Diagnostic Workflow

Your vet follows a logical sequence to find the cause of your dog's itch. Understanding this flow helps you know what to expect and when.

Overview

flowchart TD
    A[History and exam] --> B[Flea and parasite check]
    B --> C[Skin and ear cytology, scrapings]
    C --> D[Start anti-itch therapy]
    C --> E[Treat infections and start flea prevention]
    D --> F[Recheck at 2 weeks]
    E --> F
    F --> |Resolved| G[Parasites or infection likely]
    F --> |Still itchy| H[8–12 week elimination diet trial]
    H --> I[Reintroduce original food]
    I --> |Itch returns| J[Food allergy confirmed]
    I --> |No flare| K[Environmental allergy testing and immunotherapy]

Step-by-step

1. History and exam

Your vet will ask about itch distribution, seasonality, and what you've tried. They will check ears (many allergic dogs have ear issues), paws, and often-neglected areas like armpits and groin.

2. Minimum dermatologic database

• Skin cytology — Swabs or tape from red or crusty areas and ears.
• Skin scrapings — To look for mites (Demodex, Sarcoptes).
• Fungal culture — If ringworm is a possibility.

3. Immediate therapy

Your vet will start anti-itch treatment and treat any confirmed infection. They will also ensure year-round flea and parasite prevention is in place.

4. Recheck (about 2 weeks)

A follow-up visit assesses improvement. Your daily itch scores (0–10) and lesion changes are used to decide the next step. Do not stop all medications at once — taper one at a time.

5. Elimination diet trial (if itch persists)

A strict 8–12 week food trial with a veterinary prescription diet (novel or hydrolyzed protein). No treats, flavoured meds, or supplements. Track itch daily.

6. Diet re-challenge

After the trial, the original diet or suspect ingredients are reintroduced for 1–2 weeks. If itch returns, food allergy is confirmed. If not, environmental allergy testing may follow.

7. Allergy testing and immunotherapy

Once parasites, infections, and food allergy are ruled out, intradermal or blood testing can identify environmental allergens. Immunotherapy (shots or drops) can help long-term.

For your vet
Track the Itch reports show itch trends over the trial period. Use them to decide whether to extend the diet trial or proceed to challenge.