Dermatology History Form

Welcome to Yonge & St. Clair Veterinary Hospital!

Dermatology History Form

Why is it so tough to figure out what’s going on with your pet’s skin?

Unfortunately, many skin conditions look very similar, and the main presenting complaint in veterinary dermatology is itching. The cause of itching can range from hypersensitivities (allergies to food, environmental allergens, and insect bites) to immunemediated conditions and even cancer. This is why it is so important to visit your veterinarian early to figure out the cause of your pets’ itching and get them some relief

If your pet is itchy or you are concerned about their skin/ears, please schedule an appointment with your veterinarian soon. Before your visit complete this history tool with as much information as possible. This will help you and your veterinarian start the conversation and find a plan that is right for your best friend.

The age of onset of your pet’s symptoms can give your veterinarian clues about what disease process or what type of allergy could be affecting your pet.
(0—no itching to 10—constant, severe itching all day and night)
Knowing if any other animals or humans are affected can help narrow things down to ectoparasites, mange or ringworm.
The vast majority of pets with food hypersensitivities, have allergies to proteins. Please indicate which proteins you have previously fed your pet. Don’t forget about things like treats, flavoured medications, flavoured toothpaste and chew toys like bones and antlers. You may need to reach out to the pet food company for more info on the ingredient list, and bring a photo of your bag to your vet
Please include any nutritional supplements, and topicals such as ear drops or creams
It’s important to know how your furry friend has responded to previous treatments. For example, a good response to corticosteroids (prednisone, prednisolone, dexamethasone) can indicate an environmental allergy or an immune-mediated skin disease, while a poor response can be seen with a food allergy.
FOR YOUR APPOINTMENT • Be sure to bring the previous medications, pills, ointments, ear cleaners, shampoos, ingredient labels of food and treats. • Do not bathe your pet within 3 days, do not clean or treat ears within 2 days of your dog’s appointment.
Having a loved one suffer with being itchy is tough on everyone, so please help your veterinary care team help your furry friend by filling out the history questionnaire to the best of your ability