332. Your Allergy Patient Is Doing Fine... So Why Start Immunotherapy?

Send me a derm question or story through text or voicemail!Is allergen-specific immunotherapy the closest thing we have to changing the course of allergic disease in dogs?In this episode of The Derm Vet Podcast, I explore why immunotherapy remains the gold standard for long-term allergy management and how it differs from simply controlling itch. She explains how starting treatment early may help reduce the progression of allergic disease, what pet owners should realistically expect from immunotherapy, and why educating clients is critical to long-term success.Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.com/thedermvet/Timestamps:00:00 Intro01:39 Itch Inquiry: Distinguishing Autoimmune Disease from Neoplastic Disease04:40 Immunotherapy06:05 Proactively Halting the Progression of Allergic Disease07:30 Natural Therapy08:14 Instilling Trust in Your Client09:28 Preparing for Future Health Uncertainties13:06 Outro

Send me a derm question or story through text or voicemail!Learn how rostrolateral nasal alar arteriopathy is diagnosed, why it can be mistaken for other conditions, and the treatment options available to help improve quality of life. I also discusses setting realistic owner expectations and the importance of recognizing uncommon dermatologic diseases in veterinary medicine.Whether you're a veterinarian, veterinary technician, or veterinary student, this episode provides practical clinical insights you can apply to future cases. Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.com/thedermvet/Fleischman DA, Mauldin EA, Lowe A, Cain CL, Bradley CW. Clinical and histopathological features of rostrolateral nasal alar arteriopathy of German shepherd dogs. Vet Dermatol. 2023;34:441–451. https://doi.org/10.1111/vde.13173Timestamps00:00 Intro01:32 Itch Inquiry:  Topicals for General Practice 06:20 German Shepherd with Chronic Nasal Bleeding09:29 Diagnosis: Rostrolateral Nasal Alar Arteriopathy12:02 Treatment Options & Owner Expectations14:44 Outro

Send me a derm question or story through text or voicemail!Client communication can make or break even the best dermatology treatment plan...In this episode of The Derm Vet Podcast, I answer a listener's question about improving cytology skills in veterinary practice before diving into one of the most valuable communication frameworks I've found for challenging client interactions: The 5 E's.Whether you're discussing chronic allergies, recurrent skin infections, or complex treatment plans, frustrated clients are inevitable. The key is knowing how to navigate those conversations with confidence!Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.com/thedermvet/Timestamps00:00 Intro01:14 Itch Inquiry03:10 The 5 E's in Dealing with Frustrated Clients03:40 Empathize with the Client05:47 Expectations07:08 Expense08:14 Effort10:23 Encouragement12:18 Summary/Outro 

Send me a derm question or story through text or voicemail!In this episode, I tackle some of the most common (and challenging) questions surrounding the diagnosis, treatment, and long-term management of canine otitis externa. From maintenance therapy protocols and cleaning strategies to biofilm management, chronic stenosis, ear cultures, and the role of AI-powered cytology, I share practical insights you can apply in everyday practice. Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.com/thedermvet/Timestamps00:00 Intro01:25 Itch Inquiry: For maintenance therapy, do you suggest using a combination product weekly as maintenance?04:30 What is your favorite product as a cleanser when the patient has biofilm?06:51 How do tackle chronic stenosis?09:12 What is your favorite maintenance cleaning product?10:31 When dogs have recurrent otitis, how often do you suggest maintenance cleaning? 12:37 What do you think of the various AI cytology machines?14:27 What is the usefulness of an ear culture for otitis externa?16:15 What do you consider for broad spectrum treatment for otitis?17:40 Besides ear flushing, what other treatments do you use for maintenance?18:18 Outro

Send me a derm question or story through text or voicemail!Can cats safely take Apoquel or Zenrelia? In this episode, we take a deep dive into the use of JAK inhibitors in feline dermatology, exploring the science behind atopic disease, practical treatment considerations, and the realities of off-label medication use in cats.Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.com/thedermvet/Timestamps00:00 Intro01:31 Itch Inquiry: Atopic Dogs and the pathophysiology04:22 JAK Inhibitors and Cats05:58 Using Apoquel with a Cat 08:58 Using Zenrelia with a Cat10:53 Dosing These Medications in Cats 12:35 Lab Work Monitoring the Cats14:02 The Risk14:25 The Duration15:40 Discussion of Off Label Use with Owners16:58 Outro

Send me a derm question or story through text or voicemail!Skin barrier is having a moment... and for good reason. In this episode, I break down why restoring the skin barrier is a non-negotiable piece of the multimodal approach to managing atopic dermatitis in dogs and cats, and more importantly, how to actually do it when your clients can't keep up with a bathing schedule.Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.com/thedermvet/Timestamps00:00 Intro00:45 Itch Inquiry: Recurrent Yeast Otitis01:37 Antifungal Resistance in Malassezia03:54 Underlying Allergies and Immunotherapy06:29 Paronychia07:19 Toothpick vs. Tape Methods09:30 Treatment for Yeast15:35 Summary/Outro 

Send me a derm question or story through text or voicemail!A new JAK inhibitor has officially entered the veterinary market but where does it fit into managing allergic dogs?In this episode of The Derm Vet Podcast, I sit down with boarded veterinary dermatologist Dr. Christine McKinney from Merck Animal Health to discuss Numelvi, the newest JAK inhibitor approved in the United States for canine allergic dermatitis. We break down what makes this medication unique, how it compares to other allergy therapies, and why having multiple treatment options matters when managing complicated allergic patients.We also dive into practical approaches for itch control, infection management, and building confidence when treating chronic allergy cases in practice. If you manage itchy dogs regularly and want to stay up to date on the latest dermatology treatments, this episode is packed with valuable clinical insights.Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.com/thedermvet/Timestamps and references: 7:26: At the recommended treatment dose, Numelvi is at least 10X more selective for JAK1 over the other JAK enzymes in in vitro assays. Reference: Kowalski T, Schuette S. The second-generation Janus kinase inhibitor atinvicitinib is a potent and highly selective inhibitor of JAK1. Vet Dermatol. 2026;37(2):179.8:03: At the recommended treatment dose, Numelvi is at least 10X more selective for JAK1 over the other JAK enzymes in in vitro assays. Reference: Kowalski T, Schuette S. The second-generation Janus kinase inhibitor atinvicitinib is a potent and highly selective inhibitor of JAK1. Vet Dermatol. 2026;37(2):179.8:07: JAK1 is the primary driver of itch and inflammation. Reference: Huang I, Chung W, Wu P, Chen C. JAK-STAT signaling pathway in the pathogenesis of atopic dermatitis: an updated review. Front Immunol. 2022;13:106826010:36: At the recommended treatment dose, Numelvi is at least 10X more selective for JAK1 over the other JAK enzymes in in vitro assays. Reference: Kowalski T, Schuette S. The second-generation Janus kinase inhibitor atinvicitinib is a potent and highly selective inhibitor of JAK1. Vet Dermatol. 2026;37(2):179.21:52: Numelvi, starts reducing itch within 2-4 hours in a canine interleukin-31 (cIL-31)-induced pruritus model Reference: Kowalski T, Prohaczik A, Locke K, Samson C, Hope K. The second-generation Janus kinase inhibitor atinvicitinib significantly reduces pruritus 2-4 hours after dosing dogs in a canine interleukin-31 model. Vet Dermatol. 2026;37(2):179-180.23:13: Numelvi, starts reducing itch within 2-4 hours in a canine interleukin-31 (cIL-31)-induced pruritus model Reference: Kowalski T, Prohaczik A, Locke K, Samson C, Hope K. The second-generation Janus kinase inhibitor atinvicitinib significantly reduces pruritus 2-4 hours after dosing dogs in a canine interleukin-31 model. Vet Dermatol. 2026;37(2):179-180.Timestamps00:00 Intro02:29 The Complexity of Canine Allergic Dermatitis06:44 What is Numelvi and How Does it Work?13:50 Dosing Guidelines and Tablet Specifications16:57 Candidate Selection and Infection Control21:37 Onset of Action and Efficacy Timeline24:08 Final ThoughtsThis episode is sponsored by Merck Animal Health

Send me a derm question or story through text or voicemail!Skin barrier therapy has become one of the hottest topics in veterinary dermatology but with so many sprays, spot-ons, mousses, collars, and topical products available, it can be difficult to know what actually works and when to use them.In this week’s episode of The Derm Vet Podcast, we dive into the concept of skin barrier support and why managing allergic skin disease goes far beyond simply treating itch. I break down different categories of topical therapies, including AtopiVet products, spot-on formulations, mousse therapies, and skin care collars, while discussing how these products can fit into a multimodal dermatology plan.Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.com/thedermvet/Timestamps00:00 Intro01:40 The Itch Inquiry: Skin Barrier and Beyond Topicals04:48 AtopiVet Products08:04 Spot-On Products09:23 Mousse Products10:19 Skin Care Collar12:44 Outro

Send me a derm question or story through text or voicemail!In this episode, I dive into the diagnostic approach and long-term management of sterile nodular panniculitis in veterinary patients. We discuss everything from sampling claw folds and interpreting flaky cytology samples to biopsy techniques, infectious disease rule-outs, and when to consider JAK inhibitors as part of a treatment plan. If you’ve ever struggled with diagnosing challenging nodular cases or navigating long-term management decisions, this episode is packed with practical clinical insights you can apply in practice.Did you know you can submit a question or voicemail to the show by using the link at the top of the show notes? Send me any and all questions to be featured on an episode!Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.com/thedermvet/Timestamps00:00 Intro01:14 Itch Inquiry: Sampling Claw Folds and Flaky Samples06:00 Identifying Sterile Nodular Panniculitis08:54 Diagnostic Approaches and Biopsy Techniques09:56 Ruling Out Infectious Causes12:53 Use of JAK Inhibitors16:19 Long-term Management19:49 Outro

Send me a derm question or story through text or voicemail!In this episode, I tackle one of the most important — and often most challenging — conversations in veterinary dermatology: the diet trial discussion. We break down common client concerns, why compliance can be difficult, and how veterinarians can better communicate the value of diet trials in diagnosing food allergy cases.Did you know you can submit a question or voicemail to the show by using the link at the top of the show notes? Send me any and all questions to be featured on an episode!Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.com/thedermvet/Timestamps00:00 Intro01:04 Itch Inquiry07:20 The Diet Trial Conversation 09:45 Tip #1: Explain the "Why"11:06 Tip #2: Treat it as a Diagnostic Test14:26 Tip #3: Short-Term Pain for Long-Term Gain15:37 Tip #4: Challenging the Diet to Get Answers18:54 Summary20:38 Outro