How to measure pruritus: PVAS, CADESI-04 and a diary
5-year-old Cocker Spaniel with atopic dermatitis on maintenance treatment. At the check-up it does not scratch at all, but the owner cannot say whether it has improved.
What is the best way to assess response to treatment?
chevron_right Show answer and explanation
A. Count how many times it scratches during the consultation
Many dogs suppress scratching in the clinic due to stress or distraction. What you see in a few minutes does not reflect day-to-day pruritus.
B. Repeat the CBC and assess the eosinophil count
Peripheral eosinophilia is inconsistent in atopic dermatitis and does not correlate with pruritus severity.
C. Measure allergen-specific serum IgE at each check-up
IgE levels do not reflect clinical severity or treatment response; serology is only used to select allergens for immunotherapy.
D. Owner-scored pruritus visual analogue scale (PVAS), CADESI-04 lesion score in the clinic and a diary of pruritus, treatments and possible triggers
Correct. The PVAS (0–10 with behavioural descriptors) is validated for owners to score pruritus, and CADESI-04 quantifies lesions. The diary helps link flares to seasons, foods or treatment changes.
lightbulb Key takeaway
Ask the owner to score pruritus on the same scale before every treatment change and at every check-up. A reasonable goal is to approach values similar to those of a healthy dog, not the complete absence of scratching.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.