An approach to pruritus

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Pruritic skin diseases can be a diagnostic challenge to the clinician. This chapter presents an approach to pruritus that helps the veterinary surgeon investigate a pruritic patient, emphasizing the need to diagnose the underlying cause. Antipruritic therapies are also reviewed briefly.

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6.2 Pruritus is additive. When the threshold is exceeded, clinical manifestations of pruritus ensue. A practical example of these concepts can be seen in a dog or cat with both flea allergy and food-responsive dermatosis. The presence of both allergic stimuli results in a summation of the pruritic effect. Without the flea allergy, the dog or cat may be pruritic but comfortable overall with the food-responsive dermatosis, because the pruritic load is below the threshold of pruritus. When the client forgets to use a flea preventative, the additional pruritic stimulus from the fleas causes the pruritus to exceed the threshold, resulting in the dog or cat having a severe increase in itching.
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6.6 Diagnostic approach to a pruritic dog.
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6.7 Diagnostic approach to a pruritic cat.
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