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Today's VeTerinary PracTice | January/February 2016 | tvpjournal.com 70 DERMATOLOGY DETAILS Peer Reviewed susceptibility results. it is particularly important to continue treatment until at least 2 weeks past complete clinical remission. Here, topical antiseptic treatment is a valuable adjunct therapy. Pitfalls & Challenges and the pitfalls? among them, terminology and client education. in dogs, Mrs is usually Staphylococcus pseudintermedius (MRSP, an animal strain), but occasionally S schleiferi (MRSS, also of animal origin) or S aureus (MRSA, a human strain) is the culprit. it is important to get the species terminology and abbreviations correct; do not refer to these infections generically as "Mrsa." a client using "Mrsa" as an internet search term will quickly become frightened by horror stories of human contagion. instead: • reassure clients that MrsP and Mrss are animal pathogens that are uncommonly transmitted to humans. • Point the client to websites with accurate, up-to- date information about Mrs; one of the best is wormsandgermsblog.com. For the practitioner interested in additional information about treating canine pyoderma, excellent reviews have been published recently. 4,5 DILEMMA 2. What's the best way to diagnose canine atopic dermatitis? according to the current defnition, canine atopic dermatitis (ad) is a genetically predisposed infammatory and pruritic allergic skin disease with characteristic clinical features, associated with immunoglobulin E (IgE) most commonly directed against environmental allergens . 6 Pitfalls & Challenges These environmental allergens include grass, tree, and weed pollens as well as molds and dust mites. This most recent defnition allows that, in some individuals, the dermatitis may be triggered or exacerbated by other factors, such as food items. additionally, it appears that some individuals with "atopic-like" clinical signs do not produce detectable allergen-specifc ige, illustrating the multifactorial pathogenesis of this condition. For dogs with distinctly seasonal signs, diagnosis is not particularly diffcult; the main rule out is seasonal occurrence of external parasites. For dogs with nonseasonal signs, however, making an accurate diagnosis can be challenging mainly because the most common clinical signs of ad are not pathognomonic. numerous other skin conditions have overlapping signs. in addition, some dogs suffer from more than one allergic condition. Clinical Pearls in 2010, a prospective study that evaluated over 1000 pruritic dogs from 15 countries was published. 7 in this study, ad was defned as cases with clinical features of atopic dermatitis irrespective of the offending agent . clinical signs in dogs with ad were compared with signs observed in a group of dogs with pruritus from other causes, including feas, scabies, other parasites, primary skin infections, and miscellaneous causes. as a result of this study, new diagnostic criteria for ad were proposed (Table). a dog satisfying at least 5 of the 8 criteria has about an 80% chance of having ad. These criteria provide a useful and rapid screening method to identify potentially atopic dogs but must be used with some caution. 1. The criteria are only an initial step; dogs fulflling the criteria still must undergo diagnostic testing to rule out other conditions that can mimic ad. 2. The criteria are focused on dogs with typical clinical signs of ad, and some dogs have atypical presentations. an 80% chance of being right also means a 20% chance of being wrong. 3. Finally, 20% of dogs with clinical signs consistent with ad had food-induced signs that were indistinguishable from those of non–food- induced ad. Most recently, subgroups of the international committee on allergic diseases of animals have published practical "white paper" reviews TAB le Diagnostic Criteria for Canine a topic Dermatitis 7 If 5 or more of these criteria are present, there is an 80% chance that AD is the cause of pruritus. • Age of onset < 3 years • Mostly indoors • Corticosteroid-responsive pruritus • Chronic or recurrent yeast infections • Affected front feet • Affected pinnae • Nonaffected ear margins • Nonaffected dorsolumbar area