An approach to pruritus

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Pruritus is the sensation that leads to the desire to scratch. In veterinary medicine, patients use their paws and mouth to quell an itch. Thus, the veterinary medical definition of pruritus expands to include the desire to chew, lick or bite at the skin. Pruritic skin diseases can be a diagnostic challenge to the clinician. Chronic pruritus typically results in the same set of secondary dermatological skin lesions in any patient, yet multiple dermatological conditions can act as the underlying trigger for the pruritus. Ignoring the underlying cause of the pruritus only results in recurrence when antipruritic medications are discontinued. The aim of this chapter is to present an approach to pruritus that helps the veterinary surgeon with any pruritic patient. The emphasis is on diagnosing the underlying cause of the pruritus. Antipruritic therapies are reviewed briefly to enable the veterinary surgeon to select the most appropriate therapy .The chapter focuses on the following: Pathophysiology; Clinical approach; and Treatment.

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5.1 Pruritus is additive. When the threshold is exceeded, clinical manifestations of pruritus ensue.
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5.3 History form with questions specific to pruritus in the dog and cat (for general forms, see Chapter 2).
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5.6 Diagnostic approach to a pruritic dog.
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5.7 Diagnostic approach to a pruritic cat.

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