Canine atopic dermatitis and the owner

Treating canine atopic dermatitis can be challenging in itself, but keeping the owner fully engaged can be challenging too, as Pascal Prélaud describes in this short paper.
 

Introduction

Canine atopic dermatitis (CAD) is a multifactorial chronic disease that requires the veterinarian not only to deliver long-term care to the dog but also establish and maintain an excellent relationship with the owner. Unlike some other chronic diseases, there is no true consensus on the best monitoring program for CAD, but maintaining continued contact with these cases is essential to ensure the effectiveness, feasibility, and safety of the various treatment options, and this is only possible if the owner is fully informed and engaged. Optimal communication is therefore the cornerstone of long-term treatment, as CAD can negatively impact the owner’s quality of life as well as that of the patient (1)(2). A recent large-scale survey on dogs with CAD (author’s unpublished data, 2013) demonstrated both that owners frequently lack knowledge of the disease (for example, only 4% understood that CAD is a long-term disease), and that there are often shortcomings in the therapeutic options offered by the clinician (for example, only 15% had tried an elimination diet and only 6% had tried cyclosporine). 

The first, most essential step with CAD is identifying the disease and getting owners to accept its lasting nature before starting on the long journey involved in monitoring a chronic skin condition. However, there are many potential pitfalls; one study suggested there are seven fundamental mistakes to avoid in long-term management of chronic dermatology cases (Table 1) (3). This short paper provides some key measures that can be easily incorporated into daily practice to ensure that the owner of an atopic dog is kept fully engaged and better informed.
 

First steps: preparation

Atopic dermatitis is a real opportunity for veterinarians, in terms of medical, technical and interpersonal reasons, but it is essential to understand the disease in order to master the various therapeutic options and therefore communicate effectively. This involves the clinician keeping up to date with evidence-based journals and websites (e.g., www.icada.org) (4), and having access to the appropriate equipment for dermatological investigations, including a good microscope and otoscope. Good “tools” to use during the consultation, such as checklists and even metaphorical diagrams (5)(6)(7), may be useful, and additional communication resources, such as informative websites, can also be helpful. Do note however that most canine atopic dermatitis sites are either too technical or very product- or service-oriented, and it can be helpful for the clinic to have its own web page or blog designed specifically for owners of atopic dogs. In addition, follow-up consultations should always be assigned to the same veterinarian, and the clinic should have a trusted specialist for referral of difficult cases.  [...]