[music playing] Kelly: Does your pet constantly scratch and lick?

A skin condition could be the culprit.

Many different things can cause dermatological problems for our four-legged friends.

On this episode of The Paw Report, we're joined by Dr. Bailey Brame to discuss various conditions and options to help your pet live a healthier life.

Stay with us.

[music playing] Rameen: The Paw Report on WEIU is supported by Rural King, America's farm and home store, livestock feed, farm equipment, pet supplies and more.

You can find your store and more information regarding Rural King at ruralking.com.

Rob: Dave's Decorating Center is a proud supporter of The Paw Report on WEIU.

Dave's Decorating Center features the Mohawk Smartstrand Silk Forever Clean carpet.

Dave's Decorating Center, authorized Mohawk color center in Charleston.

Kelly: Thanks for joining us for this episode of The Paw Report.

I'm your host Kelly Goodwin, and we've got an exciting episode of The Paw Report today.

I'm going to pose a question to you.

Does your dog or cat itch a lot, scratch a lot, lick a lot?

Paw's red?

You've noticed some things on maybe their body that just shouldn't be there?

Well, this episode is for you because we are talking all about pet dermatology and allergies and everything you need to know about symptoms, signs, and treatment.

And to answer all of those questions, we have an expert from the University of Illinois, Dr. Bailey Brame, and she joins us today with a special friend Java.

She's new to the program, so we always start our discussion with probably the most difficult question is tell us about you, yourself and introduce us to Java.

Bailey: Sure.

So I'm a veterinary dermatologist.

And what that means is that I'm a veterinarian who has done some additional training specific to dermatology, meaning skin, allergies and ear disease.

And so right now, I'm working at the University of Illinois's Veterinary Teaching Hospital.

And I brought Java here with me today, and he actually is an allergy sufferer.

So he has food allergies and some mild environmental allergies too.

So I thought he would be a good example for us today.

Kelly: Absolutely.

Well, welcome to the both of you.

I'm going to maybe just expand a little bit upon your answer and ask what kind of led you to pursue the specialty of dermatology?

Bailey: Sure.

Well, for me, I've always really enjoyed getting to know pets and their owners and having a relationship over time and getting to see how the pet improves with treatment and dermatology, for better or for worse, is one of those specialties where we really get that follow through because most of the diseases that we treat are long-term conditions.

And so we get to form a really strong bond with the pet, with their owner and with their primary care veterinarian as well.

And so that's something that's always appealed to me.

Kelly: Now, Java, you said has allergies.

Is that kind of how, not necessarily you were paired with Java, but maybe exacerbated your interest in dermatology?

Bailey: Well, we do have a joke in the veterinary community that a lot of these pets do tend to find us.

I did not know that Java had any skin issues when he first came to me.

He actually belonged to my spouse before we married.

Kelly: Oh, okay.

Bailey: So that's how he came into our household.

I was inspired more actually by one of my cats, who's unfortunately no longer with us, but she had both flea allergy and food allergy.

And so I was really interested in finding therapies to treat her.

And that was one of the things that first got me interested in diseases that are kind of mediated by the immune system, and then that led into the interest in allergies specifically.

Kelly: How common are issues, dermatology issues with both dogs and cats, actually?

Bailey: They're really common.

They're actually the most common reason that a pet will be coming into its veterinarian for any sort of a problem.

So with general practice vets, a lot of times they're seeing routine preventative care, but among the problem visits where an owner is coming in for a specific issue, they make up about 80% of those visits for both dogs and cats.

Kelly: What are some of the, I guess, symptoms maybe that people should look out for?

I think a food allergy, I don't, unless something you break out or you actually physically see something you may not know.

Bailey: Yeah.

And so with a lot of these, people are actually seeing some sort of change to their pet's skin.

So a lot of times it'll be redness, maybe some raised bumps, even some infection.

So bacterial infections, which can cause pustules or red itchy bumps, thickening of the skin, crust scabs, those kinds of things can all also happen as a result of allergies.

We can also see a lot of ear problems and that may look like the patient's head shaking.

They may have smelly ears, or the owner might notice a lot of discharge coming from the ears.

So all of those things can be signs of any type of allergy, whether it be food or environmental.

Kelly: And that leads me too, is what causes some of these allergies?

Is it more so environmental?

Is it genetic?

Is it airborne?

Is it flea-causing?

I suppose you put everything in that pot and it's a problem.

Bailey: Yeah.

And it would be difficult to talk through all of the possibilities, but in terms of the big ones, the most common type of allergy in both dogs and cats is actually flea allergy.

And so that's always one of the first steps that we want to make sure when we're treating a pet with allergies or any sort of itchy skin disease, is that we are making sure that they're on a high quality, regular flea preventative.

And then from there, usually we're thinking about the possibility of either food allergy or environmental allergy.

And so with environmental allergy, we may see certain things that could clue us in.

So for example, if a pet is repeatably itchy at a certain time of year, so every spring, just like we might get our hay fever signs, maybe the pet is then starting to lick the paws or scratch at the side.

Something like that.

If the symptoms are present year round, then we're kind of stuck trying to decide between the possibilities of food or environmental Kelly: And grasses too, I would think.

I mean, do they have an effect we have with pollen or any- Bailey: Yeah.

Kelly: Airborne particles?

Bailey: Yeah, for sure.

So just like in people, the most common things would be dust mites.

So dust allergy is very common if they're having year round symptoms and then pollens would be the other big possibility.

And so that can be grass pollens, tree pollens, weed pollens, and sometimes the season can help us to pick that out.

So tree pollens are more common in the spring.

Then we move into grass pollens in the summer and then ragweed is really popping up in the fall.

So sometimes that can help us narrow it down a little bit if there is some sort of seasonal pattern.

Kelly: So how do I know if my dog or cat needs to come to see you?

I notice them itching.

It's maybe not something every day.

Am I being too cautious?

What kind of is my trigger to know, "Hmm, I better pick up the phone?"

Bailey: Well, I think that in general, most people probably should be checking in with their primary care veterinarian first for these kinds of issues, because since they do make up such a big proportion of the kind of sick visits, like we talked about before, most primary care veterinarians are going to be comfortable managing mild signs, especially if they're kind of present seasonally and they just have to get things under control.

And so if you are noticing itchiness that's lasting for more than a few days, or if you're noticing changes to the skin, especially hair loss, redness, thickening of the skin, then definitely you would want to start with your primary care veterinarian first.

Kelly: Is it painful for them?

I know that there are different types of allergies and different responses and different, like you said, it could be on the paws, it could be in the form of hotspots.

Is all this very uncomfortable for the animal?

Bailey: That's a good question.

And I think a lot of the time it's not overtly painful, but I like that you use the word uncomfortable because a lot of times it is.

And I think the main thing that's causing the discomfort is the itchiness.

I think we can all understand that.

Right now, the mosquitoes are out.

We're all getting itchy, but that itch is going away, usually a couple hours after a bite, right?

But these guys are itchy pretty much all day.

And so they can be very, very uncomfortable from that, but it is a matter of how severe that itch is and whether that's uncomfortable.

There are certain situations that can become painful.

The big ones for those would be ear infections, in addition to being itchy can also become quite painful, especially when they're very severe or chronic, and some paw disease can as well.

So some dogs will develop very severe inflammation of the paws.

They may even have bumps arise between the toes and those can be so painful even that some pets will not really want to walk.

So it's all kind of on a spectrum.

Kelly: You've mentioned a couple of times the ears and I've had Labs forever, and it may not be an allergy, but I'm going to throw it out here because it's been a reoccurring problem with the Labs that I've had, where they get this brown kind of gunk in their ears, and it does have an odor to it.

Is that more of an allergy or is that more of something else going on with them?

Bailey: So that's an interesting question because we used to think that with Labs, a lot of their ear infections were coming both from the fact that they have floppy ears, so it's coming down kind of trapping moisture in there.

And then also they like to go swimming, so they may have an opportunity- Kelly: Mm-hmm, that's right.

Bailey: ... to go out into a lake, get some water in there and then the ear kind of traps it down.

Now, the way we're framing it is we think that that may potentially predispose Labs to develop ear infections, but without something else, usually an allergy, that usually won't tip them over to the point that they get a true infection.

So we think it's kind of a multifactorial process where there's both some allergy and then also some kind of breed related and behavior related causes as well.

Kelly: Well, since we're talking about breeds, is there any one breed over another or group of breeds that are susceptible more to allergies?

Bailey: Yeah, for sure.

So there does seem to be some hereditary predisposition and it can be breed related.

I would say the breeds that we see probably the worst allergies in are all of the bully breeds.

So French bulldogs and English bulldogs, which are such- Kelly: Very popular.

Bailey: ... popular pets are definitely the most prone to skin problems and allergies.

But we also see it with the Bostons, the Pitties, all of kind of the American bulldogs.

So everybody kind of in that group.

But allergies don't necessarily discriminate, so we can see it really in any breed.

Kelly: What happens if they go untreated?

Somebody for whatever reason, just lets it go?

Bailey: Sure.

So that can depend a lot on severity.

So for a mildly affected dog that's more seasonal, sometimes you can wait it out, right?

If they're just a little bit itchy, maybe a few weeks later, that same pollen won't be there and then they'll be fine.

But with a lot of them that are more severe, we actually can see pretty bad outcomes if we're not addressing them.

And that's because the degree of inflammation, especially once you get some infection on top of that can lead to some pretty significant changes.

And the worst would probably be ear disease and paw disease.

So with ear disease, we can see that the whole ear canal can potentially get actually closed down because the tissue in there proliferates and narrows the canal, and that can potentially require surgery to remove the canal.

The paws, I mentioned that sometimes they'll develop little bumps between their toes.

That can potentially become severe enough that there's remodeling as well.

And so they may actually have to surgically address that.

It can affect how the pet is walking.

So it's all definitely a spectrum, and definitely depends on the severity of what we're seeing.

Kelly: Definitely should be treated though, bottom line.

Bailey: Yeah.

Kelly: I go into your office and you do an exam and I'm hearing some terminology that maybe I don't understand.

Atopic dermatitis versus contact dermatitis.

What are they and what's the difference?

Bailey: So atopic dermatitis is kind of how we refer to a pattern of inflammation that we mostly see with allergies.

So it's referring more to kind of the classic allergies like food allergy, environmental allergy to dust or pollens, where they may be exposed for example, maybe Java's out walking in the grass, he gets some pollen on his paws, but then where it shows up is he actually gets itchy ears later and I have to do some ear cleansing.

So it may not show up right in the space where he is exposed to it, whereas contact dermatitis, sometimes there's a component of allergy, sometimes there's not.

Sometimes it's just an irritant, but they're having the reaction exactly where whatever it is applied.

And people can sometimes get those confused.

So we have a lot of people who recognize maybe that the pet is worsening when they're outside, but they're worried more about chemicals on the lawns as opposed to the pollen, which is oftentimes the more likely culprit.

Kelly: Are allergies curable, or is this something that, like in Java's case, he's going to have to live with it and be treated for it for his entire life?

Bailey: In the majority of cases, no, it's not curable.

And so part of our job is trying to come up with a plan that keeps their symptoms manageable, keeps them comfortable for the rest of their life even if they still have this allergy.

The one thing that can potentially lessen the severity of the underlying allergy would be immunotherapy or allergy shots.

So that's similar to in people where you would do an allergy test to determine, "Okay, this particular patient may seem to be reacting to dust mites and ragweed pollen.

I'll include that in an allergy vaccine, give it as an injection underneath the skin.

And then over time they may become less sensitized to those things."

The majority of cases, they just kind of lessen the severity, but very rarely we can see pets that are completely cured.

My own cat actually has asthma and his asthma is completely controlled on his allergy shots, but he does still have some skin signs that haven't been fully controlled by them.

They're much, much less severe than they were to start though.

Kelly: In comparison to humans, now I've never personally had the test done, but I've had friends who have had it and their children have had it where they know something's not right, something's going on.

They go in, they see a dermatologist and they do like a skin...

They take a portion, a scrape, and then it comes up all the different things that they could potentially be allergic to.

Is that similar to what you could do with a dog or a cat?

Bailey: Yeah.

So it is important to know that you can see false positives and false negatives with allergy testing.

So what that means is that if you're a normal, healthy dog or a normal, healthy person, and you do an allergy test, it's possible that you may still see some positives.

So we always like to start with having made the diagnosis clinically of the allergy before we do the test.

But the actual test is very similar.

So with humans, you can do a prick test where it's very superficial or you can do what's called an intradermal test where you're actually making an injection with a very small needle between layers of the skin.

And we do the latter for dogs and cats.

It tends to be a little bit more reliable than the prick test.

So because we are having to make a number of different injections, they do have to be sedated, which is the biggest difference between dogs and people is we can't ask them to just stay there.

Kelly: Chill out for a little bit like Java is doing right now.

Bailey: Yes, Java's doing an excellent job of chilling out, but most of our patients will not put up for that.

Kelly: Obviously, Java is not experiencing any stress or anxiety right now, but can anxiety and stress cause skin conditions or issues with my pet?

Is that something that can be in inflamed?

Bailey: Potentially.

It's one of those things where again, we used to think that anxiety and stress were playing a bigger role in terms of being the primary cause of a pet's skin issues, and now we're realizing that allergies are much more likely to blame as the primary issue, but we're also coming around to realize now that stress has an impact on allergies because it has an impact on the immune system.

So it is all interconnected, and certainly we know that we can sometimes see flares in times of stress.

And there are certain dermatologic diseases that are caused primarily just by stress.

It's just that those are much less common than we initially thought.

Kelly: Can I take care of my pet at home?

So if it's shampoos or brushing or topicals or food, is there a regime that I can follow?

And I'm sure as you, as my doctor will help me go through this, but can it be a treatment that I can do behind closed doors and at my own home?

Bailey: Yeah.

So topical treatments are a very important part of allergy management.

So Java does get as part of his regimen, he does get medicated baths on a regular schedule.

And so for him, we use a medicated shampoo that contains chlorhexidine and miconazole because those are ingredients that help to fight bacteria and fungal overgrowth, which are a big issue for allergic dogs and cats.

Cats usually don't tolerate the bathing so much though.

Kelly: No, they don't like water.

Bailey: But we can also use sprays and mousses as well.

We try to rely as much as we can on topical therapies as opposed to oral therapies, because it's always going to be better to give a topical antimicrobial as opposed to an oral antibiotic, in terms of avoiding any stomach upset or anything like that.

Kelly: Now you mentioned shampoos and with Java, he is, you're thinking he might have a little Whippet in it, so his hair and his skin is a lot different than more of a wooly type dog that's maybe like a Saint Bernard-ish type dog that's longer.

And so do you have to keep an eye out for what kind of topicals you do use to make sure that it accommodates their coat?

Bailey: Yeah, so I would say the biggest thing is that with the dogs, especially like a Newfoundland or something that has almost like a waxy character to the fur, it can be a lot harder to get things to penetrate down to the skin because their fur is designed to repel water.

That's part of how they're bred.

And so we may have to take that into consideration.

Maybe having the owner actually part the hair and spray right down at the level of the skin.

There's no breed that really shouldn't be shampooed so that's kind of always an okay thing to include.

But the main difference I would say is actually how we treat the hair as part of the grooming process.

So the methods that you use for brushing and how often you have to do that are the biggest things that differ between coat types.

Kelly: We've talked a lot about care.

It can be a rather expensive thing to treat allergies.

I'm not looking for a dollar amount, but I think maybe one thing that you could stress to our viewers at home is that it is a commitment.

It will be a financial commitment if your dog or cat ends up with an allergy.

Bailey: Yeah, it absolutely is.

And in addition to the financial commitment, we also just talked about topicals.

I mean, there's a time component to it too.

Kelly: Right.

Bailey: And so we definitely want to come up with a management plan.

I would say the biggest place where it becomes costly is in situations where you're being reactive as opposed to proactive.

So if you are waiting until your pet has a bad skin infection or a bad ear infection, and only going to the vet then, then it's going to be a lot more expensive because you're going to be doing those visits on a repeating basis and that's going to happen for the course of your pet's whole life.

Kelly: Right.

Bailey: If you instead do kind of more of a proactive approach where you go back for a recheck after the current infections have all cleared up, and then you are kind of coming up with a plan to prevent future infections, that's ultimately going to save money, even though in the short term, it may hurt a little bit.

Kelly: Right.

And that leads me kind of into my next question is as a pet owner, it's probably important, and you probably welcome this as a doctor that a pet keep a history at home.

You know, "On this day, I noticed that Java was doing this.

He was itching this.

He was really paying attention more to his ears.

He was licking his paws."

So that way, when I come to you, and I'm not saying I'm waiting a year to do that, but when I come to you, I could say, "This is what I've noticed in the last, maybe month that my dog is doing."

Is that helpful for somebody to do?

Bailey: Yeah, it can be really helpful.

And we do have some of our clients do that kind of voluntarily and it's actually really helpful.

Kelly: Helpful.

Bailey: Because a lot of times what we're doing is we have a pet come in, they may have any number of problems.

Maybe they have a skin infection, ear infection.

They're just really, really itchy.

We're going to try to treat those infections, but we're also probably going to start initiating some treatments to actually address the underlying allergy, whether that's putting them on a hypoallergenic diet, if we think it's possibly food or giving them some sort of anti-itch anti-inflammatory treatment, if we're just trying to control that allergic inflammation.

Then we're going to start to kind of back things out, and we need to know which of these treatments that we did is actually helping the most.

And so if we can have kind of a record, not only of what's happened leading up to the appointment, but also what happens then, which of the treatments are helpful, which are not, that's really, really helpful to us.

Kelly: In our last minute, Dr. Brame, you mentioned when you went into this, you really enjoyed getting to know the pet, getting to know the pet's owner and kind of following through with them.

Any success stories that come to mind in your practice of dermatology over the years?

Bailey: Yeah, absolutely.

I mean, I would say sometimes once they start to be successful, they stop wanting to come back.

But those are the patients that I most love to see is where they're coming in just for their annual visit and it's because they're coming in just for a medication refill because they're doing so well they haven't even needed to reach out during that year.

And it's nice to see them year after year and know that they're really comfortable and happy at home.

Kelly: Excellent.

Well, some very good information today for those folks out there that have pets that are maybe suffering from dermatology issues, or maybe after hearing our discussion, they're going to pick up the phone and make that appointment to get their dog or cat checked out.

So Dr. Brame from the University of Illinois, thank you for joining us for this episode of The Paw Report.

Bailey: Thank you so much for having me.

Kelly: And Java.

He's just going to lay there and soak it all in.

Thanks for joining us too.

And of course we love it when our viewers of The Paw Report check in with us each and every week.

So again, I'm your host Kelly Goodwin.

Until then, we'll see you next week.

Rob: Dave's Decorating Center is a proud supporter of The Paw Report on WEIU.

Dave's Decorating Center features the Mohawk Smartstrand Silk Forever Clean carpet.

Dave's Decorating Center, authorized Mohawk color center in Charleston.

Rameen: The Paw Report on WEIU is supported by Rural King, America's farm and home store, livestock feed, farm equipment, pet supplies and more.

You can find your store and more information regarding Rural King at ruralking.com.

Additional support for The Paw Report provided from Soggie Paws of Mattoon.

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