Topical Therapy

 Client education on the use of topicals with written discharge information is mandatory.  The medical and financial advantages of using topical therapy should be discussed. A topical treatment and maintenance program may reduce the need for long-term continual systemic medications.  Inform owners that medicated shampoos do not typically lather well so that they do not over apply the products. It is helpful to use a general cleansing shampoo prior to the medicated shampoo to clean the skin and hair coat and reduce the amount of the more expensive medicated product.  If necessary for the skin disease to be adequately treated, have the coat cut short to facilitate application of the topical product. This is especially important for long-term management of infectious diseases in longhaired dogs.  Contact time, contact time, contact time – at least 10 minutes for most shampoos.  Monitor for possible irritancy or hypersensitivity reactions.  Use cool water for rinsing when the skin is inflamed and the patient pruritic.  At least twice weekly application is indicated initially followed by application as needed – usually every 7-14 days.  Use sprays, rinses or wipes between shampoos for more continual and residual activity.  Cytology, cytology, cytology – to select the product with the correct active ingredient(s) and to change treatment if necessary at the recheck visit.