Using experiences to guide dermatologic care

Photo: Yuliya Usikova/Adobe Stock

Allergic dermatitis in canines can cause quality of life issues for patients and lead to caregiver burden for pet owners. Complex cases can also be frustrating for clients and veterinary teams.¹

Understanding condition management frustrations and the unique experiences of patients, pet owners and veterinary teams can help guide treatment plans. In an educational session at the 2024 Fetch dvm360 Conference in Long Beach, California, talk, Brittany Lancellotti, DVM, DACVD, a Fear Free-certified practitioner at Veterinary Skin and Ear in Los Angeles, California, provided insights about these experiences from different perspectives.¹

Allergic dermatitis and quality of life

Quality of life (QOL) can decrease for an animal with allergic dermatitis, while also elevating the pet’s fear, anxiety and aggression. Dogs with the condition have also shown a significant decrease in trainability, according to Lancellotti.¹

In addition to emotional behaviors, clients may observe in pets with allergic dermatitis scratching, licking, chewing, rubbing, biting, head shaking, scooting or nibbling—all of which can worsen clinical signs of the disease. Allergic dermatitis can also cause disruptions in a pet’s play behaviors, in the job performance of working animals, and in sleep, Lancellotti added.¹

Those effects create an important welfare issue for these animals. However, Lancellotti said that early recognition of behavioral problems that may be associated with chronic allergic dermatitis of the skin and ear can lead to improved treatment outcomes and QOL for the animal and their owner and may help minimize pet relinquishment.¹

“The great news is that we have a lot of different options for individual relief from allergic dermatitis,” Lancellotti said. She followed with an overview of drug therapies that included glucocorticoids, modified cyclosporine, Janus kinase inhibitors, and lokivetmab.

Receiving input from clients

Veterinary teams can work with clients to ascertain the best path forward with treatment plans. For example, Lancellotti said, a client that finds it difficult to clean a pet’s ear or administer medication may need to work with the veterinary team to overcome the challenge or pursue a new treatment tactic.¹

“Eliciting from owners any difficulties with the treatment and where the pet might be struggling can provide an opportunity to creatively troubleshoot and overcome the discrepancy between improvement of clinical signs and improvement in quality of life,” Lancellotti said.

In the lecture, Lancellotti noted that client education about allergic dermatitis should include an explanation of why treatments are being recommended. Veterinary teams should also allow pet owners to share their concerns about the treatment plan and offer solutions to potential problems including how an animal is responding to therapies.¹

“There is no one size fits all treatment for these animals. Each pet is their own special snowflake, and so we'll adjust our management plan based on how that pet is responding. That means that good communication with the veterinarian is really crucial to finding a plan that works best,” she said.

Client expectations can be managed by communicating what the condition means long-term and how a pet’s QOL may be affected. Caregiver responsibilities such as expenses associated with treatment, including costs for doctor visits, condition management products and associated therapies, as well as the time commitment needed to continue addressing the condition, should be adequately conveyed.¹

The value of a referral

A survey of 283 veterinary dermatology practice clients was conducted by the American College of Veterinary Dermatology in 2019. Respondents of the study—cited in Lancellotti’s lecture—reported their dogs had dermatology conditions that included pruritus, ear problems, coat changes, and skin lesions.²

Results of the survey revealed that 73% of clients had visited their primary care veterinarian more than 3 times to have their pet’s dermatologic condition evaluated before being referred to a dermatology specialist. Forty-two percent of these clients reported visiting their primary care veterinarian an average of 5 times before receiving a referral.²

“Now, going [to a veterinarian] 5 times and not having an answer is incredibly frustrating. Never mind the 5 times these pets are getting packed up, poked and prodded. That's also 5 times the owner has the opportunity cost of spending their time going back and forth to the vet visit. These repeat visits are just one thing that is going to contribute to caregiver burden, and that's the strain that an owner feels from the challenges of providing care to a companion animal,” Lancellotti said.

Takeaways

A treatment plan for managing canine allergic dermatitis should be individual to the patient since no 2 pets will respond exactly the same way to the same plan.

"Symptomatic treatment should be aimed at targeting pruritus and/or inflammation, depending on the individual pet,” Lancellotti said. “With proper medication selection, once you understand the individual [patient] and the tools you have available, we can help relieve what that patient is going through, but also relieve what some of the owners are going through."

References

1. Lancellotti B. Quit your itchin: managing pruritis and client frustration from canine allergic dermatitis. Presented at: Fetch dvm360 Conference; Long Beach, CA. December 6-8, 2024.
2. Hanna B. Earlier dermatology referral rewards primary care practice (part 1): easing client expenses and enhancing patient care. dvm360. May 18, 2022. Accessed December 6, 2024. https://www.dvm360.com/view/earlier-dermatology-referral-rewards-primary-care-practice-part-1-easing-client-expenses-and-enhancing-patient-care