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Fuss-free derm: 5 products to handle most veterinary skin problems
Pustules, crusts and hot spots not your thing? These basic treatment options have you covered for most casesyou can always refer the rest.
If you find dermatology products too confusing, too time-consuming, or just a downright waste of your time, then keep reading. We're going to discuss the absolute basic dermatology products you need to be successful and remain efficient. Here are five that should be in your skin care arsenal.
1. Antimicrobial shampoo
There can be no argument that the most common skin problem of small animal patients is allergy. However, most of your allergy patients present because of infection. Chosen wisely, topical therapy treats infection, prevents infection and also supports your patients' fight against allergy. And antimicrobial shampoo remains the hallmark of topical dermatology therapy. Fetch dvm360 sneak peek:
Dr. Darin Dell, DACVD will provide more love for his favorite derm products in his lecture “Dermatology products for those who don't love dermatology” at the 2019 Fetch dvm360 conference in Baltimore. To register, visit fetchdvm360.com/ba.
You could stock just one shampoo (MiconaHex+Triz-Dechra, Douxo Chlorhexidine-Ceva, or BioHex-VetBiotek) and do well in any situation. These products contain a combination of both antibacterial and antifungal therapy in addition to ingredients that replenish the barrier function of the skin. If your client can't shampoo their pet, don't fret! Steer the conversation to wipes or mousse (same brands and formulations as above), which provide the same benefits but require less work and often less stress. Wipes are great for small areas like paws and facial folds. Mousse is great for larger areas like the axillae or groin.
One final note: I recommend using these name brands specifically. Distributor versions often contain lower concentrations of active ingredients. Over-the-counter products from the pet store should be avoided like Yersinia pestis.
2. Ear wash
Keep ear wash options simple with just two. I recommend Epi-Otic Advanced (Virbac) for routine cleaning and average ear infections. If you see rod-shaped bacteria on otic cytology, then you need a TrizEDTA product. My favorite is Mal-A-Ket Plus TrizEDTA (Dechra).
3. Isoxazoline parasiticides
Going buggy over mites and dermatophytes? Your options in the new isoxazoline class of parasiticides are all effective at killing skin mites and lice (as well as fleas and ticks). To keep your inventory simplified, consider Bravecto (Merck), which offers oral and topical formulations for both dogs and cats. Another new option is Revolution Plus (Zoetis), which is great for cats. Revolution Plus also prevents heartworm disease.
4. Dermatophyte fighters
New on the dermatophyte front is a feline-approved oral itraconazole liquid (Itrafungol-Elanco). For dogs with dermatophytosis, I recommend oral terbinafine. Terbinafine is available as a very affordable generic and has few side effects.
Speaking of dermatophytes, here's a bonus tip (not technically product-related but still valuable for general practitioners): If you've ever been plagued by the “what-if” of scabies mites, you can send off a blood sample to IDEXX for a Sarcoptes ELISA test. IDEXX also offers a dermatophyte polymerase chain reaction (PCR) test for those who don't enjoy cultures or waiting. PCR results are typically returned in one to three days.
5. Therapeutic diet
Last, what would a dermatology discussion be without some mention of therapeutic food? Hill's and Royal Canin both make “skin support” diets. These are not diets for patients with food allergies. Consider these diets for clients who want to do more after you already have a “core” therapy for the patient's atopy.
To diagnose food allergy, I recommend Royal Canin Ultamino (both dog and cat formulations but only dry), Royal Canin Selected Protein KO for dogs (formerly Iams KO), or Royal Canin Selected Protein PR for cats. If you have a client who opposes “big dog food companies,” then consider Rayne Clinical Nutrition (raynenutrition.com) or BalanceIT (balanceIT.com).
These products will cover your dermatology basics and allow you to help a multitude of uncomfortable pets and miserable owners. For everything else, feel free to send your patients to me or one of my ACVD colleagues.
Dr. Darin Dell spent six years in general practice and two years in emergency medicine before becoming a diplomate of the American College of Veterinary Dermatology in 2012. He is currently on staff at Wheat Ridge Animal Hospital near Denver, Colorado. Dr. Dell's hobbies include woodworking and mountain biking.