Dr. Stacey Holz joins Dermatology for Animals!

Dr_Stacey_Holz four seasonDr. Stacey N. Holz grew up in Danville, CA and has spent her entire life with Siberian Huskies by her side.  She has always been drawn to animals and decided at the age of 8, that she wanted to become a veterinarian (or an astronaut, if that didn’t work out). During her school years, all of her reading and report writing focused on either animals or the family vet. Throughout her youth, animals continued to be fascinating and she enjoyed her various after-school and summer jobs assisting veterinarians and working with animals.

Following high school, Dr. Holz was accepted into the Washington State University Honors College undergraduate program and was awarded early acceptance into the College of Veterinary Medicine upon enrollment. While at WSU she was a member of the women’s cross-country and track teams for the WSU Cougars and participated in many veterinary service clubs. She graduated with a Bachelor of Science degree from the WSU Honors College and the WSU College of Veterinary Medicine in 1999.

Her enthusiasm and interest in dermatology began at a young age when her own dermatologist greatly helped her with her own chronic skin disorder and continued throughout veterinary school and her early career.  In 2004, Dr. Holz completed her American College of Veterinary Dermatology Residency (at Dermatology for Animals in Campbell, CA).  Dr. Holz is currently an active member of the American Academy of Veterinary Dermatology and the American Veterinary Medical Association.

Dr. Holz published a journal article on the long-term use of cyclosporine for the treatment of canine atopic dermatitis and has lectured frequently on this, as well as various dermatology topics throughout the United States. She enjoys teaching and mentoring veterinary students; and in 2010 Dr. Holz started a dermatology clinical service and 4th-year veterinary student rotation at her alma mater. She continues to conduct this dermatology service and educational clinical rotation for the students, traveling to Washington State University every month.

Dr. Holz is very excited to provide dermatology services to the East Bay area at practices in Walnut Creek and Fremont. She enjoys seeing the positive impact controlling chronic skin diseases can have on both the patients and their owners.

When not working to help dermatology patients and their families, Dr. Holz loves to be outdoors hiking with her Huskies, mountain biking competitively, or spending time with her husband, family, and friends.

Dr. Holz will be helping pets with skin problems soon at our clinic in Walnut Creek, California.  Practice limited to dermatology.

 

Apoquel™

After much research, anticipation and high hopes, we now have a new drug available for the treatment of allergic skin disease in dogs.  The drug named Apoquel™ (oclacitinib) was developed by Zoetis (formerly Pfizer) and will be officially launched and available after January 20, 2014.   We at D4A are already familiar with Apoquel™ because of our involvement with the drug during its development.  Several of our doctors and many of our patients have been involved since the early clinical trials over the last six years.  We have participated in three different clinical trials to study the safety and effectiveness of Apoquel™.  We have also been involved in a long-term study where we have monitored patients receiving Apoquel™ for over three years and counting.  Because of our experience with Apoquel™, Dr. Lewis was one of three dermatologist invited to speak about Apoquel™ at a “First to Know” meeting in Chicago in the summer of 2013.

Apoquel™ is an amazing drug for several reasons.  It works faster than a steroid, with most patients showing some improvement in their itch the very first day. It is better tolerated with fewer side effects than either steroids (prednisone, Medrol™) or Atopica™ (cyclosporine), which are two other classes of drugs commonly used to help allergic dogs. We envision Apoquel™ being helpful in several different scenarios.  For the allergic dog who has a short-term season of itch, such as every spring when the pollen count is elevated, or for a flea allergic patient who is scratching after a flea bite, Apoquel™ should be an effective and appropriate option.  Another time to use Apoquel™ would be when short-term relief is needed while a patient is starting a food trial.  Because a patient may continue to scratch for several weeks even after the diet change, Apoquel™ can provide comfort during this “lag time” before the food helps.  Many of our allergic patients are allergy tested and then started on some form of immunotherapy (desensitization).  We have the option of either allergy shots, or allergy drops under the tongue (sublingual immunotherapy).  This is the only long-term treatment that is not a drug and is the very best therapy for many of our patients, however, it can require several months (or sometimes longer) before the desensitization is helpful.  Apoquel™ does not interfere with desensitization shots or drops, and can therefore be used in the beginning of such a program to provide relief until desensitization becomes effective.

Finally, Apoquel™ will also be a welcome treatment addition for those allergic patients who just cannot get enough relief from the traditional therapies currently available.  Treating an allergic dog requires being sure we have the correct diagnosis, and then finding the best treatment or treatments while we try and balance the safety, effectiveness, cost,  and ease of administration.  It is certainly not a “one size fits all” approach.  The doctors and staff at D4A continue to help clients find these balances so that we may provide the best comfort with the highest level of safety for your beloved pets.

 

Written by: Thomas P. Lewis II, DACVD

The Science and Art of Desensitization (Part 2)

In the past the only way to desensitize a patient was to give the allergen by injection.  Now we also have the option of sublingual which is drops under the tongue.  Once allergy test results are obtained, these results should always be critically analyzed to insure that the results are consistent with the patients ’itch history. This determination should include historical information regarding what seasons of the year are better or worse. If you have an allergic dog, cat or horse, we always want the client to pay close attention to these details since it can make a difference on our allergen selection.  If allergy testing reveals positive reactions only to seasonal pollens in a patient which is pruritic year-round, then something is being missed!  There is a saying in medicine that goes “treat the patient, not the lab results”.  This certainly applies to desensitization and the selection of allergen but this is where knowledge of the regional allergens is necessary.  For the outdoor working dog that is pruritic only in the summer and fall, then positive reactions to grasses and weeds should be present, and they need to be emphasized or prioritized when formulating the extract.  For the indoor Chihuahua which sleeps under the covers at night and who is itchy year round, then indoor allergens such as dander, mold spores, house dust and house mites need a higher priority in the extract recipe.

Read more »

The Science and Art of Desensitization (Part 1)

Allergy shots which is also known as immunotherapy or desensitization, has been one of the safest, non-drug method to treat allergies in people and animals for many years.  It also remains one of the more challenging aspects of dermatology to master.   Even though at D4A we feel the intradermal allergy (skin) test is the best way to identify what the pet is allergic to, there are many more factors to consider when deciding what to include for the process of desensitization.   Our current skin test panel includes 70 different allergens. Read more »

Why Veterinary Research Matters

Reading about the recent study where researchers at Cambridge University took cells from the lining of paraplegic dogs’ noses and injected them into their spines, improving their ability to move their hind legs reminded me of why I get excited about clinical research. See this awesome video of Jasper before and after therapy- “Click Here”

The hardest challenge in medicine is that we only have a small understanding of how the body works.  This challenge is also one of the great rewards of medicine, since asking questions and working to find the answers is what drives many of us.  We know that, no matter how much we learn in a particular field, there will always be more to discover and learn.  Medicine is a great field for people who want constant challenges and learning opportunities.

Read more »

Spokane, Washington

In January of 2012, Dermatology for Animals joined Pet Emergency Clinic and Referral Center including Veterinary Surgical Specialists and Inland Empire Veterinary Imaging in Spokane, Washington.  Doctors Thomas Lewis and Rose Miller are board certified Veterinary Dermatologists that are now working and treating patients at this hospital.  Dr. Miller spent her childhood in Coeur d’Alene, Idaho, about 30 minutes from Spokane, so, she is happy to be practicing close to home.  Currently, doctors are available in our Spokane office by appointment.  Courtney Sims, a licensed veterinary technician, has joined the Dermatology for Animals crew in this location.  Courtney has worked with Pet Emergency Clinic for years and has been a welcome addition to Dermatology for Animals.  Dermatology for Animals is very excited for this new opportunity to care for the skin of animals in the northwest.

CONGRATULATIONS!

The staff at Dermatology for Animals would like to congratulate Dr. Darren Berger and Dr. Rose Miller on passing the American Academy of Veterinary Dermatology board exam! They both are a valuable part of our team and we could not be more ecstatic!

Dr. Darren Berger and Dr. Rose Miller began their residency with Dermatology for Animals in 2009. After completion of a three year residency and hundreds (maybe thousands) of hours of studying, these doctors have been able to achieve such a feat.

Often, clients ask how a person becomes a Veterinary Dermatologist. Firstly, you need dedication, the care and compassion for the itchy, scratchy animals and a large brain capacity. Secondly, you need a Doctorate of Veterinary Medicine, which includes eight years of college and a one year residency in general practice. Thirdly, you apply for a very competitive residency in veterinary dermatology. After being accepted into a program, you spend the next three years diligently studying, learning and asking a lot of questions. So after 11 years of college and mentoring, you can understand what an honor it is to work with such amazing, dedicated doctors.

If we had to use one word to describe Dr. Darren Berger it would be gregarious. He is outgoing and always makes an effort to make his clients feel completely informed. He is kind-hearted, sociable and always goes above and beyond the ordinary for every patient.

If we had to use one word to describe Dr. Rose Miller it would be exhilarative. She is full of energy and we can have a hard time keeping up with her. She is amicable, approachable and indisputably cares about her patients well being.

Compliments to our newly board certified Diplomates! Now they have those well earned extra five letters to carry around.

by Hannah F. Anderson, Veterinary Technician Dermatology for Animals.

Puppy Love: Pugs and Kisses, Oh, and Ear flushes

When I was in general practice, some of my favorite cases were new puppies as this gave me the opportunity to try to educate people early on regarding some of preventative measures that can be taken in order to control for possible ear and skin problems in the future as well as help their pet be more amenable to certain treatments (e.g. ear flushes).

One of the many consequences of allergies and other diseases such as hypothyroidism can be recurrent ear infections (otitis) or skin infections (pyoderma, bacterial folliculitis, Malassezia (yeast) dermatitis). It is often recommended that once chronic ear problems have been identified that routine ear flushing be performed to help remove debris and infectious organisms from the ear canals, hopefully helping to prevent ear infections. Unfortunately, ear infections are often quite painful, often making it difficult to treat your pet without them always running away from you as you reach for the medications. Playing with your puppy’s ears when they are young and starting a routine ear flushing regimen can be especially helpful later on if your puppy is unfortunate to suffer from ear infections as he or she ages, as they will have become somewhat accustomed to the routine. Additionally, if your puppy is accustomed to manipulation of the ears, otic exams by veterinarians may not be as uncomfortable and stressful. Read more »

The BEAR Necessity:

Although the majority of the cases that walk through the door are dogs, cats and the occasional horse, every once in a while we each get the lucky call to come help with a wild animal.

In our Albuquerque practice we have been fortunate to get to work with a wildlife rescue who recently had an outbreak of itchy black bears and asked us for our help.

One of the young female bears was brought in for evaluation of crusting on the face and mild itching. Like any other patient we preformed all of our diagnostics, including skin scrapings and cytology. On the skin scrape we were lucky enough to find the source of our trouble. This bear and likely all the others were infested with a contagious bear mite, Ursicoptes Americans. Read more »

A New Approach to Immunotherapy

 

Allergen specific immunotherapy, also sometimes called “allergy shots,” is often the preferred method of treatment for atopic dermatitis (allergic skin and ear disease triggered by environmental allergens such as dust mites, pollens, molds, etc.).  After allergies have been diagnosed and allergy testing is performed on a patient, an individualized allergen serum is formulated based on test results.  The same types of allergy tests are used for the formulation of both sublingual and injectable allergen sera. For more information, see our past blog entry about allergy testing- The allergy testing debate serology vs intradermal.  Until recently, the only proven effective way to administer immunotherapy in dogs and cats was by subcutaneous injection.  Administering immunotherapy by injection works just great for most animals, but sometimes an alternative approach is indicated.. Read more »