199. Approach to immune mediated disease

Send me a question or story!It is very common for clients to present their pet to the veterinarian complaining that an allergy medication that used to work is no longer effective. Before changing therapies, it is important to consider four different things.1. Rule out simple mistakes like missed flea prevention, diet change, etc.2. Identify infection3. Progression of allergies4. It is no longer just allergiesLearn more details on this week's episode of The Derm Vet podcast!Timestamps00:00 Intro01:20 Looking for Simple Causes03:47 Identify Infections06:10 Allergy Progression08:30 When It Isn't Just Allergies10:22 Overview12:05 Outro

Send me a question or story!Zinc responsive dermatitis is a skin condition in dogs resulting from a zinc deficiency or an inability to properly absorb the mineral. It is a rare condition that typically presents as scaling, crusting, and hair loss around the head (especially muzzle and periocular region) and pressure points.The most common form is syndrome I which is almost exclusively seen in Nordic breeds like Huskies and Malamutes. They have a genetic defect that impairs intestinal absorption of zinc (even when sufficient quantities are in their diet). Learn about this disease process including diagnosis and treatment on this week's episode of The Derm Vet podcast!Timestamps00:00 Intro01:00 Zinc Basics04:12 What Happens If You’re Not Absorbing Enough Zinc05:55 Syndromes Seen With Zinc Deficiency07:22 Zinc Responsive Dermatitis in Huskies08:31 Presentations of Zinc Responsive Dermatitis09:50 Other Differentials You Can See11:53 Treatment for Zinc Responsive Dermatitis13:35 Length of Treatment14:10 Other Treatment Methodologies15:19 Outro

Send me a question or story!Solar dermatitis (actinic keratosis) is skin damage from prolonged UV exposure, affecting both dogs and cats, particularly those with light-colored or thin coats. So, pets that have white fur and live in high UV exposure areas (like the southern US) are predisposed. Symptoms include redness, scaling, hair loss, and thickened, crusty skin. Commonly affected areas include the nose, ears, abdomen, and inner thighs. This condition can lead to more severe issues, including pre-cancerous lesions and aggressive skin cancer like squamous cell carcinoma. We will discuss ways to identify this disease and treatment options such as CO2 laser ablation, etc.00:00 – Intro04:06 – Nasal Solar Dermatitis06:32 – Classic Canine Solar Dermatitis08:15 – Treatment Options for Solar Dermatitis16:52 – Outro

Send me a question or story!In the spirit of Thanksgiving, I like to reflect on the things I am thankful for in the world of veterinary dermatology and life. Check out the products and people I am thankful for on this celebratory 300th episode of The Derm Vet podcast!TIMESTAMPS00:00 Intro1:53 New Product Launches4:30 Dr. Bourgeois’s Experiences5:30 Dr. Bourgeois’s Family7:21 New Research8:29 Patients and Clients10:21 The Viewers11:39 Outro

Send me a question or story!For how common we see pyoderma in cats and dogs in veterinary practice, the appearance can be variable. A cutaneous bacterial infection can appear as crusting, erythema, scaling, moth-eaten alopecia, epidermal collarette, etc. Differentials can also be varied. Pyoderma can mimic dermatophytosis, demodicosis, pemphigus foliaceus, epitheliotropic lymphoma, etc. Check out this week's episode The Derm Vet podcast! Also, I highly encourage you to check out the YouTube channel to see some clinical images.00:00 – Intro01:20 – Moth-Eaten Alopecia03:18 – Diffuse Alopecia04:21 – Erythema05:27 – Scaling06:40 – Epidermal Collarettes07:57 – Crusting11:15 – Urticaria-like Lesions13:58 – Outro

Send me a question or story!As dermatologists, we LOVE topical therapy. However there are some basic things that need to be considered when suggesting a protocol. What are you treating?What is the ultimate goal?What do you or the owner have?Can it happen?Check out some simple tips on this week's episode of The Derm Vet podcast!00:00 – Intro01:15 – Q1: Why Are You Using Topical Therapy?04:41 – Q2: What is the Goal of the Product?05:58 – Q3: What Do You Have Available?08:45 – Q4: Can the Owner Do It?11:34 – Overview12:44 – Outro

Send me a question or story!Even as a specialist, I still get cases that surprise me or change appearances. It can leave me doubting what the next step is. But, if you take a breath, it is amazing what can happen when you figure them out. Check out three cases that recently threw me for a loop.1. A dog with weird paw pad ulcers2. A cat with an ulcerated nasal planum3. A service dog with non-pruritic alopecia and scalingHint: If you check out the YouTube channel, there are a lot of clinical photos!00:00  Intro02:14  Case Number 1: Veni08:02  Case Number 2: Gadget14:42  Case Number 3: Bruno19:19  Outro

Send me a question or story!Alex Sigmund, DVM, DACVO returns to the podcast to discuss something other than allergies! There are so many non-allergic things that can occur with eyeballs (or the skin around the eyes) that may also include input from a dermatologist?What non-allergic cause can lead to periocular dermatitis?How do you start evaluation of blepharitis or chemosis?We dig even deeper into eyes this week on The Derm Vet podcast!00:01 – Intro01:21 – What is the most common reason for periocular alopecia03:48 – What topical antibiotic can you safely use around the eye08:02 – Basic guidance on blepharitis12:09 – When should general practitioners consult ophthalmologists15:07 – Breeds with a strong overlap in skin and eye conditions18:01 – Outro

Send me a question or story!Back for round 2! Alex Sigmund, DVM, DACVO returns to talk us through periocular and ocular disease that can occur from allergies. How common is it?Should it go to ophtho or derm?Can you consider topical antihistamines? Topical steroids?We dive into all of your questions related to allergic eyeballs on this week's episode of The Derm Vet podcast!00:00 Intro02:46 How often are you referred patients with underlying allergy issues?05:10 Managing chronic KCS associated with atopic dermatitis10:55 Topical antihistamines or steroids to manage allergic pruritus towards the eyes?18:00 Are oral antihistamines helpful for allergic conjunctivitis?21:52 JAK inhibitors, cyclosporine and steroids vs. conjunctivitis / pruritus24:40 How atopic dermatitis affects the eyes27:29 Outro

Send me a question or story!We have so many wonderful non-steroid options to manage itch and inflammation in veterinary dermatology. HOWEVER, there is still a time and place that steroids are necessary. It is important to not be afraid of steroids, but now when and how to use them appropriately.From stenotic ears to cost concerns, check out the situations where, even as a boarded dermatologist, I lean on steroids on this week's episode of The Derm Vet podcast!00:00 Intro01:00 Taking away guilt for steroid use02:04 Scenarios where steroid use is considered03:07 Severe Inflammation05:05 While waiting for a slower medication to work07:27 Stenotic Ears9:11 Management of autoimmune diseases11:14 Cost Concerns13:10 Sometimes nothing else works14:56 Summary/Outro