Skin Issues: A Little Relief

Having a basic knowledge of the types of conditions, diagnostic methods, and the many treatment options you offer will help make sure your customers are always prepared for one of the most common reasons pet owners visit their veterinarian.

During the time I’ve volunteered with shelters and rescues, I spent a few years working with dogs in an isolation building until they were deemed healthy enough to join the pets ready for adoption. I was amazed at the high percentage of pets – whether they’d been owner surrendered or picked up as strays – with untreated skin issues. Whether it was dry coats and flaky skin, hair loss, or painful ear infections, the dogs’ conditions ranged from uncomfortable to downright miserable, so it was reassuring to know they were finally getting proper treatment and relief.

Dermatology cases, including skin and ear issues, no doubt make up a significant portion of your small animal clinics’ daily caseloads. Skin issues may be easy for owners to spot but are often tough to diagnose since similar conditions can have several causes that may be curable or chronic. Pets can suffer from a wide variety of skin problems, including autoimmune diseases, fungal or bacterial infections, parasitic infestations, and allergic dermatitis. Conditions from more than one category are often present at the same time, with each problem building on the discomfort caused by the others.

Diagnosis and treatment steps

A thorough patient history is the first step towards a diagnosis and treatment plan. The vet will start the workup by looking for the easiest issues to identify and treat, then continue eliminating possible problems to get to the underlying cause or causes. This should include a complete skin exam from nose to tail, checking ears and skin folds and between the toes to find any skin lesions, and ruling out parasites like lice or fleas. Flea bite hypersensitivity, or flea allergy dermatitis (FAD), is a common cause of itching, hair loss and inflammation when a pet’s immune system overreacts to the saliva injected by fleas when they bite. Additional diagnostics may include skin scrapings with a No. 10 blade to look for superficial skin parasites like Sarcoptes mites and examining the hair follicles for deep-dwelling parasites such as Demodex canis and Demodex injai mites.

Cytology is an important diagnostic tool in dermatology to identify infectious bacteria or yeast, determine the presence of inflammatory cells such as neutrophils or eosinophils, and to track changes in infectious agents and inflammatory cells over time. A fine needle aspirate can help diagnose neoplasia of abnormal skin growths.

Fortunately, very few skin conditions are zoonotic, but the one that most commonly affects dogs and cats that can easily spread to humans is dermatophytosis, often known as ringworm. Rather than a worm, dermatophytosis is a superficial fungal infection that spreads through direct contact or exposure to a contaminated environment. Infected hairs can remain viable for up to 18 months, so it’s important for pet owners to completely clean the environment to protect animals and humans from being repeatedly infected.

If the problem is determined to be a fungal or bacterial infection, a variety of treatments are available, including oral antibiotics, steroids, medicated shampoos, supplements, and topical treatments. The use of topical therapies in pets has four main goals: to treat and prevent the recurrence of infections, decrease the scales or greasy skin of seborrhea, treat or prevent inflamed, itchy skin from pruritus, and improve the skin barrier.

There are so many topical products available for pets that it can be difficult for clinics to decide what to carry. Recommending multiuse products like combination antimicrobial/antifungal shampoos or antiseborrheic shampoos that are also moisturizing or antipruritic, can save both inventory costs and valuable shelf space. Owner compliance is a big factor in successfully treating skin conditions, so be ready to discuss the brands that carry the same formulations in a variety of products. For example, some owners may have difficulty bathing their pet, so suggesting shampoo alternatives like sprays, mousse, wipes, spot-ons and even skin care collars give owners a choice of options for more convenience, less stress, and better treatment results.

About 20% of pets with a dermatologic disorder have allergies. Environmental allergies are thought to originate with a defect in the barrier function of the skin and can include reactions to dust mites, pollens, dander, insect particles, and molds. Food allergies are caused by a similar defect in the gut. Different types of allergies can look the same, and patients can have more than one type, which can complicate the diagnosis.

Besides the flea allergy dermatitis discussed above, atopic dermatitis (AD) is the second most common pet allergy, affecting about 12% of both dogs and cats. Nearly 60 dog breeds are considered predisposed to the condition and purebred cats seem to have a higher risk. AD is an inherited predisposition to developing hypersensitivities to environmental allergens that results in chronic inflammatory skin disease, and both species tend to show clinical signs from 1 to 5 years of age.

Atopic dermatitis is a lifelong disease, but a multimodal treatment approach improves the quality of life for most pets. The epidermal barrier is abnormal in atopic pets, allowing allergens to penetrate the skin. Topical therapies containing 3% to 4% chlorhexidine decrease bacteria, remove allergens from the surface of the skin, and help restore the top layer of the epidermis. Treatment with systemic antipruritics is necessary for most cases of AD. Options include oral Apoquel (oclacitinib) that blocks the itch receptor; injectable Cytopoint (lokivetmab) a biological that binds to the molecule that triggers itch receptors and neutralizes them; Atopica or Sporimune (cyclosporine) or corticosteroids.

Your clinics may recommend diets and supplements high in fatty acids that contain vitamins clinically proven to improve the epidermal barrier and decrease pruritus in dogs with AD. Diets include Royal Canin Skin Support, Hill’s Prescription Diet Derm Defense Canine, and Hill’s Prescription Diet Derm Complete. Redonyl Ultra is a nutraceutical soft chew and Dermaquin Skin Support Supplement is a soft chew that helps support and fortify the skin barrier.

The overall health and vitality of a pet is strongly linked to the health of their skin, and dermatological issues have a negative impact on the quality of life for both the patient and the pet owner. Being familiar with the functions and benefits of the many dermatology products you offer can help your customers successfully treat these challenging conditions.

Common skin problems

Pets can suffer from a wide variety of skin problems, including:

• Autoimmune diseases
• Fungal or bacterial infections
• Parasitic infestations
• Allergic dermatitis

Dawn Singleton-Olson has more than 25 years of experience in the animal health industry, including distributor sales, manufacturing, practice management and as a zoo supervisor. She is a volunteer, fundraiser and board trustee for several humane organizations and the Omaha (Neb.) Police Mounted Patrol.

Photo credits: istockphoto.com/Anna Reshetnikova; istockphoto.com/RuslanDashinsky