🐾 When doing a derm exam on a pet with itchy paws, take some time to look in between each digit of the dog’s paws.  The webbing of the paw will often become infected from the trauma of licking or chewing.  There is often bacteria and/or Malassezia (yeast) seen on cytology of these areas. 🐾

#dogpaws #miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedicine #veterinarians #prevet #vetschool #vettech #medicinaveterinaria #petdermatologist
Greetings from Seattle! #navdf2023 is on it’s way and we can’t wait to see you all there! For more information about the conference, visit www.navdf2023.com!
#veterinariansofinstagram #veterinarianlife #vetclinic #vetsofinstagram #veterinarystudent #veterinarians #petsofinstagram #veterinaryhospital #veterinarynurse #animalhospital #petcare #doglovers #veterinarysurgery #vetsurgeon
I post a lot on dog ear problems, but cats can also get ear infections. 

Ear infections in cats are not common.  When present it is important to look for primary causes like ear mites or mass effects like polyps and tumors, the latter two would cause unilateral ear problem. 

This video is of a 10 year old FS cat who presented for significant pruritus of the ears and bilateral otitis. Therapies the referring vet had tried were not working and she was referred for evaluation of polyp in the ear.  I used video otoscopy to show the owner that this was not a simple polyp problem, the disease was much more extensive.  The ear canal of both ears was obliterated by these nodular growths which may possibly be ceruminous cystomatosis.  These growths have occluded the ear canal and led to secondary bacterial infection.  The ear infection is not resolving because of these growths. The growths can be removed through CO2 laser or surgical removal of the ear canal may be necessary in extreme cases like this cat. 

#catsofinstagram #cats #catears #videootoscopy #miamivetderm #gotitchypet #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedicine #veterinarians #prevet #vetschool #vettech #medicinaveterinaria #petdermatologist
I have had my share of clients that originally brought in their pet for a skin problem and unbeknownst to them there was also a concurrent ear infection. Their dogs were not showing signs of an ear infection like odor, discharge or redness that would be obvious from looking at the ear externally. 

When questioned more and looking back, many did remember head shaking or pawing at the ear which they just attributed to the overall itchiness the pet was experiencing.  However, some clients didn’t see any of the signs listed above.  I believe it’s possible for some dogs to just not show any signs especially if the infection is mild.  Some dogs are just so happy go lucky that I think nothing phases them.  With that said I want to emphasize to veterinarians the importance of doing an otoscopic ear exam on all patients, especially the ones that are coming in to see you for a skin problem.  The ear is an extension of the skin.  Allergies like to affect the ear.  You may be surprised to find how many have an ear infection that the client did not notice or the dog was not showing signs of. 

For pet owners, routine annual or biannual exams with your veterinarian are important to catch things, like an ear infection, that may not have been obvious to you. 

#preventativemedicine #dogearinfections #miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedicine #veterinarians #prevet #vetschool #vettech #medicinaveterinaria #petdermatologist
#NAVDF2023 is right around the corner! Join me May 9 – 12 in Seattle, Washington for a week of valuable veterinary dermatology education and networking! Learn more or register at www.navdf2023.com!
#vetmed #veterinarymedicine #veterinarian #veterinarians #vetlife #animal #animals #animalhealth
These are two young French bulldogs with different severities to their skin infections.

Whether mild or severe, infections on the skin contribute to the itchiness a pet may be experiencing.  The infection can cause odor to the skin, inflammation, crusts, hair loss and more.

Infections like bacteria and yeast are secondary. This means there is an underlying cause that triggered the infection, and it is important to address it. Common underlying causes could be allergies, endocrine disorders, mites, and many more.

A client may see their pet improve on antibiotics or antifungal medications, but if the primary cause is not addressed the secondary infections will come back. 

Sometimes I tell my clients that the infection on their pet’s skin may be worse than the primary cause.  So much so that once the infection is treated the pet looks and feels so much better that the client thinks the pet is cured. “Don’t disappear on me” I say, because “I promise you, the infection will come back”.

Therefore, if you find yourself treating a dog for skin infections over and over again, it is because you are missing the underlying or primary cause.

#frenchiebulldog #frenchbulldogsofinstagram #dogskincare 
#miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedicine #veterinarians #prevet #vetschool #vettech #medicinaveterinaria #petdermatologist
Early registration for #navdf2023 ENDS this Friday, March 3rd! Don't miss your chance to save on reduced registration fees by registering now! Visit www.navdf2023.com/registration for more information!
#veterinariansofinstagram #veterinarianlife #vetclinic #vetsofinstagram #veterinarystudent #veterinarians #petsofinstagram #veterinaryhospital #veterinarynurse #animalhospital #petcare #doglovers #veterinarysurgery #vetsurgeon
The management of atopy or environmental allergies in pets can be challenging. The management approach is multimodal as there are a variety of therapies that may be necessary to keep a pet comfortable. 

Allergy testing for allergy vaccine desensitization (or immunotherapy) is one of these therapies, and should be considered as an option as soon as the pet, whether dog or cat, has been diagnosed with atopy.

Immunotherapy should not be used as a last resort when other therapies have failed.  By that point the allergy may be so severe and chronic that it may be difficult for vaccines to work. 

Allergy testing and vaccines may be financially difficult for some pet owners.  However, despite this, efforts should still be made to offer and educate pet owners about this option to manage their dog or cat’s atopic disease. 

#allergytesting #immunotherapy #petallergies #miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedicine #veterinarians #prevet #vetschool #vettech #medicinaveterinaria #petdermatologist
The skin consists of three layers: the epidermis (top and outer layer), the dermis (middle layer) and the subcutis (innermost and fatty layer)

A dog’s epidermis has 3-5 cell layers and human epidermis has 10-15 cell layers.

Use of the wrong shampoo 🧴can strip away the epidermis and potentially be irritating 🔥to a dog’s skin and make it susceptible to infections. 

Therefore, it is important to use shampoos made for dogs 🐶 and approved by a veterinarian.  Do not use people shampoos or dish soap to bathe your dog.  

#learnoninstagram #didyouknow #dogskincare #dogshampoo #miamivetderm #gotitchypet #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedicine #veterinarians #prevet #vetschool #vettech #medicinaveterinaria #petdermatologist
Be sure to check out the exciting program for the #NAVDF2023 Conference! To view the program, visit navdf2023.com/program

Join us in the wonderful city of Seattle, Washington May 9th - 12th to connect with experts from around the globe and learn all about the latest veterinary dermatology innovations!

#veterinariansofinstagram #veterinarianlife #vetclinic #vetsofinstagram #veterinarystudent #veterinarians #petsofinstagram 
#veterinaryhospital #veterinarynurse #animalhospital #petcare #doglovers #veterinarysurgery #vetsurgeon #vetstudentlife #pethealth 
#veterinarycare #medvetlife #veterinarios
It always surprises me when I hear pet owners say that it is normal for their dog to just have ear infections… “Oh, it’s just the breed”… or “it’s the floppy ears”… or “my dog swims a lot, so it’s the water”. Almost like they have accepted the fact that this is just what life will be for their dog and they deal with it. 
Or sometimes I hear a pet owner say: “Isn’t it just normal for a dog to scratch?” “Like how much of my dog’s itchiness is just normal dog thing versus allergies?” 
Ear infections and scratching constantly are not normal. I mean if this was happening to us we’d be at our doctor’s office immediately.  So why would it be normal for a dog to live this way?
I have never had an ear infection before, but I hear they are pretty painful.  So, imagine what our pets are going through.  I have mild atopy and when I break out in a rash I am uncomfortable but I know not to scratch my skin raw.  Unfortunately, our pets don’t have the capacity to understand that and if they chew or scratch themselves too much they will cause serious trauma to their skin. 
Therefore, a pet that is constantly with ear infections and scratching is uncomfortable.
If you have a pet that is itchy or with chronic ear infections it is time you see a veterinarian or a vet dermatologist to start getting your pet comfortable. 
#vetdermatology #miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedicine #veterinarians #prevet #vetschool #vettech #medicinaveterinaria #petdermatologist
To pluck or not to pluck … that is the question! 
My recommendation is that a dog with recurrent ear infections that has a significant amount of hair in its ears should have the hair removed routinely. 
It’s not that the hair is causing the ear infection.  Allergies are typically the underlying cause of an ear infection.  It’s that the hair blocks proper treatment of the ear should there be an infection. 
The hair holds the wax and debris. It can make it difficult to clean the ear well. The hair may block the ear medicine from reaching down the ear canal.  It also blocks view of the ear drum. 
For breeds like Poodles and Doodles with environmental allergies and issues with their ears we often advise routine ear hair removal.  The removal should be done gently. Yanking or hard plucking can lead to irritation of the ear canal.
#standardpoodle #doodle #poodlesofinstagram #dogearinfections 
#miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedicine #veterinarians #prevet #vetschool #vettech #medicinaveterinaria #petdermatologist
Another year, another brilliant #navdf2023 

Join us in the wonderful city of Seattle, Washington May 9th - 12th to connect with veterinary dermatologists, general practitioners, residents, students and techs!

To register, visit navdf2023.com/registration

#vetmed #veterinarymedicine #veterinarian #veterinarians #vetlife #animal #animals #animalhealth
Yes, I said it… don’t half a$$ the work up of an otitis case by not doing an ear cytology. 
I know cytology can be difficult to perform in a dog with painful ears. Here are a few things you can do: Sedate it, examine it and take the cytology sample. Or send the dog with pain meds and/or steroids and have the pet come back for a cytology. 
Feel uncomfortable reading an ear cytology? Then send it out to a lab to be read.
Have you gotten some clients used to just picking up a refill of ear meds without an exam and cytology? It is time to change that protocol. Do not let a client harass you or convince you otherwise.  Don’t have them make you think it’s the same infection as the last time. 
It is time to do things right. Application of ear medicine randomly when the client feels it is necessary can lead to resistant infections. 
 #letsdoitright #otitis #dogearinfections #dogsofinstagram #matthewmcconaughey #miamivetderm #gotitchypet #vetdermatology #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedicine #veterinarians #prevet #vetschool #vettech #medicinaveterinaria #petdermatologist
I posted about this case 3 months ago. It was a dog with severe deep bacterial infection of its paws and several other areas on the body.  Most striking was how the infection affected this dog’s paws to the point that the inflammation did not allow you to see his paw pads anymore. 
I am always amazed at the healing power within our pets. It is incredible that after 3 months of antibiotics, this doggie’s paws are back to normal. 
Key points about this case: 1) I took a biopsy of the paws and submitted the infected tissue for culture, 2) Based antibiotic choice on the culture, 3) Treated for an extended period of time.  Deep bacterial infections require a long course of antibiotics.
Do not lose hope with your stubborn pododermatitis cases.  Happy to see that this patient of ours is pain free.
#beforeandafter #pododermatitis #dogpaws #dogoftheday #miamivetderm #gotitchypet #allergies #vetdermatology #petowner #dermatologiaveterinaria #vet #veterinarymedicine #vetmed #vetmedicine #veterinarians #prevet #vetschool #vettech #medicinaveterinaria #petdermatologist
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
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
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
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
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
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
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
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
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
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