322. Why Your Otitis Cases Aren’t Healing (And How to Fix Them Fast)

Send me a derm question or story through text or voicemail!When an otitis case just won’t clear, there are often simple changes we can make to be more successful. In this episode, we break down the most common (and fixable) reasons ear infections fail to respond in clinical practice.From real-world struggles with client compliance and patient tolerance, to the often-overlooked importance of proper ear flushing, we unpack where cases go off track—and how to get them back on course. We’ll also dive into the consequences of choosing the wrong topical therapy, and why matching treatment to cytology is non-negotiable for success.Whether you’re dealing with repeat offenders or frustrating first-time failures, this episode offers practical, clinic-ready insights to help you troubleshoot smarter, treat more effectively, and set both your patients and clients up for long-term success.Timestamps 00:00 Intro00:24 Itch Inquiry03:47 Why that Ear Infection isn't Responding05:18 Lack of Inflammation Control06:55 The Wrong Medication08:32 Not Using Appropriate Flushing Methods11:19 It's Not Getting In There13:16 We Don't Know Why It's Happening15:34 Review17:54 Outro 

Send me a derm question or story through text or voicemail!In this episode, we take a closer look at the often-overlooked areas of the dermatologic exam in allergic dogs—because the clues you’re missing may be the ones that matter most. From the ventral neck and axilla to claw folds, lip margins, and perianal regions, these hidden sites frequently harbor early or persistent lesions that can shape your diagnosis and treatment plan. We’ll discuss why these areas are commonly skipped, what subtle findings to look for, and how a more thorough dermatology exam can improve case outcomes.Tune in for practical tips to elevate your dermatology exams, catch lesions earlier, and avoid missing key pieces of the allergy puzzle.Want to ask a question or share a story to be featured on the podcast? Tap the link at the top of the show notes to text an inquiry or leave a voicemail!Timestamps00:00 Intro01:57 Ventral Neck03:14 Axilla04:21 Claw Folds06:05 Lip Margins07:28 Perianal Region08:51 Pinna10:23 Other Folds 13:14 Review/Summary15:55 Outro

Send me a derm question or story through text or voicemail!In this week's episode, we explore an interesting feline case that illustrates why no detail should ever be overlooked. When a "perky nose" complaint actually becomes plasma cell pododermatitis.Using this case as a guide, we highlight how critical it is to go beyond the presenting complaint. A thorough dermatologic exam, combined with a detailed history, can uncover subtle abnormalities that completely change your diagnostic path, treatment plan, and ultimately, patient outcome. It’s a good reminder that even when a diagnosis seems obvious, there could be clinical clues that point you a different direction.We discuss how this case unfolded, what could have been missed with a more limited approach, and practical strategies to ensure you’re consistently gathering complete information in every appointment.References:Declercq J, DeBosschere H. Nasal swelling due to plasma cell infiltrate in a cat without plasma cell pododermatitis. Vet Dermatol. 2010;21:412–414. doi: 10.1111/j.1365-3164.2010.00869.x.Brosseau G. Feline plasma cell pododermatitis. Can Vet J. 2022 May;63(5):545-548. PMID: 35502252; PMCID: PMC9009751.Timestamps00:00 Intro03:50 The Swollen Nose07:02 Deflated Paws09:12 Biopsy and Diagnosis Confirmation12:09 Importance of Looking at the Complete History16:53 Outro

Send me a derm question or story through text or voicemail!Allergy cases can be REALLY tough!In this week's podcast episode, we explore how veterinarians and staff can build confidence using the full range of allergy medications available. From JAK inhibitors to monoclonal antibodies to cyclosporine, I discuss the importance of knowing the mechanisms and clinical applications of these medications. Atopic dermatitis is a syndrome with many layers. You can have your favorite allergy drugs, but there will always be difficult cases that don't respond and we need to try something different.Tune in for practical insights, real-world case strategies, and tips to help you feel more comfortable navigating complex allergic conditions. Studies:https://pubmed.ncbi.nlm.nih.gov/34344611/https://pubmed.ncbi.nlm.nih.gov/20887404/Timestamps00:00 Intro00:44 New Segments Starting Soon02:07 Being Comfortable w/ Allergy Medications03:25 Breed-Specific Allergy Phenotypes05:07 JAK Inhibitors06:45 Monoclonal Antibodies08:36 Cyclosporine09:58 Summary12:41 Outro

Send me a derm question or story through text or voicemail!Feline dermatology be tricky and daunting. It is easy to skip over simple steps that can make a big difference in your allergic cat management. In this episode, we break down four of the most common missteps that in managing feline skin cases.First, we tackle how to be ABSOLUTELY sure you have eliminated flea allergy dermatitis as a cause of pruritus. Next, we explore how cats express skin disease in unique ways that can be missed by owners and veterinarians such rodent ulcers.We dive into inappropriate diagnosis of food allergies, explaining why true elimination diet trials are essential and often done incorrectly. Finally, we emphasize the importance of not skipping basic diagnostics like cytology and fungal testing—foundational steps that are sometimes overlooked in favor of quick treatments such as steroids.Whether you’re a practicing veterinarian or a student, this episode can give you easy tips to implement in the clinic tomorrow for your itchy cat patients!Timestamps00:00 Intro02:22 Fleas and Ectoparasites06:33 Recognizing Unique Lesions08:50 Overdiagnosing10:58 Skipping Basic Diagnostics13:23 Summary15:48 Outro

Send me a derm question or story through text or voicemail!Remembering how to treat and prevent otitis in a complete manner can be difficult in a busy general practice. There are different acronyms to help, but everybody remembers things a bit differently.This week's podcast goes over a new acronym to make acute and chronic otitis management a bit easier.E: etiology (what infection is present)A: appearance (what does the debris look like and where is it)R: Reason (what is the primary cause)S: Support (how do we manage this long-term)EARS to help ears. Let me know your thoughts on this week's episode!Timestamps00:00 Intro01:05 EARS01:27 Etiology03:11 Appearance 04:38 Reason06:22 Support08:14 Summary09:22 Outro

Send me a derm question or story through text or voicemail!Really red, inflamed and itchy cases can be tough to differentiate. Could it be allergies? Maybe something else like an autoimmune disease has popped up...On this week's episode of The Derm Vet podcast, we discuss five RED FLAGS that you should have an autoimmune disease on your differential list.Timestamps00:00 Intro02:14 Red Flag #1: Mucous Membranes03:40 Red Flag #2: Crusting with No Infection06:12 Red Flag #3: Weird Types of Lesions08:58 Red Flag #4: Systemic Signs10:50 Red Flag #5: Weird Distribution13:51 Summary14:55 Outro

Send me a derm question or story through text or voicemail!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 derm question or story through text or voicemail!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 derm question or story through text or voicemail!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