Feline atopic skin syndrome (FASS) is a chronic and often frustrating condition for cats and clients. Effective management requires clear communication, setting realistic expectations, and fostering a collaborative approach. This article explores strategies for managing diagnosis and treatment goals for patients with FASS, including tips on effective communication, treatment options, costs, and monitoring.
Setting Realistic Expectations
The most important aspect of managing FASS is emphasizing chronicity with no cure. Treatment should focus on identifying triggers, managing signs, reducing flare-ups, and maintaining quality of life.
Key Points to Consider
Diagnosis of exclusion: FASS may resemble other allergic (eg, flea allergy, food allergy), ectoparasitic, viral, fungal, and neoplastic conditions and behavior disorders that can occur concurrently. A stepwise approach to eliminating differentials while relieving clinical signs is important but may come with financial, compliance, or comorbidity roadblocks.1
Chronic disease: FASS is a lifelong condition that can often be controlled, but ongoing management is necessary.2
Variable treatment response: Not all cats respond to or tolerate the same treatment; finding the right therapy may take time.3
Flare-ups and remission cycles: Flare-ups can occur even with effective treatment.4
What a Conversation With a Client May Sound Like
Clinician: Allergies are a lifelong disease. We can control the signs, but we need to manage flare-ups in the long term. The goal is to find the triggers so we can reduce itching and inflammation as much as possible.
Client: So this won’t go away?
Clinician: Correct, but with proper care, we can minimize the impact on your cat’s quality of life.
Communicating Treatment Options & Costs
Clients may expect a quick fix, but successful management requires accurate diagnosis and combined therapy options provided over time, including parasiticides, dietary changes, topical treatments, oral medications, immunotherapy, and antimicrobials.
Key Points to Consider
Treatment selection: Anti-inflammatory (eg, glucocorticoids, cyclosporine, immunotherapy5) selection depends on condition severity, response to treatment, treatment tolerance, client finances, route of administration, and patient comorbidities.
Cost considerations: Clients should be informed of costs of medications, diagnostics, and follow-up monitoring.
Team troubleshooting: Good communication with the client can help improve treatment effectiveness and promote working together to come up with solutions for common roadblocks.4
What a Conversation With a Client May Sound Like
Client: How much will this cost? Will my cat need medication for the rest of their life?
Clinician: We will review a breakdown of initial tests and possible further allergy testing. Medications have ongoing costs; however, costs typically stabilize with a maintenance plan. The goal is to identify triggers, minimize flare-ups, and make adjustments based on response.
Client: They may not need medication every day?
Clinician: Exactly; some cats need daily treatment, but others only need treatment every other week or only during flare-ups. We will monitor your cat and adjust treatment as needed.
Long-Term Monitoring & Collaboration
FASS is a dynamic disease, meaning a cat’s needs may change over time. Treatment that works at one stage may not be effective later due to disease progression. Regular follow-up appointments and communication with clients are essential.
Key Points to Consider
Follow-ups: Clients should expect their cat to undergo regular check-ups that evaluate treatment efficacy and adjustments.4
Communication and support: Clients should be encouraged to reach out to the clinic between visits, as this builds trust and allows issues to be addressed early. Veterinary support staff should be trained to answer common questions.4
Adjusting expectations: The treatment plan should evolve with the disease, and goals will therefore need to be revisited and adjusted regularly.5
What a Conversation With a Client May Sound Like
Clinician: Let’s plan a follow-up visit in 4 to 6 weeks to see how your cat is responding to the treatment. We may need to make some adjustments.
Client: What if something comes up before then?
Clinician: If you notice any new signs or think signs are getting worse instead of better, please contact us so we can make any necessary changes to keep your cat comfortable.
Maintaining Client Engagement
Providing clear communication, setting realistic expectations, and offering options is crucial for client engagement. Clients who feel informed and supported are more likely to stay committed to managing this disease.
Educational Tools
Appointment times are usually limited, and clients do not always retain information from the visit. Tools like the author’s Your Vet Wants You to Know podcast may be helpful. This edutainment resource reinforces important points, provides clarity, and can help improve efficiency and treatment outcomes.