The Two Ends of the Dermatology Spectrum Which ALWAYS WORK.
At the most basic level, almost all skin cases can be managed by Steroids and Antibiotics. There are very few cases that wouldn’t stop itching and heal’ on Prednisone (or a Prednisone shot called Depo Medrol) and some antibiotics. That’s how we did it in the eighties. A dog would come in and we could turn out a happy owner and dog with a “Depo and some Clavamox” but also, witness them suffer between cycles of meds, or keep them on that pair of meds 24x7x365 and watch them slowly deteriorate in other health-areas. But it really worked. And some vets still do that as a matter of reflex or habit.
It’s not fancy and it hurts them in the long-long run but it really works.
(Specialist who ends up employing ALL treatment modalities together in ALL most ALL cases.) If history is any indicator, Dermat-ALL-ogists will avoid steroids but put your dog on everything else to treat literally, everything else. I’m not kidding. The last two cases came home with a $1700 bill for allergy-testing, skin cultures and biopsies and then “just in case” treatments for literally EVERYTHING that can go wrong in the dog’s skin, from infection to ringworm, to food allergy, to mites to atopy. Basically the whole pharmacy and a special diet, MINUS steroids. What was the point of all that testing if you’re going to start ALL medicines anyway?
- Cytopoint AND/OR Apoquel
- Antibiotics for perpetuity
- Antihistamines for perpetuity
- Ivermectin based anti-mite treatments for perpetuity (Bravecto or similar)
- Hypoallergenic / limited antigen / hydrolyzed-protein food for perpetuity
- Antimicrobial and antifungal baths at a high frequency for perpetuity
I can do this, instead of referral if it appeals, but it’s an expensive, scorched-earth approach which requires zero skill. But works. At least you won’t have to pay a top-dollar dermat-ALL-ogist to prescribe and supply all these medicines.
No ‘cause’ is specifically found, and great expense goes into treating a dog for literally everything, never knowing what part of the care you can stop.
*I am NOT belittling Dermatologists – They know more about skin than I know about the entirety of Vet Medicine, but it doesn’t always translate into a novel or minimalistic approach to cases.
And I can do EITHER one or something in the middle.
What I Normally Do
We can address the symptom with as little medicine as possible, using moisturizers, wet washcloths, baby wipes, nutritional modifications, and non-steroidal approaches and minimizing the use and impact of antibiotics. This is my normal approach, it’s cheaper, but it’s a little labor-intensive, and might involve some itching that persists despite your efforts. At least at first.
But most people are naturally ‘results oriented’ and want suppression of symptoms RIGHT NOW and they’re alright with the considerable expense (Dermat-ALL-ogist panel) of meds, or ‘Roidabiotics’, with those side effects 12 months from now using certain medicines in that admittedly effective regime.
© 2019 drjohnson.com/spectrum
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