150. Why did Apoquel stop controlling my dog's itch?

Cutaneous Malassezia (yeast) hypersensitivity shows up as a marked inflammatory and pruritic response to relatively low numbers of yeast organisms, though some dogs may also have overt infection with many yeast organisms on cytology.There is no specific criteria of how to diagnose these dogs and maintain treatment. However, there are hints of how you can look at the clinical signs and history to heighten your suspicion.Find out more on this week's episode of The Derm Vet podcast!TIMESTAMPS00:00 Intro00:25 Yeast Hypersensitivity05:12 When to call a dog hypersensitive to yeast07:15 Encouraging people to allergy test08:41 How is my underlying control?11:21 Symptoms13:09 Outro 

Allergy management is a long-term game. So, how do clinicians educate clients and use their tools to practice a "proactive" approach rather than a "reactive" approach?Check out this week's episode of The Derm Vet podcast to alter how you manage these itchy pets!TIMESTAMPS00:00 Intro01:54 What's a proactive mindset?06:44 Supplements with good research08:42 Immunotherapy12:43 The Flare Prep14:46 Summary

It can be difficult to differentiate pemphigus foliaceus (PF) in certain cases. If there is a lot of infection or inflammation, it can be difficult to tell if the case is autoimmune or allergic. However, there are a few hints between dogs and cats that can give you an indication you are dealing with PF.In dogs, honey colored adherent crusting, facial lesions, nasal planum involvement and crust paw pads can occur with PF. In cats, purulent debris at the claw folds, crusting/erythema around the nipples and crusting/erythema to the pinna can be hints of PF.As always, check cytology and look for neutrophilic inflammation without infection and/or acantholytic keratinocytes (prematurely lifted skin cells). Learn more details on this week's episode of The Derm Vet podcast!TIMESTAMPS00:00 Intro01:53 Dogs and Pemphigus04:29 Oral Mucosa06:00 Cats and Pemphigus09:53 Cytology and Pemphigus 12:53 Summary

When we talk about the multimodal approach to allergy management, a large portion of that is repairing the skin barrier. As the skin is the largest organ in the body and external, it is important to keep it healthy and hydrated. Pets with atopy have genetic defects in their skin that allow allergens to penetrate easily.But, how can you restore the skin barrier? Learn about three different ways on this week's episode of The Derm Vet podcast! 1. Topicals2. Nutrition3. SupplementsTIMESTAMPS00:00 Intro03:13 Topicals08:41 Topicals That Are Good For Restoring The Skin Barrier11:53 Nutrition14:13 Supplements16:33 Summary

It is the dreaded conversation in the exam room... when the owner brings up what they heard from a friend, the internet, a social media group, etc. You have to control the eye roll or being super defensive because you want to the the only trusted source for medical decisions for the pet.Over the years, this topic has not scared me in the exam room anymore. I have learned to be curious (might as well know what information is out there) and empathize with the owner with how many sources are out there.Four steps I use in this scenario: Be open, recognize intent, validate and educate. I hope you find this episode of The Derm Vet podcast helpful!

This week's episode is a replay! We ran into some technical difficulties with a guest episode that was scheduled for this week (super excited about this guest) and will release at a later date. Stay tuned!So... you have ruled out flea and food allergy and now it is time for THE talk. The chronic, lifelong, multimodal therapy required atopic dermatitis talk? For such a common disease, how come this spiel can be so difficult? Check out this week's episode of The Derm Vet podcast for tips and tricks!TIMESTAMPSIntro 00:00Explaining Feline Atopic Skin Syndrome To Pet Owners 00:56The Reasoning For Atopic Dermatitis In Pets 05:04Explaining Multimodal Therapy To Pet Owners 11:08Outro 14:02

We have all had those super difficult otitis cases... the debris, infection and discomfort never seem to fully respond to treatment. You keep switching topicals but nothing seems to be working. This episode of The Derm Vet podcast will go over four considerations when managing a nonresponsive otitis case. 1. Infection2. Inflammation3. Advanced imaging 4. Surgical interventionTIMESTAMPS00:00 Intro01:50 Where is our infection control sitting04:50 Inflammation08:11 Do we need other diagnostics?10:47 Surgical intervention 13:00 Summary

Cat dermatology is always a bit tricky. They present their allergies in so many different ways that are unique to this species. Oral lesions and asthma are not as commonly seen in allergic dogs, but often seen in allergic cats. Also, the struggle of administering medications to cats which can be more difficult compared to dogs. I always think of cats as little derm aliens... BUT, just because their management is not as straightforward, doesn't mean we shouldn't provide relief.Learn more on this week's episode of The Derm Vet podcast!TIMESTAMPS00:00 Intro02:02 Cats and flea allergy05:29 Food Allergy06:49 Oral Lesions08:08 Difficulty in medicating10:33 All the ways they show atopic disease12:55 Summary

Hormonal disorders can be very difficult to recognize in dermatology cases, especially since many of these cases have been managed for other conditions like allergies earlier in their life.So, when do you suspect a hormonal disorder in your dog patient? Age of onset, alopecia, recurrent pyoderma and weight gain discussed on this week's episode of The Derm Vet podcast!TIMESTAMPS00:00 Intro00:25 Thank you to everyone I met this past week02:30 How do I know if things are hormonal?03:49 Age06:25 Non-pruritic Alopecia07:52 Recurrent Pyoderma11:38 Weight Gain13:21 Summary

Obesity has been an increasing issue in dogs and cats over the years. This could be due to increased caloric intake, reduced physical activity, endocrinopathies, etc. There are many issues that occur with obese pets: cardiac issues, joint pain, organ dysfunction, etc. However, the skin can also be included in these issues.Elbow calluses, fold dermatitis and pododermatitis can all be worse as a patient gains weight. Learn more on this week's episode of The Derm Vet podcast!TIMESTAMPS00:00 Intro00:25 Skin Issues with Overweight Dogs03:49 "A World of Inflammation"06:08 Dysbiotic Drift08:00 Skin Integrity of Obese Pets10:05 Secondary Issues11:28 Fold Dermatitis12:39 Elbow Calluses14:10 Summary