Pseudomonas ear infections are tops in my book for one of the most awful smelling infections. Rancid yeast skin infections are atrocious too. It is incredible what a pet owner will tolerate and I can empathize with their need to get in to see us ASAP to fix their dog’s skin and ear infections.

Anything else stinkier than Pseudomonas and yeast?

 #vethumor #dermpatientssmell #stinkyears #stinkyskin #vetdermatology #petdermatology #vetmedicine #pets #petsofinstagram #mayarudolph #miamivet #miamiveterinarian
Repeated use of the same antibiotic with no resolution to the skin infection should prompt a skin culture.  Empirically changing the antibiotic is another option, but the pet owner must understand that you are making an educated guess that could be wrong.

Avoid antibiotic roulette with your patients! You know what I mean, when one antibiotic does not work, then you try another one, and then if that does not work you try another and so forth.  We think we may be saving our client money by avoiding a culture, but in fact we are making them spend more money with each round of antibiotic and the pet continues to suffer.  If an antibiotic does not work then it is time for a skin culture.

I advise that if you are going to empirically change antibiotics, please avoid a big gun like fluoroquinolone (i.e. enrofloxacin). 

The patient in this video had a methicillin resistant staphylococcal infection, he had already been on cephalosporins and fluoroquinolones before he saw me.

Inspo for this reel @jorgeguzmanmvz

#antibioticresistance #antibioticstewardship #dogskininfections #vetdematology #petdermatology #veterinarydermatology #miamivet #miamiveterinarian #pets #petsofinstagram
Ear infections can happen in dogs with any kind of pinnal shape. A dog with floppy ears, erect ears and even cropped ears can get ear infections. There is a myth that cropping a dog’s ear will prevent it from getting infections. I see many dogs with cropped ears that have ear infections. Cropping a dog’s ear to prevent it from getting infections is just causing unnecessary pain to that dog. Dogs with floppy ears are said to be predisposed to ear infections because moisture is trapped in the ear, but these dogs are also prone to allergies which is typically the main cause of the ear infection. Allergies to food or environmental allergens are the number one reason a dog gets an ear infection. If the allergy is not addressed, the dog will continue to get ear infections.

#dogearinfections #earflaps #croppedears #pets #petsofinstagram #vetdermatology #petdermatology #veterinarydermatology #miamivet #miamiveterinarian
Why was Cytopoint not working for this dog?  Because there was an infection on the skin. 

Infection on the skin makes a dog itchy.  Make sure when you have an allergic dog that is continuously itchy that infection is not playing a role in that itchiness.  Sometimes infection on the skin is obvious because the skin looks inflamed and there are crusts and bumps.  But sometimes the skin may not look too bad and you do cytology and boom… bacteria or yeast or both are present.  Do not ignore the value of a skin cytology in all your patients that are itchy.  Cytology and culture of this dog’s skin showed a Staphylococcal infection. 

#cytopoint #cytology #dogallergies #itchydog #vetdermatology #petdermatology #veterinarydermatology #pet #petowner #petownersofinstagram #miamivet #miamiveterinarian
I had a client the other day tell me that Cytopoint used to last 6 months for her atopic dog and now it only lasts 4 weeks and therefore, she thought it was not working anymore. This comment is something I hear often from clients and there are two points I want to make about it.

First, Cytopoint is an injectable allergy medicine that only lasts 4-8 weeks. Cytopoint does not last 6 months. Second, it was not that Cytopoint was not working anymore for my client’s dog, it was that her dog’s allergies were no longer seasonal with a short period of itchiness, now her dog’s allergies were year-round. I want to make a strong emphasis on the latter point that allergies can start seasonal and for many dogs it can turn into non seasonal. As a dog gets older it can become allergic to more things in the environment turning their seasonal itchiness to year-round itchiness. Therefore, this patient of mine needed Cytopoint monthly now. And there is nothing wrong with giving Cytopoint monthly if it is keeping the dog minimally itchy and comfortable in that month. Atopy is a life long allergy that requires life long symptomatic therapy. 

Is your dog on Cytopoint? What has been your experience with this medication?

#cytopoint #dogallergies #pets #petowners #petownersofinstagram #cytopoint #vetdermatology #veterinarydermatology #vetmedicine #miamivet #miamiveterinarian
Reposting about this product that I still get so many questions about. Hair and saliva allergy testing as seen here by this popular product sold on Amazon is not a reliable way to assess allergies in your pet. The companies that make these tests have no science or research to support their product. 

Studies have shown these tests do not have any reproducibility and could not differentiate between normal and allergic dogs. One study even sent out fake fur and there were positive results!!

These tests should not replace a veterinary visit where a thorough medical history and examination can shed light if there is an allergy causing your pet’s skin problem.

Do not waste your money on these hair and saliva allergy tests. Save your money and go see a veterinarian or vet dermatologist.

If you want to do more reading, here are two studies that disprove the accuracy of hair and saliva allergy testing.

Share this with someone you know that has used these tests on their pet.

Hair and saliva analysis fails to accurately identify atopic dogs or differentiate real and fake samples.
Joseph A. Bernstein and Kathy Tater, Veterinary Dermatology. Jan 24th 2019.

Hair and saliva test fails to identify allergies in dogs. Kim Coyner and Andrea Shick. Journal Small Animal Practice. Feb; 60 (2) 2019. 121-125

#buyerbeware #5strands #dontbuy #itsascam #vetdermatology #petdermatology #vetmedicine #pets #petowner #petownersofinstagram #miamivet #miamiveterinarian
Allergy medications like Apoquel are not miracle drugs.  Apoquel will not cure a pet of its environmental allergies.  It will provide symptomatic relief of the itchiness but it is possible for dogs to have flares on Apoquel or any other allergy medication like Cytopoint and Atopica. 

Every allergic dog has a pollen threshold and if the pollen counts rise above that threshold, it can make the pet so itchy that it overwhelms the allergy medication.

If a dog gets too itchy it will traumatize its skin through excessive licking, chewing, or scratching and likely create a secondary bacterial and/or yeast infection.  Secondary infections can quickly happen in dogs with environmental allergies. The dog in this video has a bacterial infection of its paws.

Once there is infection on the skin, the itchiness will escalate.  Apoquel does not treat infection. Medicated baths and/or systemic antimicrobials are necessary to treat the infection and bring the pet relief. 

Allergy flares will happen on allergy medications, prepare the pet owner for this. 

#allergymedications #dogallergies #dogskinproblem #apoquel #vetdermatology #petdermatology #vetmedicine #pet #petowner #petownersofinstagram #petownerproblems #miamivet #frenchbulldog
Environmental allergies or atopy can make a dog prone to getting ear infections.  The allergy causes inflammation of the ear canal that can then lead to bacterial and/or yeast infections.  After repeated ear infections I find that some dogs just do not have normal ear canals anymore.  A healthy ear canal is smooth, pink and can clean itself by moving wax from deeper in the ear out the ear canal entrance.  This mechanism is lost in unhealthy ears.  Unhealthy ears may still be open ear canals, but the epithelium of the ear canal is thickened and scarred.  These ears do not clean themselves well and debris and wax can accumulate.  In ears that are unhealthy I often advise pet owners to help their dog’s ear by cleaning it routinely. I often recommend weekly to maybe twice weekly cleanings.  My favorite ear cleaner is Epiotic, but there are several others from the Duoxo, Vetoquinol and Dechra product line that are just as good.  Please ask your vet what is the best ear cleaner for your pet. It is important with certain ear cleaners to make sure that the eardrum in your pet is intact before the cleaner is used. 

Maintenance ear cleaning to me is an important part of the allergy therapy regimen in dogs with environmental allergies that present with ear symptoms, most especially those that have already unhealthy ear canals.  We focus a lot on the skin allergy, but forget the ear needs therapy too.

#dogears #dogearinfections #allergiesinpets #dogallergy #vetdermatology #petdermatology #vetmedicine #pets #petowner #petsofinstagram #miamivet #miamiveterinarian
An ear smear is a diagnostic tool I will typically perform in a cat with itchy ears, particularly a cat with ceruminous or waxy debris in its ears or dark coffee ground crusty type of debris. An ear smear will let you know if there are mites, like demodex cati mites or otodectes cynotis mites.  This is a very easy diagnostic to perform in your clinic. Ear mites can now be treated with isoxazoline products. 

#earmites #itchyears #catears #cats #catsofinstagram #catowner #petowner #vetdermatology #petdermatology #vetmedicine #miamivet
It’s World Veterinary Day!!! And I want to remind everyone that the World Congress of Veterinary Dermatology is 3 months away!!! 

Go to the conference website and take a look at the lectures and fun social events that your registration includes. 

Don’t forget about the early bird registration that ends May 31st. 

Any questions send me a DM. 

I hope to see you there!! 

#wcvd10 #wcvd2024 #worldcongress #vetdermatology #detmatologiaveterinaria #vetderm #vetdermatologist #vetmedicine #medicinaveterinaria #vetconference #worldveterinaryday
Maybe it is something about the dermatitis around this dog’s eyes that gives him a sad look, or maybe and more likely it is because he really does feel sad and depressed. If you could see the rest of this dog’s skin and his ears, it would be impossible not to believe that this dog is hurting. Skin and ear problems can make a pet feel miserable. Happy this doggie’s pet parents found us, and we are starting the journey to help heal him.

#dogskinproblems #saddog #germanshepherd #germanshepherdsofinstagram #pets #petownersofinstagram #petowner #vetdermatology #petdermatology #vetmedicine #miamivet
Let us talk about ear flap infections. The ear flap is skin just like any other area of a dog’s body. Dogs with allergies can often have this part of the ear affected by their allergy. The ear flap can get red, hot, scaley and oily.

Sometimes when there is an ear infection the ear flap is affected- like the two dogs in this video. I will do tape cytology of the ear flap and sometimes the infection is the same as inside the ear canal and other times not. Like there could be a bacterial infection in the ear, but the ear flap has yeast.

Do not forget to treat the ear flap because the infection in this area can make a dog very itchy and uncomfortable. I like to use ear medications on the ear flap a few times a week. Or I will have the client clean the ear flap with a medicated ear cleaner a few times a week.

I have also seen dogs with just ear flap infections and no infection inside the ear. This shows how important it is to do an ear exam and ear cytology. No need to put medicine inside an ear that does not need it.

#itchydogears #dogears #dogearinfections #pets #petsofinstagram #petowners #petownersofinstagram #veterinarydermatology #vetdermatology #petdermatology #vetmedicine #miamivet
Take time to look closely at patients that present with dry flaky skin. It is hard to part the hair in these dogs with short coats, but it is important to do so to not miss key information like these bumps.
Flaky skin with bumps often means there is a bacterial infection. Confirm it with skin cytology and/ or skin culture.
This dog needs antibiotics and an antibacterial shampoo. There is also an underlying allergy that needs to be addressed. I often find in these patients that there is a food allergy or environmental allergy problem.
#dogdryskin #dogskinproblem #flakyskin #vetdermatology #petdermatology #vetmedicine #miamivet #petowners #petownersofinstagram #doberman #dobermanpinscher
LOL. Who is with me? I love my job, but some days and some weeks are just simply hard. I will leave it there. TGIF! TGIF! 

#braindrain #introvert #workweek #hardweek #tgif #vetdermatology #petdermatology #vetmedicine #miamivet #miamivetderm
This dog has stretchy skin because she has a syndrome called Ehlers Danlos. 

This is an inherited rare connective tissue disorder caused by a defect in the collagen of the skin. In this disease, the skin can be stretched to extreme lengths. The skin will hang loosely in folds.  Look at this dog’s rear end/thigh area to see how the skin just folds there.  The skin is prone to tearing easily.  A small cut or nick can result in a large gaping hole that requires suturing.  Careful with these pets at the groomers. 

Diagnosis is through a clinical exam and seeing the stretchy skin, no other disease will mimic this.  There is a history of repeated suturing for minor trauma causing large tears in the skin. There is no treatment for this syndrome. 

Pet owners must prevent these dogs from becoming itchy because they can really hurt their skin.  In this patient we wanted to make sure her allergies had not gotten so bad that she would scratch or chew and hurt herself even more.

These pets can live a normal life, but the pet owners must do lifestyle and housing modifications. An assessment must be made of the pet’s home so there are no sharp edges on furniture corners and the pet should always be walked on a leash and avoid areas with pointy brushes. 

Many of these dogs are euthanized due to the extensive care and constant visits to the vet for wound repair. 

Have you seen this syndrome in a dog?

#ehlersdanlos #ehlersdanlossyndrome #ehlersdanlosindogs #stretchyskin #petowner #petownersofinstagram #vetdermatology #petdermatology #vetmedicine #rareskincondition #miamivet
It has been a long time since I have seen this product!  I suspect many of my younger colleagues don’t even know of this cream.  I remember seeing its use when I was a vet tech in the 1990’s. Nu stock has been available for several decades now and its primary use is in large animals, but the bottle states it can be used in dogs and cats. This cream has 73% sulfur, 25% mineral oil and 2% pine oil.  It claims to treat all sorts of skin conditions, even mange, and remove certain growths from the skin.  I am always wary of any product with a big hoof on the front of the bottle to be safe in dogs, let alone cats.  The high percent of sulfur can be extremely drying and irritating on the skin.  Go read the material and safety data sheet and you will see that it can aggravate a pre-existing dermatitis.  I just saw a patient that had this applied to most of its skin lesions, and where I can see how the cream may have helped reduce pruritus because sulfur has that property, I can also see how it could have irritated the skin further. 

Buyer beware of this product, there are safer, less irritating products for dog and cat skin lesions.

Let me know if you have seen this product before. 

 #buyerbeware #oldschoolmedicine #oldschool #vetdermatology #petdermatology #vetmedicine #miamivet #petowners #petownersofinstagram #dogskincream
A quick glimpse of my open house! 

So happy to have family, friends, and colleagues there to support me. 

#openhouse #newvetclinic #vetclinic #vetdermatology #petdermatology #vetmedicine #miamivet #miamivetderm #dermatologiaveterinaria #openhouseparty
Open house is on today! 

Super excited to show off this place! 

I want to thank so many people that helped make this happen, from my family, friends, team members, my manager, colleague advisors, financial advisors, business advisors, banking advisors at Provide and Fifth Third, my realtor at Carr Realty, lawyers up the wazoo, and lastly my construction team, Davie Construction Co. whom I’d highly recommend if you are thinking of building a vet clinic from the ground up. 

#openhouse #vetclinic #newvetclinic #miamivet #vetdermatology #petdermatology #vetmedicine #vettech #veterinarian
Lichenification is the medical term given when the skin becomes thickened with a leathery appearance. It looks like elephant skin. Seen with this skin change is darkening of the skin or it can be a red and inflamed skin. The skin is often very oily.

These changes on the skin often indicate a bacterial and/or yeast infection is present and has been present for several weeks to months. Make sure to perform skin cytology on these patients.

When a skin looks like this it will take weeks to months to resolve. This is not a skin infection that is going away with two-three weeks of antibiotics. It is important for a pet owner to understand this so that they have proper expectations on how long therapy will take.

I find that medicated baths done frequently will make a significant difference in removing the infection and start making the skin soft and smooth again. Make sure to incorporate topical therapy in patients with these lesions.
#dogskininfection #lichenification #chronicskinproblems #vetdermatology #petdermatology #vetmedicine #dermatologiaveterinaria #miamivet #itakecareofitchypets
I am sure you have been hearing the buzz of the World Congress of Veterinary Dermatology that will be held this summer in Boston.  This conference is held every four years. Four years ago, the conference was not done live but virtual because of COVID so it is exciting that this year it is back in person and we get to meet up with dermatologists once again from around the world. 
Since the conference is in the United States, we also wanted general practitioners with an interest in dermatology to experience this type of conference.  If you like dermatology then this is a conference for you to check out.  Take advantage that the conference is in the summer and you could consider making it a family vacation in Boston. 
Visit  for more information and registration. 
#wcvd2024 #wcvd10 #vetdermatology #petdermatology #vetmedicine #dermatologiaveterinaria #vetconference #vettech #prevetstudent #worldcongress
This is a picture of a dog’s right and left ear drum.  Can you tell which ear drum is damaged?

Not all normal ear drums look alike. There are variations of normal. My advice is to do an otoscopic exam on all your patients especially the ones that don’t have ear infections so you start to feel comfortable with what normal looks like because then you will know when an ear drum is abnormal or not there. 

#dogear #dogeardrum #vetdermatology #petdermatology #vetmedicine #dermatologiaveterinaria #videootoscope #dogearexam #petowner #petownersofinstagram #miamivet
These past two weeks we had the pleasure of having another extern, Dr. Daniela Markus Gotze from Brazil. 

We enjoy having veterinarians do an externship with us because as much as they learn from us we get to learn from them too.  There are many different ways to practice dermatology.  Hope to see you again Dr. Daniela. 

#vetexternship #vetdermatology #petdermatology #vetmedicine #medicinaveterinaria #dermatologiaveterinaria #brazil #miamivet #itakecareofitchypets
Me emociona que esté tan cerca el congreso mundial de dermatología veterinaria. A todos mis colegas de América Latina los invito a unirse a mí y a muchos otros colegas en esta increíble conferencia que solo se lleva a cabo cada 4 años. Me encantaría ver una fuerte presencia latina/hispana. ¡Representemos! Y por supuesto, ¡vamos de fiesta y a bailar!
I am excited that the world congress of veterinary dermatology is so near.  To all my colleagues in Latin America I invite your to join me and many other colleagues at this amazing conference that is only held every 4 years.  I would love to see a strong latin/hispanic presence.  Lets represent!  And of course, lets party and dance! 

#wcvd #wcvd10 #wcvd2024 #dermatologiaveterinaria #médicinaveterinária #vetdermatology #petdermatology #veterinarioslatinoamericanos #latinamerica #representamos #manoarriba
All pet owners with dogs and cats that have environmental allergies deserve the conversation and education on allergy testing for allergy vaccine desensitization (or immunotherapy). Not all will move forward with this therapy, but it is still important to properly inform them that this treatment exists.  

Allergy vaccines is the administration of gradually increasing quantities of allergen extracts to an allergic patient.  The purpose of the vaccine is to get the pet’s immune system to better react to the allergens it is allergic to, thus reducing or eliminating the allergic symptoms.

Allergy vaccines can decrease a pet’s allergic signs by up to 60-70%.  By no means is this therapy a cure, but it can certainly decrease the severity and frequency of the allergy.  For example, a dog may be breaking out every other month, and on allergy vaccines it breaks out twice a year.  Or a dog will have severe breakouts that require a sleuth of medications, and on allergy vaccines the break outs are mild and it can be treated with just topical therapy.

Allergy vaccines is the only allergy treatment that can change or reverse part of the immune response in this condition. This means it can help prevent the allergy from worsening over the pet’s life.  This is why I strongly advocate starting on immunotherapy early in the allergy disease process rather than waiting until the pet gets worse and allergy medications are not working well anymore.

It has been shown that dogs on allergy vaccines have a better quality of life compared to dogs not on allergy vaccines and only on symptomatic allergy medications.  The quality of life for the pet owner also improves as they are not constantly stressed over their pet’s health, there are less vet visits and less financial concerns.

Do you have a pet or patient on allergy vaccines? What has your experience been like? 

#petdermatology #vetdermatology #miamivet #petowners #petsofinstagram #vetmed #vetmedicine #petallergies #allergytesting #immunotherapy #allergyskintest #itakecareofitchypets
I invite you to come see my new clinic. 

I will be having an open house on Saturday, April 13th from 12-4 pm. 

6448 South Dixie Highway  Unit E
South Miami, Florida 33143

Wearing one of my favorite @fableticsscrubs. 

#openhouse #vetdermatology #petdermatology #vetmedicine #dermatologiaveterinaria #miamivet #miamivetderm #itakecareofitchypets #fableticspartner #fableticsscrubs #scrubsmadetomove