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Avoiding Pet Owner Burnout When Treating Canine Skin Disease

Katherine Doerr, DVM, DACVD, Veterinary Dermatology Center, Maitland, Florida


November/December 2021

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In the Literature

Spitznagel MB, Hillier A, Gober M, Carlson MD. Treatment complexity and caregiver burden are linked in owners of dogs with allergic/atopic dermatitis. Vet Dermatol. 2021;32(2):192-e50.


Chronic allergic dermatitis in dogs can result in significant caregiver burden for pet owners. A previously published report1 discussed the positive correlation between caregiver burden and severity of canine skin disease. 

The goal of the current study was to relate caregiver burden to both objective and subjective treatment complexity. Eighty-six participants were enrolled after completing an online survey about their dog with skin disease. An adapted 18-item Zarit Burden Interview validated for companion animal owners was used to assess caregiver burden, and a previously published measure was used to determine severity of skin disease. Complexity of treatment plans was subjectively determined using statements from the Pet Owner Adherence Scale. To decrease the influence of owner perception of difficulty, objective treatment complexity was determined by requesting the specific number of individual treatments required for management. 

A majority (ie, >80%) of enrolled dogs had moderate to severe skin disease that was positively correlated with caregiver burden. In addition, caregiver burden increased as the owner’s subjective assessment of treatment complexity increased, independent of disease severity. Objective analysis of treatment complexity was also positively correlated with the degree of caregiver burden.

Assessing caregiver burden is vital for successful management of dogs with allergic dermatitis. It is important to understand that as treatment complexity increases, compliance may decrease due to caregiver burden. Burden transfer to the clinician, in which owners overburdened with caregiving transfer their stress to the clinician, may also increase if the owner does not feel they can complete the treatments recommended for their dog.2 Although multimodal therapy is paramount in the treatment of allergic dermatitis, starting with a simple, yet effective, treatment plan can yield lower caregiver burden.


Key pearls to put into practice:


Simple, effective treatment plans should be chosen, if possible, for dogs with skin disease. Additional therapies may be provided once the patient is comfortable, but caregiver burden should be assessed at each examination.


Compliance may be increased by limiting the number of treatment modalities and initially focusing on the most effective therapies.



Simplistic treatment plans may also decrease burden transfer to clinicians, as caregiver burden would decrease, potentially resulting in fewer treatment-related follow-up questions or confusion.


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