DIALOGUE DERM
FROM THE PRESIDENT
I am excited to enter my second year serving as the president of the Academy. I would like to offer my sincere thanks to Klaus Loft, who rotated off as past president and Natalie Theus, who had to leave the board due to other obligations. Klaus has been a driving force in the AAVD Executive Board, and we are all grateful for his dedication to the task. As a member-at-large, Natalie has been crucial to initiating and implementing the virtual round tables offered by AAVD. The board members also would like to thank our previous secretary Amy Blankenhorn from the Pennsylvania Medical Society (PAMED) for her expert and tireless dedication to assist us in our tasks. We are excited to have Brendan Leahy taking over from Amy and supporting us. Currently the executive board includes
the following members: Rose Miller (Past President), Verena Affolter (President), Anna Jenstead (Vice President), Jennifer Thomas (Treasurer) and Brian Scott, Lara Tomich, Emily Binversie (Members-at-Large) and Jeanne Budgin (Acting Representative to WAVD).
We would like to apologize for the gap offering Derm Dialogue in 2024; this has partially been due to re-assigning editorship after Norma White-Weithers retired as editor for Derm Dialogue over 12 years. We are tremendously thankful for Norma’s dedication fulfilling this task for so many years. We are grateful to Emily Rothstein for taking over this task and getting us back on track, offering this valuable source of information. Lots has happened since the last Derm Dialogue issue.
We had a very successful 10th WCVD in Boston in July 2024. Under the skillful guidance of Catherine Outerbridge (President) and Emily Rothstein (Vice President), this meeting was packed with exciting information presented in six different concurrent tracks, workshops, wet labs, and wonderful social events for participants to catch up with friends. The AAVD would like to thank everyone who was involved in making this event one to remember. In April 2025, the NAVDF meeting was held in Orlando, Florida. The meeting was highly attended, and in addition to the scientific and clinical streams and roundtables, it offered an entire day for our Spanish-speaking colleagues, as well as sessions on artificial intelligence.
Our next annual NAVDF meetings will be in Indianapolis, Indiana, April 30 - May 4, 2026, and in Anaheim, California, March 22-26, 2027. And then we will be ready for the 11th WCVD in Seville, Spain, September 6-10, 2028.
Our Virtual Round Tables have been very popular and highly attended. The board would like to thank everyone who was involved in leading these round tables. Our goal is to offer up to 3 sessions each year, and I am grateful that Laura Tomich and Emily Binversie agreed to spearhead the organization of future sessions. Please do not hesitate to let us know any topics you would like to see addressed in a future roundtable.
We are excited to acknowledge the two recipients of the Frank Král Award over the last 2 years. The Frank Král Award, first established in 1973, recognizes outstanding achievements and dedicated services to the veterinary profession and specialty of veterinary dermatology by current members of the AAVD. In 2024, this award was presented to Dr. Gail Kunkle, Professor Emerita at the University of Florida in Gainesville, where she has served as a professor in Dermatology and acting Service Chief for many years.
Dr. Verena K. Affolter
From the President (continued)
She has been the recipient of various awards, among others the ACVD Award for Excellence in Dermatology and the Northern Distinguished Teacher of the Year Award. She held various positions in professional organizations, including both the ACVD and AAVD, and served on the scientific advisory boards of Pfizer and Novartis. The 2025 award was presented to Dr. Rosanna Marsella, a Full Professor in Dermatology at the University of Florida in Gainesville. She graduated from the School of Veterinary Medicine at the Universita degli Studii di Milano, Italy in 1991 and became a Diplomate of the ACVD in 1996. Over the years, she has lectured extensively at national and international meetings, as an invited keynote speaker, presenting supporting reviews as well as original studies and continuing education sessions. She has been very active in various professional organizations, including the AAVD, ACVD, ESVD, and AVMA. She has been approached by many journals to serve as a reviewer and co-editor. Congratulations to both recipients!
We are excited to announce the five recipients of the AAVD Technician Scholarship, which provides reimbursement for expenses related to attending the annual NAVDF meeting. Our 2025 recipients are: Erica Bachinski, Shelbi Woods, Alvara Linares, Theresa Campbell, and Kaitlyn Newkirk. Congratulations.
The AAVD continues to offer the AAVD Veterinary Student Annual Award in recognition of excellence in Veterinary Clinical Dermatology to senior veterinary students from various schools. The cash award, along with a complimentary 2-year AAVD membership, was presented to 21 students this year.
It is with great sadness that I need to let you know that over the last two years, we lost four dear colleagues and members of the AAVD: Karyn E. Beningo–Rozman, Claudia von Tscharner, Liora Waldman, and Ton Willemse. They are all greatly missed.
The board would like to encourage the membership to reach out to us. We welcome new ideas for how AAVD could further spread knowledge in dermatology. This is your organization – so do not hesitate to let us know. Either email a board member or send a message to info@aavd.org.
Sincerely,
Verena K. Affolter
Dr.med.vet., Dipl. ECVP, PhD
Acting President AAVD
Overview of Staff and Leadership
Administrative Assistant Jill Bennish, jbennish@pamedsoc.org
AAVD Executive Board
President
Verena Affolter, DVM, Dipl., ECVP, PhD Davis, CA
Immediate Past-President
Rose Miller, DVM, DACVD® Coeur d’Alene, ID
Vice President
Anna Jenstead, DVM Madison, WI
Treasurer Jennifer Thomas, DVM Boston, MA
Members At Large
Brian Scott, DVM, DACVD® Bradenton, FL
Lara Tomich, DVM, MS, DACVD® Madison, WI
Emily Binversie, DVM, PhD, MS Ames, IA
Derm Dialogue,
Editor
Emily Rothstein, DVM, DACVD®
Southington, CT
WAVD Representative
Jeanne Budgin, DVM, DACVD®
New York, NY
ADVT Representative
Chantelle Hanna, BS, CVT, VTS Charlotte, NC
Executive Secretary
Brendan Leahy, CAE
Association Coordinator Rhianna Zimmerman
Meeting Manager Jessica Winger
NAVDF 2025 Program Committee
Program Chair
Co-Chair
Klaus Loft, DVM, MS
Amelia White, DVM, MS, DACVD®
Members At Large Cindy Bauer, DVM, MS, DACVD®
Paul Bloom, DVM, DACVD®
Alberto Cordero, DVM, DLACVD®
Valerie Fadok, DVM, PhD
Valerie Fadok, DVM, PhD, DACVD®
NAVDF 2025 Organizing Committee
President Kristin Holm, DVM, DACVD®
Vice President & Program Chair
Klaus Loft, DVM, MS
Past President
Rose Miller, DVM, DACVD®
Treasurer Allison Kirby, DVM, DACVD®
Social & Sponsorship Chair
Allison Kirby, DVM, DACVD®
Members At Large
Heather Akridge, DVM, DACVD®
Melissa Eisenschenk, MS, DVM, DACVD®
Anna Jenstead, DVM
Chantelle Hanna, BS, CVT, VTS
Lindsay McKay, DVM, DACVD®
Alexis Borich, LVT, DACVD® (Hon.)
WAVD Update – April 2025
AAVD is a member organization of the World Association for Veterinary Dermatology. Below is the report submitted to AAVD in April 2025.
World Congress of Veterinary Dermatology (WCVD)
Final figures for WCVD10 are still being accounted for. Surplus sharing will be forthcoming, but the meeting was very successful in terms of registrants, content, and revenue. WCVD11 in 2028 will be held in 2028 in Seville, Spain.
World Association of Veterinary Dermatology (WAVD)
The administration committee continues to meet quarterly via zoom. There is interest in expanding efforts in Africa, and a working group has been created to explore this further. Meetings have been arranged with WSAVA and AFSCAN (African Small Companion Animal Network) to discuss establishing African Veterinary Dermatology Associations based on geography and language. Plans to provide virtual CE this year are also under development.
The digital library project, generously sponsored by Elanco and hosted by MediaLogix, is receiving and uploading image collections from select colleagues. Drs. Stefan Hobi and Christopher Klinger have been leading this project.
Education Committee Updates
Dr. Galia Sheinberg is the current Education Committee Chair, and this committee is actively planning for World Veterinary Dermatology Day scheduled for February 3rd, 2026.
An ambitious plan is under development to improve engagement and reach. The goal is to create a 24-hour live interactive dermatology event to include quizzes, panel discussions, and sponsored content with support from Paul Heasman at ELEARNING.VET.
ELEARNING.VET was involved in creating virtual content for the last Congress. The program will be free for the first 12 hours for live and recorded content viewing, then open to paid ticket holders {early bird (£49) and standard rates (£99)} until 12/31/2026. The current plan is for two tracks to be available – one in English, and one in multiple languages – as well as small and large animal/equine. A focus on mid-level content and the possibility of including sponsored lectures are being discussed. Speakers are currently being proposed and contacted.
Peter Ihrke Scholarship
The Peter Ihrke Scholarship was created to honor the life and career of Professor Peter Ihrke and commemorate his contribution to the discipline of veterinary dermatology. This scholarship provides the opportunity for an individual from an under-privileged region to attend a two- to four-week externship in the veterinary dermatology service of the University of California-Davis (UCD) Veterinary School. The scholarship will fund a return economy airfare, modest accommodation and meal allowance, and professional liability insurance for the successful applicant.
Dr. Neelam Singh Josan from India was awarded the fifth scholarship for 2025. Dr Neelam Singh Josan is a small animal practitioner from India with 26 years of experience and a special interest in dermatology. She is also a founding member of the India Association for Veterinary Dermatology (IAVD).
The application window for the 2026 Scholarship opens September 1, 2025.
Respectfully submitted,
Jeanne B. Budgin, DVM, DACVD
WAVD
Representative to AAVD
ROUNDTABLE SUMMARIES
NAVDF 2025 CRYOSURGERY ROUNDTABLE NOTES
Moderator:
Alberto Martin Cordero
1. Participant Introductions & Experience Levels
n Clinicians from multiple veterinary dermatology and oncology practices shared their backgrounds and comfort levels with cryotherapy.
n Experience ranged from “no prior use” to “regular use for several years,” with common uses during residency primarily on papillomas or sebaceous adenomas.
2. Equipment Inventory & Familiarity
n Common devices mentioned:
• Liquid nitrogen-based units (“Cryo-baby,” spray systems)
• CO₂-laser + cryotherapy combination
• “Full Renewal” spray-can system
• Cryo-pen with disposable canisters
• Thermal probes (“touch probes”) and various interchangeable tips
• Mid-size handheld units (e.g. Brymill model)
n Noted that many practices have units “gathering dust” due to uncertainty about applications or pricing.
3. Typical Indications & Lesion Types
n Benign lesions (e.g., papillomas, sebaceous adenomas, angiomas):
• Most clinicians use 2 freeze–thaw cycles
• Good outcomes even with heavily bleeding angiomas; recommend post-treatment observation for 1–2 days
n Malignant lesions (e.g., mast cell tumors, squamous cell carcinoma, adenocarcinomas):
• Generally 3 cycles recommended
• Some pre-medicate with prednisone and antihistamines to reduce degranulation risk
• Case series reported successful treatment of facial and nasal tumors with minimal morbidity
n Other applications:
• Oral papillomatosis—multiple small nodules treated with excellent results
• Eosinophilic granulomas (curiosity but no widespread use yet)
4. Treatment Protocols & Technical Details
n Cycle timing:
• Freeze–thaw cycles: 2 cycles for benign, 3+ cycles for malignant
• Short thaw period (~1 minute) between freezes; thaw cycle ideally ≥ 50% longer than freeze
n Depth control:
• Aim for a freezing halo ~1.3 × probe diameter
• Touch the surrounding tissue manually or use isolation gels to prevent over-freeze
• Slow thaw critical for maximal cell kill
n Monitoring:
ROUNDTABLE SUMMARIES
• Visual assessment of white “halo” and ice-ball formation
• In some cases, ultrasound to measure lesion dimensions and ice-ball margins
5. Sedation & Analgesia
n Local anesthesia (infiltration or topical) used by nearly all; most patients awake and cooperative.
n General sedation reserved for:
• Head/face/ear procedures where movement risk is high
• Very anxious or fractious patients
• Multiple lesions (> 3) in one session
n Pain described as a brief “pin-prick” sensation under local; minimal additional sedation usually suffices.
6. Combining Modalities
n Laser excision + cryo-base freeze to improve margins and reduce regrowth
n Surgical debulking + cryo for subcutaneous or deep tumors
n Chemotherapy + cryo (experimental “cryo-chemotherapy”) and electrochemotherapy for high-grade sarcomas
7. Safety & Client Counseling
n Anatomic cautions:
• Thin structures (ear pinna, penile skin)—risk of cartilage/skin necrosis; advocate gentle freeze, manual warming of adjacent tissue
• Cartilage defects reported when over-freezing
n Cosmetic sequelae:
• Possible depigmentation or altered hair regrowth (e.g. white hairs on dark coats)
• Important to counsel owners on these risks and set pricing/expectations accordingly
8. Pricing & Follow-Up Strategy
n Tiered pricing model:
• Higher fee for first 2–3 lesions (e.g. $70–75 each), reduced rate for additional lesions (e.g. $35–40)
n Re-treatment guarantee:
• 30-day re-check and “free refreeze” for any lesions that persist or recur
9. Research & Clinical Trials
n Ongoing clinical trials on intralesional cryotherapy for mast cell tumors show lesion shrinkage, minimal degranulation when pre-medicated.
n Interest in recruiting additional sites for collaborative studies on immunologic (abscopal) effects and long-term outcomes.
ROUNDTABLE SUMMARIES
Key Takeaways
1. Standardize protocols: 2 cycles for benign, 3+ for malignant lesions, with short thaw intervals.
2. Emphasize training: Many units sit unused—hands-on wet labs and mentorship can boost clinician confidence.
3. Counsel clients thoroughly: Discuss costs, possible depigmentation, need for follow-up, and sedation options.
4. Explore combined therapies: Integrating cryo with laser, surgery, or chemo can expand indications and improve outcomes.
5. Leverage research opportunities: Growing interest in cryo’s immunologic benefits—clinicians are encouraged to participate in clinical trials.
ROUNDTABLE SUMMARIES
Healing with HBOT roundtable
Moderator: Charli Dong from Animal Dermatology Group – Pasadena, CA
Summary: Five people were present: one general practitioner, three Diplomates and one veterinary technician who was working on her VSP. The moderator was the only one that had access to a chamber. The group agreed to share contact information.
1. Kaityln Peden, Dermatology for Animals – Florida, DACVD®, no previous HBOT experience a. Kaityln.peden@thrive.com
2. Karen Campbell, Missouri Veterinary Dermatology Center, DACVD®, no previous HBOT experience a. campbellmotsingerk@missouri.edu
3. Andrew Bodenstein, VCA- Spokane, Washington, GP, referral HBOT experience and familiar a. avboden@gmail.com
4. Jessie Miceli, Louisiana State University, Veterinary Technician, shadowed HBOT procedure but has not used herself a. jmccrary@lsu.edu
We established goals for the roundtable. The main goals were exploring clinical applications for HBOT dermatology as well as other HBOT benefits. Two clinicians were particularly interested in HBOT uses for sterile nodular panniculitis and pythiosis. One clinician was interested in accepted vs. debatable HBOT implications. Everyone was interested in learning about HBOT dermatology cases and the respective outcomes.
The most widely used clinical application of HBOT in veterinary dermatology was wound healing Burn victims were discussed and we looked at chronological pictures of a basenji that was saved from a house fire. We discussed a case with a Bengal kitten that had bilaterally ulcerated lesions on her caudal thighs of unknown origin. She was originally managed by a surgeon and a criticalist with no improvement, so she started HBOT. There was noticeable improvement after one session and complete healing after 2-3 weeks. We also discussed HBOT for vasculitis case management, but it was unclear how much contribution HBOT played since those cases were not medically managed prior to HBOT. For refractory pinnal vasculitis, HBOT had been helpful as an adjunct therapy for a difficult case to stay in remission, but ongoing sessions were needed to keep the patient in remission. HBOT was helpful for mycobacterium cases as adjunctive therapy for its synergistic antimicrobial effects. A recent article was published in Veterinary Dermatology: Positive effects of hyperbaric oxygen therapy in a cat with cutaneous nocardiosis (see moderator comments for citation). For most cases, it could be concluded that chronic cases would need continued HBOT sessions to keep the disease in remission. Calcinosis cutis was brought up as a possible implication but there had not been any experience with HBOT and calcinosis cutis. It was noted that in the participants’ experience, all purposes of the HBOT chambers were explored by clinicians in large animal medicine.
For non-dermatological cases, HBOT had been effective for spinal aspergillosis, arthritis, and acute anestheticrelated deafness. There was copious evidence in literature that HBOT was effective for the management of carbon monoxide poisoning and drowning. Although there was some literature that stated HBOT was effective in snakebite wounds, a 2024 article stated otherwise.
We then discussed protocols but there were no established protocols. In general, the moderator suggested 1520 minutes for acclimation, 30 minutes for therapeutic sessions, and 15-20 minutes to decompress. However,
ROUNDTABLE SUMMARIES
there was an array of protocols in literature which much shorter acclimations and decompressions times, and longer therapeutic sessions. Protocols for specific purposes should involve a literature search for previous case protocols. The number of sessions was also dependent on the disease, logistics, finances, and expectations. Some protocols suggest more than one session per day.
We also discussed HBOT finances, charges, training technicians, technician power during HBOT sessions, oxygen availability, and protocols, but unfortunately time was limited and only a few sentences were discussed.
HVM (https://www.hvmed.com) could be contacted for trial periods with their HBOT chambers as well as certifications and continuing education.
Moderator comments:
Simpson AC, Wiener DJ. Positive effects of hyperbaric oxygen therapy in a cat with cutaneous nocardiosis. Vet Dermatol. 2021 Aug;32(4):392-e112. doi: 10.1111/vde.12978. Epub 2021 Jun 9. PMID: 34105850
Olin S, Schildt J, Lane M, Odunayo A, Springer C, Call D, Jones S, Geiser D, Millis D, Drum M. The effects of hyperbaric oxygen therapy on snake-bite-associated wounds in dogs. J Vet Emerg Crit Care (San Antonio). 2024 May-Jun;34(3):211-221. doi: 10.1111/vec.13383. Epub 2024 May 18. PMID: 38761038.
Thank you all for your active participation and it was lovely meeting you! Please see next page for a basic “Do’s” and “Don’ts” list.
ROUNDTABLE SUMMARIES
GO
Material and Equipment:
Cotton Elastikon
Polyethylene tubing
IV sets
IV catheters – must be capped appropriately
Heimlic valves, chest drains
Cotton towels
Medications:
Alpha 2 agonists
Diazepam
Most other medications
NO GO
Material and Equipment:
Nylon/polyester anything
Electrical devices, incl. battery operated
Heating devices, patches, chemical warmers
Anything that might produce a spark
Steel/metal (especially horseshoes)
Velcro
Vet-wrap or comparable
Horse blankets, non-cotton blankets
Medications/Topicals:
Alcohol, incl. alcohol preps
Any petroleum based product
Baby oil
Petrolatum Ointments
Fly sprays, other topicals
Hoof packing
Hoof paint
Medications—absolute contraindications
Cisplatin Disulfiram
Doxorubicin
Mafenide acetate
Opiates (butorphanol, etc.)
Conditions—absolute contraindications
Untreated pneumothorax
Tension pneumothorax
Condition—relative contraindications
Fever
Seizure disorder
Viral infections
Optic neuritis
Chronic emphysema with CO2 retention
History of:
Guttural pouch disease
Eustachian tube disease
Otosclerosis
Spontaneous pneumothorax
Thoracic surgery
ROUNDTABLE SUMMARIES
Client Communication in Oncologic Cases: A Multi-Perspective Discussion
Moderator: Dana Connell
A conversation between two veterinary dermatology residents, one veterinary oncologist, and three boardcertified veterinary dermatologists explored the challenges and strategies surrounding client communication in cases where a cancer diagnosis arises during dermatologic consultations. A central theme was the unique position veterinary dermatologists occupy in delivering unexpected oncology-related news, compared to oncologists whose clients typically arrive prepared for such discussions.
Key Insights:
1. Emotional and Time Constraints:
Dermatologists feel confidence in their ability to discuss oncology with clients; however, they emphasized the emotional weight and time burden of delivering a surprise cancer diagnosis. Because owners typically do not expect such news during a dermatology visit, these conversations tend to be longer and require a higher degree of empathy. This unplanned emotional demand poses logistical challenges within tightly scheduled clinical days.
2. Strategic Communication Solutions:
The group discussed pragmatic strategies for managing these cases, including offering follow-up virtual consultations. These could be conducted by the dermatologist or a trained technician, allowing time to share detailed information after the initial visit. Offering these at a reduced cost—while still valuing the clinician’s time—was suggested as a balanced approach to extending care while preserving workflow efficiency.
3. Language and Clarity:
Many dermatologists acknowledged a tendency to soften their language around cancer, particularly when discussing euthanasia or prognosis. Terms like ‘euthanasia’ or direct acknowledgment of mortality were often avoided, leading to confusion or leaving clients to initiate difficult topics. The group identified this as a critical gap and resolved to adopt more direct yet compassionate language to ensure clarity and support client decision-making.
Takeaway Message:
Veterinary dermatologists often diagnose cancer, placing them in a critical communication role. To improve client understanding and emotional support, the group endorsed a twofold strategy: implementing timeconscious follow-ups for complex discussions and using clearer, more direct language around diagnosis and prognosis. These shifts aim to better prepare pet owners for next steps.
ROUNDTABLE SUMMARIES
Feline Dermatology: So Many Challenges, So Few Therapeutic Options
Moderator: Jeanne Budgin
A mixed group of participants were in attendance as follows: private dermatology practice in the US and Mexico (15), private general practice in the US and Japan (4), Industry (1), and dermatology residency (1).
The roundtable began by asking for everyone to share challenges in managing feline skin disease. The following topics were raised: feline “non-responsive” pruritus (including head/neck and feline atopic syndrome), lack of non-steroidal options, limitations to therapy (no monoclonal antibodies), ineffective barriers (E collars) and managing self-trauma, difficulty with medicating and compliance, treating shelter cats with limited histories, toxoplasmosis testing and interpretation, dietary trials, and managing otitis media.
There was a brief initial discussion on discontent surrounding general practitioners referring non-compliant clients or clients that simply cannot medicate their cats. The importance of educating owners prior to referral was emphasized. Many clients may be more compliant when they are referred or consult with a dermatologist. This may be related to hearing the same recommendations more than once, time, or financial investment.
A deeper discussion on several topics ensued.
Medicating cats – general
Pill AssistTM from Royal Canin® was mentioned as being popular as a pill pocket for cats specifically. Best Pet Rx, a compounding pharmacy, has also created a dissolvable disk that melts within seconds when placed on a mucous membrane. Many agreed that establishing mealtimes with the elimination of free choice feeding may aid in the administration of medication since cats are hungrier. It was also emphasized to administer meds in a small amount of palatable food vs. a whole meal. Churu®, Rayne rabbit pate, and Rayne rabbit meat balls for pilling were all suggested.
Medicating cats – cyclosporine
All agreed that liquid cyclosporine was very unpalatable. One participant was curious if generic modified cyclosporine, Modulis® (Ceva) may vary in odor or taste. Based on the ingredient list, this was not believed to be the case. One person shared that she purchases empty gelatin caps and can put liquid cyclosporine or even multiple medications inside. No one was using injectable cyclosporine therapy, however some found the capsules (25 mg/cat was proposed) easier for clients to administer and while underdosing in some patients, this was often effective. Many were titrating cyclosporine up slowly to prevent side effects including foaming, nausea, and soft stool – dosing every 12 hours may be better tolerated in some cats. No one was concerned with using cyclosporine in FeLV and FIV+ cats provided they were monitored appropriately. None of the participants were performing cyclosporine levels, but all were weaning to the lowest dose that controls clinical signs. Toxoplasmosis levels were run by a few; if IgM positive, clindamycin therapy was initiated. While most agreed that compounded cyclosporine wasn’t stable or effective, some had used the non-modified form – often at higher doses 7-10 mg/kg/day+ - in a flavored tablet with treatment success through the following pharmacy - https://bcpvetpharm.com/
ROUNDTABLE SUMMARIES
Medicating cats – glucocorticoids
Most were familiar with using injectable dexamethasone sodium phosphate orally and associated dispensing systems. One person commented that they mixed this with tuna juice! Some raised concerns with the longer activity of this therapy, as well as triamcinolone therapy, however generally this was considered to be advantageous if medication could be administered less often. Several shared that triamcinolone was a very effective steroid in cats – many agreed, however the form is important for potency—acetate or acetonide is best. It also is now off the market, so compounding is required. Marshmallow remains popular for cats! Multiple people felt that methylprednisolone was more effective vs. prednisolone in cats. Diabetes induction with steroid therapy was briefly discussed. Some felt young, lean cats were fairly resistant to this and older, overweight cats far more predisposed. Methylprednisolone acetate was used infrequently but under certain circumstances (shelter environments for example) this may be a necessity.
Other therapies and therapeutic limitations
High dose Apoquel® (oclacitinib; 0.8-1 mg/kg PO q 12 hours or 0.4-0.6 mg/kg PO q 12 hours or 1 mg/kg PO q 24 hours) was used frequently by multiple participants and an abstract was forthcoming that reviewed safety and efficacy data. One individual shared data that approximately 60% of cats need to stay on twice daily and 40% can be reduced to once daily therapy. Neutropenia, gastrointestinal signs, and transient elevations in liver values were the most common side effects. There was also a report of elevations in fructosamine levels, however these remained within the reference range based on this reference (https://pmc.ncbi.nlm.nih.gov/ articles/PMC6506962/). Some shared that cats enjoy the chewable tablet! One person has prescribed ZenreliaTM at the canine label dose in combination with other therapies for a cat and felt this may be therapeutically beneficial.
A discussion ensued about using behavior modifying medications in cats such as fluoxetine, amitriptyline, doxepin, and gabapentin. Bengals, Abyssinians, and Savannahs were mentioned as breeds that may be more prone to having an anxiety component to their skin disease. Gabapentin was mentioned at a dose of 10 mg/ kg PO q 12 hours for 75 mg PO q 8 hours and not usually prescribed as a solo agent. One person mentioned Vetriscience Composure™ chews (Thiamine, Colostrum Calming Complex®, L-theanine) as being useful for cats with anxiety.
Very few were prescribing antihistamines, however cetirizine at 5 to 10 mg/cat PO q 24 hours, cyproheptadine, or chlorpheniramine transdermal gel were referenced.
Other therapies touched upon included topiramate with very little to no use and Phovia for eosinophilic plaques.
Barriers to self trauma
Vet Med Wear - https://vetmedwear.com/, Kitty Kollar - https://www.kittykollar.com/, and soft claws were mentioned.
ROUNDTABLE SUMMARIES
Round table discussion on the use of diode lasers in veterinary dermatology.
Moderator:
Klaus Earl Loft
The round table contained members from veterinary dermatology in Canada, the United States, and India Most participants had access to the CO2 laser, and some had access to both types of lasers.
The group consisted of veterinary board-certified specialists, non-board-certified clinicians, general practitioners, residents, and industry.
It appears that among the round table attendees, in veterinary otology, attendees currently use diode lasers less than CO2 lasers. Three attendees used diode lasers and shared how they used them to collect biopsies and manage chronic and refractory ear conditions. This tool has potential additional applications for laser surgery and other aspects of the skin, for example, oral papillomatosis and dermal mass removals in a similar fashion to CO2 lasers, electrocautery, and more conventional surgical techniques.
Those attending discussed a question about using it in conjunction with reconstruction surgery for proliferative pododermatitis. Given the limited knowledge and experience in laser surgery, this might be something to discuss or consider. Still, several members felt this might be slightly riskier than a CO2 laser, electrocautery, or regular surgical intervention.
We discussed some of the ways diode lasers are currently being used and their potential advantages compared to CO2 lasers, electrocautery, and even cryo-freezing of various tissues.
Given the flexible fiber used in the diode laser, this allows advantages for a minimally invasive approach, even in a space where there is intermittent or constant need for flushing while operating, specifically when dealing with vascular otic neoplasia or purulent-filled ear canals. Examples of various ways to stabilize the long fiber while working through a video otoscope were mentioned, but most of these are “MacGyver” adaptations to help the operator perform procedures. It was shared that the small diameter size of the fiber (600µm versus 800 µm) permits concurrent flushing while using the laser. This was a significant advantage compared to CO2 laser and electrocautery, neither of which allows the concurrent use of flushing while utilizing the devices. So, a “bloodless field” of surgery allows improved visualization and better preservation of ear anatomy.
It was felt that until we see a significant improvement in the various adaptations, each veterinarian operator will likely have to identify the best way to develop comfort and routine utilizing flushing, suction, or other forms of manipulation in parallel with the video otoscope and laser fiber.
ROUNDTABLE SUMMARIES
Some discussion of the risk of deep tissue trauma from the potent power source of the diode laser tip was shared. There would be a lesser risk of cryo-freezing within the ear canal (unless by a very experienced cryo-surgeon), and the same could be argued when compared to using a scalpel. There were some differences in how much watt power each user of the diode laser felt was safe, and no obvious resources or recommendations are available at this point, so a round table discussion of this type will be helpful as more people gain experience and knowledge.
1.
Ablation/biopsy of Masses/tissue in the External Ear.
n Effective for removing and biopsying: Within the ear canal (cats and dogs)
• Ceruminous gland adenomas (feline cystadenomatosis)
• Papilloma on pinna, tragus
• Polyps, by seeking out the remaining stalk of tissue and ablating it after traction removal could be an advantage, particularly if the stalk/attachment is vascular or in very close proximity to the tympanic membrane
Chronic Otitis Externa
Diode lasers can reduce and debulk tissue hyperplasia in chronic, inflamed, and end-stage canine canals. However, none of the attendees felt compelled to pursue this approach at their current skill level or need. Some mention of places where CO2 lasers were being used for this purpose, but none of the attendees currently use either laser option for reconstructive ear canal surgery
One attendee had used the diode laser for an oral papilloma case with approximately 50-80 papillomatous masses. They were waiting for updated information from the owner, as the procedure was done less than 2 weeks ago, but this was the first case it had been used on at this point.
Cost of laser contrasted with other tools was briefly mentioned but none of the attendees had any specific details to share on pricing.
When working on the water in the ear canal less demand for vacuum cleaning and suction of air fumes, etc. but when using the diode laser is the same concerns about aerosolized tissue bacteria etc. I asked with cauterizing devices or CO2 laser.
Thoughts on how the diode laser could become a potential for:
n Beneficial for proliferative or stenotic otitis externa (e.g., in cocker spaniels or bulldogs).
n Laser ablation or vaporization of:
• Hyperplastic tissue
• Ceruminous gland adenomas or cysts
• Fibrous or polypoid tissue
• Diode lasers help reopen stenotic canals by selectively removing fibrotic or proliferative tissue.
• Often used to debulk tissue before or as an adjunct to total ear canal ablation (TECA) or lateral wall resection.
ROUNDTABLE SUMMARIES
Stop Horsin’ Around
Moderator: Lara Tomich, DVM, MS, DACVD®
Roundtable panelists: Julia Miller, DVM, DACVD®; Stephen White, DVM, DACVD®; Roseanna Marsella, DVM, DACVD®; Annette Petersen, DVM, DACVD®; Wayne Rosenkrantz, DVM, DACVD®
Summary:
Our panelists included three academic veterinary dermatologists and two private practice dermatologists representing the Midwest, Southeast, and West Coast. We started with questions from the attendees’ registration forms and answered some questions from attendees on the fly.
We first discussed the rate at which we see methicillin-resistant Staphylococcus aureus in horses. Most agreed that we see MRSA uncommonly. When we have identified MRSA on bacterial culture and susceptibility; it tends to be in patients that have an extensive antibiotic history. One panelist felt it was most commonly isolated from the distal limb. One academic dermatologist felt they were isolating more methicillin-resistant Staphylococcus pseudintermedius (up to 80%) and felt they were now culturing more horses. All suggested that MRS may be identified more commonly in an academic/tertiary setting. Many agreed that the most common antibiotic seen prior to presentation belonged to the sulfa class. One dermatologist felt they see more prior gentamicin treatment and expressed that previous treatment, and therefore resistance, may be more region-dependent.
An attendee asked about equine trainers and clients utilizing topical therapies. This is a concern from the standpoint of both contact reactions and resistance. The panel agreed that they are typically recommending chlorhexidine-based topicals. Two panelists like using topical mupirocin on focal areas. Another dermatologist likes using dilute bleach or hypochlorous products. One dermatologist likes using silver-containing products.
We next discussed severe facial dermatitis without significant pruritus in other locations of the body. The panel expressed they would want to see a picture to see if it was symmetric or not. If it was symmetric, it could be that the face was so pruritic and inflamed that the owner may overlook pruritus elsewhere. If it was not symmetric, it could be a pruritic dermatophytic lesion. If it was a white-faced horse, it could be a solar dermatitis or dermatophilosis. Atopic horses can also preferentially rub at their face or muzzle. Cytology is recommended to rule out secondary infection, especially during months where fly masks are used for long periods of time. One dermatologist had a patient with a pruritic muzzle secondary to self-trauma from a round bale.
We next discussed considerations for working up food allergy in horses. All agreed this is very difficult in horses given how many people are often involved in the care of most horses, how often supplements are used, and the difficulty in sourcing single grass hay. One dermatologist mentioned that some feed companies will make a single grass, complete bagged hay that can be useful. In her experience, she has noticed horses develop hives with peanut hay since she practices in the Southeast. One dermatologist feels they have seen a number of horses develop hives in response to supplements including a flax seed supplement. All expressed that supplements need to be stopped during a diet trial, and there were mixed feelings on the ability to truly find a single-source hay and feed this exclusively in a boarding stable where other types of hay may also need to be fed. An attendee mentioned teff hay in the comments, and the group agreed that this could be an alternative option for a diet trial. One dermatologist from the Southeast expressed it’s difficult to find, and another said it’s expensive.
ROUNDTABLE SUMMARIES
We next discussed medical management of allergic horses for immediate relief. The group lamented that options were limited. All agreed that they liked systemic steroids as they tend to work most consistently; most preferred dexamethasone given orally, though prednisolone is also an option. Dosing depends on severity of pruritus; cases with more severe inflammation and pruritus or angioedema will likely require the high end of the anti-inflammatory range. You can often reduce steroid dosing to alternate day or every 3 days for long term management. Pentoxifylline (10-15 mg/kg PO q 12 hrs; 5000 mg PO q 12 hrs) can often lower how much steroid is needed to control pruritus and inflammation; or may be effective as monotherapy for urticaria in some cases. Two dermatologists also recommended adding injectable dexamethasone into chlorhexidinebased topicals (e.g. 8 mL of dexamethasone into a bottle of TrizChlor4® spray) One of the dermatologist cautioned about using topical steroids on the distal limbs due to potential cutaneous atrophy. The group has used Apoquel® at 0.25 mg/kg PO q 24 hrs dosing for management of atopic dermatitis with mixed results and occasional adverse effects including significant lymphopenia and upper respiratory infection. One dermatologist found that Apoquel® worked better in pemphigus foliaceus cases rather than atopic dermatitis. One dermatologist liked doxepin (0.5-1 mg/kg; 400 mg) twice daily in some pruritic horses. Two dermatologists feel their referring population has often already reached for Apoquel® prior to presentation, and they are usually seeing these cases because the Apoquel® is no longer working. In some cases, this is due to secondary infection, and they can respond to the Apoquel® again once the infection is cleared. One dermatologist brought up a case report of an atopic mini donkey managed successfully with cyclosporine.
An attendee asked about USEF restrictions around Apoquel®, and the group said this would be restricted as it’s off-label. Because it may not be on the list, there are likely no withdrawal periods listed. FEI does allow the use of Apoquel®.
None have used Zenrelia™ in atopic horses yet.
We next discussed the use of antihistamines for atopic dermatitis. One dermatologist preferred hydroxyzine and cautioned that Tri-hist® has poor bioavailability. Another dermatologist also liked hydroxyzine (1 mg/kg PO q 8hrs- 12hrs; 500-600 mg PO q 8hrs- 12hrs ), mentioned that it is restricted by USEF, and mentioned that they found it easy to source in a powder form to top dress food.
Next we discussed including insects in allergen-specific immunotherapy. One dermatologist does include them after correlating results with patient history. One dermatologist includes dust and storage mites due to their ubiquitous presence and will include biting insects if there is room in their immunotherapy as they feel it is unlikely to hurt even if it may not be effective. Two other dermatologists do not include insects and referenced the literature which showed that immunotherapy was ineffective for management of insect-bite hypersensitivity likely due to the fact that we only have whole-body insect extracts readily available currently. All were interested to see the response to immunotherapy with recombinant proteins from biting insects if and when that becomes available. One dermatologist mentioned the group out of Switzerland who is looking at molecular vaccines against interleukins 5 and 31 with promising results. This is not yet currently available.
An attendee asked whether those that do include biting insects in their immunotherapy see more urticaria at the administration site. One dermatologist who does include biting insects felt that they did not see a higher incidence of urticaria compared to immunotherapy without insects and proposed that urticaria at the injection site may be more likely due to the injection going either intramuscularly or intradermally rather than subcutaneously.
ROUNDTABLE SUMMARIES
What’s new in JAKs Round Table
Moderator: Tom Lewis
Participants included dermatologist in private practice, academia, as well as dermatology residents and other specialist, including oncology. Veterinarians employed by Elanco, Zoetis and Merck were also in attendance. No general practitioners were present. Obviously, the topic of “What’s new” centered around Elanco’s JAK inhibitor Zenrelia™ (ilunocitinib)) which was approved in the US in September 2024. The Moderator has used Zenrelia™ in over 25 patients. Several of the dermatologists present had yet to prescribe the drug.
For those who had prescribed the medication, rough estimates regarding efficacy were as follows:
Efficacy:
n In 60-70% Zenrelia™ is more effective than Apoquel®
n ~20-40% observed similar efficacy, or Apoquel® was more effective. The moderator felt 10-20% of his clients preferred Apoquel®.
n Only the moderator had utilized Zenrelia™ for some of the more challenging pododermatitis or otitis cases, with surprising efficacy, some patients even responding better to Zenrelia™ vs cyclosporine in combination with corticosteroids and or Apoquel®.
n One participant described a case where she was unable to manage the Malassezia dermatitis until starting Zenrelia™ (the patient had failed steroids and multiple antifungals but resolved within a month of starting Zenrelia™) .
Vaccinations:
n Since most participants do not vaccinate their patients, it was disappointing to not have input from general practitioners. The box warning was discussed. The participants present who were prescribing were taking the time to discuss the “Vaccine Response Study”. It was noted we have no data regarding Bordetella vaccines while treating with Zenrelia™.
Monitoring:
n Several start with baseline blood work, then performing a CBC/Chemistry panel 2 and 5 months later.
n This moderator recommends blood work after 4 months of treatment to his clients. He has now seen two patients develop a non-clinical leukopenia which was resolved by lowering the dose (approximately 25%). These patients have remained stable (did not flare) despite lowering the dose
Additional indications:
n The discussion turned to the use of all JAK inhibitors for the treatment of inflammatory dermatosis besides allergy. Most of the experience was with Apoquel®. Many in the room had been utilizing Apoquel® for erythema multiforme, pemphigus group, vasculitis/ischemia, sebaceous adenitis, symmetrical lupoid onychodystrophy and even T-cell epitheliotropic lymphoma, sometimes with impressive results. Many of the participants felt JAK inhibitors can be a good first line therapy for many of these conditions given the relative safety and tolerance of JAK inhibitors compared to the more traditional options of corticosteroids, cyclosporine and azathioprine. Many examples of successful treatment with Apoquel® for immune-mediated skin disease were given. A few examples were given where Zenrelia™ was more effective than Apoquel® at managing pemphigus foliaceus.
ROUNDTABLE SUMMARIES
Adverse events: This discussion centered on Zenrelia™
n One participant relayed a case with Fever of Unknown Origin two times in a dog being treated with Zenrelia™, although she was unsure if this was related to the drug.
n GI upset
n Thrombocytopenia in one dog taking Zenrelia™
JAK Inhibitors and Neoplasia
n QOL discussion
n Most oncologists prefer them to be comfortable, studies suggesting JAK inhibitors causing neoplasia aren’t strong enough to deter them from keeping patients on their JAK inhibitor. It was pointed out the warning regarding neoplasia is applied to all drugs in this class.
n Most felt that JAK inhibitors (primarily Apoquel®) do not make the neoplasia more difficult to treat.
n Utilizing Pub Med to evaluate the studies of JAK inhibitors and neoplasia are equivocal
JAK Selectivity
n Still up in the air even in human medicine because they are still seeing adverse effects suggestive that it is affecting other JAKs (janus kinase 2 and tyrosine kinase)
n Goal is to have it be cell-specific vs. general effect
At this point the conversation proceeded with more random points and questions/experiences from the various attendees:
Use of JAK Inhibitors with other Immune Modulators
n Pemphigus
• Cyclosporine with Apoquel®
• Especially cases that don’t tolerate steroids
n For cases where cyclosporine manages skin but not pruritus
JAK Inhibitors in cats
n Apoquel®
• Dog dose 0.4-0.6 mg/kg q 12 hrs
• Average was 1.5 mg/kg/day
• ~60% needed it q 12 hrs
• 6-7% neutropenia, most respond to dose decrease
• Usually 2-5 month mark (mostly 2 month)
• Recommend felines be indoor only, not hunting or eating raw diets if receiving Apoquel®
• Monitor at 2 and 5 months, then every 6 months
Autoimmune/Immune-mediated Disease
n Zenrelia™ at label dose
n Apoquel® q 12 hrs
n Is it better to use high doses of one drug or add in a low dose of a second drug?
• Potential for receptor inhibition where higher dose won’t work better
Chewable Apoquel
ROUNDTABLE SUMMARIES
n Cats love it, very palatable
n May crumble when splitting
n Now comes in a blister pack
n May flare when switching from tablet to chewable
• Are they pork allergic?
• 20% of allergic dogs are food allergic, 2% are pork allergic, although questions of crossreactivity between other proteins and pork
• Not recommended during diet trial
n A few reported cases where chewable formula was not as effective
n Palatability in dogs was also felt to be good by the participants
AI and Google search results:
n Possibility of AI generated information that is not actually accurate
n Many of the actual published studies are likely to be open access
n Participants agreed it was important to question clients from where they are getting their information
ROUNDTABLE SUMMARIES
Eosinophilic Dermatoses in Cats
Moderator: Mitzi D. Clark, DVM, DACVD®
Seventeen people were present. 1 veterinary student; 4 veterinary dermatology residents; 1 LVT; 2 general practitioners; 9 dermatology specialists. After introductions, we started with a brief review of the eosinophilic granuloma complex and started a discussion of how clinicians work this up/treat – starting by exploring hypersensitivity conditions in the cat.
There was a discussion about which practitioners/locations see D. gatoi. In Dallas, overgrooming is most common clinical sign; miliary dermatitis not a feature. Typically using topical Bravecto® to treat. Others felt Revolution® PLUS was good for D. gatoi, but specialist from Minnesota had seen treatment failures and liked Bravecto® for D. gatoi in MN.
In Dallas (and perhaps South/heavily flea-burdened areas in general), topical Bravecto® was not enough for FAD at q12 week dosing, need it q 8 weeks. Many felt the isoxazolines dosing in combo products like Simparica® Trio (for dogs) was not sufficient for certain mites (Demodex) and sometimes for FAD. They preferred Bravecto® or isoxazoline-only products when treating an ectoparasite condition.
We next discussed food allergies and what practitioners were using for their elimination diets. Some found Blue Buffalo®s HF palatable, and it has a wet option. One FL dermatologist was a fan of Rayne Nutrition® (rabbit) and liked all the different consistency options for cats. Royal Canin® Ultamino was being used with and without freeze-dried treats from Rayne. We discussed that cats could be challenging for diet trials and palatability was often an issue. A Canadian dermatologist highlighted the need for specialists to consider home-cooked trials if we are seeing these cases as referrals and they have already been through commercial diet trials, especially in challenging allergy cases and in cats that are indoors-only and nonseasonal allergics from the start. Some do offer home-cooked vs. prescription diets from the start. There was discussion about regional differences and that in the US in the south, some indoor-only, nonseasonal pruritic cats respond well to immunotherapy for environmental allergies as well so that history may not always = food allergy.
For environmental allergy testing, 8 participants started with intradermal testing, 5 with serum testing, and 4 with both in the cat. Most felt that cats responded well to either sublingual or injectable immunotherapy and that they responded well AGAIN to immunotherapy after a lapse in treatment, although it could take a while for the ASIT to become effective again. The need for retesting and reformulating ASIT was seen in the cat, but rarely.
We discussed medications that controlled allergies in general, and eosinophilic granuloma complex specifically. Some felt DepoMedrol® worked better IM than SQ. Gabapentin at 100mg per cat in the evening before bed daily for 10 days or so was used successfully by one practitioner to pull some cats out of a flare when caught early (and in addition to their regular regimen). There were a few proponents of Apoquel® for cats who had success with ~8mg PO BID per cat (often starting around the 1mg/kg BID dose). They monitored lab work at baseline and then around 2 months and then at 5/6months and then yearly. They had seen neutropenia most commonly but would check a blood smear to make sure it was real and not an artifact of blood clotting in the tube. They also saw other changes occasionally, but sometimes just had to monitor and things would self-resolve. One practitioner had used chlorambucil for severe cases at around 1mg/cat EOD. Cerenia® helped one cat out of the group of practitioners who had tried it.
ROUNDTABLE SUMMARIES
We had a brief discussion about Convenia® and the new ISCAID antimicrobial guidelines for treating skin infections and a brief side discussion about antiyeast/antifungal resistance in dogs. Various breeds affected – hounds, mixes, shih tzu. Some trying terbinafine at higher doses – 40mg/kg/day, some trying Zenrelia® in addition to antifungals and allergy work up, some use 10mg/kg PO SID for fluconazole while others do 5mg/ kg/day for dogs. Some include Malassezia in immunotherapy. Still seeing issues with Malassezia not clearing in certain cases. One practitioner had a golden retriever with plaques on its flank secondary to Malassezia that would go away when its ear infections were treated and resolved.
Turned away from hypersensitivity conditions to discuss other eosinophilic dermatoses in cats and asked if anyone had seen Pythium or other oomycetes – practitioner from TN had; resident from FL had. TN case doing well on steroids and probably had an antifungal. U of FL cases usually severe disease. Dr. Santoro has a protocol there. They think it is increasing – either that or more are just aware that they treat it and are sending more cases to FL.
Briefly discussed pemphigus and if anyone was using anything “new” to treat. Some votes for Apoquel® (0.6-1mg/kg PO BID) along with steroid induction.
General notes – some like dexamethasone SP orally for cats; if trying intralesional steroids, both DepoMedrol® (methylprednisolone) and Kenalog® (triamcinolone) are being used.
ROUNDTABLE SUMMARIES
Equine Dermatology
Moderator: Nicole Heinrich DVM, DACVD®
We first discussed the types of dermatology and allergy cases that we see, and these included: itching and allergy, recurrent urticaria, asthma, insect bite hypersensitivity, pemphigus, vasculitis, contact dermatitis, pyoderma, pastern dermatitis and rarely food allergies, Pythium and Corynebacterium.
We discussed how allergen specific immunotherapy is helpful in the treatment of asthma, although it is best used in combination with other therapies. Dermatologists ideally work with an internist and/or general practitioner to provide this adjunctive therapy. We briefly discussed bronchoalveolar lavage as a tool for diagnosing asthma, but that the cytology tends to be more rewarding in symptomatic cases rather than asymptomatic cases.
We discussed clinical signs of pemphigus, including the highly suggestive crusts and how the coronary band can be affected. We discussed use of oclacitinib in horses and how some practitioners have used it with success in urticarial disease, pemphigus and allergy. Doses discussed included 0.2-0.4mg/kg by mouth daily. One clinician shared their experience with oclacitinib-induced leukopenia in horses.
We discussed how poor blanketing hygiene contributes to skin disease.
The second topic of discussion centered around areas where clinicians would like to see more research. Topics suggested included: allergen specific immunotherapy, allergy testing, in vitro food allergy testing, skin barrier function, asthma, polyclonal antibody therapy and vaccine, anti-pruritic treatments, mechanism of action of pruritus, autoimmunity, skin cancer (squamous cell carcinoma, sarcoids and melanoma), pharmacokinetics and pharmacy safety.
The third topic of discussion asked the question: how can dermatologists provide more support to equine practitioners?
Veterinary school professors were identified as a highly respected source of information. Other sources of information that were discussed included: colleagues, Equine Veterinary Journal, AAEP Journal (Equine Veterinary Education) and AAEP annual meetings (dermatology sessions). Social media was suggested as a possible avenue for reaching both practitioners and horse owners.
Finally, there was a general discussion of interesting cases and experiences with various treatments. Case discussions involved interface dermatitis associated with Equine herpesvirus 5, severe contact dermatitis and tobacco hypersensitivity. Pentoxifylline (many uses), steroids (caution), tacrolimus and omega 3 supplementation (flax vs fish) were also discussed.
It was generally agreed upon at the end that this was a good discussion and that an equine dermatology task force or equine dermatology discussion group could be useful in the future.
ROUNDTABLE SUMMARIES
Cannabidiol (CBD) for Atopic Dermatitis
Moderator: Andrew Rosenberg
Summary
The roundtable discussion on the use of CBD in veterinary dermatology focused on a range of experiences and clinical insights. Andrew Rosenberg facilitated the conversation. Views on CBD use varied—some attendees rarely recommended it, while others, including both doctors and technicians, reported frequent use for anxious, pruritic patients and those suffering from osteoarthritis. Reputable brands such as Pet Releaf® and ElleVetTM were recommended for their quality and consistency. The conversation also covered topics like dosing, side effects, and the need for further research, especially regarding feline patients. Legal and regulatory issues were also discussed, with an emphasis on using products from trustworthy companies.
Experiences and Brands of CBD Use
One attendee recommended Pet Releaf® and another holistic brand for their organic formulations and overall quality. A participant joining from the UK shared experience using CBD for dogs with allergic dermatitis and expressed interest in learning more about different product formulations. Several attendees, including technicians, noted success using CBD for patients with anxiety and osteoarthritis, stressing the importance of beginning with a low dose.
There was broad agreement about the variability in CBD product quality and the value of selecting reputable, consistent brands. Another attendee noted the lack of uniform research and the overwhelming range of available products, pointing to a need for more evidence-based information in this space.
Dosing and Effectiveness of CBD
One participant discussed typical dosing recommendations—generally 1–2 mg/kg/day—while pointing out the inconsistencies in product profiles. Another attendee endorsed brands with third-party verification, highlighting the need for reliable sourcing. The discussion included the importance of different cannabinoid profiles, such as the role of CBDA, and the need for more robust clinical research.
Monitoring liver enzymes was raised as a necessary precaution when CBD is used, particularly in combination with other medications. One attendee shared a positive outcome involving a dog that was able to discontinue steroids thanks to CBD therapy, ultimately leading to improved overall health.
Behavioral and Clinical Observations
CBD’s potential benefits for behavioral conditions were noted by several attendees, especially in dogs experiencing anxiety. One participant mentioned possible applications for seizure and neurological management, though emphasized that more data are required. Another attendee inquired about use in cats, with the general consensus being that while promising, studies remain limited.
Some attendees discussed the potential development of tolerance to CBD over time, necessitating periodic dosage adjustments. One participant shared a multimodal management case, combining CBD with biome support and laser therapy, which yielded encouraging results.
ROUNDTABLE SUMMARIES
Regulatory and Legal Concerns
The group discussed the complex legal and regulatory environment surrounding veterinary CBD use. Several participants noted the absence of clear guidance from veterinary boards and flagged the risk of legal implications. The importance of choosing brands with strong quality control practices was emphasized. Practical issues such as setting appropriate client expectations were also addressed. One attendee shared challenges encountered when stocking and recommending CBD products in a clinical setting.
Topical and Additional CBD Products
The conversation also explored the use of topical CBD. Some attendees had seen success in conditions such as pemphigus and arthritis using topical formulations. One study was mentioned that suggested CBG (cannabigerol) may help inhibit resistant bacteria, although more research is required in this area.
CBD shampoos and conditioners were discussed, with varying feedback regarding efficacy and client satisfaction. One participant described using a homemade CBD-THC salve with positive results for a localized DLE. Others were curious about the future of alternative delivery methods, such as dental sticks and capsules, again pointing to the need for further investigation.
Future Studies and Research
There was unanimous interest in additional research, particularly for feline patients and other species. Attendees highlighted the importance of funding and supporting studies to better understand the therapeutic scope of CBD. Several expressed hope that future veterinary training might include information on cannabinoid therapies.
The need for more placebo-controlled studies was underscored, along with the ongoing challenge of standardizing research due to the broad variability in product formulations.
Client Perceptions and Marketing
The role of marketing and client perceptions was a significant part of the discussion. Many attendees noted that marketing heavily influences client demand, sometimes leading to unrealistic expectations. Education was emphasized as key—clients need accurate, science-based information about both the benefits and limitations of CBD.
The group also touched on how marketing often outpaces science, making it essential for veterinarians to be transparent and well-informed. CBD’s potential integration with other treatment modalities was seen as promising, provided the clinical evidence continues to grow.
Final Thoughts and Closing Remarks
In closing, attendees agreed on the need for more research, better standardization, and a stronger evidence base for CBD use in veterinary medicine. The facilitator thanked everyone for their thoughtful contributions and encouraged ongoing dialogue and exploration in this evolving field.
Participants expressed appreciation for the opportunity to learn from one another and shared enthusiasm about the future possibilities for CBD in veterinary dermatology—and potentially beyond, including areas like oncology and neurology.
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