts of hair.
When I saw these growths, I knew it was time to biopsy. Biopsies were sent to a dermatopathologist, Dr. Karen Trainor, whom I have tagged on this reel @innovativevetpath. The biopsies revealed nodular dermatofibrosis.

This is a rare skin disease where collagenous type of skin growths appear on the skin as a manifestation of internal disease or paraneoplastic syndrome. Nodular dermatofibrosis has been associated with renal (kidney) cysts, cystadenomas, or cystadenocarcinomas. In female dogs, it has been associated with uterine leiomyomas.

This condition is primarily seen in German Shepherd dogs and may have a hereditary component, however, there are reports of this condition occurring in other breeds.

If you diagnose this skin disease, it should warrant evaluation of the kidneys thru bloodwork and ultrasound.

This case highlights that diseases that are typically seen in a certain breed of dog, can still occur in other breeds. Also, I like to point out the importance of a dermatopathologist reading skin biopsies, as they are able to assess these rare skin conditions.

Who has seen this condition before in a non-German Shepherd breed?


#cancersucks #dogcancer #paraneoplastic #germanshepherdsofinstagram #dogsofinstagram #miamivetderm #gotitchypet #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedworld #vetmedicine #veterinarian #prevet #vetschool #vettechlife #vettech #medicinaveterinaria #petdermatologist
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Quick anatomy for non-veterinarians: a dog’s ear canal is shaped like an “L.” There is a vertical and horizontal part to the ear canal.

Lateral ear resection is a surgery where the lateral wall of the vertical ear canal is removed. Veterinarians once thought that removal of this part of the ear in a pet with ear infections would make it easier to treat the patient’s ear. If done properly, it allowed easier access to the horizontal ear canal for application of topical ear medication. However, if the horizontal part of the ear canal is diseased, stenotic/closed/scarred ear canal, then a lateral ear resection does not help the patient because topical medication still cannot get thru a closed ear canal.

Since allergies are the most common cause for a dog’s ear infection, the chronic changes that affect the vertical ear canal will also extend to the horizontal ear canal. With that said, lateral ear surgery does not resolve the primary cause, the allergy, which is affecting the ear. The pet will keep having ear infections even with this surgery.

Lateral ear resection makes sense if there is a growth in the vertical part of the ear canal blocking the ear. However, it is important to make sure the rest of the ear canal is normal, possibly using imaging like CT or MRI.

There is thought that this procedure may help some dogs if done early before there has been chronic changes to the ear canal or in breeds like Shar-pei’s that have stenotic vertical canal.

I graduated from vet school 22 years ago and learned about this surgery to help with otitis cases. The surgery has since fallen out of favor as most dogs with chronic changes to their ears, which cannot be managed medically anymore, need a total ear canal ablation surgery. If the allergy is addressed early before chronic changes develop in the ear, we can avoid any kind of surgery to the ear. Let’s save these ears my fellow colleagues!!

I would love to hear if anyone has had success with lateral ear resection surgery for otitis cases.

#dogears #earsurgery #dogearinfections #vet #vetmedicine #vetderm #dermatologíaveterinaria #dogowner #vetmedworld #vettech #vetstudent
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