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​Repair the Barrier – Not Rinse and Repeat

REPAIR THE BARRIER – NOT RINSE AND REPEAT

By Meghan E. Burns, DVM
May, 2016

 

Help your veterinary customers with owners who aren’t compliant with shampooing as often as prescribed.

 

It’s all well and good when the medicine your veterinary customers prescribe does the trick the first time around. But, when owners are not compliant with treatment instructions, skin infections don’t respond to antibiotic therapy due to underlying disease, or the ear infection recurs resulting in angry owners and a dog that is still potentially in need of further diagnostics as well as treatment. What if this could all be avoided before this cycle starts? Proactive therapy can often be the best medicine. Here’s how it works. 

Your customers already know that atopic dermatitis (AD):

• Affects 10 to 15 percent of the canine population

• Itchy skin is the most common clinical sign

• Along with redness on the face, paws, ears, and inguinal areas

• Clinical signs in most cases are triggered by:

• dust mites

• pollen

• flea/insect bites

• food allergies

 

Management of AD requires your customer to pick from a large number of available treatment options and select the ones best suited for long-term control for the individual needs of each patient. For instance, many atopic dogs require:

• Anti-inflammatory medications

• Antihistamines

• Essential fatty acids

• Injectable therapy specific to allergens

• Steroids

However, some of these options present concerns for the pet owner due to the cost, difficulty to administer, or risk of side effects.

 

Shift in thinking

So how do we educate our veterinary customers on a shift in thinking? Research has shown that affected dogs, like humans, have an abnormal immune reaction to environmental allergens. It is well known that allergens can be absorbed through the skin as well as via inhalation. In research in humans with AD, alterations in fat and ceramide compositions were identified in the top layer of skin critical to barrier function. When the skin barrier is altered, it is possible for allergens to more easily penetrate the skin. So your customers can shift their thinking from controlling and suppressing inflammation to a more proactive approach where improving the skin barrier is the focus in order to minimize the risk of future reactions to environmental allergens. 

 

Reduced barrier function of the skin also has clinical implications related to treatment. Limiting skin contact with allergens may be helpful to these patients, such as:

• Decreasing the dust mite burden in the home

• Applying monthly flea preventative

• Washing exposed areas of skin, like the feet and muzzle, to remove allergens before they can penetrate the skin.

 

Restoring and/or maintaining epidermal barrier function may also become a more integral part of therapy for AD. Maintenance of barrier function could be achieved through topical applications to help restore the skin barrier. Dietary means or nutritional supplementation may also yield improvement in barrier function.

Maintaining the skin barrier to infection, environmental onslaught, and other stressors can help reduce pet owner frustrations and help keep pet owners coming back to your customers’ practice. Your customers can easily relieve owner concerns about cost by comparing the cost of treating skin issues versus the cost of preventing them. It is much more cost-effective for the owner to maintain routine preventative treatments, such as flea prevention, skin grooming and moisturizing, than to stop these measures and deal with consequences of opening the skin barrier to insult and dealing with the subsequent flare down the road.

 

The top 5 simplified tips for being proactive:

• Realize the benefits of maintaining a strong barrier in AD patients

• Your customers need to establish a regular skin routine with their patients at a young age

• Emphasize importance of flea control to help reduce opportunities for flare

• Remove allergens in the home, such as dust mites

• Wash exposed areas of skin before allergens are allowed to penetrate skin


 

Dr. Meghan Burns owns Connect Veterinary Consulting. Her expertise includes product and business development, key opinion leader management, medical writing, and marketing. You can reach her at meghanburns@connectveterinaryconsulting.com or www.connectveterinaryconsulting.com.

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