The flare plan

The first 48 hours

A flare is the bucket spilling over (Chapter 4): a jump of a few points above his usual score, a new spot, a smell, or an ear that's suddenly bothering him. Fill in the top of this page now, while things are calm.

My vet:Phone:

After-hours or emergency clinic:Phone:

His usual (baseline) itch score:His usual flare spots:

1 Check the red flags first

Emergency, get seen now

Swelling of the face or muzzle, hives all over, trouble breathing, or vomiting, weakness or collapse along with sudden itching or swelling; a head tilt with falling, circling or eyes flicking side to side.

Get seen in the next day or two

Open, oozing or bleeding sores; a fast-spreading red, wet hot spot; an ear that's painful, swollen, smelly or has discharge; a head tilt with a sore, smelly ear in a dog who is otherwise steady on his feet; itch at 8 or higher, or he isn't sleeping or eating; a dog who was well controlled on an itch medicine and is suddenly much worse.

2 Call your vet

Call, describe what you're seeing, and ask whether he needs to be seen and how soon. Many clinics will want a look under the microscope, because the most common reason a flare happens on a good plan is an infection on top of the allergy (Chapter 7).

Called on:What they said:

3 Don't change five things at once

Hold off on the new food, the new shampoo, the new supplement and the new chew until you've talked to your vet. If you change everything in the same week, nobody will ever know what helped.

Don't stop, skip or double any medicine he's already on unless your vet tells you to.
Don't restart leftover steroids, antibiotics or any other medicine without calling first. Leftover ear drops are often fine for a familiar flare, if your vet says so. Get the ear seen if it's different, very painful, or he has a head tilt.
Nothing from your own medicine cabinet without asking your vet. Only a single-ingredient product your vet names: never a "-D," "PE," "Sinus," "PM" or other combination product, and watch for xylitol in liquids and chewables.

The flare plan

Steps 4 to 6: write it down, take photos, bring it all

itchydog.vetDr. Steve Pelton, DVM

4 Write it down

Date the flare started:Today's date:

	Notes
Itch score today (0 to 10)
Where (paws, ears, face, armpits, belly, back end, lower back)
Ears (smell, redness, discharge, shaking, tilt)
Skin smell (musty, corn-chip, sour)
Skin look (red, bumps, scabs, rings, greasy, wet, hair loss)
Sleeping and eating normally?
Date of last flea dose, every pet in the house
Anything new in the last 2 weeks (food, treats, boarding, grooming, new pet, trip, weather, pollen)
Missed or late doses of any medicine

Notes

Itch score today (0 to 10)

Where (paws, ears, face, armpits, belly, back end, lower back)

Ears (smell, redness, discharge, shaking, tilt)

Skin smell (musty, corn-chip, sour)

Skin look (red, bumps, scabs, rings, greasy, wet, hair loss)

Sleeping and eating normally?

Date of last flea dose, every pet in the house

Anything new in the last 2 weeks (food, treats, boarding, grooming, new pet, trip, weather, pollen)

Missed or late doses of any medicine

5 Take photos

Photograph the worst spots now, in good light, before any treatment. Then again in 2 or 3 days. If the ear is draining, a photo of the discharge on a cotton ball helps too.

Photos todayPhotos in 2 or 3 daysEar discharge on a cotton ball (if draining)

6 Bring it all to the visit

Bring this page, your itch notebook and the photos. Ask: "Which tap opened?" (New fleas? Infection? Pollen season? A food slip?) Then ask how you'll know it's fixed.

Which tap opened:

How we'll know it's fixed:

Recheck date:Score at recheck: