llergy season is upon us, and many pets will soon be suffering from the spring bloom and changes in weather. However, our “allergy seasons”—spring and fall—are often accompanied by weather changes, particularly increased dryness. That raises an important question: Are we truly dealing with allergies, or are we dealing with dry skin?
One thing that always stands out to me is how veterinary dermatologists approach these so-called “allergy” cases. Their list of rule-outs typically includes environmental allergies, food allergies and parasites. But when fall arrives and we are complaining about our own dry skin, do we assume we all suddenly have allergies or parasites? Sometimes common sense needs to prevail.
Dermatologists emphasize that infections are almost always secondary, not the primary cause. It’s also important to remember that bacteria and fungi exist in competition; eliminate one, and the other often flourishes.
In an ideal world, once the primary “bug” is identified, it gives the veterinarian a starting point for treatment. I say starting point because many of the bacteria we see in skin infections are drug resistant.
Most of us are familiar with MRSA (methicillin-resistant Staphylococcus aureus), but in pets the more common concern is MRSP (methicillin-resistant Staphylococcus pseudintermedius). One dermatologist stated last year that 80% of his patients were MRSP-positive. With this in mind, when clients take their pets to the veterinarian for itching, it’s critical they request a culture and sensitivity test so treatment can be properly targeted.
In more refractory cases, or when autoimmune disease or cancer is suspected, a biopsy may be performed. This involves removing a full-thickness sample of skin so it can be fixed, sectioned and examined under a microscope. Biopsies are essential for diagnosing autoimmune diseases, sebaceous adenitis and many cancers.
It’s also important to note that a pet can test positive for an allergen without that allergen being the cause of their itching. Many of these reactions are subclinical, which likely contributes to the low success rate.
So, what about a definitive test for allergies? Unfortunately, there isn’t one. Allergies are a diagnosis of elimination—or, put another way, an educated guess—especially when dry skin isn’t even part of the conversation.
Treatment for these “allergies” commonly involves anti-itch medications such as steroids, Apoquel, Cyclosporine, Zenrelia or Cytopoint. Several dermatologists emphasized that Cytopoint, while effective for itch, does not function as an anti-inflammatory like the other drugs.
Most treatment protocols also include medication to address secondary infections. Food changes/trials may be recommended if food involvement is suspected, but this was not emphasized as strongly as other approaches.
Topical therapies are becoming increasingly popular in treating skin conditions. For resistant infections such as MRSA or MRSP, dermatologists recognize that topicals may provide benefit without the risks associated with strong systemic antibiotics. This is where many groomers were surprised.
Chlorhexidine was repeatedly recommended because, at a 3–4% concentration, it kills bacteria and fungi and has residual activity. That sounds great—until you consider what it does to the skin. You’re taking an itchy dog and applying a product known to dry and irritate healthy human skin. What outcome would you expect?
Repairing the skin barrier is paramount for long-term success. And replacing the skin’s oils is achieved through conditioners.
Anyone experienced with skin issues knows repairing the skin barrier is paramount for long-term success. And replacing the skin’s oils is achieved through conditioners. Yet in the last three years (and roughly 70 hours of continuing education), I have not heard a single dermatologist mention conditioners.
It’s also important to understand that dermatologists consider a 3/10 on the itch scale a successful outcome. But if you continue to be a good student of the science of hair and skin, and products and techniques, you can achieve results that go beyond what many dermatologists consider a good outcome. Groomers, you’ve got this—we aim for 0/10! &
Dr. Cliff Faver graduated with a BS in Biology/BA in Chemistry before getting a Veterinary degree in 1987. He is the past owner of Animal Health Services in Cave Creek, Arizona and now the US distributor for Iv San Bernard products, teaches the ISB Pet Aesthetician Certification program, and speaks internationally on hair and skin. His passion is to merge groomers and veterinarians to aid in helping and healing pets. He is also a member of AVMA, AAHA, AZVMA, Board member with Burbank Kennel Club, and has served on Novartis Lead Committee, Hill’s International Global Veterinary Board, and a Veterinary Management Group.