314. Topical Therapy & the ISCAID Guidelines: Practical Updates with Dr. Allison Inga

Send me a question or story!Allison Inga, DVM, DACVD is back on the podcast! In this week's episode, we review the systemic antimicrobial recommendations from the International Society for Companion Animal Infectious Diseases (ISCAID) and what they mean for veterinarians treating superficial or deep pyoderma.We highlight when systemic antibiotics are truly indicated, first-line drug selection, along with more resitant infections that may require second- or third-line antibiotic treatment. The discussion also reinforces antimicrobial stewardship principles, including avoiding unnecessary use of critically important antibiotics.A focused update designed to help veterinarians and staff members to apply ISCAID guidance confidently and responsibly in everyday clinical cases.Timestamps00:00 – Intro01:35 – When To Use Systemic Therapy02:32 – Topical Therapy 2-Week Period03:35 – Different Types of Pyoderma07:18 – First Choice Drugs10:20 – Go-To Drug Choice11:50 – Wiggle Room When Prescribing14:03 – Second Choice Drugs16:57 – Where To Dose18:54 – Usage in Dogs19:37 – Other Second Choice Considerations23:09 – Usage Experience with Rifampin25:52 – Systematic Use of Amikacin28:03 – Chloramphenicol Use in Patients31:08 – When To Limit Use32:46 – Other Considerations34:08 – Outro

Send me a question or story!In this week's podcast episode, I get to interview Allison Inga, DVM, DACVD who practices at Animal Dermatology Clinic in Robbinsville, NJ. We take a practical, clinician-focused look at the latest guidelines from the International Society of for Companion Animal Infectious Diseases (ISCAID) on the use of topical therapy in managing bacterial skin infections.Topical therapy is no longer just an adjunct — it’s a central component of antimicrobial stewardship in dermatology. We review how the ISCAID guidelines support cytology-driven diagnosis, when topical therapy can be used as sole treatment, and how it helps reduce systemic antibiotic use in cases of superficial pyoderma and Malassezia dermatitis. 00:00 – Intro01:25 – Dr. Inga 03:50 – Advantages of Topical Therapy in Pyoderma Cases05:40 – Evidence of Using Chlorhexidine Percentages08:22 – Factors to Consider In Chlorhexidine Cases09:30 – Other Topical Anti-Septics to Consider10:44 – Diluting Bleach 13:50 – Addressing Concerns Around Bleach15:00 – Topical Antibiotic Use17:26 – Efficacy of Topical Therapy21:20 – Simple Things That Yield Good Results23:10 – Concurrent Use26:10 – Outro

Send me a question or story!This is the last installment in our series of DERM DRUGS. Monoclonal antibodies are becoming an important tool in veterinary dermatology — but what are they, and how do they actually work?In this episode, we break down monoclonal antibody therapy in practical terms. We explain how these targeted treatments are designed to recognize and block specific molecules in the immune system, helping reduce itch in allergic dogs without broadly suppressing immunity.We discuss commonly used products like Cytopoint which targets IL-31, a key cytokine involved in pruritus. We also introduce the announcement of an upcoming (not yet released) product called Befrena, another monoclonal antibody therapy, and what we know about this therapy today.00:00 – Intro02:07 – What is a Monoclonal Antibody03:18 – Cytopoint Basics05:35 – Potential Side-Effects06:33 – Befrena Basics08:44 – Overview09:22 – Outro

Send me a question or story!Janus kinase (JAK) inhibitors have become a cornerstone in managing pruritic and allergic skin disease in dogs by targeting the JAK-STAT signaling pathway, which transmits itch and inflammatory cytokine signals. With so many medications hitting the market, it is important to understand the differences between all of the different JAK inhibitors in veterinary medicine.Apoquel (oclacitinib) has been in the veterinary field the longest with over a decade of use. However, Zenrelia (ilunocitinib) has been available in many countries for over a year. Additionally, Numelvi (atinvicitinib) has recently become available in Europe and will hit the market in the United States very soon (with others to follow). Learn about the differences in these medications and why it is important to become comfortable with all of them on this week's episode of The Derm Vet podcast.Timestamps00:00 Intro01:35 JAK Inhibitor Basics02:35 What are JAK Receptors03:31 Apoquel and Zenrelia 05:20 Numelvi 07:57 How To Tell If a Pet Is Atopic 09:12 Are JAK Inhibitors Safe with Neoplasia11:32 What Does JAK Selectivity Mean 13:47 Common Side-Effects of JAK Inhibitors 17:01 Using JAK Inhibitors Off-Label18:51 Outro

Send me a question or story!In veterinary dermatology, gram-negative rods like Pseudomonas, E. coli, Proteus, etc. can develop in chronic or deep skin infections. When systemic therapy is needed, culture and sensitivity are essential. But what are some of the more common antibiotics that are effective against these nasty bugs?Common options include fluoroquinolones, potentiated penicillins, later-generation cephalosporins, etc. These organisms are frequently multidrug-resistant so appropriate diagnostics and re-evaluation is crucial.Learn more as we continue our current series on DERM DRUGS on this week's podcast!00:00 – Intro01:36 – General Things to Keep in Mind03:49 – The Importance of Topical Therapy05:31 – Systemic Therapy Options06:38 – Antibiotic Choices10:35 – Last Resort Antibiotics12:44 – Overview13:39 – Outro

Send me a question or story!When a senior dog walks in with multiple lumps and bumps, the big question becomes: which ones actually need a needle? And how do we make those decisions when time, finances, and patient comfort all matter?In this episode of The Derm Vet Podcast, I take a break from the Derm Drugs series to dive into an exciting new diagnostic technology... VISTA iQ. This conversation features Dr. Liron Levy-Hirsch (managing director for HT VET), who breaks down exactly what VISTA iQ is, how it works, and why it may be a game-changer for evaluating multiple masses in dogs.Timestamps02:29 What Does Vista IQ Do?04:03 Why Was This Tech Needed?06:07 The Basics of HT Vista08:17 The Practical Applications10:46 How the Science Works11:56 Process Efficiency13:15 Limitations of the Vista IQ15:21 How It Fits With Existing Tools16:28 Final Thoughts18:37 Outro

Send me a question or story!Continuing our DERM DRUG series... we are discussing one of the most common class of drugs asked about: antibiotics! Specifically, those used for staphyloccal pyoderma since it is seen almost every day in general practice.A majority of this discussion was developed from the newly updated ISCAID (International Society for Companion Animal Infectious Diseases). These guidelines were updated in 2025 and are open access to the public. You can find them at https://onlinelibrary.wiley.com/doi/10.1111/vde.13342.These guidelines cover duration of treatment, topical therapy and different tiers of systemic antibiotics. Which antibiotics can you feel more comfortable using empirically? Find out on this week's episode of The Derm Vet podcast!00:00 – Intro02:12 – Important Precursors05:37 – First Choice Drugs08:50 – Second Choice Drugs14:39 – Reserved Microbial Drugs21:21 – Overview23:47 – Outro

Send me a question or story!Welcome to our first podcast series of the year: DERM DRUGS! We will spend the next few weeks jumping into different categories of medication and provide real world application of when and how we reach for these medications.Our first installment in this series are anti-yeast medications. How do you know when to reach for systemic anti-yeast drugs? Which one should you pick? How long should you treat and when do you recheck?We address all of these questions and more on this week's episode of The Derm Vet podcast!00:00 – Intro02:53 – Azoles07:26 – Which Anti-Fungal to Choose12:27 – Azole Side Effects13:34 – Length of Treatment14:26 – Pulse Dosing18:45 – Overview

Send me a question or story!I have had quite a few cool video otoscopy procedures lately. With cool procedures, come the ability to share these videos and images online. With that, comes lots of questions from you!When should I refer for video otoscopy?What is the purpose of video otoscopy?When should I choose video otoscopy over everyday handheld otoscopy?We break down the four main reasons to consider video otoscopy. If you check out the YouTube channel, there are some cool images and videos or recent scopes that will confirm how cool this procedure can be!00:00 – Intro01:43 – Should you have a video otoscopy02:58 – Four main reasons to consider video otoscopy03:12 – Magnifying the image04:26 – Deep flushes06:15 – Middle ear cytology and culture07:37 – Removing things09:19 – Overview11:17 – Outro

Send me a question or story!Recurrent infections can be so difficult in our allergic patients. Learn how to minimize severity of frequency of pyoderma on this week's episode of The Derm Vet podcast!1. Work up the underlying allergies2. Support the skin barrier3. Adjust topical therapy accordingly4. Recognize historical patterns5. Refer to a dermatologist early in the disease00:00 – Intro02:24 – Working up the underlying allergies04:53 – Support the skin barrier07:36 – Adjust your topical therapy accordingly10:27 – Recognize historical patterns13:02 – Referring these patients early13:56 – Overview14:32 – Outro