Back in school, we all learned the “gold standard” methods at diagnosing or treating a variety of medical conditions. And while the diagnostic framework we received at approaching clinical cases is most definitely very important, it goes without saying that actual practice of medicine does not always — and rarely does — follow the exact work-up we were taught. I find especially this is evident when it comes to me seeing patients with mild to moderate gastrointestinal or skin issues. For example, acute moist dermatitis or superficial pyoderma (also known as a “hot spot”) is something that I tend to see on a daily basis. Whenever I observe the lesions associated with it and hear the accompanying history from the patient’s owner, I pretty much know exactly how I want to go about treating it in my head.
But it may play out differently in reality…I have to consider the uniqueness of each patient, how some may have had severe adverse reactions from antibiotics prescribed previously, how the owners may not feel physically comfortable with oral administration of medications, and no matter how much emphasis I put on prevention of further trauma from scratching or licking, many owners have a difficult time with compliance when it comes to ensuring E-collar usage.
At the end of the day, there is no one right way to go about helping our patients. But I do find that the best offense is defense and, as such, always discuss prevention of common issues in the first place.