The Derm Vet Podcast

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In this episode, I dig into why rechecks matter in veterinary dermatology: how I set expectations with owners from the first visit, what I look for at a recheck, the problems that slip through when owners skip them, and how I celebrate the “happy recheck” when things are going well. Plus, why “boring” is the best word in dermatology.

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TIMESTAMPS

00:00 Intro
01:00 Itch Inquiry: Acral Lick Granulomas
04:40 Why Rechecks Matter
05:18 The Recheck Is Part of the Treatment Plan
06:43 What We’re Actually Looking for at a Recheck
09:02 Pitfalls When Owners Skip Rechecks
10:06 Case Stories: When It’s Not Just Allergies
11:17 Catching Patterns, Compliance, and Itch Scores
15:00 The “Happy Recheck”
16:15 “Boring Is Great”
16:51 Outro

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What happens when a dermatology patient you've treated for years suddenly develops symptoms that don't quite add up? Is it another allergy flare, or could something entirely different be going on?

In this episode of The Derm Vet Podcast, I share two fascinating clinical cases that highlight the importance of looking beyond a patient's history and reconsidering your diagnosis when something doesn't fit.

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Timestamps
00:00 Intro
00:41 Itch Inquiry: Maintenance Ear Cleaning
05:20 Case 1: The Bulldog’s “Interdigital Furuncle”
06:46 The Exam
08:40 The Aspirate Reveals a Plasmacytoma
10:52 Why You Can’t Assume It’s the Same as Last Time
12:06 Case 2: Sam, the Allergic Lab
14:20 “Boring” Cytology
16:46 Taking a Fresh Lens
17:40 Outro

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What happens when a dog you've successfully managed for allergies suddenly starts developing new symptoms, recurrent pyoderma, or worsening pruritus? Is it truly a progression of atopic dermatitis, or could something else be going on?

In this episode of The Derm Vet, I explore the importance of reframing your diagnostic approach when chronic dermatology cases stop responding to previously successful treatments.

Building on last week's refractory allergy checklist, I share a practical framework to help veterinarians recognize when it's time to reconsider an existing diagnosis, investigate concurrent diseases, identify overlooked allergy flare factors, or adjust long-term treatment strategies.

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Timestamps
00:00 Intro
00:24 Zoetis Ad
00:54 Working Mom Check In
02:27 Setting Up "The Allergy Reframe"
03:47 Itch Inquiry: Refractory Papilloma
07:10 Signs A Long-Managed Allergy Case Is Changing
09:26 Reframe #1
12:21 Reframe #2
14:19 Reframe #3
15:28 Reframe #4
17:18 Summary
19:25 Outro

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What do you do when an itchy dog just isn’t responding to allergy treatment the way you expected?

In this episode of The Derm Vet Podcast, I break down my refractory allergy checklist to help veterinary professionals reevaluate difficult allergy cases. From choosing the wrong medication or dose to poor compliance, concurrent disease, and even an incorrect diagnosis, I walk through the key questions to ask before labeling a patient as a treatment failure.

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Timestamps
00:00 Intro
01:56 Itch Inquiry: Managing a 7-Month-Old Allergic Dog
03:43 Refractory Allergy Checklist
04:10 #1 The Wrong Drug
05:27 #2 Wrong Dose
06:24 #3 Too Short a Duration
07:44 #4 Wrong Expectations
09:04 #5 Poor Compliance
10:13 #6 Concurrent Disease
12:00 #7 It's Not Allergies: Mimics & Lookalikes
14:10 Recap and Outro

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Lupus can show up in more ways than one in veterinary dermatology!

In this episode of The Derm Vet Podcast, I break down three important lupus and lupoid diseases seen in dogs: discoid lupus erythematosus (DLE), symmetrical lupoid onychodystrophy (SLO), and mucocutaneous lupus erythematosus (MCLE).

Learn the clinical signs that should put these autoimmune diseases on your differential list, from loss of the normal cobblestone appearance of the nasal planum to painful nail loss and persistent mucocutaneous ulcerations. I also discusses diagnosis, biopsy considerations, and treatment options, including the growing off-label use of JAK inhibitors in autoimmune skin disease.

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Timestamps
00:00 Intro
00:44 Itch Inquiry: Off-Label JAK Inhibitors for Autoimmune Diseases
02:33 Systemic Lupus Erythematosus (SLE) Overview
03:15 Discoid Lupus Erythematosus (DLE): Clinical Signs & Diagnosis
06:03 Treatment Strategies for DLE
07:28 Symmetrical Lupoid Onychodystrophy (SLO): Presentation & Diagnostics
09:03 Managing and Treating SLO
10:42 Mucocutaneous Lupus Erythematosus (MCLE)
12:11 Summary & Outro

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Is your allergic patient still itching despite treatment? They may be dealing with more than one allergy!

In this episode, I break down how to identify the multi-allergy veterinary patient and recognize the clues that suggest multiple underlying causes of pruritus. I discuss partial responses to allergy therapy, seasonal changes in itching, persistent problem areas, recurrent otitis, and why different lesions may respond differently to treatment.

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Timestamps
00:00 Intro
00:43 Itch Inquiry: Managing Chronic Ear Inflammation & Steroid Therapy
04:19 Identifying the Multi-Allergy Patient
06:11 Clue 1: Partial Response to Allergy Therapy
07:16 Clue 2: Seasonally Fluctuating Pruritus
08:26 Clue 3: Persistent Itch in Specific Anatomical Regions
09:57 Clue 4: Recurrent Otitis vs. Improving Skin Disease
11:52 Clue 5: Variable Lesion Response Across Treatments
13:28 Recap
14:59 Outro

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French Bulldogs, English Bulldogs, and other brachycephalic breeds are frequent flyers in veterinary dermatology but successfully managing their skin disease often requires looking beyond the obvious itch.

In this episode of The Derm Vet Podcast, I break down some of the most common dermatologic problems seen in brachycephalic dogs, including skin fold dermatitis (intertrigo), pododermatitis, secondary infections, and underlying food and environmental allergies.

Learn why examining every facial, tail, and vulvar fold matters, how cytology can guide treatment, why topical therapy is so important for both treatment and long-term maintenance, and how to build an allergy workup that is realistic for both the patient and owner.

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Timestamps
00:00 Intro
00:52 Itch Inquiry: Feline Ear Flushing and Horner's Syndrome Risk
04:05 Fold Dermatitis and Key Fold Locations
07:14 Cytology and Topical Therapies for Skin Fold Infections
09:58 Pododermatitis
12:48 Allergic Workups and Long-Term Inflammatory Options
16:15 Overview and Final Takeaways
18:03 Outro

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In veterinary dermatology, the right diagnosis often starts before the physical exam... it starts with the history!

In this episode of The Derm Vet, I break down how a thorough dermatologic history can help veterinary professionals build stronger differential lists, choose more targeted diagnostics, and develop more effective treatment plans.

Whether you're working through a new pruritic patient or reevaluating a case that isn't responding as expected, this episode highlights the historical clues you don't want to overlook!

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Timestamps
00:00 Intro
00:24 The Value of History Taking in Veterinary Dermatology
03:52 Itch Inquiry: Cyclosporine Use in Allergic Disease
06:00 Building Differentials, Diagnostic Plans, and Treatments
08:30 Core History Basics: Signalment, Seasonality, and Travel
12:15 Age of Onset Considerations
14:46 Analyzing Past Medication Responses
16:03 Identifying Systemic Signs and Underlying Internal Disease
17:59 Reevaluating History in Chronic Cases
20:05 Outro

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Crusty, irritated, or abnormal paw pads in cats can point to much more than a simple skin problem. In this episode of The Derm Vet Podcast, I break down the differential diagnoses behind feline crusty paw pads, including plasma cell pododermatitis, autoimmune disease, allergies, eosinophilic granulomas, contact dermatitis, infections, trauma, cutaneous horns, and even neoplasia.

Plus, this week’s Itch Inquiry features a medication-averse German Shepherd and a discussion about the limitations of monoclonal antibody therapy!

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Timestamps
00:00 Intro
00:24 Itch Inquiry: Case Study of a Med-Averse German Shepherd
05:20 Limitations of Monoclonal Antibodies
07:00 Feline Crust Paw Pads
07:44 Plasma Cell Pododermatitis
10:58 Autoimmune Causes
12:22 Allergic Conditions, Eosinophilic Granulomas, and Contact Dermatitis
13:52 Infectious, Viral, Fungal, and Traumatic/Burn Causes
16:02 Cutaneous Horns, Neoplasia, Lung-Digit Syndrome, and Diagnostic Workup
19:02 Outro

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Crusty paw pads may seem like a straightforward dermatologic finding... but they can point to everything from simple hyperkeratosis to autoimmune, metabolic, infectious, and even systemic disease!

In this episode of The Derm Vet Podcast, I break down my diagnostic approach to canine paw pad disease and the major differentials veterinarians should keep on their radar. I cover hyperkeratosis, pemphigus foliaceus, erythema multiforme, vasculitis, hepatocutaneous syndrome, zinc-responsive dermatosis, canine distemper, infections, trauma, and more. Plus, learn why lesion distribution, breed, systemic signs, and (most importantly) biopsy can be critical for reaching the right diagnosis!

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Timestamps
00:00 Intro
00:24 Itch Inquiry: Feline Inflammatory Ear Polyps
04:46 Canine Paw Pad Disease
05:17 Primary Hyperkeratosis & Weight-Bearing Patterns
07:31 Autoimmune Paw Pad Diseases
09:58 Metabolic Causes
12:47 Infectious, Traumatic, & Viral Causes
14:25 Outro

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Allergy cases are rarely straightforward... and explaining the diagnostic process to pet owners can be just as challenging as managing the itch.

In this episode of The Derm Vet Podcast, I break down a practical approach to talking with clients about allergic skin disease in dogs and cats. From ectoparasites and food allergies to environmental allergies, learn how to organize the conversation so owners understand not only what you're recommending, but why it matters.

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Timestamps
00:00 Intro
00:24 Zoetis Ad
02:13 Itch Inquiry: Convincing Owners on Symptomatic Meds
06:08 Category 1: Ectoparasite Control
09:05 Category 2: Food Allergies & Diet Trials
11:13 Category 3: Environmental Allergies & Symptomatic Therapy
13:24 Allergy Testing & Immunotherapy
16:14 Tailoring Communication and Visual Aids
20:10 Outro

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Why do cats develop crusting, curling, inflammation, or unusual lesions on their ears? In this episode of The Derm Vet Podcast, I'm diving into feline pinnal diseases and the dermatologic conditions that can affect the feline ear.

I cover why oral exams are an important part of evaluating itchy cats, reactions to topical steroids that can cause pinna curling, and key conditions including solar dermatitis, auricular chondritis, cystomatosis, pemphigus foliaceus, and proliferative necrotizing otitis externa!

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Timestamps
00:00 Intro
00:24 Feline Pinnal Diseases
01:37 Itch Inquiry: Why Perform Oral Exams on Cats
03:45 Topical Steroid Reactions & Pinna Curling
04:55 Solar Dermatitis
06:53 Auricular Chondritis
08:23 Cystomatosis
10:44 Pemphigus Foliaceus
12:36 Proliferative Necrotizing Otitis Externa

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In this episode, I answer a listener question about off-label JAK inhibitor dosing before taking a deep dive into common canine pinnal (ear flap) diseases. Learn how to recognize and manage canine scabies, pinnal vasculitis, pemphigus foliaceus, ear margin seborrhea, zinc-responsive dermatosis, and thrombovascular necrosis. Whether you're a veterinarian, veterinary technician, or student, this episode delivers practical dermatology insights you can use in practice!

Watch The Episode: https://www.youtube.com/@thedermvet3932
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Timestamps
00:00 Intro
00:54 Itch Inquiry: Off-Label JAK Inhibitor Dosing and Usage
05:32 Introduction to Canine Pinnal Diseases and Ear Anatomy
08:08 Canine Scabies
09:33 Pinnal Vasculitis Presentation and Management
11:22 Pemphigus Foliaceus
13:08 Ear Margin Seborrhea
14:27 Zinc Dermatitis
15:47 Thrombovascular Necrosis
16:45 Outro

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Dogs don't always scratch when they're itchy and that can make diagnosing allergic skin disease much more challenging! In this episode of The Derm Vet Podcast, I break down the subtle and commonly overlooked signs of itching in dogs, from scooting that isn't caused by anal glands to head shaking, excessive licking, perineal dermatitis, and secondary skin changes that can easily be missed during an exam.

Watch The Episode: https://www.youtube.com/@thedermvet3932
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Timestamps
00:00 Intro
00:24 Zoetis
01:15 Itch Inquiry: Non-Anal Sac Causes of Scooting
03:25 How to Tell If a Dog is Itchy
06:03 Common Itching Behaviors
08:42 Overlooked Indicators
10:35 Perineal Dermatitis and Head Shaking
13:16 Identifying Secondary Skin Changes
15:39 Outro

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How do feline dermatology cases differ from canine dermatology? In this episode, I answer a listener's question on treating yeast-only ear infections before breaking down three major clinical differences between cats and dogs... from ear flap lesions and claw fold inflammation to oral cavity and mucous membrane disease!

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Timestamps
00:00 Intro
02:20 Itch Inquiry: Treating Yeast-Only Ear Infections
05:51 Feline vs Canine Dermatologic Distributions
06:27 Difference 1: Pinna (Ear Flap) Lesions
08:27 Difference 2: Claw Fold Inflammation
11:00 Difference 3: Oral Cavity & Mucous Membrane Lesions
13:58 Outro

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Constant scratching, chewing, and ear infections aren't just annoying... they're your patient's way of telling you something's wrong! In this episode, I break down everything veterinary professionals need to know about managing allergic dogs, from spotting the first signs of trouble to building a long-term treatment plan that actually works.

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Timestamps
00:00 Intro
01:39 Itch Inquiry
02:55 Maintenance Therapy for Allergic Dogs
05:35 Nutrition
06:07 Ear Care
07:19 Client Education and Early Detection
09:34 Utilizing Our Pharmaceuticals
11:27 Identifying Allergy Triggers
13:09 Routine Rechecks
15:27 Summary
17:39 Outro

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Is allergen-specific immunotherapy the closest thing we have to changing the course of allergic disease in dogs?

In this episode of The Derm Vet Podcast, I explore why immunotherapy remains the gold standard for long-term allergy management and how it differs from simply controlling itch. She explains how starting treatment early may help reduce the progression of allergic disease, what pet owners should realistically expect from immunotherapy, and why educating clients is critical to long-term success.

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Timestamps:
00:00 Intro
01:39 Itch Inquiry: Distinguishing Autoimmune Disease from Neoplastic Disease
04:40 Immunotherapy
06:05 Proactively Halting the Progression of Allergic Disease
07:30 Natural Therapy
08:14 Instilling Trust in Your Client
09:28 Preparing for Future Health Uncertainties
13:06 Outro

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Learn how rostrolateral nasal alar arteriopathy is diagnosed, why it can be mistaken for other conditions, and the treatment options available to help improve quality of life. I also discusses setting realistic owner expectations and the importance of recognizing uncommon dermatologic diseases in veterinary medicine.

Whether you're a veterinarian, veterinary technician, or veterinary student, this episode provides practical clinical insights you can apply to future cases.

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Fleischman DA, Mauldin EA, Lowe A, Cain CL, Bradley CW. Clinical and histopathological features of rostrolateral nasal alar arteriopathy of German shepherd dogs. Vet Dermatol. 2023;34:441–451. https://doi.org/10.1111/vde.13173

Timestamps
00:00 Intro
01:32 Itch Inquiry: Topicals for General Practice
06:20 German Shepherd with Chronic Nasal Bleeding
09:29 Diagnosis: Rostrolateral Nasal Alar Arteriopathy
12:02 Treatment Options & Owner Expectations
14:44 Outro

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Client communication can make or break even the best dermatology treatment plan...

In this episode of The Derm Vet Podcast, I answer a listener's question about improving cytology skills in veterinary practice before diving into one of the most valuable communication frameworks I've found for challenging client interactions: The 5 E's.

Whether you're discussing chronic allergies, recurrent skin infections, or complex treatment plans, frustrated clients are inevitable. The key is knowing how to navigate those conversations with confidence!

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Timestamps
00:00 Intro
01:14 Itch Inquiry
03:10 The 5 E's in Dealing with Frustrated Clients
03:40 Empathize with the Client
05:47 Expectations
07:08 Expense
08:14 Effort
10:23 Encouragement
12:18 Summary/Outro

Send me a derm question or story through text or voicemail!

In this episode, I tackle some of the most common (and challenging) questions surrounding the diagnosis, treatment, and long-term management of canine otitis externa. From maintenance therapy protocols and cleaning strategies to biofilm management, chronic stenosis, ear cultures, and the role of AI-powered cytology, I share practical insights you can apply in everyday practice.

Watch The Episode: https://www.youtube.com/@thedermvet3932
Follow The Derm Vet Podcast: https://www.instagram.com/thedermvetpod/
Follow Me: https://www.instagram.com/thedermvet/

Timestamps
00:00 Intro
01:25 Itch Inquiry: For maintenance therapy, do you suggest using a combination product weekly as maintenance?
04:30 What is your favorite product as a cleanser when the patient has biofilm?
06:51 How do tackle chronic stenosis?
09:12 What is your favorite maintenance cleaning product?
10:31 When dogs have recurrent otitis, how often do you suggest maintenance cleaning?
12:37 What do you think of the various AI cytology machines?
14:27 What is the usefulness of an ear culture for otitis externa?
16:15 What do you consider for broad spectrum treatment for otitis?
17:40 Besides ear flushing, what other treatments do you use for maintenance?
18:18 Outro