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Why a thorough work-up is a good idea for chronic or recurrent skin cases

July 13th, 2017 Posted in Uncategorized

We often see pets with chronic itch for second opinions at this clinic. Perhaps the word is out that we are good at these challenging cases?

There is a long list of conditions that can cause itchiness. These include allergies, parasites such as fleas or Sarcoptic mange, bacterial or yeast infections, thyroid disease, seborrhea (excess production of dandruff cells and skin oils), nutrient deficiencies, etc.

There are two ways to approach itchy pets. One is what I will call the “Trial and Error Method”. We make an educated guess at the cause and try this and that. It’s an acceptable choice for the acutely itchy pet. For the recurrent case, it is not. The problem with trial and error is that it can take months or even years to find what works. That ends up costing a lot of money in the long run, and the pet suffers a lot of discomfort while waiting for results.

It can be expensive but a thorough work-up is a good investment for these pet owners. If we run a bunch of tests all at once, we get quick answers and then we know how to approach the case properly. We don’t waste time and money with medications or diets that won’t help. So, doing all the tests might be a little more expensive in the short term but it is a lot LESS expensive in the long run.

What tests are recommended for chronic itch?

1/ A blood test to rule out Hypothyroidism in dogs and Hyperthyroidism In cats.
2/ Skin scrapings to rule out Sarcoptes and Demodex mites.
3/ Skin swabs to check for bacteria or yeast.
4/ Skin biopsies to rule out seborrheic disorders and to rule in allergies.
5/ An elimination diet to rule out food allergies or hypersensitivities.
6/ Blood tests to find out what the pet is allergic to, if the skin biopsies come back suggestive of allergies. The lab tests for pollens, weed and grass allergies, dust mite and mold allergies, etc. The blood test might be combined with intradermal skin testing (prick tests) for some patients. This latter test is best done by a dermatologist; we will arrange for a referral if this test is indicated.

Once we have a definitive diagnosis, we know better how best to treat. Most diseases causing itch in pets are life-long conditions, so having a diagnosis makes good sense!

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