Tackle the allergic itch conversation with clients to help curate a plan that works best for both the owner and the patient.
When it comes to pruritus, many patients and their owners shoulder a heavy burden. According to Ashley S. Bourgeois, DVM, DACVD, a dermatologist at Animal Dermatology Clinic in Portland, Oregon, and dvm360® Editorial Advisory Board member, market studies have found that most owners with pruritic dogs express concern for their pet’s overall well-being.1
At the Fetch dvm360® Kansas City conference, Bourgeois discussed the emotional challenges many owners face when caring for pets with pruritus, including sadness (46%), frustration (44%), and helplessness (43%).1 To better navigate these conversations with clients, she highlighted a few communication pearls—from formulating a therapy plan early to demonstrating empathy.
According to Bourgeois, “Allergies are not cured, but managed.” From the very first appointment, it’s imperative that owners are made aware that in most cases, a one-time treatment isn’t enough to sufficiently cure allergic dogs and cats. “Continued therapy and an ongoing veterinary relationship will be required the rest of the pet’s life. It is important for owners to realize that from the first appointment,” Bourgeois explained, adding that along with formulating a plan to accommodate the individual needs of both the patient and the owner, frequent check-ins and therapies will be needed to maintain the pet’s comfort.
She also emphasized that some owners get confused when trying to understand the relationship between infections and allergies. Carving out time during a visit to explain how infections are a secondary issue related to allergies can help curb frustration and strengthen commitment to multimodal therapy, including frequent bathing and ear flushes. Bourgeois advised alerting clients of common early signs of allergies such as paw chewing, scratching, rubbing, etc, because this knowledge “prevents owners from being surprised when there is another infection or symptoms progress.”
When starting a diagnostic investigation for allergic disease, Bourgeois recommended finding out the client’s main goal, priority, and definition of success. Here are a few questions to ask:
Flare-ups in even the most well-controlled allergic pets can occur for a variety of reasons (eg, seasons changing, dropped food, and flea control getting missed). Bourgeois urged veterinary teams to work in tandem with the owner to help educate them on what these flare-ups look like. It is also important to provide routine calls to owners so they feel supported and prioritized. She recommended investing in multiple communication methods including phone, text messaging, and communication apps to give owners an efficient communication method that works best for them.
Skin issues like pruritus are traditionally a visual ailment, so it’s crucial to keep in mind the emotional state of many dermatologic clients when they begin to see physical changes on their pet’s skin. Bourgeois explained that because clients have different reactions, emotions, and expectations, it’s up to the veterinary team to address each client’s needs when presenting information such as diagnostics and treatment options.
“It takes practice, but you’ll learn to pick up on subtleties that reveal the needs of each individual client,” she said.
For example, Bourgeois noted that some clients prefer a lot of information upfront and will be persistent in understanding the reasoning behind every diagnostic test, treatment, and long-term outlook. Some characteristics of these clients include direct eye contact and head nodding. For clients who appear disengaged, it may be due to information overload. Characteristics of disengaged clients include blank stares, rummaging eyes, and fidgeting.
Demonstrating empathy, especially to frustrated clients, is an important skill that can lead to relief for their pets. “When we can relate to them and recognize their goals, we have the best opportunity to make progress with a treatment plan and become a part of that pet’s team,” she explained.
For allergic patients, it’s critical to refer a board-certified dermatologist. Bourgeois said that even if patients aren’t presenting with severe symptoms or infections, incorporating a dermatologist early on can ensure that safe therapies and preventative measures are being taken to thwart further progression. Fostering a relationship with local dermatologists is crucial since many cases require comanagement. If there aren’t any available dermatologists near your clinic’s location, Bourgeois advised using telemedicine companies to provide consultation options.
Another option is to discuss cases prior to referring a patient to a dermatologist, as this can “maximize diagnostic results upon initial diagnosis,” she said. Finally, it is important that the veterinary team vocalize these options to clients because any of these can help improve their pet’s quality of life.
Owners of pets with allergic pruritus can often encounter complex emotions such as confusion and frustration. It’s important to tackle the issue from the first appointment and curate a dependable treatment plan that keeps the needs of both patient and owner in mind.
“The impact of allergic itch on patient and owner quality of life, as well as the potential for client frustration, highlights the importance of a consistent, thorough team approach to diagnosing and treating patients with allergic pruritus,” said Bourgeois.
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