ecallenKey insights from Dr. Robert Schick’s recent webinar on small animal dermatology diagnostics.*
Veterinary dermatology has evolved dramatically over the past four decades, and so have our diagnostic tools. In a recent webinar, Dr. Robert Schick, DVM, DACVD, shares critical insights on what’s changed—and what remains essential—in dermatology laboratory techniques. Just as modern cars require different tools than classic vehicles, today’s dermatology cases demand both traditional skills and cutting-edge technology.
The Modern Approach: Dr. Schick's Philosophy
Dr. Schick demonstrates that modern veterinary dermatology isn’t about choosing between old and new—it’s about strategically combining time-tested techniques with advanced tools to deliver superior patient care and diagnostic accuracy.
Success requires:
- Mastering fundamentals while embracing innovation
- Prioritizing consistency over perfect technique
- Leveraging digital systems to reduce variability
- Utilizing point-of-care testing for faster diagnoses
- Proper sample handling regardless of testing method
Skin Scrapings: Dr. Schick's Refined Technique
Despite revolutionary parasiticides like isoxazolines dramatically reducing mite cases, Dr. Schick emphasizes that proper scraping technique remains crucial for accurate diagnosis.
Essential steps Dr. Schick teaches:
- Gently squeeze skin before scraping
- Scrape until capillary oozing occurs
- Use skin spatulas instead of blades for safety (around $6)
- Scan at 4X power initially
Monitoring treatment success: Dr. Schick explains that understanding mite life stages is key. Finding dead adults after 4 weeks indicates effective treatment, while continued eggs and larvae suggest therapy adjustment is needed.
Cytology: Dr. Schick's Most Valuable Diagnostic Tool
The Consistency Challenge
While diff-quick remains the gold standard, Dr. Schick emphasizes that consistency matters more than perfect technique.
Common pitfalls Dr. Schick identifies:
- Using frosted tape instead of clear tape for preparations
- Inconsistent staining protocols
- Variable heat-fixing methods
Ear Cytology vs. Cultures: Why Dr. Schick Chooses Cytology
Dr. Schick strongly advocates for cytology over cultures in ear cases:
“I have not cultured an ear in so many years I couldn’t even tell you how many.” —Dr. Schick
Dr. Schick’s reasoning:
- External ear cultures are often misleading
- Sensitivity patterns based on blood levels don’t reflect topical concentrations
- Multiple ear sites yield different culture results
- Cytology provides immediate, actionable information
Digital Microscopy Revolution: Dr. Schick Champions The TRUVIEW™ Microscope
The Game Changer for Consistency: Traditional cytology faces a major challenge: technician variability in staining. Dr. Schick demonstrates how Zomedica’s fully automated digital microscope, TRUVIEW™, solves this problem.
Benefits Dr. Schick highlights:
- Automated, consistent staining with 5-minute processing time
- Standardized slide preparation eliminating human error
- Superior documentation for medical records
- Easy image sharing with clients and referring veterinarians
- Remote consultation capabilities
“This takes all of that variability out,” Dr. Schick notes, highlighting how the system removes human error from the diagnostic process.
Point-of-Care Revolution: Dr. Schick's TRUFORMA® Platform Success Stories
Dr. Schick showcases how Zomedica’s TRUFORMA® diagnostic platform has transformed in-house diagnostics for dermatology cases:
Thyroid Testing Breakthrough
- Accurate canine TSH levels (previously impossible in-house)
- Total T4 and Free T4 testing with 30-minute results vs. overnight shipping
Adrenal Function Assessment
- ACTH measurements for Cushing’s screening
- 25-minute results vs. 8-hour dexamethasone suppression tests
Real case impact: Dr. Schick shares how TRUFORMA diagnosed hypothyroidism in a Cocker Spaniel when the owner’s suspicion proved correct—elevated TSH and unmeasurable T4 confirmed the diagnosis, leading to successful treatment.
Dermatopathology Excellence: Dr. Schick's Biopsy Guidelines
Dr. Schick emphasizes that proper biopsy technique dramatically impacts diagnostic accuracy:
Critical Guidelines:
- Never scrub lesions before biopsy
- Use 6-8mm disposable punches (not 2-4mm)
- Handle samples gently at the base
- Request dermatopathology-trained pathologists
Dr. Schick’s Top Mistakes to Avoid:
- Reusing disposable punches instead of using fresh ones
- Grabbing biopsy centers with forceps causing tissue damage
- Scrubbing away diagnostic surface material before sampling
- Using inadequate punch sizes that limit diagnostic capability
- Failing to request specialized pathologists for dermatology cases
Key Takeaways for Modern Practice
Dr. Schick’s comprehensive approach demonstrates that the practices that thrive will be those that maintain diagnostic fundamentals while leveraging technology to overcome traditional limitations like staining variability and lengthy turnaround times.
Essential points from Dr. Schick’s webinar:
- Consistency in technique matters more than perfection
- Digital microscopy eliminates human variability in cytology
- Point-of-care testing provides immediate, actionable results
- Proper biopsy technique is non-negotiable for accurate diagnosis
- Modern dermatology combines proven methods with advanced technology
Dr. Schick’s bottom line: Today’s dermatology diagnostics combine proven techniques with advanced technology. Success comes from mastering fundamentals while strategically embracing innovations that solve real diagnostic challenges.
Ready to modernize your dermatology diagnostics? Visit Zomedica.com to learn more about TRUVIEW digital microscopy and TRUFORMA point-of-care testing solutions from Zomedica.
*Dr. Schick was paid by Zomedica, Inc. for his educational webinar.
