The Skin Flint Podcast Podcast Por elearningvet arte de portada

The Skin Flint Podcast

The Skin Flint Podcast

De: elearningvet
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Whether you simply have a pet with skin issues, or are a vet / vet nurse looking to bolster your CPD record with free, easy to listen to, on the go discussion on and around pet skin disease - this is the podcast for you! Join European leading dermatologist Dr Sue Paterson, Dermatology Veterinary Nurse John Redbond and Elearning.Vet content provider Paul Heasman as they pick their way through the scabby surface of pet skin disease. Expect interviews with some of the smartest minds in animal dermatology to get beneath the surface of the latest thinking on all things fur and skin, keeping their gloved fingers on the pulse of current topics itching to be discussed. This podcast is brought to you by Nextmune UK (formerly Vetruus), specialist in veterinary dermatology and immunotherapy. Nextmune bring you products such as Otodine and CLX Wipes – market leading products in the management of skin and ear cases. In association with Elearning.Vet - providing the highest quality veterinary content free of charge.Copyright 2021 All rights reserved. Ciencia
Episodios
  • Episode 32 - Resistance is Futile! Managing MRS in Practice

    Episode 32 - Resistance is Futile! Managing MRS in Practice
    Aug 9 2025

    Chapter 1: Meet the Microbes

    (02:41) John opens the episode, introducing Dr Vanessa Schmidt and inviting her to share her background. Vanessa explains her role at the University of Liverpool, her PhD in antimicrobial resistance in staphylococci, and her leadership in infection control and antimicrobial stewardship.

    (03:38) John asks whether staph infections in pets are usually caught or part of their natural skin flora. Vanessa replies that most infections come from an animal's own commensal microbiota, which coexist harmlessly but can cause disease when the immune system or skin barrier is compromised.

    (05:07) Sue asks whether humans and animals share the same commensals. Vanessa explains that while many organisms are shared across species, each host also harbours unique flora. Cross-species transfer is possible but not common.

    (06:16) Sue asks whether different body sites have different staph species. Vanessa says this is well-mapped in humans, while in pets we know carriage is common in the nose, mouth, and perineum, but site-specific species need more study.

    (07:28) John asks about coagulase-positive vs coagulase-negative staph. Vanessa explains that coagulase-positive staph are generally more virulent, while coagulase-negative species can still be important, especially in immunocompromised hosts or in association with implants.

    (09:37) Sue asks how to interpret a coagulase-negative result on a lab report. Vanessa advises considering clinical context, immune status, culture growth level, and cytology to judge significance.

    (12:34) Sue emphasises the value of cytology. Vanessa agrees, explaining it's routine in dermatology and helps identify intracellular bacteria and neutrophilic inflammation.

    Chapter 2: Resistance Training

    (14:30) John transitions to methicillin resistance. Vanessa explains MRSP carries the mecA gene, conferring resistance to beta-lactam antibiotics. It spreads clonally and is more stable than resistance in Gram-negatives.

    (17:40) Sue asks whether antibiotic use can switch the resistance gene on or off. Vanessa says it's about selection pressure - resistant strains survive when antibiotics are overused.

    (19:03) Sue shares her “rucksack” analogy. Vanessa agrees, adding that over time resistant strains adapt, carrying resistance genes more efficiently.

    (20:15) John asks about zoonotic risk. Vanessa confirms bacteria like MRSP can pass between pets and owners, though actual infections are rare.

    Chapter 3: Less is More: Treating MRS the Smarter Way

    (22:33) Sue asks about managing MRSP pyoderma in practice. Vanessa outlines a tiered approach: treat the underlying disease, apply barrier nursing, and use topical therapy like chlorhexidine, aiming to avoid systemic antibiotics.

    (27:00) Sue raises chlorhexidine use and guideline updates. Vanessa recommends 2% or above concentrations of chlorhexidine and warns that dilution reduces effectiveness and may lead to treatment failure.

    (30:05) Sue mentions suspected resistance. Vanessa confirms resistance is reported and linked to bacterial efflux pumps. She uses hypochlorous acid or bleach as follow-up options in certain MRSP cases.

    (33:15) John asks what Vanessa avoids. She avoids systemic antibiotics in superficial MRSP unless absolutely needed, and tailors treatment to the underlying disease. Immunosuppressives are avoided if the infection arose due to immune compromise.

    (35:00) Sue asks about treating MRSP otitis. Vanessa explains that lower chlorhexidine concentrations are potentiated by TRIS-EDTA, so she still uses them as first-line ear cleaners.

    (36:40) John asks about long-term carriage. Vanessa explains MRSP can persist for months or even years. Decolonisation before high-risk surgery is common, but long-term clearance is difficult and evidence is limited.

    (39:42) Sue summarises the discussion: in MRSP, less is more - fewer antibiotics and more topicals. New guidelines offer hope for better resistance control.

    ISCAID guidelines

    https://onlinelibrary.wiley.com/doi/10.1111/vde.13342?af=R&utm_campaign=Nextmune%20-%20Nextmune%20UK%20Updates&utm_source=hs_email&utm_medium=email&_hsenc=p2ANqtz--e1aa7hsXEupaiUzNH8tbxLSDEH8s4jALF4ScLWjefX83QJvKt5H20n5xE--r0sn9CVwFI

    Protect Me guidance from BSAVA

    https://www.bsava.com/Resources/Veterinary-resources/PROTECT-ME/
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    45 m
  • Episode 31 - Son of a Birch! The Pollen Predicament

    Episode 31 - Son of a Birch! The Pollen Predicament
    Jul 4 2025
    Show Notes On this month's episode, Sue, John and Paul invite Darragh O'Hanlon (@thetopicalvet) onto the pod to discuss pollen allergies. Chapter 1 – How Pollens Affect Animals (02:32) John introduces the topic of pollen allergies and welcomes guest Darragh O’Hanlon. Darragh shares how Sue’s lecture on otitis sparked his dermatology journey, and how John’s CPD also played a role. (04:09) John asks how pollens cause allergic reactions in animals. Darragh explains that pollens are airborne reproductive grains from grasses, trees, and weeds, and describes their microscopic structure and typical transmission routes. He shares the story of Mitzi the fox terrier, one of the first dogs documented with airborne pollen allergy. (06:30) Sue asks whether pollens affect more than just the skin. Darragh explains that: In dogs, pollens mostly trigger atopic dermatitis but can also affect eyes and ears.Cats may show respiratory and skin symptoms, including asthma and eosinophilic conditions.Horses show skin reactions like urticaria and, in some regions, respiratory issues like heaves. (08:45) John asks why grass pollens are so problematic over say garden flowers. Darragh notes a rising trend in grass pollen allergy and explains the volume and dispersal of wind-pollinated plants. Garden flowers are less allergenic due to heavier, insect-borne pollen; wind-pollinated plants like grasses and trees produce vast quantities of light airborne pollen. Sue discusses tree flowers and their pollen production. (11:30) Sue asks which trees cause the worst reactions. Darragh highlights birch as a major allergen in Northern Europe. He explains its cross-reactivity with other tree pollens and regional variations such as cypress (Mediterranean) and cedar (Japan). Conifers and pines, though present in air samples, are less allergenic due to their size and resin content. Chapter 2 – Seasons, Cross-Reactions, and Geography (14:20) Sue asks about pollen season overlap and the role of allergy testing. Darragh agrees and describes how pollen calendars can predict seasonal challenges. He outlines Ireland’s pollen calendar, from alder and hazel in winter through to weeds in autumn. (16:20) John asks if pollens cross-react with each other or be linked to food sensitivities. Darragh explains: Cross-reactivity is common among grasses and within trees and weeds.Birch is highly cross-reactive.Some food cross-reactions exist in humans (e.g. Mugwort-Birch-Celery Syndrome), but evidence in dogs is limited. (19:55) Sue mentions bee foraging and asks about using tape strips to detect pollens on animals. Darragh shares anecdotes and online interest in identifying pollens via tape stripping. (21:36) Sue asks about ragweed in Ireland. Darragh says it’s rare locally but problematic in the US. He discusses its introduction to Europe and control measures. (23:20) John asks how pet owners can reduce pollen exposure. Darragh shares advice: Allergen avoidance is difficult; pollens travel long distances.Regular washing, foot rinsing, and barrier-supporting shampoos help.Avoid walking dogs on freshly cut grass or on high pollen days. (26:10) John asks about environmental factors like altitude or proximity to the sea. Darragh explains: Pollen can travel thousands of kilometres.Grass pollen is more localised than tree pollen.Higher altitudes and coastal winds can reduce exposure. (29:12) Sue mentions a 2023 study on reactions to grass sap, not just pollen. Darragh reflects on cases that may fit contact dermatitis patterns seen with grass sap exposure. Chapter 3 – Testing, Treatment & Takeaways (31:14) Sue asks for practical advice on pollen avoidance and resources. Darragh recommends: Monitoring pollen forecasts (e.g. Met Office, Met Éireann).Using allergy maps from dermatology providers.Avoiding warm, dry, windy days; walking dogs after rain.Understanding how weather affects pollen counts, including the impact of thunderstorms and urban pollution. (35:15) John asks about immunotherapy and vaccine formulation. Darragh explains: Allergen-specific immunotherapy aims to desensitise.Earlier intervention is better.Cross-reactivity helps simplify formulations. (38:36) Sue stresses that vaccine components must reflect relevant, local allergens. Darragh notes the importance of seasonal coverage and discusses challenges with mixing mould and pollen extracts. (41:05) Sue shares an anecdote about a mismatched allergy vaccine and wraps up with thanks to Darragh. Useful Links: Nextmune – Veterinary allergy diagnostics and immunotherapy. https://nextmunelaboratories.co.uk/
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    49 m
  • Episode 30 - Understanding The New ISCAID Pyoderma Guidelines

    Episode 30 - Understanding The New ISCAID Pyoderma Guidelines
    May 28 2025
    This podcast is based upon the new 'Antimicrobial use guidelines for canine pyoderma by the International Society for Companion Animal Infectious Diseases (ISCAID)' available HERE (00:00) John introduces the podcast with his co-hosts Sue Paterson & Producer Paul. Chapter 1 – Understanding Pyoderma and the Need for New Guidelines (02:56) Sue welcomes Dr. Anette Loeffler, who introduces herself and her background in veterinary dermatology. Originally from Germany, she studied in Munich and has worked in the UK for over 30 years. She is currently a dermatologist at the Royal Veterinary College (RVC) and has a special interest in Staphylococcus and bacterial skin infections and this has led her to work over the last 4 years on the new pyoderma treatment guidelines, aimed at improving antibiotic use and promoting topical therapy. (04:30) Sue asks Anette to explain antimicrobial stewardship and why it is important. Anette describes antimicrobial resistance as a major global threat. Overuse of antibiotics leads to resistance, so it is crucial to avoid unnecessary prescriptions and focus on appropriate diagnostics. (06:10) Sue asks how common pyoderma is in domestic species, particularly dogs and cats. Anette explains that staphylococcal pyoderma is very common in dogs due to their unique skin structure, making them more prone to bacterial overgrowth. While cats and other species can develop bacterial skin infections, it is far less frequent and usually not recurrent. Chapter 2 – Diagnosing and Classifying Pyoderma (08:00) John discusses evolving perspectives on pyoderma classification and asks if the traditional categories of superficial and deep pyoderma are still relevant. Anette confirms that the new guidelines still use these classifications as they help determine treatment: Surface pyoderma (dysbiosis): Often in skin folds where bacteria and yeast overgrow due to friction and moisture.Superficial pyoderma: Involves hair follicles and is the most common type.Deep pyoderma: A more serious infection requiring systemic antibiotics. (10:19) Sue notes that past treatment approaches lacked strong clinical evidence. Anette explains that many historical treatment protocols were based on anecdotal evidence rather than research. While deep pyoderma has more robust studies, superficial cases often lacked proper research, leading to overuse of antibiotics. (13:04) John asks how vets can determine whether a case is surface, superficial, or deep pyoderma. Anette explains that clinical examination alone can often differentiate them: Surface infections show redness and are in friction areas (e.g., nasal folds, hotspots).Superficial pyoderma presents with papules, pustules, and epidermal collarettes.Deep pyoderma causes swelling, draining tracts, haemorrhagic crusting, and pain. (16:04) Sue asks how to confirm true bacterial pyoderma and rule out mimicking conditions. Anette stresses the importance of cytology, a simple and cost-effective test that can quickly confirm bacterial involvement. Cytology can also differentiate between bacterial infections, yeast overgrowth, and sterile pustular diseases. Chapter 3 – Treatment Approaches and Key Takeaways from the New Guidelines (19:36) John asks about traditional treatment approaches and why they need updating. Anette outlines how older guidelines recommended unnecessarily long courses of antibiotics (e.g., 3-4 weeks for superficial pyoderma, 4-6 weeks for deep pyoderma). While this was logical before antimicrobial resistance became a concern, modern research supports shorter, targeted treatments. (26:13) Anette explains the new recommendations: Surface pyoderma should be treated topically only – systemic antibiotics are inappropriate.Superficial pyoderma should primarily be treated with topical therapy – which has been shown to be as successful as a course of antibiotics.Deep pyoderma requires systemic antibiotics but can benefit from adjunctive topical treatment. (32:40) Sue asks about helping vets communicate these new approaches to pet owners. Anette explains that the guidelines include tables, visual aids, and quick-reference guides to support busy practitioners. (33:28) John asks about when systemic antibiotics are still necessary. Anette explains that systemic therapy is still essential for deep pyoderma or when topical treatment alone is impractical (e.g., large dogs, owner limitations). In such cases, culture and susceptibility testing should guide antibiotic choice. (38:15) Sue asks which antibiotics should be the first choice if empirical treatment is necessary. Anette recommends clindamycin, lincomycin, cephalexin, or co-amoxiclav as first-line choices, with fluoroquinolones reserved for resistant infections. (42:32) Sue asks Anette for her top five takeaways from the guidelines: Read the dog, not just the textbook. Diagnose based on clinical lesions and determine if the infection is surface,...
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    52 m
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