Frequently Asked Questions

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While we no longer require a referral, a referral from your primary veterinarian is ideal to allow us to make sure we are the correct specialist to help your pet. At Redbud Animal Dermatology and Allergy Specialists, we are experts in skin and ear disease, but your primary care veterinarian is the expert on your pet's overall health. We believe in a teamwork approach- we will handle your pet's skin and ear disease, but your primary veterinarian should continue to manage your pet's wellness and other issues. We all want what is best for your pet, and to do this, we must collaborate. All notes, tests, etc. performed at Redbud Animal Dermatology will be shared with your pet's primary veterinarian so that we can all be on the same page. Redbud Animal Dermatology does not offer wellness services such as vaccines, hospitalization or sick visits not directly related to a pet's skin or ear disease.

It is difficult to estimate costs of initial appointments without having seen your pet. However, base cost quoted at the time of making the appointment will never be surpassed without your consent, but also does not include any additional testing or medications. Estimates are always provided after the initial exam and before proceeding with any additional diagnostics, medications, or procedures.

The new client paperwork allows our doctors to have an idea of the history of your pet and the issue we are seeing them for from your eyes. Submitting this paperwork the Friday before your appointment allows our doctors to have ample time to prepare and streamline your pet’s appointment.

Yes. We ask that you refrain from feeding your pet the morning of their appointment due to a variety of reasons. Some lab work that may need to be done requires that pets be fasted. This also allows us to perform procedures same day if they are needed and time allows.

First appointments typically take an hour to an hour and a half. However, this may be shorter or longer depending on the specific needs of your pet. This time allows our team to make sure we are being thorough with you and your pet.

This depends entirely on the specific needs of your pet. We will discuss this with you at the time of your appointment if it is necessary.

We ask that you bring all of your pet’s medications with you to the appointment. This includes any medications your vet has prescribed, any supplements (e.g. joint supplements, allergy supplements, etc), over-the-counter medications, and any topicals (e.g. shampoos, mousses, ear cleaners, etc). Please give any medications as directed by your vet until your appointment - this includes if your pet needs any pre-visit medications such as trazodone and/or gabapentin. Please do not bathe or apply any medicated mousses/sprays to your pet for a minimum of 48 hours prior to your appointment.

Follow-up visits are necessary to ensure that your pet is progressing with the treatment plan and make necessary adjustments and/or perform additional diagnostics if treatment is not progressing as expected.

Well, first of all, primary care veterinarians are rockstars. They have to know something about EVERYTHING and are the expert in your pet's overall care and well being. In specialty practice, we know a whole lot about our particular thing as we have had an additional 3-4 years in training (on top of the 4 years needed to complete a veterinary degree). This focus and additional training allows us to have a deeper knowledge base and skillset in all aspects of dermatology and ear disease because it is what we do, all day, every day. It is literally our job to be the best at this. To have and maintain these additional skills and knowledge, our veterinarians have (and continue to undergo) vigorous training and teaching in dermatology in addition to a focus on staying up to date with current and evolving medical literature about the diseases that we manage. A specialist can often get to the underlying answer faster and have more success managing a disease because of that narrow focus and additional knowledge. However this is in no way a replacement of your primary care veterinarian (see above).

Veterinary Dermatologists diagnose and treat all kinds of diseases of the skin, ears, paws and claws including but not limited to all types of allergic, autoimmune, infectious and cancerous diseases. In addition to allergy testing, we also perform specific procedures for chronic ear disease ( video otoscopy) and surgical procedures for various conditions ( CO2 laser surgery, basic biopsy and cryotherapy).

CO2 lasers emit a highly focused invisible wavelength of light that is absorbed by the water in cells resulting in vaporization or ablation of the tissues. These lasers are adjustable, allowing them to be incredibly precise, limiting the damage to surrounding tissue. Lasers help reduce pain and bleeding during surgery by cauterizing the blood vessels and nerve endings as it cuts, allowing for quicker recovery times with less swelling and risk of infection. Lasers can be used in many different procedures including mass ablation, debulking & removal, and skin resurfacing.

Antimicrobials (i.e. antibiotics, anti-fungals, etc) are a powerful tool when used appropriately. However, antimicrobial resistance has become a significant problem in both veterinary and human medicine. At Redbud Animal Dermatology, we take resistance very seriously and try to only prescribe antimicrobials when necessary and appropriate. Diligent topical therapy with appropriate antiseptic products (i.e. medicated shampoos, mousses, sprays) is often very successful in treating skin infections and can be used by itself or in conjunction with antimicrobials.

A Registered Veterinary Technician (RVT) is an individual who has received an associate degree in veterinary technology in addition to passing both a state and national board exam to become credentialed. Registered Veterinary Technicians are required to attend several hours of continuing education to renew their license each year. Registered Veterinary Technicians are a vital part of veterinary medicine and although their title is "technician" they are seen as nurses in veterinary medicine. Registered Veterinary Technicians are responsible for obtaining medical histories, performing exams, collecting various samples (ie blood, urine, hair/skin, etc) for diagnostics to be performed as well as knowing how to properly perform those diagnostics, medication administration (oral and injectable), knowing various disease processes, intravenous catheter placement, anesthetic/sedation monitoring, assisting in procedures, and so much more! The only things Registered Veterinary Technicians cannot do are diagnose conditions, prescribe treatments/medications, or perform surgery. There are also different areas of specialty for Registered Veterinary Technicians such as dermatology. Our Registered Veterinary Technicians are very passionate about helping your pet and they are a great source of information!

Cryotherapy is a minimally invasive procedure that uses extreme cold (typically liquid nitrogen) to freeze and destroy abnormal or diseased tissue, as well as remove skin tags and other growths. Depending on the location and extent of the area being treated, this can be performed awake with a local/numbing anesthetic or under sedation/general anesthesia.

Yes! Fleas and flea allergies are one of the most common skin diseases. While your cat may not go outside, unfortunately, fleas are still able to find a way inside and one adult female flea can lay at least 40 eggs per day which can easily lead to an infestation. Cats are excellent groomers and typically remove any evidence of the flea itself, but all it takes is for one flea to jump on and bite to cause an allergic response. Cats can also develop an allergic phenomenon called eosinophilic granulomas which are small plaques that can build up anywhere on the body, most commonly due to a hypersensitivity to fleas. When a cat is already allergic, these allergies stack up until they reach a threshold and become symptomatic, so if we can easily take out one of those allergic triggers, we have a better chance of managing your cat's allergies. Prescription flea prevention given as directed is a safe and cost-effective preventative measure that should be administered year-round regardless of being indoors.

Each pet has a threshold or "red line" for allergic triggers that they can tolerate before becoming symptomatic with itch as evidenced by scratching, licking, and/or chewing. Allergic pets typically have several triggers, such as various environmental allergies, foods, fleas, secondary infections, etc. that stack up and send them over their threshold. Ignoring or inadequately managing any one of these triggers can be a reason for perceived treatment failure. With our allergic pets, we want to control as many triggers as possible to keep them below that threshold to better manage their allergies.

Video otoscopy uses an endoscope with a built-in camera that can be inserted into the ear canal and projects the image to a screen. It gives us the benefit of a very bright light source and superior magnification that allows increased visualization of the ear canal. These procedures are performed under general anesthesia so that the airway can be protected, and so that our patients are completely still and comfortable. A small channel through the otoscope allows instruments to be used in the ear to help facilitate flushing, polyp and mass removals, and additional procedures. During this procedure, a deep ear cleaning is performed by flushing the ear with saline to remove built up debris. We will be able to asses the presence or absence of the ear drum more fully and better determine whether there is likely disease extending into the middle ear (although full evaluation of the middle ear requires advanced diagnostics such as CT scans).

Intradermal skin testing is used after determining whether a pet has environmental allergies and determines what environmental allergens are relevant to your pet (pollens, molds, danders, insects, etc). This test does not test for food allergies and does not diagnose environmental allergies as it is designed to be a therapeutic tool. Diagnosis of environmental allergies comes from a combination of your pet’s history, clinical signs, and ruling out other potential causes of itch.

During an intradermal skin test your pet is under light sedation to keep your pet comfortable, a small area of hair is shaved on their side, and 61 individual allergens are injected into the skin. This causes a histamine release which in turn shows up as a welt with redness and swelling if there is an allergic reaction. You may be asked to monitor the area for 48 hours after the test to watch for any delayed reactions (redness and/or swelling). The reaction is then graded on a scale of 0-4, with 4 being highly reactive. Based on this grading system our dermatologists will determine what allergens should be included in your pet’s serum for immunotherapy and which allergy triggers should be avoided.

The immunotherapy serum will be used to gradually get the body’s immune system to build up a tolerance to these allergens so that they no longer have a hypersensitive response so we can potentially decrease symptomatic therapies for itch (like Apoquel and Cytopoint) and decrease the likelihood of secondary infections.

There are no blood, hair, or saliva tests that have been proven to be effective in the diagnosis of food allergies. In fact, some of these tests have returned positive results on fake hairs taken from teddy bears and tap water presented as saliva! The only true way to test for this is to put your pet on what is called a food diet trial or an elimination diet trial. This is an 8-12 week trial of feeding a prescription food exclusively that is specifically made to be unrecognizable to the body, meaning they have never had contact with it before or it is broken down too small to be noticed. No other foods, treats, or flavored supplements will be given during this time (with the exception of a monthly heartworm or flea preventative). During this trial, if a pet is food allergic, we should see improvement of symptoms (itching, flatulence, diarrhea, etc.) as long as secondary infection and flea treatments are continued. After this 8-12 week period the diet is challenged, usually with the previous food the pet was on. If the pet has an increase in the symptoms again after adding in the old food, normally within 14 days, then your pet can be diagnosed with a food allergy. If this is the case then the pet will go back on the strict prescription diet until symptoms resolve and then individual ingredients can be added to test for specific food allergies.

Please note that while there are many limited ingredient diets available over the counter, studies have shown that the majority of these foods contain proteins that are not on the label ( because of cross contamination in the manufacturing process) and therefore are not diagnostic and not useful in managing most pets with a true food allergy.

In addition, most pets with a food allergy are triggered by proteins and grain-free diets are almost never indicated in pets with skin disease.

Cats are very sensitive in general to things that are not their idea, especially getting them to take medications. Medicating your feline friend needs to be done with caution as we certainly don't want you to get bit!

There are "pet pillers" to help facilitate administration by placing the pill in the device and then carefully opening the cat's mouth and plunging the medication into the mouth. Gently hold the mouth shut and rub the throat to encourage swallowing and then follow the medication with a small syringe of water to assist with fully swallowing the pill. Depending on your cat's temperament, you may be able to do this method without using a "pet piller" by using your hands to carefully place the pill as far back into the mouth as possible.

The best way to administer oral liquid medication is to hold the cat's head to prevent them from moving around. Place the syringe with liquid medication in the corner of the cat's mouth and plunge the medication into the cat's mouth. Gently hold the mouth shut and rub the throat to encourage swallowing.

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If your cat does not have a food allergy, you can try hiding the medication (pills or liquid) in a very small amount of wet food, a squeeze-up treat, or there are commercially available treats to hide medication in. If your cat does not typically eat wet food or treats, try offering it first without medication to make sure that they will eat the special food or treat before hiding the medication in it.

Please avoid putting medications into your cat's regular food as we do not want your cat to avoid eating as anorexia can result in serious medical complications in our feline friends.

Plucking:

It is a common misconception that plucking ear hair for maintenance grooming is a good thing. However, not only is this painful, it can also cause micro-trauma to the ear canals which will lead to inflammation, predisposing your pet to an ear infection. If it is medically necessary to pluck ear hair (ie: ear hair causing a compaction in the canal), this should be done under sedation by a medical professional.

Over bathing:

Bathing is an important part of keeping the skin healthy but it is important to find the right shampoo for your pet. Some shampoos can cause overdrying or irritation if used too often but there are shampoos specifically designed to be used as often as daily. These shampoos boost the skin barrier function when pets need more frequent baths and help prevent overdrying.

Allergy testing and allergy shots are a last resort for a pet that is really severe:

While allergy testing and desensitization via immunotherapy can be done at any stage in a pet appropriately diagnosed with environmental allergies (atopic dermatitis), the earlier this process is pursued, the better. Allergy testing (in appropriate patients with an appropriate test) and immunotherapy are the only way to effectively treat the cause of allergic disease in animals that have environmental allergies. Therapies like Apoquel and Cytopoint are great for treating the symptoms of allergies (i.e. itching/scratching/biting/chewing/licking) while antibiotics and topical therapies may be needed for addressing secondary infection, but these are "bandaids" and not addressing the root cause. The success rate of allergen specific immunotherapy (“allergy shots”) is variable but is higher in the hands of a Veterinary Dermatologist as Veterinary Dermatologists have significantly more experience, training and expertise in this area.

Over-The-Counter (OTC) elimination diets and limited ingredient diets, including raw:

Most food allergies are triggered by the protein (and more rarely the carbohydrate) source in food. A lot of food companies use the same facilities and equipment to produce their foods, whether that is limited-ingredient or not, which can produce cross-contamination.

The same difficulty comes with raw diets at home. Raw diets are already difficult to make to ensure proper nutrition and food safety, but trying to ensure that only one type of novel protein and carbohydrate are used is even more challenging as most of our homes are not sterilized in between cooking our food and food for our pet, which means the risk of cross-contamination is very difficult to eliminate.

With prescription diets, the facilities and equipment are cleaned in between products to ensure there is no cross-contamination between one type of food and another. In addition, quality control tests are performed to ensure there is no contamination so that we can be confident our diet trial will be accurate.

Saliva and hair tests can diagnose allergies:

Unfortunately, a diagnosis of allergies requires evaluation of your pet's history and clinical signs, and ruling out other causes of itching. While it might seem easier to do a quick at-home test for allergies in your pet, studies have shown that the results between samples taken from allergic dogs and healthy dogs, show no difference in reliability than that of random chance. In fact, some of these tests have returned positive results on fake hairs taken from teddy bears and tap water presented as saliva!

Blood tests can diagnose food allergies:

Food allergy testing by blood or saliva is testing for antibodies (IgE, IgA, and/or IgM) levels. These tests can produce positive levels in healthy dogs that do not have clinical disease, which is why these tests cannot be relied upon to be accurate. Food allergy testing should be done with a food diet trial under the strict guidelines of your veterinarian for diagnosing your pet.  For more information, please see the section on Food Allergy Testing in our FAQs.

Every itchy pet has allergies:

There are many reasons that a pet can be itchy. Allergies are certainly one potential cause. However skin infections, autoimmune diseases, and ectoparasites (fleas, mites, etc) can also cause itch.  It is important to see a veterinary medical professional for appropriate diagnosis and management of your pet's specific issues.