I have a few "topics" I thought about discussing that were inspired by some cases recently but today one of my last cases made such an impression, I'm using that as blog fodder today.
A middle-aged lab mix came in to have a skin problem evaluated. This has been going on for over a year. Another practice saw it, then another vet at this practice saw it and treated it differently. All of that was many months ago. In the meantime, the owner had changed the diet and got some meds "off the internet." Hm. Whatever they are.
The owner was also advised to seek the counsel of a veterinary dermatologist. This is not a bad idea in a case like hers. Skin problems are among the most common reasons us general practitioners see dogs. They are also among the most frustrating to treat. One reason is compliance, but another is that many of them are and will be chronic. It seems even when I tell owners this up front, they still don't "get it." They'll treat for a while and then stop or not have a follow up visit.
This client told me she didn't want to see a veterinary dermatologist. I thought money would be the reason. That's fair and understandable. Yes, specialists do cost more. Her reason was not that. Her reason was that she felt they wouldn't solve the problem. Huh? But I can? I hope. If she hears what I am saying I guess. Still, THEY deal with the worst, most unsolvable problems that us GP's cannot seem to fix or at least the owners hear the same thing from a $150/visit specialist so they actually do listen!
In any case, this dog has a condition that is chronic- a yeast infection of the skin. There can be underlying allergies but again, that can take a lot of time, money and diligence on the owner to figure out. Food allergies are complex. She has the pet on a "grain free" diet - a trend these days. However, all dogs are not simply wheat or corn sensitive. I've seen those that have issues with eggs, peas, pork, lamb, chicken, beef...get the picture? A true food trial involves a novel protein/carb diet for 8-12 weeks with NO..NO..No other treats/foods, etc. AND then you re-challange the dog with the old diet. THAT is a true diet trial.
The other component is inhalant allergies. We can blood test for these. This can be costly and will require injections if there are things the pet reacts to.
This dog needs to be on long term oral meds for her skin. And by long term, I mean life time. She will get weaned to a 2-3x/weekly dose at some point if the owners follow up properly.
Situations like this are frustrating for us too. We want to see these animals get better but it requires a TEAM effort.
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