Going abroad for a big-picture view of veterinary practices

I am writing to you from abroad, feeling quite the worldly correspondent.

You see, I learned that every four years there is a World Veterinary Conference in Dermatology. The meetings have been held in the United States and Canada, and this year were scheduled in Bordeaux, France. All animals have skin, right? Someone had to go, yes? So for the sake of my patients (and just a little because I lived in Paris for a year between high school and college) I volunteered to go.

Veterinarians were represented from around the world, both board-certified dermatologists and general practitioners such as myself. Brazil sent a huge contingent; Korea and China and Japan were there. All of North America and Europe attended in droves. English was the common language, though one day they set one course of programs strictly in French. An entire group theme was devoted to skin problems of the horse, another to the cat, a third to a variety of exotic small mammals and birds.

I was amazed to learn that up to 80 percent of the time the reason clients brought their dogs to the veterinary dermatologist was for allergy and/or ear problems. We as veterinarians in Merced have long known the shared occurrence of skin allergies with ear disease. Our Valley, so bountiful with edible crops and produce, is equally pollen and allergen producing, affecting human and pet alike. We see a tremendous variety of skin diseases and allergies, so I felt right at home at this conference.

Sadly, they did not serve the equivalent of doughnuts with coffee in the morning like conferences in the United States. Starbucks has crossed the ocean, however, and its familiar logo was everywhere as I listened to the top dermatologists in the world argue the value of allergy testing, either by skin or blood samples.

They argued over allergy “desensitizing shots” vs. treatments delivered in the mouth, under the tongue. They argued over steroid choices and steroid substitutes. (Not so much anti-histamines. Dogs lack the kind of histamine receptors that people have, so antihistamine medication is less effective for many of canine allergies.)

I will submit the theory that veterinarians around the world argue about the same stuff. Everyone wants to help their patients. Everyone shared. After the third day I noted glasses of wine circulating at lunch, some open oysters, a little paté. Now that you don’t see in the States.

Entire blocks of time and workshops were given over to the treatment of otitis externa, or ear infections of the outer ear canal. Lift up your dog’s ear flap – we’re talking about the pink underside of the flap and down the hole, or ear canal, two inches down to the ear drum, or tympanic membrane. That relatively small patch of skin commanded a lot of attention from these specialists! Ear disease is painful. The message home: Treat the ears all you want, but if allergies are present, unless you address the underlying allergies (called atopy), the dog will never be properly comfortable.

Because allergies are never cured, but are managed or controlled with medication as needed, then the ear disease will require management, too, seasonally or year round. But take heart, there are multiple medications both for allergy relief and ear problems and many need only be given weekly at home for good effects.

It is true that the French love their French bulldogs, as I saw them everywhere on the streets. Whippets and Yorkies were well represented, along with Jack Russell terriers and German shephard dogs. I saw only one Dalmatian and for some reason he appeared completely out of place, ambling past the croissants and cheese market. I didn’t see a single poodle!

It was interesting to see how other countries treat their patients. I only noted one medication available in Europe and not yet attainable in the United States. Overall the practice of veterinary medicine appears similar around the world, which is good news for our furry friends.

This story was originally published June 10, 2016 at 1:09 PM with the headline "Going abroad for a big-picture view of veterinary practices."