Multiple factors, including client financial constraints, play a role in clinician decisions for canine atopic dermatitis: spectrum of care in a chronic and relapsing disease.

Financial constraints influence but don't always alter CAD treatment; recommendations often diverge from guidelines.

This survey-based study examined diagnostic and treatment approaches for canine atopic dermatitis among 718 North American veterinarians, with particular attention to how client financial constraints influence clinical decision-making. The findings reveal that 57% of respondents encounter clients with substantial financial limitations, while 28% report that over half their clientele face significant financial constraints. Despite these constraints, most veterinarians reported frequently using financial status to guide treatment recommendations. Regarding diagnostics, skin cytology and skin scraping were consistently preferred regardless of financial situation. For pyoderma management, cephalexin was the preferred choice for methicillin-sensitive infections in financially constrained cases. Notably, while most respondents demonstrated awareness of guidelines recommending sole antiseptic therapy for methicillin-resistant superficial pyoderma and acknowledged the importance of aerobic bacterial culture before antimicrobial use, their actual recommendations did not always align with consensus guidelines. The study emphasizes the disconnect between veterinarian knowledge and clinical practice, suggesting that improved education regarding spectrum-of-care decision-making is necessary to optimize outcomes while considering both client resources and evidence-based recommendations.

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