Very rarely will I ever rant about my colleagues, but I feel that I have to get on a little soapbox today. Bear with me as I get it out of my system.
Today I saw a 9 year-old Weimaraner with chronic skin and ear infections. This dog had been affected most of its life, and the owner had always taken it to the vet. The vets had treated the problems with appropriate medications, but then the problem would return. Now to me this is a prime suspicion for allergy problems. But apparently in all these years no doctor had ever even mentioned the possibility of allergies to the client. Just an hour or two later I saw a golden retriever with chronic foot irritation. This dog's previous vets had done various alllergy treatment, but apparently had never talked about food allergies.
I hate to say it but these aren't the first times I've run into situations like this. Several times per year I'll see a pet for the first time and learn that they have had chronic or recurrent problems with skin and/or ear. The dog will have had treatments at vets, but those vets have never discussed allergies.
Why is this a concern? Because ear and skin disorders, especially infections, don't "just happen". When they occur several times per year there is an underlying cause that must be determined. Yes, the infection/irritation needs to be treated, but doing that and nothing else is like putting out a house fire but never figuring out what started the fire. When problems are recurrent, the infection is only a symptom and is not the main problem.
Allergies are the most common reasons for these disorders, and can include seasonal allergies (pollens, grasses, etc.), flea allergies, dust mite allergies, and food allergies. Unfortunately most allergies in pets affect the skin in similar ways, regardless of the root cause or allergen. So several causes can have the same appearance and it can be difficult to quickly figure out which is the culprit. If we can determine the allergen we can often prevent the infections from happening in the first place.
None of this is new information, and veterinarians have known about allergies for decades. I was taught all of this back in the mid-90s, and frequently see it brought up in journal articles and continuing education meetings. No vet should be surprised at allergies as a cause of skin or ear infections, and every vet should be considering this as a possible diagnosis when they are recurrent. This is why I'm surprised when owners come in and say that their vets have never talked about this.
I know that clients don't always pay attention to what we say or remember it well, so there may be some cases where the vet did mention it, but the client didn't pick it up. I also have seen plenty of clients where the previous vet DID do a thorough work-up and treatment, considering all aspects of allergies. But this situation happens too frequently for me to believe that it's always the client not listening to the vet.
Here's the bottom lines....Vets, make sure you are talking to clients about allergies with recurrent dermatitis and otitis. Clients, if your pet has ongoing skin and ear problems, ask about environmental and food allergies.