Are you and your clients frustrated by fire engine medicine, going from one pruritic crisis to the next, and constantly fighting skin and ear infections? The following principles can make a big difference in your success helping your clients (and patients) address chronic canine itch.

1. Focus initially on the pet and the owner, not the “disease.”  We tend to want to dive into all manner of diagnostic tests and therapeutic trials to understand all the factors contributing to the pruritus. Nothing wrong with that in principle, but it may take weeks and, importantly, does not solve the immediate problem – the dog and owner are emotionally distressed and miserable, and they need relief.
2. The first priority is to stop the itch. Provide rapid, safe itch relief for the pet (and relief for the owner!). Allowing the pet owner to get back to normal quickly generates trust and confidence; this is an owner who will far more likely be compliant, return for rechecks, and be open to the diagnostic workup that is necessary. (See earlier NEWStat article for clues on how best to stop the itch) 
3. Insist on a diagnostic workup – it is NOT an option. We have to find out why the dog is itching if we want to stop the vicious cycle of itch. Most owners also want to know what the real cause of the problem is, but only after they have been assured that the immediate itch will be addressed.
4. Outline a simple streamlined workup. It may sound something like this: “Now that we have Buster comfortable, we will rule out parasites, treat any infections that are present, and then perform a dietary trial if we think food allergy may be playing a role. If Buster is still itchy at that time, we can say that he has atopic dermatitis, for which I have several highly effective options that allow me to tailor treatment to meet your needs, and Buster’s needs. How do you feel about that plan?”
5. Assure the owner that you will always prioritize keeping their dog comfortable during the diagnostic workup regardless of whether it takes a few weeks or a few months.
6. Always show the value of any treatment or diagnostic recommendation. For example, don’t just say “Your dog may have a food allergy so we should do a food trial”. It would be far better to say “This chronic itch may be caused by a food allergy. If so, by feeding prescription diet we could see the itch resolve over several weeks. It would be wonderful to find out that we could provide long term relief by just changing the diet.’
7. Learn how to have relationship-centered communication with pet owners. Listen, and give owners opportunities to share their thoughts and concerns; emphasize partnering and finding common ground to reach the goal of long-term itch relief for their pet.

If you are able to practice according to these principles, it is likely you will have happy pets as patients, and happy owners too. That’s good for you and good for your practice.

Written by Andrew Hillier, BVSc, MANZCVS (Canine Medicine), Diplomate ACVD, Medical Lead Dermatology, Veterinary Specialty Operations, Zoetis PETCARE