When Itching Isn’t Simple

Inside Sales | May 2026

Written by:

Dawn Singleton-Olson has more than 25 years of experience in the animal health industry, including distributor sales, manufacturing, practice management and as a zoo supervisor. She is a volunteer, fundraiser and board trustee for several humane organizations and the Omaha (Neb.) Police Mounted Patrol.

There are plenty of health problems that stay hidden or go unnoticed by pet owners, but dermatology issues are usually hard to miss. Flaky, red irritated skin is easy to spot unless the pet has a very long or dense coat, and once the scratching, digging and licking start, it doesn’t take long for owners to realize a trip to the veterinarian is necessary.

It’s no surprise then that skin problems, particularly allergies, are the No. 1 reason for veterinary visits.

A structured, stepwise approach

Diagnosing skin problems is often a process of elimination, starting with the easiest issues to identify and treat and ruling out possible problems to get to the underlying cause, or causes. The first step is checking for parasites on or just below the skin surface.

Flea allergy dermatitis (FAD) is the most common skin disease in dogs and the main source of allergic skin reactions in cats (feline miliary dermatitis.) FAD is a reaction to histamine-like compounds in flea saliva injected as they feed. The pruritus resulting from FAD can be severe and spread over the entire body. Besides treatment with medications to control the itch and eliminate any secondary bacterial or yeast infections, effective flea control is a necessity for pets with FAD.

Along with flea bite hypersensitivity, the most common allergies that cause pet pruritus are food allergies and atopic dermatitis (AD). AD is the second most common pet allergy affecting about 12% of both dogs and cats. It’s an inherited predisposition to developing hypersensitivity to environmental allergens. The epidermal barrier is abnormal in atopic pets, allowing allergens to penetrate the skin that cause chronic inflammatory skin disease. Breeds most predisposed to canine atopic dermatitis are boxers, bulldogs, pugs, Labrador retrievers and West Highland white terriers.

AD nearly always requires multimodal treatment strategies including topical therapies and antimicrobial shampoos. Most cases of atopic dermatitis are treated with systemic antipruritics, including the following.

JAK inhibitors reduce the production of inflammatory cytokines and have a fast onset of action decreasing inflammation and relieving the itch of AD. Options include once-daily Zenrelia (ilunocitinib) and oral Apoquel (oclacitinib). This past February, the FDA approved NUMELVI (atinvicitinib) tablets, a second-generation JAK inhibitor. NUMELVI can be given to dogs as young as six months of age and as small as 4.4 pounds.

Cytopoint (lokivetmab) is an injectable biological therapy that targets the protein that sends itch signals to the brain, given every 4 to 8 weeks, as needed. Atopica and Sporimune (both cyclosporine) and corticosteroids are other systemic antipruritic options.

Traditional daily-use products are still an important part of treatment protocols. There are a variety of products and a number of formulations to help with owner compliance from shampoos to sprays, spot-ons, wipes, mousses or creams. The veterinarian can discuss options with the pet owner to determine which type they’re most comfortable with and then send home a product they’ll actually use to bring their pet relief.

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Sources of itchy skin
The source of itchy skin (or pruritus) usually falls into three categories: infection, a parasitic infestation, or allergies. Hair loss can be caused by any of those, or it may be symptomatic of an endocrine disease like hypothyroidism or Cushing’s or an autoimmune disorder. Often, conditions from more than one category are present at the same time, which can make diagnosis a real challenge. Constant scratching due to fleas or an allergy may lead to a secondary skin infection, for example.

When the itch moves deeper

Canine otitis externa (OE) is an inflammation of the external ear canal, most often driven by allergies such as atopic dermatitis, but also caused by infections, ear mites, or foreign bodies. Dogs with long, floppy ears or narrow ear canals are especially prone. OE is painful and often leads to head shaking, scratching, and rubbing, creating significant stress for both pets and owners.

Treatment can be difficult, as painful ears often make topical medications hard to administer at home. To address this, longer-acting in-clinic therapies have become more common, improving compliance and reducing treatment burden for both owners and veterinarians.

Options include Osurnia Otic Gel (two in-clinic doses seven days apart), Claro Otic Solution (single dose lasting up to 30 days), and its bio-equivalent, Simplera Otic Solution. Mometamax Single is another recently introduced long-acting gel, while DuOtic, launched in 2025, is an antibiotic-free option providing up to 45 days of antifungal and steroid therapy in two in-clinic doses.

Along with improvements in medications, advances in diagnostics have enhanced the treatment of ear infections. Getting to the root cause of otitis externa is vital, and now video-based otoscopic examination tools are available at various price points that have improved and magnified visualization of the ear canal. CT scans of the head for deep-ear imaging are becoming more common in specialty clinics. AI is now another option for ear diagnostics. Zoetis Reference Laboratories lets veterinarians upload a stained sample to an AI microscope which will analyze the cytology and quantify what it sees.

The health and well-being of pets is impacted by the health of their skin, and dermatological problems have a negative impact on the quality of life for both pets and pet owners. Just like there are multiple approaches to diagnosing the source of the problem, there are a variety of treatment options, so it’s worth your time to be familiar with the products you carry. Your knowledge of the expanding variety of dermatology products and treatments will ensure that you’re helping your customers provide the best care possible.

Photo Credits:

istockphoto.com/Anna Reshetnikova

istockphoto.com/sony_moon

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