As spring warms up, my own nose and sinuses have detected increasing pollen levels, and there’s been a corresponding increase in pruritic patients coming across the threshold.
I think the role of pyoderma in allergic skin disease is well established and accepted. However, it is not uncommon to see dogs with no obvious skin lesions that are markedly pruritic, and cytology often reveals large numbers of cocci without the correspondingly high levels of inflammatory cells.
In patients with reduced barrier function, this overgrowth can contribute significantly to the levels of pruritus. I find a significant number of dogs’ pruritus reduces by at least 50%, if not more, with appropriate antibiotic and shampoo therapy when overgrowth is identified by cytology.
I usually repeat the cytology in around 2 to 3 weeks to check for resolution, although, of course, given the relapsing nature of the condition periodic treatment is required.
Rosenkrantz W (2010). Proceedings of the NAVC Conference 2010.