What to Expect During a Pet Skin Specialist Appointment
- Dr Simon Want BVM&S CertVD MRCVS RCVS
- Feb 18
- 12 min read
Updated: Feb 26
If you’re seeing a pet skin specialist or advanced practitioner for the first time you may be wondering what will happen at your pet’s first appointment. Whether you have sought an appointment yourself or been referred by your primary vet, the main difference when seeing a pet dermatologist is the time it takes for the consultation.
Your pet dermatologist will perform a full health exam and then detailed dermatological examination of your pet. Within the consultation they may take samples to be examined using the microscope or test that may require sending away, such as blood tests or skin biopsies. Sometimes your pet may need an anaesthetic or sedation in order to take samples, perform an allergy test, initiate treatment of the ears using a video-otoscope or perform CO2 laser treatment. It is often advisable to starve your pet for at least 6 hours prior to the appointment.
It may be possible to diagnose the skin problem within the initial consultation. However, you may need to wait for test results, organise follow up appointments or schedule further treatment. This holistic approach results in a tailored, individualised plan taking everything into account.
In this article, we’ll talk you through how to prepare, what to expect and treatment plans you may be given.
In this article we’ll explain:
Initial Consultation and Medical History
You can expect a much more detailed history-taking conversation at the beginning of your consultation with your pet dermatologist. This allows the dermatologist time to listen to what brought you to them in the first place, how long the condition has been going on, how it first presented and how that may have changed over time.
As things progress your pet dermatologist may ask more detailed questions relating to all aspects of your pet. Things that may be asked are often similar for cats and dogs but there may be some questions more relevant to either one.
Common questions for cats and dogs:
What age did symptoms start?
How have they changed over time?
Was it itchy from the start and then developed a rash or the other way around?
Does your pet have any other medical problems?
Are other parts of the body affected?
Have you any other pets?
Does anyone in the household have a skin problem?
Has your pet been abroad?
Was it a rescue pet and was it born abroad and imported?
Does your pet go outside or live exclusively indoors?
Is the problem worse indoors or outdoors?
Is it worse at certain times of the year?
Can you think of anything that may trigger a problem?
What type of parasite control do you use and how often?
What does your pet eat, including titbits?
Thinking about the answers to some of these questions in advance may make the process feel less stressful, especially preparing a list of parasite treatments and foods, with ingredients.
Full Physical and Dermatological Examination
It’s really important that nothing is missed, so a full physical examination will take place prior to a detailed dermatological examination.
During the physical examination a dermatologist will look at the whole pet from nose to tail. The heart will be listened to and the abdomen palpated. The mouth is examined and the overall condition is assessed. This is really important if the skin condition is part of a more generalised internal disease.
During the dermatological exam we assess the areas of the body that are affected, including the:
Ears
Feet
Mouth
Nails
Then the nature of the skin lesions. Do we have:
Hair loss (alopecia)
Crusting and scaling disease
Ulcers
Changes in skin pigmentation
Lumps
Ears - If the ears are affected are they red or do they have a discharge?
All this information can help make a list of potential conditions that may be affecting the cat or dog and then help decide which tests may be most appropriate to make a definitive diagnosis.
Diagnostic Tests to Identify the Cause
The history and physical exam will help your vet make a differential diagnosis list. This list will determine which tests are required in order to end up at a definitive diagnosis.
Tests usually fall into those that can be done at the clinic and those where samples need to be sent away for analysis at an external laboratory. Many tests are performed on the conscious pet but some may require sedation or a general anaesthetic. It is always best to bring your pet in starved on the day of the appointment in case sedation or anaesthesia is required.
Diagnostic tests commonly performed in dogs for skin allergy include:
Skin scrapes and coat brushings to exclude parasites
Cytology of the skin to look for secondary infections
An elimination diet trial to rule in or out food allergy (blood tests for this are notoriously inaccurate)
Blood tests to check for antibodies to potential airborne allergens such as pollens and house dust mites
An intradermal skin test, performed under sedation, to also look for airborne allergens (The two tests combined are the ‘gold standard’)
Diagnostic tests performed for alopecia, crusting/scaling dermatitis or nail disease in dogs may include:
Skin scrapes and coat brushings to exclude parasites
A trichogram - examination of the hair shafts and hair bulbs
Wood’s lamp test - to screen for a fungal disease
Fungal culture of hair and skin samples - sent to an external laboratory
Blood tests - general health screen and hormonal tests to look for Hypothyroidism and Cushing’s disease
Skin biopsies - often performed under sedation and samples sent to an external laboratory
Diagnostic tests for dogs with ear disease may include:
Cytology to look at the nature of any secondary infection
Bacterial culture and antibiotic sensitivity testing - sent to an external laboratory
Video otoendoscopy - performed under general anaesthesia this technique is used both to diagnose and treat ear diseases using a special ear endoscope that gives a magnified image of the ear canal and a channel to allow for treatment
Diagnostic tests commonly performed in cats for skin allergy include:
Skin scrapes and coat brushings to exclude parasites
Cytology of the skin to look for secondary infections and abnormal cells
A trichogram - examination of the hair shafts and hair bulbs
A flea elimination programme at home to rule in or out flea allergic dermatitis
An elimination diet trial to rule in or out food allergy (blood tests for this are notoriously inaccurate)
Blood tests to check for antibodies to potential airborne allergens such as pollens and house dust mites
Diagnostic tests performed for alopecia, crusting/scaling dermatitis or nail disease in dogs may include:
Skin scrapes and coat brushings to exclude parasites
A trichogram - examination of the hair shafts and hair bulbs
Wood’s lamp test - to screen for a fungal disease
Fungal culture of hair and skin samples - sent to an external laboratory
Blood tests
Skin biopsies - often performed under sedation and samples sent to an external laboratory
Your vet dermatologist will explain the tests that may be required.
How Long Does It Take To Get My Pet's Test Results Back?
Tests performed by the dermatologist in the clinic using the microscope give instant results more often than not. If your vet carries out intradermal allergy testing also will give results before the pet leaves the clinic.
Blood tests can take 24 hours to a week to get results back. Fungal and bacterial cultures and skin biopsies often take up to a week to obtain results.
Your dermatologist will often phone with results or may opt to discuss them face-to-face at a follow-up appointment.
Discussion of Diagnosis and Possible Causes
Once there is a definitive diagnosis your pet dermatologist can discuss treatment options and discuss potential benefits of certain treatments as well as any potential side effects with you.
Sometimes there are practical issues related to your individual pet or indeed home circumstances. For example some pets may not tolerate topical therapy, such as shampooing or ear cleaning. Some owners may find tablets difficult to administer and long-acting injections may be more appropriate.
The sad fact is that not everything works all of the time and many medications, such as when treating allergic skin disease, may work in only 80% of cases. So vets may find that 1 out of 5 dogs or cats fail to adequately respond to the initial therapy and a new treatment option is required.
If your pet is sensitive or allergic to some foods then a novel life-long prescription diet may be required.
It is not possible to ‘cure’ many dermatological conditions and some pets often require life-long therapy that may require regular monitoring and adjustment, such as with skin and ear allergy.
It is also sad to say that not all conditions have a treatment. This may range from some alopecic conditions, that although may not affect the pet unduly, can have a cosmetic result that can be upsetting for some owners to more serious conditions that may be life-limiting, such as some skin cancers. Also, genetic conditions can range from the cosmetic to the life-limiting as well.
Tailored Treatment Plans
You and your pet will receive a tailored treatment plan after discussion about the underlying conditions.
Hormonal conditions may require tablets and regular monitoring using blood tests. Immune-mediated and autoimmune conditions require regular monitoring relating to the success of treatment and potential side effects. This may require additional appointments and blood tests.
Alopecia is complex as it can be caused by parasites, infections, immune-mediated diseases, hormonal conditions and genetic factors. The underlying cause will determine if any treatment is available and what would be required afterwards.
Treating allergic skin disease
The most common condition pet dermatologists see is allergic skin and ear disease in dogs and cats. This condition often results in secondary infections and requires a multimodal approach to achieve long-term control of the patient and reduce flare ups of the condition.
Allergy is not currently curable, unless your dog or cat has food allergy exclusively, whereupon a special hypoallergenic diet may control the symptoms. However, 90% of allergic patients will have atopic dermatitis with or without food allergy. This is an allergy to airborne allergens, such as pollens or house dust mites. As we cannot avoid these, your pet will often require long-term management with potentially tablets, liquid oral medications or regular injections.
Allergy testing may allow the use of immunotherapy (allergy shots) to help desensitise your pet specifically to what it is allergic to. However, this may also be life-long. Topical therapy including shampoos, foams and sprays may help reduce infections and improve the skin. Regular ear cleaning may help reduce infections. Topical steroids can be used safely and may help reduce other medications. Finally, essential fatty acid therapy can help the skin barrier and reduce other medications, as well as improving the skin and coat quality.
Again, this may require regular monitoring and revisits.
At each appointment a detailed, numbered treatment plan, with doses and frequency of treatment will be provided. This can be printed or emailed so that everything is in one place and easy to follow.
Guidance on Home Care and Lifestyle Adjustments
Treatment options are initially discussed and verbally agreed with you and your vet. It is really important that you and your dermatologist are on the same page as it is often the owner administering the treatments at home. Any specific treatments that are not part of the normal owner routine will be also discussed and demonstrated to make sure you can use them at home.
Shampoos often require 5 to 10 minutes contact time with the skin and ear cleaning can be a challenge. If you are happy to inject your pet at home your vet will always put aside time to teach them the best way to inject their cat or dog.
“Personally, I have found some medications difficult to open, especially when first presented with them. As a result of this I always make sure owners know how to open their medication as well as how to administer it. All the medications will be individually labelled but I also print or email a numbered treatment plan detailing each individual therapy, doses and treatment frequencies. My pet owners always seem to appreciate this and the plan is updated after each visit.” Dr Simon Want
Follow-Up Appointments and Monitoring
Some conditions are curable, however, many are not. It is common that repeat visits will be required and regular monitoring.
Some drug therapies may require regular blood tests to check for side effects.
The Royal Veterinary College states that vets must see animals regularly when they are on long-term prescription medications and that they should be ‘under their care’. This may be your primary vet or your pet dermatologist, but be aware that even if you feel the condition is under control your vet still has a duty of care, and a legal obligation, to see you and your pet at least every 6 months when on prescription medication.
Revisit appointments may initially be quite frequent, even weekly, when trying to get a condition under control, such as a nasty, ulcerated ear infection. When trying a new therapy you may need to be seen after 1 to 2 months and you and your dermatologist will want to see each other at the end of an elimination diet trial when looking into allergic skin disease.
Immunotherapy can take anywhere between 6 months and 2 years to be fully effective so regular assessments are required and dogs or cats may require injections every 3 to 4 weeks.
More often than not the next appointment will be agreed upon and scheduled at the time you see your veterinary dermatologist. However, if the condition flares and symptoms recur then your dermatologist will encourage you to make contact sooner than planned so that things can be promptly diagnosed and treatment initiated or changed.
How Much Does a Pet Skin Specialist Appointment Cost?
Although not as expensive as major surgery there can be considerable costs associated with skin and ear disease in dogs and cats.
Initial consults usually start around the £300 mark but with in-clinic tests and medications this may be over £600. If external laboratory tests and anaesthesia with specialist procedures are required, such as allergy testing, video otoendoscopy or laser surgery, costs may be in the region of £1000 to £3500.
If your pet is insured the majority of insurers will cover the costs associated with skin and ear disease, depending on the nature of your policy.
Advanced Veterinary Dermatology prices are available and to make it easier to budget we provide some fixed price, often discounted, treatment options. Klarna payments are available in some vet clinics as well.
How Long is a Vet Appointment With a Dermatologist?
One of the main challenges facing GP vets is time. This is why dermatological appointments start at 1 to 2 hours. If additional tests are required than result in sedation or an anaesthetic expect to be there for 3 hours or more. A revisit is often 30 to 60 minutes.
These longer appointments are a huge advantage when trying to make a diagnosis but also allows time to discuss what is going on with you and show what we are seeing.
At Advanced Veterinary Dermatology a digital microscope is linked to a computer so that pet owners can see what the vet is seeing. This makes it easier to explain what is being seen and what impact that has on your pet.
Tips for Preparing for the Appointment
Preparing yourself before seeing a veterinary dermatologist
Make sure you know where you are going in advance and how long it will take to get there, allowing for traffic if necessary.
Take medical records if possible or ask your referring GP vet to provide them in advance of the appointment. Include any flea or and worming medication.
Some pictures of how things looked previously may be a good idea if things are not too bad at the time of presentation to your pet dermatologist.
What does your pet eat and what has it eaten in the past, including treats. Lists of ingredients from the label of pet foods can be useful.
If possible get an estimate in advance and know how you are going to pay for treatment.
If your pet is insured will the clinic allow direct claims or expect you to pay upfront.
Does the clinic have a cancellation policy and will you be charged if you cancel at short notice or fail to attend your appointment?
Preparation of your pet in advance of the appointment:
Ask if your pet should be starved prior to the appointment and how long for. If in doubt Dr Simon Want would advise NOT feeding your pet for at least 6 hours prior to the appointment. Though access to water should be fine.
Find out if you can give your pet any treatments they are on at the moment
Ask if you are shampooing your dog should you stop prior to the appointment and how long for? You may wash off valuable lesions that can help make the diagnosis.
Ask if you should stop any medication prior to my appointment? This is especially true of corticosteroids. For example, if you expect your pet to have an allergy test then you may need to stop medication for at least 3 weeks prior to testing.
Finally, bring an open mind and don’t worry. Your dermatologist has yours and your pet’s best interests at heart.
Now You Know What to Expect at a Veterinary Skin Specialist Appointment
If you have a dog or cat that has skin or ear disease you may be trying to decide if it is worth seeing a veterinary dermatologist to help your pet. ‘Skin doctors’ have additional training and expertise when it comes to diagnosing and treating dermatological conditions. They also often have specialised testing and treatment capabilities.
This not only results in a more accurate diagnosis but treatment can be quicker and often more successful. The range of treatment options is often greater too. It can, more often than not, result in cheaper bills in the long-term and avoid the chronic changes than can result in poorer outcomes later down the line.
If this has helped you make a decision then don’t put things off any longer and contact us at Advanced Veterinary Dermatology.
Written and Approved by:
Dr Simon Want BVM&S CertVD MRCVS
RCVS Advanced Practitioner in Veterinary Dermatology
Director of Advanced Veterinary Dermatology Ltd
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