Quick diagnostic tips for evaluating pruritic pets

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Editors note: Quotes have been lightly edited for brevity and clarity.

At Fetch Charlotte 2025, Joya Griffin, DVM, DACVD, kicked off her dermatology series of lectures with Treating the itch that won't quit: Diagnostic approach to the pruritic pet. One aspect she keyed in on was the fundamental importance of a meticulous history and basic diagnostics in the evaluation of pruritic pets.

“For me, it really is just getting back to basics,” Griffin said, “I'm trying to figure out how do I get the case from looking like a disaster to looking good again and feeling good?” She explained to attendees that focusing on these foundational principles is 1 of the most important pieces of the puzzle for effectively managing complex dermatologic cases.

Obtaining a thorough history

“All of pruritus is not created equally”, Griffin said. “The history of pruritus sometimes can confuse us. Sometimes that confusion comes from a pet parent, because they can actually know when the disease how it started, but they don't know how it started.”

With the mindset of getting back to the basics, Griffin said that when assessing a dermatologic condition, these are the questions she’s asking and the information she is looking for:

• Onset and progression of clinical signs: Determining the age of onset, whether symptoms are intermittent or continuous, and how they have evolved over time.
• Seasonality and initial presentation: Ascertaining if signs were initially seasonal and if pruritus preceded lesions or vice versa.
• Environmental and household factors: Inquiring about the pet's travel history, indoor/outdoor status, and the health status of other pets or human family members.
• Medication history: A thorough review of past and current medications, including their efficacy, dosage, duration, and consistency of administration.
• Diet history: Asking whether the pet’s bowel movements were solid or diarrhea, and whether there was any vomiting.
• Flea control: Assessing the type of flea control being used and the consistency and correctness of its administration—especially in atopic dogs, which may exhibit heightened sensitivity to flea bites.

Cytology

Griffin stressed the importance of cytology, stating, "I do have cytology on the majority of my dermatologic cases because looks can be deceiving." She reminded attendees that you can't truly know if a lesion is bacterial, yeast, or sterile without it. She advocates for its use not only as a diagnostic tool, but also as a means of monitoring response to treatment and to guide decisions on whether to pursue culture and susceptibility testing.

For those who find cytology intimidating, Griffin suggests utilizing available tools such as AI analyzers and online image libraries to improve confidence in sample interpretation. She also shared a tip for improving client compliance. "I like to show pictures when I'm talking about cytology, because it really is just pattern recognition." She added, "If I have a skeptical client, I can bring them back, show them, and say, 'This is what I'm looking for. This is why,' and I can help them understand the importance of the cytology and the importance of the recheck exam."

Skin scrapings

Griffin also reminded attendees that skin scrapes are essential for detecting superficial and deep ectoparasites. She also shared a tip for improving client compliance, “Another reason to have a camera on your scope is you can bring the pet parents back, and they can show them the mites, and then they will believe that you're not just trying to sell them.”

Griffin said that these in-house diagnostics are not only quick and cost-effective but also integral in prioritizing treatments and determining the necessity of further diagnostics.

Takeaway

Griffin explained that a back-to-basics approach helps prevent overlooking simple diagnoses. A thorough history and basic diagnostics provide a solid foundation for subsequent diagnostic and therapeutic decisions, ultimately leading to more effective management of pruritic pets.

Reference

1. Griffin J. Treating the itch that won't quit: Diagnostic approach to the pruritic pet. Presented at: Fetch Charlotte 2025; Charlotte, North Carolina. March 14-16, 2025.