A crucial step in treating any skin disease is to make a specific diagnosis, to be able to give the disease a name, and thus to understand its causes. Then one can treat the disorder properly, for there is no point in just treating the symptoms. This is what I try to do. I need to know and understand the whole history of the animal before he or she was brought to see me. I need to know what your usual vet or vets have done, and, just as important, everything that you, the owner can tell me about the problems. Once this is done, then I perform a full examination of the animal. Not just the skin problem, but I make a “clinical examination”, which includes palpating the abdomen, listening to the chest, and examining the whole skin surface. Only then do I concentrate upon the affected areas.

During a consultation, I may need to take simple skin samples (that is, “skin scrapings”), or blood samples. Occasionally it is necessary to remove small pieces of skin surgically, under sedation and local anaesthesia; i.e., biopsy specimens. Once a diagnosis has been established, then I can advise upon appropriate treatment. This may be injections or tablets, dietary changes, or “topical therapy”.In simpler language these are “shampoos”, but the new “topicals” are marvellous examples of pharmacology in action; the word “shampoo” hardly does them justice! After each consultation I write a report to your own vet, and you, the owner, get a copy of this too. I then arrange with you how, between us, we are to monitor the patient’s progress. Usually I ask to see the animal after two or three weeks, to re-assess the case, to monitor progress, and provide continuing advice and support. Skin problems usually need time; time to reach a diagnosis, time to heal the patient. It is true that owners need to be patient too. I regard each case as a collaboration between the owner, the patient and myself; and keeping your own vet informed as well.

A young science
In most of the cases, which come to me I can make a diagnosis. However, veterinary dermatology is a “young” science, and there is much that we understand poorly, or do not understand at all. It may be necessary to collaborate with pathologists. Sometimes specialists in other fields may be needed, for example, aspects of the patient’s behaviour may occasionally affect a skin problem. But always, my aim is, by working together, to make a diagnosis; then we can move on to treatment.