346. When Allergy Treatments Stop Working: Rethinking Chronic Skin Disease in Dogs

Send me a derm question or story through text or voicemail!What happens when a dog you've successfully managed for allergies suddenly starts developing new symptoms, recurrent pyoderma, or worsening pruritus? Is it truly a progression of atopic dermatitis, or could something else be going on?In this episode of The Derm Vet, I explore the importance of reframing your diagnostic approach when chronic dermatology cases stop responding to previously successful treatments.Building on last week's refractory allergy checklist, I share a practical framework to help veterinarians recognize when it's time to reconsider an existing diagnosis, investigate concurrent diseases, identify overlooked allergy flare factors, or adjust long-term treatment strategies.Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.comTimestamps00:00 Intro00:24 Zoetis Ad00:54 Working Mom Check In02:27 Setting Up "The Allergy Reframe"03:47 Itch Inquiry: Refractory Papilloma07:10 Signs A Long-Managed Allergy Case Is Changing09:26 Reframe #112:21 Reframe #214:19 Reframe #315:28 Reframe #417:18 Summary19:25 Outro 

Send me a derm question or story through text or voicemail!What do you do when an itchy dog just isn’t responding to allergy treatment the way you expected?In this episode of The Derm Vet Podcast, I break down my refractory allergy checklist to help veterinary professionals reevaluate difficult allergy cases. From choosing the wrong medication or dose to poor compliance, concurrent disease, and even an incorrect diagnosis, I walk through the key questions to ask before labeling a patient as a treatment failure.Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.comTimestamps00:00 Intro01:56 Itch Inquiry: Managing a 7-Month-Old Allergic Dog03:43 Refractory Allergy Checklist04:10 #1 The Wrong Drug05:27 #2 Wrong Dose06:24 #3 Too Short a Duration07:44 #4 Wrong Expectations 09:04 #5 Poor Compliance10:13 #6 Concurrent Disease12:00 #7 It's Not Allergies: Mimics & Lookalikes14:10 Recap and Outro

Send me a derm question or story through text or voicemail!Lupus can show up in more ways than one in veterinary dermatology!In this episode of The Derm Vet Podcast, I break down three important lupus and lupoid diseases seen in dogs: discoid lupus erythematosus (DLE), symmetrical lupoid onychodystrophy (SLO), and mucocutaneous lupus erythematosus (MCLE).Learn the clinical signs that should put these autoimmune diseases on your differential list, from loss of the normal cobblestone appearance of the nasal planum to painful nail loss and persistent mucocutaneous ulcerations. I also discusses diagnosis, biopsy considerations, and treatment options, including the growing off-label use of JAK inhibitors in autoimmune skin disease.Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.comTimestamps00:00 Intro00:44 Itch Inquiry: Off-Label JAK Inhibitors for Autoimmune Diseases02:33 Systemic Lupus Erythematosus (SLE) Overview03:15 Discoid Lupus Erythematosus (DLE): Clinical Signs & Diagnosis06:03 Treatment Strategies for DLE07:28 Symmetrical Lupoid Onychodystrophy (SLO): Presentation & Diagnostics09:03 Managing and Treating SLO10:42 Mucocutaneous Lupus Erythematosus (MCLE)12:11 Summary & Outro

Send me a derm question or story through text or voicemail!Is your allergic patient still itching despite treatment? They may be dealing with more than one allergy!In this episode, I break down how to identify the multi-allergy veterinary patient and recognize the clues that suggest multiple underlying causes of pruritus. I discuss partial responses to allergy therapy, seasonal changes in itching, persistent problem areas, recurrent otitis, and why different lesions may respond differently to treatment.Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.comTimestamps00:00 Intro00:43 Itch Inquiry: Managing Chronic Ear Inflammation & Steroid Therapy04:19 Identifying the Multi-Allergy Patient06:11 Clue 1: Partial Response to Allergy Therapy07:16 Clue 2: Seasonally Fluctuating Pruritus08:26 Clue 3: Persistent Itch in Specific Anatomical Regions09:57 Clue 4: Recurrent Otitis vs. Improving Skin Disease11:52 Clue 5: Variable Lesion Response Across Treatments13:28 Recap14:59 Outro

Send me a derm question or story through text or voicemail!French Bulldogs, English Bulldogs, and other brachycephalic breeds are frequent flyers in veterinary dermatology but successfully managing their skin disease often requires looking beyond the obvious itch.In this episode of The Derm Vet Podcast, I break down some of the most common dermatologic problems seen in brachycephalic dogs, including skin fold dermatitis (intertrigo), pododermatitis, secondary infections, and underlying food and environmental allergies.Learn why examining every facial, tail, and vulvar fold matters, how cytology can guide treatment, why topical therapy is so important for both treatment and long-term maintenance, and how to build an allergy workup that is realistic for both the patient and owner.Watch The Episode: https://www.youtube.com/@thedermvet3932Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/Follow Me: https://www.instagram.comTimestamps00:00 Intro00:52 Itch Inquiry: Feline Ear Flushing and Horner's Syndrome Risk04:05 Fold Dermatitis and Key Fold Locations07:14 Cytology and Topical Therapies for Skin Fold Infections09:58 Pododermatitis12:48 Allergic Workups and Long-Term Inflammatory Options16:15 Overview and Final Takeaways18:03 Outro

Send me a derm question or story through text or voicemail!In veterinary dermatology, the right diagnosis often starts before the physical exam... it starts with the history!In this episode of The Derm Vet, I break down how a thorough dermatologic history can help veterinary professionals build stronger differential lists, choose more targeted diagnostics, and develop more effective treatment plans.Whether you're working through a new pruritic patient or reevaluating a case that isn't responding as expected, this episode highlights the historical clues you don't want to overlook!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 Intro00:24 The Value of History Taking in Veterinary Dermatology03:52 Itch Inquiry: Cyclosporine Use in Allergic Disease06:00 Building Differentials, Diagnostic Plans, and Treatments08:30 Core History Basics: Signalment, Seasonality, and Travel12:15 Age of Onset Considerations14:46 Analyzing Past Medication Responses16:03 Identifying Systemic Signs and Underlying Internal Disease17:59 Reevaluating History in Chronic Cases20:05 Outro

Send me a derm question or story through text or voicemail!Crusty, irritated, or abnormal paw pads in cats can point to much more than a simple skin problem. In this episode of The Derm Vet Podcast, I break down the differential diagnoses behind feline crusty paw pads, including plasma cell pododermatitis, autoimmune disease, allergies, eosinophilic granulomas, contact dermatitis, infections, trauma, cutaneous horns, and even neoplasia.Plus, this week’s Itch Inquiry features a medication-averse German Shepherd and a discussion about the limitations of monoclonal antibody therapy!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 Intro00:24 Itch Inquiry: Case Study of a Med-Averse German Shepherd05:20 Limitations of Monoclonal Antibodies07:00 Feline Crust Paw Pads07:44 Plasma Cell Pododermatitis10:58 Autoimmune Causes12:22 Allergic Conditions, Eosinophilic Granulomas, and Contact Dermatitis13:52 Infectious, Viral, Fungal, and Traumatic/Burn Causes16:02 Cutaneous Horns, Neoplasia, Lung-Digit Syndrome, and Diagnostic Workup19:02 Outro

Send me a derm question or story through text or voicemail!Crusty paw pads may seem like a straightforward dermatologic finding... but they can point to everything from simple hyperkeratosis to autoimmune, metabolic, infectious, and even systemic disease!In this episode of The Derm Vet Podcast, I break down my diagnostic approach to canine paw pad disease and the major differentials veterinarians should keep on their radar. I cover hyperkeratosis, pemphigus foliaceus, erythema multiforme, vasculitis, hepatocutaneous syndrome, zinc-responsive dermatosis, canine distemper, infections, trauma, and more. Plus, learn why lesion distribution, breed, systemic signs, and (most importantly) biopsy can be critical for reaching the right diagnosis!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 Intro00:24 Itch Inquiry: Feline Inflammatory Ear Polyps04:46 Canine Paw Pad Disease05:17 Primary Hyperkeratosis & Weight-Bearing Patterns07:31 Autoimmune Paw Pad Diseases09:58 Metabolic Causes12:47 Infectious, Traumatic, & Viral Causes14:25 Outro 

Send me a derm question or story through text or voicemail!Allergy cases are rarely straightforward... and explaining the diagnostic process to pet owners can be just as challenging as managing the itch.In this episode of The Derm Vet Podcast, I break down a practical approach to talking with clients about allergic skin disease in dogs and cats. From ectoparasites and food allergies to environmental allergies, learn how to organize the conversation so owners understand not only what you're recommending, but why it matters.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 Intro00:24 Zoetis Ad02:13 Itch Inquiry: Convincing Owners on Symptomatic Meds06:08 Category 1: Ectoparasite Control09:05 Category 2: Food Allergies & Diet Trials11:13 Category 3: Environmental Allergies & Symptomatic Therapy13:24 Allergy Testing & Immunotherapy16:14 Tailoring Communication and Visual Aids20:10 Outro

Send me a derm question or story through text or voicemail!Why do cats develop crusting, curling, inflammation, or unusual lesions on their ears? In this episode of The Derm Vet Podcast, I'm diving into feline pinnal diseases and the dermatologic conditions that can affect the feline ear.I cover why oral exams are an important part of evaluating itchy cats, reactions to topical steroids that can cause pinna curling, and key conditions including solar dermatitis, auricular chondritis, cystomatosis, pemphigus foliaceus, and proliferative necrotizing otitis externa!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 Intro00:24 Feline Pinnal Diseases01:37 Itch Inquiry: Why Perform Oral Exams on Cats03:45 Topical Steroid Reactions & Pinna Curling04:55 Solar Dermatitis06:53 Auricular Chondritis08:23 Cystomatosis10:44 Pemphigus Foliaceus12:36 Proliferative Necrotizing Otitis Externa