Joseph A Bernstein Dacvd

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(410) 593-9929Visit WebsiteMap & Directions13515 Long Green PikeBaldwin, MD 21013 Write a Review

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Joseph A Bernstein Dacvd

Preventive Care

Nutritional Counseling
Cyclosporine (Atopica, Neoral) binds to specific intracellular receptors in T-lymphocytes and has been investigated for treating a number of skin diseases in veterinary dermatology. Though not labeled for use in the cat, it appears to be tolerated well by the feline patient at a dose of 25 mg/cat once a day. Good response has been noted in eosinophilic plaques and granulomas, and atopic dermatitis. Ideally the drug should be given on an empty stomach (1hr before or 2 hrs after a meal). The most common adverse effect is nausea and loss of appetite.

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Joseph A Bernstein Dvm, Dacvd

Bernstein, Joseph A, DVM

Bernstein, Joseph Dvm, Dacvd

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http://www.lganimalderm.com

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Veterinarians, Pet Grooming, Veterinarian Emergency Services, Veterinary Clinics & Hospitals, Veterinary Specialty Services

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Phone: (410) 593-9929

Address: 13515 Long Green Pike, Baldwin, MD 21013

Website: http://www.lganimalderm.com

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Joseph A Bernstein Dacvd

Preventive Care

Nutritional Counseling
Cyclosporine (Atopica, Neoral) binds to specific intracellular receptors in T-lymphocytes and has been investigated for treating a number of skin diseases in veterinary dermatology. Though not labeled for use in the cat, it appears to be tolerated well by the feline patient at a dose of 25 mg/cat once a day. Good response has been noted in eosinophilic plaques and granulomas, and atopic dermatitis. Ideally the drug should be given on an empty stomach (1hr before or 2 hrs after a meal). The most common adverse effect is nausea and loss of appetite.

Illness Treatment

Parasites Treatment and Control
The common causes fall into two groups: external parasites and allergies. External parasites that most commonly cause chronic itching dermatitis include fleas and sarcoptic mange. We often recommend therapeutic trials for sarcoptic mange in chronically and severely itchy dogs. We always recommend stepped-up flea control and monitoring for fleas, as flea infestation can really make allergy worse!
Vomiting Treatment
Diarrhea Treatment
Skin Condition and Allergy Treatment
In the diagnosis and treatment of these allergies in horses, the veterinary dermatologist keeps in mind the “summation of effect”. In other words, more than one condition may have an additive effect resulting in the clinical signs of the horse. Therefore, as in the small animal patient, the diagnostic and therapeutic protocol must proceed in an orderly step-by-step fashion in which the patient’s environmental and predisposing influences are examined in conjunction with treatment of secondary perpetuating factors like bacterial and yeast infections. Typically we recommend ruling out or treatment of secondary infections or parasitic disease prior to proceeding with allergy testing.
Upper Respiratory Illness Treatment
This extremely pruritic reaction pattern can be very frustrating for the small animal practitioner and cat owner as the level of itching often results in a significant amount of self-trauma and tends to be less steroid-responsive than the other reaction patterns. Self-excoriation can result in extensive ulceration with secondary infection. The most likely causes include: Various mites, food allergy, flea allergy, atopy, dermatophytosis, and other ear disease. Initial diagnostics include: ear examination, skin scrapes, Woods lamp, DTM culture, combing and flea control rule-out. Food allergy is much more likely with head and neck pruritus cases than it is in the other reaction patterns; so earlier institution of a hypoallergenic dietary trial may be considered. However, a lime sulfur trial to rule out Demodex gatoi is often preferred prior to allergy work-up. This is a mite that inhabits the surface layer of the skin but may not be seen in a routine skin scrape. These cases can be so severe and the cat’s owner so desperate for relief for their pet that definitive diagnosis may be difficult due to the need to move quickly with diagnostics and therapy. Glucocorticoid (steroid) administration and E-collar may be needed initially in attempting to stop the self-trauma. One differential diagnosis that is often overlooked is feline herpesvirus ulcerative dermatitis. Feline herpesvirus-1 (FHV-1) is known best for causing upper respiratory disease and conjunctivitis. However, FHV-1 can cause a variably pruritic eosinophilic dermatitis seen predominantly on the face. This can easily be confused with allergic dermatitis. While biopsies may reveal intranuclear viral inclusions, these can be absent. While immunohistochemistry and PCR testing may be supportive, the most reliable way to rule out this differential diagnosis is a 2-3 week trial course of Famciclovir (Famvir®, 125 mg BID), a safe and reliable antiviral in cats.
Injury Treatment

Infection Treatment

Bacterial and Viral Infection Treatment
6) Oclacitinib (Apoquel®) - This medication has been developed for symptomatic treatment of itch in canines and works by inhibition of a single enzyme system, Janus Kinase. It is faster acting than cyclosporine and has been an increasingly popular choice for symptomatic control. Possible side effects include increased susceptibility to viral infections and some types of neoplasia.
Ear Infection Treatment
Allergies are often the underlying cause of recurring skin and/or ear infections. Bacterial and yeast infections, though secondary to the allergy, can cause an increase in your pet’s level of itching. Long term treatment with antibiotics and anti-yeast medications is commonly required, along with medicated bathing programs.

Chronic Condition Treatment

Diabetes Treatment
Although cats tend to tolerate steroids better than dogs and people, adverse effects due occur including: obesity, diabetes mellitus, alopecia, skin fragility, aggravation of heart failure, behavioral alterations and predisposition to infection. Therefore diagnosis and therapy of underlying causes is highly preferred to reliance steroid use in the itchy feline patient.
Thyroid Disease Treatment
Pyodermas are extremely common in veterinary medicine. Staphylococcus intermedius is the most common bacterial skin pathogen in dogs and cats. Most cases are secondary to hypersensitivities (atopy, food allergy, flea allergy dermatitis), endocrinopathies (hypothyroidism, hyperadrenocorticism), or ectoparasitic infestation (demodicosis, sarcoptic mange). The depth of involvement of pyoderma is classified as surface, superficial, or deep. Surface pyodermas consist of superficial dermal erosion, the most common of which include skin fold pyoderma and pyotraumatic dermatitis (hot spots). Superficial pyodermas involve bacterial invasion into the hair follicle (folliculitis) and microabscessation of the epidermis. The unifying lesion of superficial bacterial pyoderma/folliculitis is the folliculocentric pustule. However, pustules are transient and rupture easily, resulting in the formation of crusted papules and/or epidermal collarettes. In the condition known as superficial spreading pyoderma (SSP), pustules evolve into coalescing and expanding erythematous macules. As these macules expand, superficial keratin layers lift and peel peripherally, resulting in expansive epidermal collarettes. The collarettes in SSP are more prominent than in folliculitis, and pustulation is less evident. Bacterial folliculitis and SSP may coexist, though one form usually predominates. The most common presentation of feline bacterial folliculitis is miliary dermatitis. If the bacterial infection extends beneath the hair follicle, the disease is termed deep pyoderma. Lesions of deep pyoderma include furunculosis (ruptured hair follicles), nodules, and/or draining tracts.
Heart Disease Treatment
Although cats tend to tolerate steroids better than dogs and people, adverse effects due occur including: obesity, diabetes mellitus, alopecia, skin fragility, aggravation of heart failure, behavioral alterations and predisposition to infection. Therefore diagnosis and therapy of underlying causes is highly preferred to reliance on steroid use in the itchy feline patient. However, in cases where ongoing steroid use is required, the best course of action is to use them at the least frequency required (pulsed dosing).

Veterinary Surgery
Small Animal Surgery

Laboratory Services
Dr. Joseph A. Bernstein is a native of Maryland and received his undergraduate Bachelor of Arts degree in Biology at Bucknell University in Lewisburg, PA in 1997. He received his degree of Doctor of Veterinary Medicine from Ross University School of Veterinary Medicine in 2002. He completed an internship in companion animal medicine and surgery at Purdue University Veterinary Teaching Hospital followed by a three year residency in dermatology at Louisiana State University School of Veterinary Medicine. With an interest in cutaneous oncology, he instituted the first veterinary program for Mohs micrographic surgery for the removal of locally invasive skin cancers. His other research lay in the field of non-human primate dermatology. He became a board certified diplomate of the American College of Dermatology (ACVD) in 2006 and has established his private practice in Baltimore County, Maryland. Dr Bernstein continues to publish research and is also a national dermatology and dermatopathology consultant for Antech Diagnostic Laboratory. In addition to managing small animal and equine cases in private practice, Dr. Bernstein acts as a consultant for zoos and research centers for the benefit of exotic animals and nonhuman primates. He is the founder of VetDermPath Atlas, the first comprehensive online digital atlas for the instruction of veterinary dermatopathology.

General Pet Care

Grooming

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