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Clinical signs of dermatologic disease should be discussed in lay terms with clients. For example, many owners may not consider excessive licking a sign of pruritus. They may answer in the negative when asked “Is your dog itchy?” even if the dog is up half of the night licking its paws. Use wording such as chewing, rubbing, scratching, licking, and shaking. Determine the initial problems (redness, rash, hair loss, color change, bumps, etc.) and disease progression. The client can also provide information about locations of problems, as some (such as pruritus) may not be obvious on physical examination.

Dermatologic cases are frequently chronic and require repeated clinic visits for successful management. The client should provide their interpretation of the patient’s pruritus level at each visit. There are two ways to do this. The first is a numeric rating scale where the owner selects a number from 0 (no itching) to 10 (severe, constant itching). The second is using a visual analog scale, as shown in Figure 2.2. The client makes a mark on the line indicating their pet’s level of pruritus. Having the client reassess the patient’s pruritus at each appointment, and recording this data, can help determine if a patient has responded to therapy. Some clients may get frustrated if they think their pet’s itchiness is not decreasing. However, the evolution of the pruritus score may demonstrate improvement by recording the initially higher pruritus score that they are not remembering.