Chapter 1 - The Dermatology Consultation
The initial, most important step in achieving a satisfactory
consultation and management of any dermatological condition is
to obtain a thorough history. Taking short cuts in this step
can lead to a misdiagnosis, affect the welfare of the animal,
and add a lot of unnecessary expense and dissatisfaction for
the owner. The history should be obtained in a logical fashion,
with the view of building up a picture of the condition and a
list of differential diagnoses, while examining the patient.
This book shows how to work up a case in this manner. With computerized
records in most practices, the age at onset, breed and sex of
the individual animal should be readily available. This information
provides some useful clues when formulating a list of differential
Age at onset:
- Parasitic problems such as pediculosis, otoacariasis, cheyletiellosis
and demodectic mange are more commonly seen in puppies and adolescent
- Genodermatoses can become progressive and, in some cases,
are more apparent with age. They are usually established by 3
years of age.
- Of the allergies, atopic dermatitis has an age of onset of
more than 6 months and below 3 years, and flea allergic dermatitis
is more common in animals older than 5 years of age.
- Hormonal problems tend to manifest after the age of> 6
- Neoplastic conditions generally occur in older animals.
- Demodicosis in Staffordshire bull terriers, Scottish terriers.
- Atopic dermatitis in Labradors, West Highland terrier and
other terrier breeds, German shepherd dogs, whereas flea allergic
dermatitis can occur in any breed.
- Dermatophytosis is more prevalent in Persian cats.
- Dilute coat colour in certain breeds, i.e. blue coat in Dobermanns
may be responsible for colour dilution alopecia.
Sex: Note whether the individual is entire or neutered.
This is of particular interest when dealing with skin conditions
associated with sex-hormone imbalance. There are few other skin
conditions where sexual predispositions are recognized.
History taking is divided into those enquiries that relate
specifi cally to the skin's condition and those about the general
history and management of the animal. In general practice, because
time is limited, you could combine some of the questioning with
the examination of the animal. If the condition is recurrent,
much of the history will already be available on records and
will just need confi rmation from the owner.
Specific history - key questions:
- Date of onset?
- Is the condition seasonal or non-seasonal?
- If non-seasonal is it continuous and progressive or is it
- Is the condition pruritic or non-pruritic? This should include
licking, biting, scratching or rubbing. If pruritic, we need
to know whether initially non-pruritic and subsequently changed
or has always been pruritic.
- Distribution of the lesions now, and initially, and how they
- Is there a smell associated with the condition?
- Are there any in-contact animals in the house or casual contacts
and if so are they affected?
- Are any people in the house affected?
- Did the condition start following a visit to the grooming
parlour, or to boarding kennels?
- Are there any fleas on any of the pets in the house?
Non-specific history: You should include questions relating
to the animal's general health and management, and you may need
to ask more specific questions as you build up a picture of the
Chapter 1 - continued
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Animal Dermatology index