Tom Lewis, DVM, DACVD is back on the podcast! Last year, Dr. Lewis joined the podcast last year to discuss the release of Zenrelia. One year later, he is back to discuss his experience with having this medication for a year and the relief it has provided for hundreds of his canine patients. Also, we discuss the recent change to the US boxed label warning which removed the vaccine induced disease portion of the label.

Learn more on this week's episode of The Derm Vet podcast!

Studies mentioned in podcast:
Recent study regarding vaccine booster response in dogs receiving Zenrelia: Fent, G.M., Jacela, J., Plazola-Ortiz, R. et al. Immunologic response to first booster vaccination in dogs treated with zenrelia™ (ilunocitinib tablets) at up to three times the recommended therapeutic dose compared to untreated controls. BMC Vet Res 21, 481 (2025). https://doi.org/10.1186/s12917-025-04929-z

Recent study regarding safety of Zenrelia: S. Forster, C. M. Trout, S. Despa, A. Boegel, D. Berger, and S. King, “ Efficacy and Field Safety of Ilunocitinib for the Control of Allergic Dermatitis in Client-Owned Dogs: A Multicenter, Double-Masked, Randomised, Placebo-Controlled Clinical Trial,” Veterinary Dermatology (2025): 1–13, https://doi.org/10.1111/vde.70009.

Timestamps
00:00 Intro
02:46 Zenrelia box label warning change
08:14 What does the box label warning change mean and why it's only in the US?
12:10 Looking at every patient as an individual
17:00 How comfortable do you feel using Zenrelia long-term?
22:14 Outro

Otitis is a common thing for veterinarians to treat. Commonly associated with underlying allergies, we can see other things cause ear infection such as ear canal masses, endocrinopathies, etc.

When you are busy in the clinic, it can be hard to think about every aspect of ear canal disease. In an attempt to make things a bit easier, I put together the top 5 mistakes I recognize in management of otitis cases. Let me preface with the fact that I have also made these mistakes in the past! Learn more on this week's episode of The Derm Vet podcast!

00:00 Intro
01:49 Mistake #1: Not performing ear cytology
05:18 Not implementing appropriate ear flushing protocol
07:46 Fail to control inflammation
09:45 Don’t recheck progress
12:14 Not identifying the underlying issue
14:49 Recap / Final Thoughts
16:27 Outro

As always, you bring the best questions for these grab bag episodes. Today, we cover dog autoimmune diseases (though cats find their way to make it in a bit).

How do you tell the difference between DLE and PF?

What if an owner can't biopsy the case?

How do you treat SLO? Sebaceous adenitis?

Find the answers to these questions and more on this week's episode of The Derm Vet podcast!

00:00 Intro
01:30 SLO & sabaceous adenitis
09:40 Steroids and Autoimmune diseases
12:23 What to do when owners can’t biopsy the case
15:12 Pemphigus foliaceus in Dogs
16:05 Pemphigus foliaceus in Cats
17:07 Autoimmune Disease vs Allergies
18:31 Differentiating between DLE and Pemphigus Exfoliation in dogs
21:48 Outro

Hyperbaric Oxygen Therapy is the use of supplemental oxygen in a chamber under increased pressure so the blood oxygen concentration increases which facilitates healing. There are not many veterinary practices that have HBOT for pets. However, we are lucky enough to have Trenton Ewing, DVM, DACVD back on the podcast to discuss HBOT since his practice (Animal Dermatology Clinic in Pasadena, CA) has had HBOT available for years!

Learn what diseases he has used this therapy to treat, what a typical HBOT "dive" looks like and how this therapy works! Not only can you check out our conversation on traditional podcast apps, but check out the YouTube channel which includes pictures and videos!

00:00 Intro
01:12 Hyperbaric Oxygen Therapy with Trenton Edwards
02:34 What is an HBOT?
04:36 Common cases referred to HBOT
07:15 Typical HBOT Dive Protocol
09:00 Issues doing it long-term?
12:15 How stressful is it be for pets?
14:12 Training for HBOT
16:28 Contraindications
19:56 How available is HBOT?
23:12 Downsides
24:00 Final Thoughts/Outro

It can be scary to have a dog that goes through a life-threatening reaction to a honeybee sting. Often, these dogs are young and active. Though owners can take preventative measures, it is impossible to guarantee 100% avoidance of these venomous insects. So, what can be done?

Trenton Ewing, DVM, DACVD joins the podcast this week to discuss a very effective way to manage these cases. Dr. Ewing practices at Animal Dermatology Clinic in Pasadena, CA and has previously done research on venomous insect testing and desensitization. We discuss a typical history in these patients, how testing is performed and the success rate of long-term desensitization. Enjoy this unique topic on this week's episode of The Derm Vet podcast!

00:00 Intro
00:25 Venomous Insect Testing with Trenton Edwards
01:49 What spiked your interest in venomous testing?
05:08 Typical history that a dog presents to Trenton as an initial exam
09:27 Testing process
14:27 Most common culprits
15:40 Desensitizing
20:39 Faster protocols
22:29 How long do we do monthly injections?
25:10 What do you send them home with and what is the expectation?
28:27 Outro

It is back to school season! For this episode, I review the four things I have learned to implement as a dermatologist. Even as a specialist, I like to progress and grow into how I am practicing!

We will go over how to use supplement and skin supportive diets, venomous insect testing, improving immunotherapy and proactive skin management.

00:00 Intro
02:15 Being more thoughtful in recommending skin supplements or skin diets
07:02 Venomous Insect Testing
09:33 Improving immunotherapy
12:48 Proactive, not reactive with allergy management
16:53 Summary

Skin damage and cutaneous wounds can be frustrating and difficult to manage. With a growing world of antibiotic resistance and difficult cases of skin repair, alternative solutions are needed. Zarasyl combines the natural power of silica to optimize the wound healing environment. The product helps to moisturize while being semi-occlusive to allow oxygen through the barrier.

Julia Miller, DVM, DACVD is a frequent guest of the podcast and joins once again to discuss her experience with Zarasyl in dogs, cats and horses. This episode provides comedic relief with discussion of being a hand model and Labubus. But, most importantly, you will learn additional ways to treat wounds and manage dermatology cases with Zarasyl.

00:00 Intro
00:25 Dr. Julia Miller
02:16 Zarasyl
05:04 Using non-antibiotics when possible
07:41 What is Zarasyl?
10:54 How and when to use Zarasyl
13:20 Can it safely be used long-term?
18:04 Top diseases where you're using Zarasyl
19:50 Horses
22:36 Lessening the duration of antibiotics
26:40 Zarasyl's scientific support
29:14 Final thoughts about Zarasyl
31:58 Outro

I love getting your questions and answering them on the podcast. This week is one of my favorite topics: cytology!

What tips do I have for direct impression smear vs. tape prep?

How do I know the appropriate treatment based on quantity of infectious organisms?

What is the difference between superficial pyoderma and deep pyoderma?

Get your questions answered on this week's episode of The Derm Vet podcast!

TIMESTAMPS

00:00 Intro
01:22 What advice do you have for collecting tape prep versus collecting direct impressions?
03:47 Tape prep
07:06 How to stain tape prep
08:43 How can we get better at sampling interdigital spaces?
11:16 Dry Lesion vs Wet Lesion
14:15 How do you interpret the number of Malassezia or bacteria on skin or ear cytology?
17:13 How do you differentiate between a deep pyoderma and a superficial pyoderma?
20:00 How many organisms do you consider 1 plus, 2 plus, 3 plus?
22:20 Thoughts on AI/Digital cytology machines
24:34 Outro