Veterinary Medicine - November 2008 - (Page PD14)

IMAGE: GETTY IMAGES 10TO AVOID COMMON MISTAKES Lowell Ackerman DVM, DACVD, MBA, MPA Clinical Professor, Tufts University Cummings School of Veterinary Medicine, North Grafton, MA. Senior Specialty Hospital Liaison, Pﬁzer Animal Health DERMATOLOGY MADE EASIER: Managing a pet’s chronic dermatologic conditions can be frustrating to both clients and clinicians, but there are tips to making the process easier for everyone. Avoid the following 10 mistakes sometimes made in managing dermatology cases and you’ll ﬁnd the process considerably easier in the future. inking cure, rather than control: Most pet skin problems can not be cured, regardless of the medication selected, so set realistic expectations with clients early on. When discussing the management of conditions such as allergies, I tell clients that it is like managing diabetes or degenerative joint disease. We can often achieve long-term control with ongoing close monitoring and intervention, but it’s unlikely that we’ll be able to “ﬁx” the underlying problem. Not scheduling eﬀectively: No one can solve a complicated dermatology case in a single visit, regardless of the appointment’s duration. You can address the client’s primary concerns, but be clear with the client that the pet’s problems will not be solved with that single visit. The key to successful dermatology management is scheduling frequent follow-up examinations. Ignoring the basics: Utilizing the basics, such as skin scrapings, cytologies, and fungal cultures, is good medicine and good business. And, if you do have something such as sarcoptic mange on your list of differential diagnoses, it is reasonable to do a parasite-control trial with selamectin—even if you don’t ﬁnd parasites on the scrapings. A properly conducted dietary trial also yields a lot of useful information in the workup of a pruritic animal. Expecting too much from one modality: Most dermatologists will tell you that many clients come to referral appointments with a plastic bag full of products that have been ineffective. Clients are often looking for the magic bullet, that special drug that the dermatologist has access to, but the primarycare veterinarian does not. The reality is that dermatologists rarely rely on one product to help their patients. In fact, the number of products that we dispense for clients to use all at one time is sometimes overwhelming, and can adversely affect compliance. Not anticipating recurrence: Because most dermatologic 14 PRACTICAL DERMATOLOGY FOR THE BUSY PRACTITIONER

Table of Contents Feed for the Digital Edition of Veterinary Medicine - November 2008

Veterinary Medicine - November 2008 Contents Leading Off Editors' Guest Just Ask the Expert Letters Practice Makes Perfect Clinical Exposures Practice Matters Idea Exchange Author Guidelines A Challenging Case: Esophageal Leiomyoma in a Dog Osteoarthritis in Cats: What We Now Know About Recognition and Treatment Product Preview CE Form/Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - November 2008

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