Rotation #7: Dermatology

Dermatology is portrayed in Grey's Anatomy as a magical place where the doctors are calm and relaxed, they serve water filled with floating fruit, and everyone is dressed in pastels. Dermatologists work 9 to 5, no weekends, no on-call duty, and as they say, "there are no dermatologic emergencies."

My experience on the veterinary dermatology service hasn't involved any fruit-filled water, but it has been a nice change of pace from Small Animal Medicine. The biggest difference is that we don't have any hospitalized patients, so we get to focus only on the clients coming in for appointments. We also see a lot of long-term patients and spend a lot more time on client education than some other services, since animals with skin disease can require fairly intensive management to keep their diseases under control.

Derm is a huge part of veterinary medicine (Dolittler puts skin diseases as her #1 and #2 most common types of appointments), so it's been good to get my feet wet working with some of the most common types of skin problems. We've seen food allergies, environmental allergies (aka atopic dermatitis), sarcoptic mange, demodectic mange, endocrine disorders like hypothyroidism, autoimmune diseases like onychodystrophy (where the body attacks the nails) and sebaceous adenitits (where the body attacks the sebaceous glands of the skin), and some unusual diseases like Daschund Pattern Baldness.

Despite the economy, the Dermatology Service is still booked out for over a month in advance. I don't mean to sound cynical, but I suspect the reason that people are so willing to treat their pets' skin diseases is because they are embarassing (dogs with inflammed skin or hair loss are very noticeable on walks or at the dog park) and annoying (the constant licking, chewing, biting, and scratching of an itchy dog can wake owners up at night and drive them crazy during the day). It's relatively easy to ignore a limp, brush off those little lumps and bumps, or think that drinking more or eating less are just signs of old age.

Nonetheless, I think it's wonderful to see owners that are willing to devote all the time, money, and energy that it takes to manage what are often lifelong diseases. The differences that a dermatologist can make in an animal's quality of life can take a long time, but they can be dramatic. For example...

Treatment of generalized demodectic mange can turn a dog from this:
into this:
I don't think I'd ever specialize in dermatology, but it's nice to have a better idea of how to diagnose and manage the most common conditions I'll be likely to see in practice.

Next up is another Small Animal Medicine, then the wedding!