Ashley Bourgeois, DVM, DACVD: I have a personal question as someone who adopted 1 of these pandemic puppies who's allergic. She picked extremely well. We are bathing her quite frequently right now and we have some more flexibility, my husband's working from home. But knowing that there is going to be a point, hopefully, where the world returns to normal but we know allergies are not just going to get better because people aren't around as much. We still know topical therapy is going to be important. What do you think are tips that I can talk to owners about—and I will mentally take some personal notes for myself—of how we transition to this post-pandemic life? Do we need to make changes to the topical therapy? I can touch on some of my thoughts, too, after I hear what you're going to enlighten me with.
Christopher Pachel, DVM, DACVB, CABC: For me, that comes down to a couple of different key pieces. One, this is tying into what we were talking about in terms of asking additional questions. Meaning, for some people the difference between pandemic life and before and after is actually not that different. They may have had a work from home lifestyle to begin with and so their reality is relatively unchanged. For other people, like myself, who was on planes at least 3 times a month and was spending 10, 12, 14 days away from home, to not leaving my home for 12 months at a time, that was a big change. For that particular client, if I was the client and thinking about returning to a travel schedule again, not only does this just make my life a little bit different on a daily basis but I now have blocks of time when I'm not even accessible to administer those therapies.
The first thing is identifying what looks different from the perspective of the animal and your availability to do the treatment, whatever the treatment happens to be. That's probably the most important thing. From there we can then get into problem-solving and saying, “Right now, you're remembering to do your topical therapy 3 times a day, that's great. When life changes again and you're not there, is there something else that's already happening within your life that's already happening 3 times a day, for example. Can we set your animal’s little—your little pungent, your little wipes, your mousse whatever it happens to be—can we set that next to your cell phone? Can we set that next to your lunch?”
Can we set that next to what will encourage habit stacking to get those little prompts or reminders that will encourage us to do that as the routine is shifting again. Ultimately, what are we trying to solve with our strategies is where the question and answer comes into play.
Ashley Bourgeois, DVM, DACVD: I really love the thought of the habit stacking. I have an example, not so much topical therapy, but my own dog is on immunotherapy as she should be, as an allergic dog of a dermatologist. We had her set up with her allergen-specific immunotherapy to be every 2 weeks. Honestly, after a few weeks into it that was difficult for me. People would think, “Less frequent, everyone loves that.” Yes, you can put it on the calendar, but I already feel like there's so much in my calendar that I don't want to add another thing. That sounds silly but for me to see that day with another thing added on is stressful. I changed her immunotherapy to more frequent injections lesser amount. It's way easier for me to say, “Tuesday is her injection day.” I don't have to think, “Did I do it last Tuesday or not?” That's same thing I feel like what you're describing with habit stacking.
We don't necessarily always have to pull back on bathing. Some people are open to it or they can do it once a week. “Wednesday's bath day, that's just what we do. Here we go.” Sometimes when you start to decrease frequency—and this is where it's important to talk to the owner about it—suddenly it decreases to nothing. It decreases to every other week. “It's been a couple months. I forgot. Oops.” It's talking to the owner and finding out what works. Sometimes you can mix and match. Maybe we need some sort of topical therapy on their skin but it really is hard for them to do it twice a week or once a week long term. Maybe they're the ones that will put in their calendar every other week and it’s OK, but they can do the topical mousse in between the bathing. That works really well for them.
You're right. Once we get into this crazy world and back to our whatever normal life is, for some people if they see the success with their pet or they've been at home with their pet more, they're more aware of the issues that can come with allergies. They might be willing, even though their schedule is going to get crazy, to still make it happen. It's just working with them.
Transcript edited for clarity.