Ensuring a beneficial bath time

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There are various topical therapies that can be recommended as treatment for conditions such as Malassezia dermatitis, surface pyoderma, allergies, and autoimmune diseases. Although Natalie Marks, DVM, CVJ, CCFP, Elite FFCP-V, discussed some of these therapeutic options in lecture on topical solutions at the 2024 Fetch dvm360 conference in Atlantic City, New Jersey, she emphasized that there is even more to consider when treating dermatologic conditions than which therapy or shampoo is right for each patient.

According to Marks, one of the “major” components of topical treatments is bath time. “This can be a huge struggle, not just for us, but obviously for our pet parents and families,” she said.

Frequency of baths should be considered with prescription therapies for dermatological conditions, with the goal of preventing condition reoccurrence. Ideally, Marks said, bathing should happen 1 to 2 times a week and that maintenance is 2 to 4 times a month. The contact time for the pet should be 5 to 10 minutes.

“That’s a long time,” Marks said. “I know we've all been there 5 to 10 minutes with a reactive dog or an anxious dog in a bath.”

She noted that it is important for many veterinary professionals to “take a step back” in their practices with topical treatments and shampoos and refrain from simply instructing clients about how often to bathe their pet. “I think we've learned along the way that compliance is not great when we do that, and we also know more about dog's emotional health,” she said.

She continued by posing the question of how to change the mentality of a client and patient around bath time that would make it less emotionally stressful and a more effective treatment. “Well, one of the first things we need to think about is what we teach in Fear Free and also a lot of positive reinforcement training, which is the conditioned emotional response,” she said.

She encouraged the audience to consider how the patient responds when see a shampoo bottle, hear the water or feel the water, and whether they are relaxed, or appear to be triggered with an anxiety or fear. “Remember, any time of our patients, hear, see, taste, feel or smell something fearful to them, it imprints permanently in their amygdala, and it never goes away ever,” Marks said.

Negative experiences could imprint on a dog and shown through behavior, such as a fear of water if a patient was previously sprayed with a water bottle. “If we don't condition them to have a different emotional response, they will forever have that fear. And every time they get triggered, the amygdala tells them to have more intense response and a longer duration of response,” Marks said.

She recommended teaching clients how to condition their pets to respond positively around the bath. “So that might be they hold up a shampoo bottle and [the dog gets] a yummy treat just from seeing it in the garage or on a walk at the park. It might be taking it out of context. The shampoo bottle doesn't even need to be close to the dog, and they don't even need to see the shampoo or feel the water, but starting with something like that, and then changing that game. So then maybe next time they're outside and you run a hose, the dog [is there], and they get something yummy. So it's usually a yummy treat, but it can also be praise. It depends on the dog's motivation, but the big thing is we're trying to get them comfortable,” Marks continued.

Marks said she emphasized the importance of the bath behavioral response because veterinary professionals do not often enough ask clients if their dogs are fearful of the bath. “Because we just prescribe topicals and shampoos, especially in our allergic dogs, and just assume everybody's going to bathe. And that is not the case,” she said. “So it's important to have that conversation from the beginning of ‘how does your dog do?’”

A practitioner’s goal is to have their patients bathed routinely with prescribed treatment for the skin. “The majority of our dogs that are going to benefit from topical therapy are really struggling with the superficial layer of the skin, the stratum corneum,” she concluded.

Reference

Marks N. Scrub-a-dub-dub: sudsy topical solutions for pruritic patients. Presented at: Fetch dvm360 Conference; October 14-16, 2024. Atlantic City, NJ.