Itching for a Permanent Cure

Dog owners come into my clinic every day seeking help with skin issues. Sometimes it’s been going on just a short time, but not infrequently the patient has wandered far into dermatological misery. We see animals that are mostly bald, animals that are entirely red (an undesirable skin color for any breed), patients that can not pause from scratching themselves, even ones that we can smell from 20 feet away.

It didn’t get this way overnight, so it is not going to be reversed overnight. Skin issues virtually always require multiple visits and multiple medications. No matter how badly you want it, the doctor will not be able to set you on a guaranteed path to success at your first meeting. A treatment plan will be chosen, and you will be sent home to execute it. At the recheck visit, you will provide a precise report on what you observed at home. A new medication or therapy will then be added, or one of the previous ones will be replaced. Tough dermatology cases usually require a lot of treatments at the outset, with attempts to withdraw as many medicines as possible as the skin improves.

It could get expensive. There is absolutely no joy in telling someone that more money needs to be spent on their problem. Multiple visits do add up, but they are non-negotiable. If an overly expensive drug is suggested, ask about options. You won’t be the first to do so. Maybe there is some kind of alternative.

It could be labor-intensive. Injudicious use of antibiotics threatens all future patients (animal and human)and our environment itself. The responsible treatment of skin may therefore rely heavily on shampoos, rinses, and sprays, which have much less environmental impact. In general, these take substantially more of your time and attention than feeding a pill twice a day. Sorry… but the planet is grateful for your efforts.

There might not be a cure. The vast majority of chronic skin problems in dogs are linked to the immune system, and a problematic immune system needs constant tending. If you’re lucky, that involves keeping a calendar or diary so that you can pounce on your annual allergy flare-up before it progresses too far. If you’re less lucky, it means medication could be needed for the rest of your pet’s life. Fortunately, this is much safer than it was with older allergy drugs.

Please don’t bother saying, “We’ve tried everything.” This is a phrase people use when they are frustrated and feeling hopeless, a condition often observed in folks who own a balding, itchy dog. Do bring a list all the specific things you have tried; this will help us bypass or reconsider certain therapies. If you have actually “tried everything,” the doctor will sign off onit, releasing you to go home and wallow in self-pity. Since that never happens, be sure to come to each visit with your game face on. If you’re willing to put forth your best effort, we’ll go to the ends of the earth to help you both live a better life.

Dr. M.S. Regan