Is this a lot of medication? Is this excessive? I do not think so. Some allergic dogs need this amount of care to keep their allergies controlled. Environmental allergies or atopy is a condition that will never go away. It can only be managed. Once your pet is diagnosed with this allergy it will need constant care. It is no different than a dog with diabetes that needs insulin for the rest of its life, atopic pets need maintenance care for the rest of their lives so that they stay comfortable and minimally itchy. A weekly bath, a weekly ear cleaning, daily allergy medicine, +/- allergy vaccines (or immunotherapy) and +/- supplements. Keeping up with this care avoids visits to the vet’s office.

These are some of the brands of meds that I use, but there are so many others that are just as good! Please speak to your veterinarian about medications for your allergic pet.

Do you have an atopic dog? What are you doing for its maintenance care?

#atopicdogmeds #atopymeds #allergyindogs #petowner #petownersofinstagram #petdermatology #vetdermatology #dermatologiaveterinaria #vetmedicine

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I asked my team what is the best part of working in dermatology. I did not prompt them with the question. I was surprised that my entire team had pretty much the same answer!!!

So …. It is not just me; it is my entire team that work together to help transform pet life’s.

#igquestion #bestpartofmyjob #petdermatology #vetdermatology #vettech #vettechlife #prevetlife #vetstudent #vetmedicine

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This was a tough case. It took about 5 months to get this dog better.

This 5 year old male neutered atopic bully dog was a self-referral case.

He had been on and off antibiotics for some time.

He had been on every allergy medicine (Apoquel, Cytopoint, Cyclosporine and steroids), even immunotherapy and still had these draining lesions on his legs and worse on his paws.

Why weren’t the allergy medicines working? Why was he still so itchy and painful?

It’s because he had a deep skin infection that based on a tissue culture showed it was due to a resistant bacterium. The culture report showed that the commonly used antibiotics would not work on this infection.

Getting him on the right antibiotic for the right length of time made the biggest difference.

Clearing up the bacterial infection allowed his allergy to be managed better.

Do you want to be good at dermatology? My advise to you: learn as much as you can on treating skin infections.

#dogskinproblems #dogskininfection #bullydogsofinstagram #bullydogproblems #bullydog #petowner #bullydogowner #petdermatology #vetdermatology #dermatologiaveterinaria #vetmedicine

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A few months ago, I posted about my newly adopted dog Shadow.

I adopted him already knowing he had heartworm disease.

He went through his treatment and has been doing very well.

I wanted to share about his follow up appointment with cardiologist Dr. Prosek @floridavetcardiology and once again make awareness on heartworm disease.

Do not forget to put your dog on heartworm prevention.

#heartwormsurvivor #heartwormprevention #heartwormdisease #pleaseadopt #vetcardiology #vetmedicine

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On this day of thanksgiving… I am thankful for my family, my friends, an amazing work team and a career that brings me so much fulfillment.

A special thanks to my IG followers whose support of my posts and the value they see in those posts keeps me going on this platform. Happy thanksgiving to all 🧡🧡🧡🧡

#thanksgiving #thanksgiving2023 #thankful #lovemyfamily #lovemyjob #petdermatology #vetdermatology #dermatologiaveterinaria #vetmedicine

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It is time to let the cat out of the bag. Lol. And show you what’s been keeping me so busy.

It is with excitement and in all honesty a lot of nervousness that I share this news with all my IG followers - my new dermatology clinic is scheduled to open January of 2024.

#vetclinicmiami #miamiveterinarian #miamivet #businesswoman #businessowner #vetdermatology #petdermatology

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There is no doubt that coming to see a dermatologist can be expensive for a pet owner. Depending on the severity and chronicity of the skin and/or ear problem the number of diagnostics needed to figure out what is causing the patient’s dermatological issues can be costly for pet owners. I am fully aware that pet owners have spent a lot with their primary vet already. And even though I do my best to work with a client’s financial means, it does help when I can do all the diagnostics necessary for the patient, we get to the bottom of things much faster.

#getpetinsurance #vetdermatology #petdermatology #petinsurance #dermatologiaveterinaria #petowner #petownersofinstagram #vetmedicine #dancingboy

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There are conditions other than allergies that can cause skin problems.

Cushing’s disease is an endocrine or hormonal disorder that can make a dog prone to recurrent bacterial skin infections. These patients are not typically itchy to begin with but can become itchy if the infection gets extensive. A typical scenario is you treat the pyoderma, but shortly after antibiotics are finished the infection comes back. Cushing’s is a condition where the adrenal glands produce too much cortisol. Common signs seen with Cushing’s are excessive drinking, urination, appetite, and panting. This is a condition common in middle age to older dogs, particularly small breeds like Poodles, Dachshunds, Yorkie, and Maltese. Common medium to large dog breeds are Beagles, Cocker spaniels and Boxers. Besides recurrent skin infection, other dermatological signs of Cushing’s are thinning of the skin, comedones (blackheads), symmetrical hair loss or thinning of the coat over the trunk.

Another dermatological sign to watch out for in Cushing’s dogs is calcinosis cutis. This is a rare condition where the skin calcifies. The calcium deposits formed in the skin cause a lot of inflammation that will often lead to secondary bacterial infections. In my experience the skin infection is deep. The video shows a dog with this condition. It has taken weeks of antibiotics, medicated baths and a product called DMSO to dissolve the calcium in the skin. This patient still has a long way to go to be fully resolved of its calcinosis cutis condition. It is important for the Cushing’s to be properly controlled so that the calcinosis cutis condition does not continue to occur on the skin. This is a very frustrating condition to manage, which can leave a dog’s skin scarred.

#cushingsdisease #calcinosiscutis #deepskininfection #notallergies #petdermatology #vetdermatology #dermatologiaveterinaria #vetmedicine #learnoninstagram #poodlesofinstagram #dachshundsofinstagram #yorkiesofinstagram #malteseofinstagram

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The pustular/papular lesions on this dog are due to an autoimmune skin condition called pemphigus foliaceus. I can see how these lesions could confuse a veterinarian to think this is a pyoderma.

Cytology of the lesions may show bacteria if there is a secondary bacterial infection. However, treatment with antibiotics does not completely resolve the lesions as you would expect in a pyoderma case. Cytology may show acantholytic cells, which are round, darkly staining nucleated keratinocytes, but these cells do not always have to be present in pemphigus. And, if you are not comfortable with cytology you may miss the acantholytic cells.

If you find yourself with a case like this consider a culture of the lesions to rule out a resistant bacteria, make sure your are not dealing with demodex mites or dermatophyte which can present clinically as pustule or papules, and if that’s been ruled out then biopsy. The best diagnostic to definitively diagnose pemphigus is a biopsy.

I have two cases in the last few months of dogs being treated for a pyoderma that was just not going away. Patients were treated with allergy medications, but they were still not improving. Cultures of the skin did not grow resistant bacteria. So why were there still lesions on these dogs? It’s because both had autoimmune skin disease, pemphigus foliaceus.

#papule #pustulesontheskin #pemphigusfoliaceus #autoimmuneskindisease #notallergies #vetdermatology #petdermatology #dermatologiaveterinaria #vetmedicine #thinkingoutsidethebox

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It is November, and in many cities across the United States the cool fall weather abounds. In Miami, Florida, November means warm (not blistering hot) weather with a slight breeze here and there. So, what fun to have these new Caribbean Blue scrubs from @FableticScrubs to enjoy the season in South Florida. This time I got a different scrub top than what I normally wear, and I love the style.

Another peek into my workday… another day of dogs bigger than me! Yikes, it is great that I have #scrubsthatmove.

Happy November!

Thank you to my vet tech, Kim and Kathy for helping with these videos.
And tell me this is not one of the best eighties songs ever! LOL.

#FableticsPartner #FableticsScrubs #workday #vetscrubs #petdermatology #vetdermatology #myworklife #vetmedicine #veterinarymedicine #dermatologiaveterinaria #ilovethissong

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Sometimes it looks like a yeast infection, but cytology says otherwise.

These are two cases that when I was examining the pet I thought there had to be yeast on the skin. However, cytology showed only numerous cocci! In the Westie, the cocci ended up being a methicillin resistant staph infection. I cultured this Westie’s skin because his medical records showed several antibiotics had been prescribed over a period of a year that were not working to clear up the skin infection. The second case, a Labrador Retriever, had no recent history of antibiotic use and therefore I did not see the need for a skin culture at this time.

You hear us dermatologists say it so many times: cytology, cytology, cytology. Do not underestimate the value of cytology. Taking it a step further, if you are treating a skin infection with the appropriate antibiotic and the infection is not resolving, then it is time for skin culture.

#skincytology #bacterialskininfection #westie #westiesofinstagram #labradorretriever #petdermatology #vetdermatology #dermatologiaveterinaria #vetmedicine #veterinarymedicine

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I was about 9-10 years old when I started thinking about veterinary medicine as a career. My teacher, Mr. Levine (yes! I remember his name) asked us to write an essay about “What we wanted to be when we grew up?”  I recall going to the library (no internet back then) and looking up different careers that involve animals. I was especially focused on a career where I could spend my entire life with animals, a career that would give me the skills to make a sick pet feel better, because I just couldn’t stand seeing a sick animal. Well, it was a no brainer- veterinary medicine was it and that is what I wrote my essay on. From that point, I stayed focused and made sure I did everything right to get into vet school. I told this story to kids today on Career Day at my daughter’s school. My nurse, Kim, and I had a great time talking to kids in first grade and third grade about what it is like to be a veterinarian, the different aspects of this profession and just some cool facts about dogs. We brought neat giveaways.  And the best part of it all was having Rosie so that we could show the kids how a physical exam is done on a dog.  Having the kids auscultate a dog’s heart was a hit.
So here I am 40 years later from when I first started thinking about vet med and now talking to kids about vet med. Wow! Full circle moment!  I hope I inspired some kids to consider this profession.

#careerday #careerdayatschool #dfefalcons #vetmedicine #medicinaveterinaria #vetdermatology #petdermatology #inspiringkids

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I don’t know about you, but my last three days have been non-stop days of back-to-back appointments.  September and October are just bad allergy months for South Florida, and it appears to be extending into November.  To join us in our crazy week, we had Dr. Rocio Leal from El Salvador doing an externship with us. Rocio had messaged me back during COVID of her interest in veterinary dermatology and wanting to spend some time with our team. Since the COVID restrictions are over we were happy to see it worked out for her to join us these past few days. Dr. Leal is the first in her country to be practicing veterinary dermatology.  Imagine that!

I like to share when veterinarians come and do externships with us. I know they are taking time away from their family and job to come learn and I feel honored that they chose my team! I also know there is a financial expense in coming to this country, so there is no charge for these externships.  For me and my team it is goodwill to share what we know so that more pets can be helped across the world.

If you are interested in an externship, please DM me.  If you come in a week like we had these last few days, you have got to be ready to move fast and write notes fast, but I think you will learn a lot.

#vetexternship #pasantias #vetdermatology #petdermatology #dermatologiaveterinaria #vetmedicine #busyworkweek #elsalvador🇸🇻 #elsalvador

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When a dog is itchy due to allergies, we often think of the paws or trunk becoming affected by the trauma from the pruritus. But, in some dogs with allergies, whether it is flea, food or environmental allergies, the tail area can become involved. Some of these dogs will chew on the tail or if they cannot reach the tail, they will scoot or drag their rear ends. The trauma from the itchiness then leads to secondary bacterial infections. The infection and trauma from the pruritus can also cause the hair to fall off and leave the tail not looking so nice anymore.

Another common tail problem I see in dogs is hair loss because of how they sit on their tail. In these patients, the tail becomes a pressure point area and loses hair. Some dogs with docked tails have an area of hair loss on the stump that will never regrow hair either.

Dogs with non-pruritic hair loss on their tail should be checked for hypothyroidism, as this is one of the first area they will begin to lose hair leading to a “rat-tail” appearance.

This reel is of two allergic dogs. The first case is of an English Bulldog with a significant Staphylococcal pseudintermedius infection, the second patient is a Cocker Spaniel with a MRSP infection (methicillin resistant staph pseudintermedius). The Cocker’s tail has become lichenified from the chronicity of the infection. Both these cases are being treated with antibiotics based on culture.

#dogtails #dogskininfections #dogallergies #uglytails #dogallergies #petdermatology #vetdermatology #dermatologiaveterinaria #vetmedicine #petsofinstagram #englishbulldog #cockerspaniel #petownersofinstagram

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A repost of this video from 2 years ago.

Nothing like creepy crawlers inside a cat’s ear to wig you out this Halloween day.

Enjoy the day!

#happyhalloween #halloween2023 #happyhalloween🎃 #earmites #catears #videootoscopy #vetdermatology #petdermatology #dermatologiaveterinaria #vetmedicine

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Environmental allergies in dogs and cats are lifelong. This allergy like all allergies cannot be cured. Environmental allergies are managed or controlled with lifelong allergy medications. For dogs with this allergy, many benefit from frequent medicated baths. Baths remove allergens from their skin before the skin absorbs it and causes itchiness. Baths remove microorganisms, like bacteria and yeast, before it starts causing infection which then often leads to more itchiness. Baths hydrate the skin, cool down the skin and just make the dog feel less itchy for a few days. Dogs with environmental allergies need constant care to keep their allergies controlled. Some dogs are on immunotherapy, some need ear care to keep ear infections away, most need flea prevention because a flea bite can exacerbate an atopic dog’s itchiness. This maintenance care is important and it is the reason why a dog will stay stable; it is a care that is necessary for the life of the pet. Stopping this maintenance care will often lead to relapse of symptoms.

If a pet has seasonal allergies, then stopping the allergy treatment on the off season makes sense. But the allergy therapy plan will need to restart right before the allergy season starts up again.

Before stopping or changing any allergy treatment, discuss it with your veterinarian first.

#dogswithallergies #catallergies #allergymedications #atopy #petdermatology #vetdermatology #dermatologiaveterinaria #vetmedicine #petowners #petownersofinstagram

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Just a glimpse of my workday. Sometimes it feels like it goes this fast… and it’s always busy.
I am not sure about most vets, but I like to examine my medium to big dog patient on the floor. So, it helps that I have #scrubsthatmove. Putting these dogs on a table or even a lift table just does not work for me. I get down to their level. I think it makes the pet feel more comfortable.

How do you examine your big dog patients?

I do want to give a shout out to @fableticsscrubs for these hibiscus scrubs that I have on. I get so many compliments. Really love this color on me!

#myworkday #fableticspartner #fableticsscrubs #petdermatology #vetdermatology #dermatologiaveterinaria #vetmedicine #workclothes #scrubs

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Talking to a client about TECA surgery is one of the saddest things I have to do. They come to me with hopes that I will fix their dog’s ear infection and when I tell them I can’t and that their dog needs TECA surgery I feel awful. But I must advocate for the patient and as noted in this video I focus on explaining how painful ear disease is. I discuss about the financial burden of constant ear meds and vet visits and how it will all finally end with surgery. Many clients are also suffering themselves seeing their dog’s ear not getting better. I tell them they will no longer have to fight with their pet to get ear meds into them.

Once surgery is done their dog will get relief and live the best life they deserve- pain free.

Now it is because of these difficult conversations that I have been so empowered to talk about ear disease in dogs here on social media. TECA surgeries for chronic ear infections are avoidable. We can do a lot before the ear gets to a point of needing surgery!!!

#dogears #dogearinfections #TECAsurgery #petdermatology #vetdermatology #dermatologiaveterinaria #vetmedicine #petlovers #petowner #petsofinstagram #fabletics #fableticspartner #fableticsscrubs #scrubsmadetomove

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When is total ear canal ablation surgery indicated?

When an ear infection is impossible to resolve. I have had a handful of cases with resistant Pseudomonas infections that despite various oral and topical treatments and repeated ear flushes and middle ear flushes that were hopeless to resolve, and unfortunately were referred for ear canal surgery.

When the ear canal has proliferative changes that have scarred and narrowed the ear canal not allowing proper ear treatment and perpetuating the infection. The ear canal does not yet have to be mineralized to have significant chronic changes that are only causing pain and discomfort for the patient. Before I even consider surgery on these ears, I give them a chance with strong anti-inflammatories like oral and topical steroids. If steroids cannot open the ear canals, then it is not a good sign.

When the ear canal is calcified. When an ear canal reaches a point of calcification it is called an end stage ear. The insult of infection in the ear canal over months to years can cause the ear canal to calcify. When an ear reaches calcification, it is at a point of no return. These ears are so stenotic that treatment is impossible.

When there is a mass effect in the ear canal. This mass effect can be a tumor or polyp. These growths can sometimes be “plucked out” via video otoscopy but some growths cannot as they are too attached to the wall of the ear canal or middle ear. Even growths that can be removed via video otoscopy may still regrow and continue to block the ear and cause problems.

I hope this makes you feel comfortable making the decision to recommend ear canal surgery. If in doubt, refer the case to a dermatologist for a second opinion.

#dogearinfections #otitisindogs #earinfections #TECA #vetdermatology #petdermatology #vetderm #dermatologiaveterinaria #vetmedicine #vetmed #petownersofinstagram #petowners

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Ear infections are not caused by bacteria and/ or yeast. Infections like these are a secondary component to the ear problem.

The most common cause of ear infections is an allergy to either food or environmental allergens.

At this point I am probably speaking to the choir but there is a lack of understanding that it is not normal for a dog to get recurrent ear infections. If you look in the medical record and see that Fluffy is at your office for its 4th ear infection that year then there is a problem.

I might let one or maybe 2 ear infection slide by but once there is 3 or 4 or more then it’s important to start investigating for the underlying cause of that ear infection.

Allowing an ear infection to reoccur because the underlying cause is not addressed can lead to chronic changes to the ear canal that may be irreversible. This can happen very quickly in brachycephalic breeds and cocker spaniels.

Pet owners need to heed their veterinarian’s recommendations when it comes to ears. Ignoring the allergy work up or the follow up appointments may lead to serious consequences for your pet’s ear(s).

Do not let another ear infection go by without addressing the underlying cause.

Let’s do better for these dogs with ear infections.

#dogearinfections #otitisexterna #vetdermatology #petdermatology #vetmedicine #dermatologiaveterinaria #petowners #petownersofinstagram #dogearproblems #videootoscopy

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Synotic is one of my favorite products to use in ears that are stenotic. I will often combine it with a systemic steroid in severe cases, but in dogs that I may want to avoid systemic steroids then I will use it alone. This drug is my go-to for ears that are so closed that I can barely get my otoscope past the entrance of the ear canal.

Synotic has a steroid, fluocinolone acetonide at 0.01%. The steroid is combined with DMSO that helps the absorption of the steroid through the ear canal. This combination of ingredients is why it works so great in those stenotic ears. I have been surprised how it can quickly open some severely swollen ears.

I have even used Synotic on localized interdigital cysts to help reduce inflammation.

Is this your first-time hearing about this medication? If you haven’t used this medication, consider it as an option for your patients with very inflamed ears.

#earmedicationfordogs #otitisindogs #dogearinfections #otitisexterna #vetdermatology #petdermatology #vetmedicine #dermatologiaveterinaria #vetpharmaceutical #vetdrugs

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Here is how we stain our ear cytology slides.

I like to heat fix the slide, but I know veterinarians that skip this step. The heat “fixes” or makes the organisms stick to the slide so that it does not wash off with the staining. After the slide is heat fixed, I like cleaning the heat fixed side so that the burnt part does not dissolve off into my stain bottles. I use diff quik stain for all my cytologies. The slide is dunked into the fixative for 30 seconds, then dunked into the red stain for 30 seconds and then the blue stain for 1 minute. The slide is then rinsed and dried gently. When drying, careful not to remove the stained ear debris. You are now ready to read the ear cytology slide via microscope under oil immersion power.

I am sure there are many ways to do this and still get good results. Let me know how you do your ear cytology slides.

#earcytology #earinfectionsinpets #thisishowwedoit #learnoninstagram #vettech #vettechnician #vettechlife #vetdermatology #petdermatology #vetmedicine #veterinarian

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I posted this message two years ago, I thought it was worth repeating again …

There are so many reasons to honor veterinary technicians this week, but one reason that stands out for me is how much they have taught me in my veterinary career path… taught me skills that I now take for granted.

Before I entered vet school, I worked as a vet tech in a small animal clinic. It was another vet tech that taught me how to draw blood, how to put an IV catheter, how to read a fecal test, how to get a TPR on a pet, how to administer meds to a pet, how to do an x-ray and the list goes on and on. I had a wealth of knowledge before starting vet school all thanks to technicians that took me under their wing.

During vet school, it was a vet derm tech that taught me how to do a good skin scrape and how to prep and read a skin and ear cytology.

After I finished vet school, I went into private practice before doing a derm residency. It was a veterinary technician with over a decade of vet surgical experience that was by my side during my first solo spays and neuters. If it was not for her, I am not sure how I would have made it through surgery days. I can still recall my first foreign body removal and the incredible confidence this technician had in me… she boosted my ego.

I am grateful to veterinary technicians for the impact they have made in my career and for being one of the best cheerleaders when I needed them most. Now in the present I appreciate all their hard work with our patients and carrying on the mission of the practice: to dedicate time to the client and pets and provide the highest level of medical care. My techs ROCK! ❤️

Happy Veterinarian Technician Week!

#vettechweek #vettech #vet #vettechlife #vetmed #vetdermatology

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Pet owners can often confuse ear cytology with an ear culture. They are not the same thing.

It is important to perform ear cytology on all pets that have an ear infection. The ear cytology tells us what type of infection is in the ear, whether it is a bacterial or a yeast infection. This will help guide the treatment plan.

An ear cytology will NOT tell us what species or type of bacteria or yeast is in the ear. However, we know that for most simple ear infections in a dog, cocci shaped bacteria seen on cytology are typically Staphylococcus pseudintermedius and the yeast seen is due to Malassezia pachydermatis.

If the ear infection is chronic and not resolved despite proper topical ear treatment or if there are rod shaped bacteria on ear cytology, then an ear culture if often necessary. Ear cultures are done to determine what type of bacteria is in the ear. Fungal ear cultures are rarely if ever done. Most yeast ear infections can resolve easily with antifungal ear topicals and do not require cultures.

Performing an ear culture may look to a pet owner like an ear cytology, but it is different in that the discharge taken from the ear is put into a culture tube and sent out to a lab. The lab will then grow the sample from the ear and let the veterinarian know what species of bacteria is causing the ear infection. Knowing the bacteria, especially if dealing with resistant bacterium like Pseudomonas, will help decide the treatment plan for that patient.

When do I perform an ear culture? I will do an ear culture if I see rods on cytology or my treatment plan for an ear infection is just not working.

#dogearinfections #otitisexterna #earcytology #earculture #petowners #petownersofinstagram #petdermatology #vetdermatology #vetmedicine #dermatologiaveterinaria #vettech #vettechsofinstagram

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This is my silly post to talk about ear exams and what to look for when examining an ear. It helps to use descriptive terms of what you are seeing in the ear rather than just writing otitis or ear infection on medical records. 

The three things that I advise should be noted are: what the ear canal looks like, the type of discharge in the ear and if the eardrum is present or not.  The ear canal may be inflamed of varying degrees to the point of being stenotic or closed. Make sure there is no growth, like a tumor or polyp, blocking the ear canal. This is not something you want to miss. The discharge may be ceruminous (waxy) or purulent (pus), sometimes I will note the color of the discharge and how much discharge is present. The eardrum can be difficult to see if the ear canal is very inflamed, if this is the case then make a note of it. If the eardrum is present, it is important to note if it’s intact and normal (translucent). Or does the eardrum appear opaque or cloudy to make one worry about discharge behind the eardrum in the middle ear. 

It is important to take note of the ear exam findings in the medical records so that when another associate or even you follow up on the case you have something to compare to.  Don’t be afraid of doing ear exams!

#dogearexams #dogearinfections #otoscope #otitis #medicalrecords #vetdermatology #petdermatology #dermatologiaveterinaria #vetmedicine #vetmed #videootoscopy

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As a dermatologist, skin cytology is one of my main diagnostic tools to help me see if infection is causing a pet’s itchiness. Just like a dog that is vomiting would get blood work and an X-ray done to find the cause of the vomiting, a dog that is itchy, with or without skin lesions, should have skin cytology performed. It can provide a lot of information. Even a negative cytology is valuable information .

Remember this from vet school: You miss more for not looking than not knowing.

#skincytology #vetdermatology #petdermatology #dermatologiaveterinaria #vetmedicine #vettech #vettechlife #vettechstudent #petownersofinstagram

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There are many different methods on how to perform a skin cytology.

Using tape cytology is how I learned to do cytologies during my residency and it is what I am comfortable with. I think the tape method works great for tricky spots like the spaces in between the toes and even the nailbeds.

Here I am using the tape method on a paw. The rest of the video shows how the tape is looped to the slide and then stained.

Multi-scotch tape is the best.

I like diff quik stain. I will do a quick dip in the fixative, but this step can be skipped. I then do 5-10 dips on the other stains or it can sit in the stain for 30 seconds to a minute. Rinse the slide, then stick the tape to the slide and you are set. The tape fogs up if you do not look at it under the microscope immediately.

Find a method that you feel comfortable doing. The important thing is to be doing cytology on all your dermatology cases.

#thisishowwedoit #ourway #learnoninstagram #tapecytology #usesofscotchtape #scotchtape #vetdermatology #petdermatology #vetmedicine #dermatologiaveterinaria #vettech #vettechstudent #vettechsofinstagram

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Otitis or ear infection in cats is not common. When there is otitis in a cat it is important to rule out common primary causes like ear polyps (usually a unilateral problem) and ear mites like Otodectes. Not commonly thought of is demodex mites in the ear or otodemodicosis. A pet owner brought her cat to our practice a few weeks ago to have its itchy ears evaluated. The owner’s concern was that her cat’s ears also had a lot of waxy debris. The waxy debris was sampled into an ear smear with mineral oil and evaluated under microscope. To our team’s surprise, demodex mites were observed. Our whole team was so excited at this rare find. You can see the mites in the video, they are a long cigar shaped organism. We treated this cat with a topical isoxazoline. We will follow up in a few weeks with another ear smear and see if the ears are less itchy.

Demodex cati mites should be a differential to consider for a cat with itchy waxy ears.

#catearmites #earproblemincats #otitisincats #catshaveearproblems #catsofinstagram #catownersofinstagram #vetdermatology #petdermatology #dermatologiaveterinaria #vetmedicine

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I previously posted that allergy medications, like Apoquel, Cytopoint or Atopica can be used long term to control the allergy signs of a dog with environmental allergies or atopy. Another therapy option for this allergy is allergy vaccines or immunotherapy. I highly recommend allergy vaccines because it can potentially lower your pet’s allergy signs, potentially allow your pet to use less allergy medication in the future and halt the progression of the allergy. Allergy vaccines are made from the results of allergy testing.

Allergy testing, whether through intradermal skin testing or blood allergy testing, should only be done once a pet has been diagnosed with environmental allergies. The point of the test is to narrow down what in the environment (i.e., pollen from trees, grass, weeds, mold, dust mites) is making the pet allergic so that an allergy vaccine can be formulated for desensitization. Allergy testing is not a test for diagnosis but for therapy or management of the environmental allergy.

The process of allergy vaccine desensitization can take a year or two to start seeing results. The improvement of a pet’s allergies can range from 50-70%. It is not a cure. The pet, especially those with more moderate to severe allergies, may still need to remain on allergy medications along with the allergy vaccine. The combination of both will usually keep the pet more stable.

Allergy testing should be done early in the atopic disease process. It is easier to desensitize a pet with mild symptoms and at a young age, then to wait until the allergy has become chronic and the pet is older.

As the years go by, most atopic pets get worse. Allergy vaccines can help prevent the allergy symptoms from worsening. It can potentially halt the progression of the allergy.

I do not think we are allergy testing atopic pets early enough. If you have an atopic pet, talk to your veterinarian about allergy testing or consider seeing a dermatologist. Dermatologist have experience on managing immunotherapy for these allergic patients.

#petallergies #atopicdogs #petdermatology #allergyskintesting #vetdermatology #dermatologiaveterinaria #vetmedicine #petownersofinstagram

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How do we diagnose environmental allergies or atopy in pets? Atopy is diagnosed through exclusion of other itchy conditions as well as taking into consideration the pet’s medical history and exam findings. This is important to understand because there are other allergies that affect dogs, like flea allergy, food allergy and much less commonly contact allergy. All these allergies are controllable. Flea allergic dogs need flea prevention FOR LIFE. Food allergic dogs need to stop eating the food ingredient that is making them itchy and once you do that, they will be perfectly fine. Environmental allergies is not easy to control, because we cannot control the allergens in the atmosphere. Therefore, there is justification for using allergy medications, like Apoquel, Cytopoint or Atopica, long term if a pet has an allergy like atopy.

For pets whose allergy symptoms are seasonal, meaning the pet has skin problems and is itchy only during certain times of the year and the rest of the year it has no symptoms, then this automatically is seasonal (pollen) allergies. Nothing hard here to diagnose.

The thing is that many dogs and cats with environmental allergies are not seasonal, they have year-round skin problems and there are other conditions that can occur year-round that should be ruled out. Therefore, the diagnosis of environmental allergy is through exclusion of other itchy conditions.

There is also NO test to diagnose environmental allergies. Allergy skin tests or blood allergy tests are done to narrow down what in the environment is making the pet itchy to formulate an allergy vaccine for desensitization.

Atopy is a diagnosis of exclusion: It’s a hard concept to understand and I hoped this post helped.

#dogallergies #atopy #atopyindogs #environmentalallergies #petdermatology #vetdermatology #petowners #dermatologiaveterinaria #vetmedicine

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The management of environmental allergies or atopy is better now than it was 10-20 years ago. We know more about the disease and we have more medication options like Apoquel, Cytopoint and Atopica, where in the past we only had steroids.

I know there are pet owners reluctant to put their dogs on allergy medications long term for fear of side effects they read on Google, but these medications are in general safe to use when monitored closely by a veterinarian. They can keep a dog relatively itch free and allow it to live a comfortable life.

Once I have diagnosed a dog with environmental allergies my conversation starts with talking about these three allergy medications. Everyone knows about Apoquel and Cytopoint, the new kids on the block. Atopica has fallen out of use, but it is a formidable option when a dog does not respond to the other two. The client and I chose the best one for their pet. I monitor these patients every few months at the start of the medication and once stable those visits get extended out. These are not drugs that should be prescribed without follow up visits.

Are there some environmental allergic dogs that do not need these types of drugs? Yes. But usually these are mild cases. And it is possible for mild cases to be managed with supplements and topicals alone. But, most moderate to severe cases of atopy need allergy medications for life. We want to prevent the dog from scratching, licking, and chewing itself so much that it then creates an infection on its skin which then causes more itchiness.

It is worse to constantly be putting a dog on antibiotics for secondary infection from an allergy that is not well controlled, than to place that dog on lifelong allergy drugs.

No shame should be brought upon pet owners who chose these drugs to manage their dog’s allergies. Atopy is forever and we now have medications that can make a difference in the lives of the pet and their owners.

If you have an atopic dog, please speak to your veterinarian about these medications.

#dogallergies #atopicdogs #apoquel #cytopoint #atopica #petowners #petdermatology #vetdermatology #dermatologiaveterinaria #vetmedicine

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The number of yeast organisms seen in cytology should not guide the treatment of a Malassezia skin infection. One can be tempted to use only topical therapy if there is a few yeast on cytology, but those few yeasts on a particular patient may be enough to cause a significant amount of itchiness.

My recommendation is to take into consideration the pet’s level of itchiness and the extent and severity of the infection to make your decision on how to treat the yeast infection. Systemic antifungals in combination with a topical antifungal will make the patient feel relief much faster.

Systemic antifungals to consider using are the azole drugs like ketoconazole, itraconazole and fluconazole. Terbinafine is another option as well. Antifungal ingredients to look for in topicals are miconazole, ketoconazole, climbazole, clotrimazole and selenium sulfide. Selenium sulfide is found in Selsun Blue shampoo, but caution that this ingredient can also be drying to the skin. Chlorhexidine also has antifungal properties, but this works best at greater than 2% for Malassezia.

Topical antifungals come in a variety of forms: shampoos, leave ons, sprays, mousses, wipes, and creams/ointments. My preference for topical treatment of Malassezia is using shampoos. Malassezia is an organism that is superficial on the skin and bathing a dog with a shampoo that has antifungal ingredient will help remove the infection better.

And finally, it is important to control or resolve the underlying cause for the yeast infection. Allergies to food or environmental (atopy) are the main causes. However, endocrine, or hormonal disorders like hypothyroidism is another. If the underlying cause is not addressed, then there will be a reoccurrence of the Malassezia infection.

#yeastskininfection #malassezia #dogallergies #petallergies #petpawinfection #dogpaws #vetdermatology #petdermatology #dermatologiaveterinaria #vetmedicine #petownersofinstagram

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When a dog has a yeast skin infection, like the dog in this video, where does that yeast come from?

Malassezia pachydermatis is the species of yeast found in dog skin. It may surprise some pet owners that this yeast species is a NORMAL part of a dog’s skin, but it exists in low numbers. There is a big myth that when there is a yeast infection on the skin it is due to the food the pet is eating, and this is false. The yeast also does not come from the outside environment. Malassezia is a commensal or normal inhabitant of dog skin.

When the microenvironment of the skin becomes abnormal the yeast organisms can grow in more numbers than there should be, and it then can become pathogenic. More numbers of yeast on the skin causes the skin to be itchy and irritated. What changes in the skin must happen to allow yeast to grow: changes in the skin pH, increase lipid (or oily) content to the skin, increased humidity (think moisture from licking) and breakdown of the skin barrier (trauma from licking or chewing).

Malassezia is always secondary to an underlying cause, the most common is food allergy or environmental allergies. These allergies cause the dog to be itchy, there is then trauma to the skin and you can see how that can cause a secondary yeast infection to develop.

#malassezia #yeastskininfection #dogpaws #pawitchiness #pawyeastinfection #petallergies #petdermatology #vetdermatology #dermatologiaveterinaria

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