Quick diagnostic tips for evaluating pruritic pets

Editors note: Quotes have been lightly edited for brevity and clarity.

At Fetch Charlotte 2025, Joya Griffin, DVM, DACVD, kicked off her dermatology series of lectures with "Treating the Itch That Won't Quit: Diagnostic Approach to the Pruritic Pet." One aspect she emphasized was the fundamental importance of a meticulous history and basic diagnostics in evaluating pruritic pets.

“For me, it really is just getting back to basics,” Griffin said. “I'm trying to figure out how [to] get the case from looking like a disaster to looking good again and feeling good.” She explained to attendees that focusing on these foundational principles is one of the most important pieces of the puzzle for effectively managing complex dermatologic cases.

Obtaining a thorough history

“All of pruritus is not created equally,” Griffin said. “The history of pruritus sometimes can confuse us. Sometimes that confusion comes from a pet parent because they can know when the disease started, but they don't know how it started.”

With the mindset of getting back to the basics, Griffin said that when assessing a dermatologic condition, these are the questions she’s asking and the information she is looking for:

• Onset and progression of clinical signs: Determining the age of onset, whether symptoms are intermittent or continuous, and how they have evolved over time.
• Seasonality and initial presentation: Ascertaining whether signs were initially seasonal and whether pruritus preceded lesions or vice versa.
• Environmental and household factors: Inquiring about the pet's travel history, indoor/outdoor status, and the health status of other pets or human family members.
• Medication history: A thorough review of past and current medications, including their efficacy, dosage, duration, and consistency of administration.
• Diet history: Asking whether the pet’s bowel movements were solid or diarrhea, as well as whether there was any vomiting.
• Flea control: Assessing the type of flea control being used and the consistency and correctness of its administration, especially in atopic dogs who may exhibit heightened sensitivity to flea bites.

Cytology

Griffin also stressed the importance of cytology, stating, "I do have cytology on the majority of my dermatologic cases because looks can be deceiving." She reminded attendees that you can't truly know whether a lesion is bacterial, yeast, or sterile without it. She advocates for its use not only as a diagnostic tool but also as a means of monitoring the response to treatment and guiding decisions on whether to pursue culture and susceptibility testing.

For those who find cytology intimidating, Griffin suggests using available tools such as artificial intelligence analyzers and online image libraries to improve confidence in sample interpretation. She also shared a tip for improving client adherence. "I like to show pictures when I'm talking about cytology, because it really is just pattern recognition," Griffin said. "If I have a skeptical client, I can bring them back, show them, and say, 'This is what I'm looking for. This is why.' And I can help them understand the importance of the cytology and the importance of the recheck exam."

Skin scrapings

Griffin also reminded attendees that skin scrapes are essential for detecting superficial and deep ectoparasites. She also shared a tip for improving client adherence. “Another reason to have a camera on your scope is [so] you can bring the pet parents back...show them the mites, and then they will believe that you're not just trying to sell them.”

Griffin said that these in-house diagnostics are not only quick and cost-effective but also integral in prioritizing treatments and determining the necessity of further diagnostics.

Takeaway

Griffin explained that a back-to-basics approach helps prevent overlooking simple diagnoses. A thorough history and basic diagnostics provide a solid foundation for subsequent diagnostic and therapeutic decisions, ultimately leading to more effective management of pruritic pets.

Reference

1. Griffin J. Treating the itch that won't quit: diagnostic approach to the pruritic pet. Presented at: Fetch Charlotte 2025; March 14-16, 2025; Charlotte, NC.