Ashley Bourgeois, DVM, DACVD: Do you think dogs adopted during COVID-19, or the “pandemic puppies” like my own, do you think they’re going to suffer from greater anxiety? We have talked about self-mutilation and acral lick granulomas, that these can be related to primary behavioral issues. Do you think that’s going to be an issue moving forward? I’m sure it’s going to be “it depends.” What are the things that you’re going to look for knowing that this is going to be a big problem? Should they be working with a behaviorist? Potentially a dermatologist? A combination of both of us? What recommendations would we use, and I think we’ve covered some of these already, in preventing that from happening?
Christopher Pachel, DVM, DACVB, CABC: The biggest thing that comes to mind is remaining vigilant without being worried. Meaning, if your dog is proving to us that we have the ability to navigate day-to-day changes, and you’ve started doing a couple of outings—maybe you went back to the gym, maybe you didn’t, but maybe you did—you’re now away from the home for an hour or two at a time, and you have your webcam or your nanny camera on, and your dog is snoozing on the couch or they’re sleeping in their kennel, and life is good. Cool. You probably don’t have anything to worry about, at least based on what we’ve seen so far. We’ll want to spot check to make sure everything continues to go well. It’s about maintaining that awareness and not making assumptions. Even if you as the owner know that dog better than anyone, each animal is their own living, breathing creature with their own agenda, and emotional responses, and learning history. I want to make sure that we’re setting them up to be as successful as possible without giving ourselves a bunch of busy work that doesn’t need to be there.
If you find that you are someone who may not have a strong understanding of how to read a dog’s body language and communicate utilizing that language, there are some amazing resources out there to inform you. If your animal is showing a level of distress, or if we’re starting to see an increase in licking, and you’re wondering, “Is this stress? Is this itch? Where do we go with this?” You can start to dig into some of those context clues in the history that you and I have been chatting about today to guide that.
If you’re not sure, check in with your primary care veterinarian and let them guide that process for you. Or reach out to one of us. You and I have both had cases where a client has come in, we’ll take about 30 seconds to look at the animal and go, “Not it!” You may need me, but I’m not your guy right now. Let’s cut this short right now and get you the help you need. I can do that knowing the behavior side as well as I do, and you do the same thing for dermatology. What I love about the collaborations between our professional interests, both in friendship as well as in these professional spaces, is we can have that conversation so that any of those pandemic pups who are going to experience distress, are going to be getting the help and support they need to navigate this next chapter, whatever that looks like.
Ashley Bourgeois, DVM, DACVD: Yes. That’s great. It’s been an informative discussion we’ve had, in general, how important this multimodal approach is from a dermatology standpoint and a behavior standpoint. You’ve talked about supplements, pheromones, and lots of different things that show the intersection of our 2 specialties. I’d love to give some final thoughts, then if you don’t mind, get some final thoughts from your end.
For me, what we’re seeing are a couple of different key things that keep coming up. History is very important whether you’re talking about dermatology or behavior. In these allergic itchy dogs, history is going to be extremely important, and that includes the rechecks. The history of what has happened since they’ve seen you last. What has worked, what has not worked. The other big thing: a multimodal approach is important, so make sure we are working with the clients so they understand. We educate them on why topical therapy is important, why cytology is important. Why do I charge for cytology almost every time they’re here? They need to understand why we would want to utilize that. Make sure they know why we would use an anti-pruritic treatment. Why are we looking at the long-term therapy?
That doesn’t all have to happen at the first examination. I always tell clients when we’re done talking, “I hit you with a ton of information. It is a lot to come and see us.” That includes continual education for your client. Sometimes they forget what you talked about the first time, or things have changed. Making sure we’re continuing to educate them becomes really important.
Those are some of my big things: history is super important. A multimodal approach. Meeting the client where they are, whether that’s education wise, needing to hear things over and over again. Or meeting them where they are in their life as far as changing. Maybe what could happen 6 months ago can’t happen now, but maybe it can 3 months from now. Those are all the things that we have to be willing to adjust to when we’re managing these chronic diseases, like an itchy dog. What are some final thoughts you have?
Christopher Pachel, DVM, DACVB, CABC: My brain wants to say, “Ditto that.” I do have a couple of additional things too, but I love how so many thoughts on how we practice, even though our specialties are so different, there are so many similarities in the way in which we practice. I would say a couple of things: advocacy is one of them. I say this from a couple of different angles, especially for the pet owner, to be advocating for the needs of their animal, whether that be itch or inflammation.
We can do stuff; we can make this better. Or whether that’s from an anxiety or stress component, we can do things to improve that. I know that both you and I deal with clients every single day who come in thinking, “I’ve done everything.” No, you haven’t. I guarantee that you haven’t. I guarantee you haven’t. You may have done a lot, and I want to honor that, absolutely. We can take that advocacy in trying to do well by that animal and create some additional awareness. What’s going on? What are the options that exist? What does the history tell us about what additional options still stand in front of us?
Lastly, be flexible to some degree. Again, this builds on what you were saying, I don’t know what the outcome is going to be of an individual case. I’ve got a lot of case history. I’ve worked with thousands of animals over the years. Probably tens of thousands at this point, and I still don’t know what’s going to happen for your dog. Let’s do the best we can to assess and advocate for everybody’s needs: the client’s, the vet’s, the animal’s, mine, all of that. Then let’s see where that takes us with this collaborative partnership, and we’ll reassess and adjust based on what happens. We’re in this together as long as we’re both ready to go.
Ashley Bourgeois, DVM, DACVD: I love that. As always, it has been such a pleasure to chat about such an important topic, one that we both see a lot of and is very common for our general practitioners to see. Of course, Dr Pachel, thank you so much for being here and having this discussion with me. To our viewing audience, we hope you found this DVM360® Insights discussion to be rich and informative. It’s something we’re passionate about. It’s something that’s important. Hopefully you have picked up some good information from us today.
Transcript edited for clarity.