Hypothyroidism in dog

10615967_4509428271902_7318235873151930765_nDr. Marta Todorova

Veterinary Clinic Ruse, Bulgaria

 

Clinical case

Case description

Dog , male , entire, five years old was evaluated because of signs of hair loss. The name of the dog is Ares. He lives in apartment with his owners.

History

About two years ago the dog has easily epilated hairs. The coat is typically thin on the neck  , on the head and on the trunk symmetrically. The is crusts  on the all body. Some parts of the skin are depigmented. Alopecia is growing to the tail. Hair regrowth non  existent.It was unhappy dog.

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Diagnostic approach

  • Skin tests
  • Brushing test- a lot of crusts
  • Scotch test – negative
  • Cytology – negative
  • Scratch test – negative
  • Trichogram – more hairs in telogen phase
  • Blood test – FT4 7.84 pmol/l

 

 

Therapy

-Levothyroxine 10micrograms/ kg/2twise daily

-Dermoscent – ones a week, for four weeks

-Dermacomfort

– washing with Sebolytic

 

There are visible results two months after therapy and the dog regained his previous behavior.

Blood test after therapy – FT4 19.17pmol/l

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Fibrosarcoma in rabbit

13645233_1318532268176553_6937383040185403316_n

Dr Spas Spasov

Dr Spas Spasov

United veterinary Clinic Varna, Bulgaria

 

Fibrosarcoma in rabbits are malignancy rapidly grow soft tissues tumor. Can affect cats dogs and rabbits . The couse of fibrosarcoma in rabbit also can be a viral infection (polyomavirus, malignant rabbit fibroma virus)

Clinical case

Case description
Rabbit, female , entire , 5 years old was evaluated because of sings of anorexia and apathy .
History
The owners reported  that a week ago the rabbit progressively stops  eating. The last two days it didn’t eat at all. Тhe rabbit has regularly deworming and vaccination.
The rabbit eats hay and rabbit granules only and lives in an apartment and  never go outside, there are no others animals in the apartment.

19679595_1713702035326239_246743106_n 19720422_1713702041992905_1551514530_o 19723892_1713702011992908_958302465_o
Clinical manifestations
Anorexia, cachexia, apathy, unilateral uveitis, normal temperature (38.5).
Clinical examination revealed all of the body (back, neck, abdomen and all the legs) nodules, which are not painful, mobile, not tempered and pigmented .The size of the nodules was variable from 1 to 5 centimeters.
Some nodules were ulcerated and bleeding, and still painless. Such formations are not observed in the nose and the ears, and the front part of the head.
Diagnostic approach:
We did not find any abnormalities on the X-ray examination of the chest and abdomen. A nodule was surgically removed by cutting.
Symptomatic therapy was appointed until the results of the histopathological examination:
Metoclopramide-0,5mg / kg
Ranitidine-4 mg / kg
Simethicone-65mg / rabbit
Meloxicam-1mg / kg
Enrofloxacin, 10 mg / kg
Intravenous infusion Hartman 4ml / kg / hour.
So designated therapy lasted about 10 days pending the results of pathological examination The condition of the animal slightly improved, which is expressed in phrases in appearance of appetite. The animal took small amounts of food.

Diagnosis:

Fibrosarcoma
The prognosis for this type of tumors is garded to poor. Because of poor condition of the patient and the prognosis owners decided to euthanased the rabbit.

FELINE PLASMA CELL PODODERMATITIS

okan 2

Dr Okan Kahraman

Case Presentation

 

Vet.Okan KAHRAMAN Greenpet Veterinary Clinic     İstanbul/Turkey

 

 

 

Signalament and History

. 3month unvaccinated female cat

. The cat licking the affected foot pads also smelling bad at foot pads sometimes lamess were observed

 

 

Pysical Examination

.All foot pads were affected

.Swollen,soft,ulcerated/erosions (also contaminated with bacteria )

.and some of them were paintful while pysical examination espacially whish one has ulcerated

.vital signs were completly well

okan 1

Picture 1

.photos (include each foot pads) ( Picure 1)

 

Laboratory results

. Just Leucocystosis other parameters were okay. FIV And FelV test was (-)

Differential Diagnosis.Plasma Cell Pododermatitis.FIV ,FelV.Autoimmune Dermatoses (pemhigus complex,lupus eryt.).Neoplasia

 

Diagnosis and Treatment.

Feline plasma cell pododermatitis .

prednisolon 1mg/kg X 2 PO (3 day ) after 3.

Day 4mg/kg Metilprednisolon asetat

S.c.cefovesin (convenia ) 8mg/kg S.C.

clindamycin 15mg/kg X 2 PO (5 day ) .

 

okan 3

Picture 2

After 10 days later Photos( Picture 2)

Scabies incognito in dog

stef artStroe Marina- Ștefania

6-th year student at FMVB, Faculty of Veterinary Medicine of Bucharest

Rottweiler dog, 1 year old, male, intact develop intense pruritus, mild erythema, crusts and less-hairy skin on the phalanges, hocks; no other cutaneous lesion than this diffuse erythema.

  • Other differentials (demodicosis, dermatophytosis, contact dermatitis, Malassezia dermatitis, hipersensitivity).
  • Pinnal-pedal reflex: rubbing of the ear margin and may obtain a scratch reflex.
  • The pinnal-pedal reflex in this case was positive
  • Microscopy

Superficial skin scraping: negative but false-negative results are commnon because mites are extremely difficult to find.

derm3

Macroconidia Alternaria alternata

derm2

Eggs/ova mites

Deep skin scraping: negative (for Demodex).

derm4

Malassezia spp.

Scotch test: detection of eggs/ova mites Sarcoptidae like, derm5 derm6Malassezia 8/OIF, bacterial cocci, macroconidia Alternaria alternata.

Serology (ELISA): detection of IgG antibodies against Sarcoptes. This is highly specific and sensitive test but false-negative results can occur. In this case the test was negative.

 

Diagnosis: “Scabies incognito”

 

Treatment and prognosis

  • Topical treatment applied to the entire body two times per week, 4-6 weeks. Bathing with a shampoo that contain chlorhexidine and antifungal (ketoconazole) – KetoHexidine shampoo 1%ketoconazole, 2%chlorhexidine.
  • Omega 3 and Omega 6 fatty acid supplements, which reduce inflammation and itching – Megaderm >10 kg, 1 dose/day, 1-2 months.
    • Systemic treatment with Ivermectin: 300-400 mcg/kg po or sc, once weekly for weeks. I use this scheme for 5 administration.
    • Recheck: progress, hair regrowth, decrease of the lesions.
    • The prognosis is good. S. scabiei is a highly contagious to other animals and to humans.

 

 

CANIN HYPERCORTISOLISM (CUSHING SYNDROM)

daniDr Daniela Bajenaru

Tazyvet veterinary clinic

Bucharest, Romania

 

Singalment and hystory

 

Bella, presented on 12/13/2016

10 year old, female, Labrador retriever

5 month history of polydipsia, polyuria, polyphagia and pruritus

 

Physical examination

 

Abdominal enlargement

Palpable hepatomegaly

Thin, hypotonic skin, easy bruising

Phlebectasias

Erythema

Calcinosis cutis over the dorsal neck, thorax and rump

Bacterial pyoderma

 

 

 

6 1 unnamed7

 

 

 

8 9 4 10

Investigations

Ultrasound

Urinalysis

Coagulation time

Serum chemistry panel

Trichogram, scoch test

Bacteriological examination

ACTH stimulation test

 

Laboratory results

Ultrasound- hepatomegaly

Urinalysis – low specific gravity (1.005)

Coagulation time – 5’

Serum chemistry panel: GPT -361,  ALP>1980, CHOL- 215, CREA -0,587, UREA -25,2

Trichogram/ scoch test – no significant findings

Bacteriological ex. – Staphylococcus aureus  (++++)

Basal cortisol level  > 10 µg

ACTH stimulation test – cortisol= 29,4 µg/dl

Diagnosis

CANIN HYPERCORTISOLISM (CUSHING SYNDROM)

SUSPICION: PITUITARY DEPENDENT

 

Treatment

TRILOSTANE -120 mg once daily

Amoxicillin with clavulanic acid -12,5 mg/kg/12h, 30 days

Probiotics

Topical: – moisturizing and desinfectant shampoo, once weekly

– antiseptic, anti inflammatory and healing gel, once daily

EFA supplements

Diet: low fat

EVOLUTION

After 3 days of topical treatment

15

After 3 days

Basal cortisol level      > 10 µg/dl

13

After first bathing

 

 

Bella1

21

After 7 weeks basal cortisol – 5,3 µg/dl

22

After 7 weeks basal cortisol – 5,3 µg/dl

Bella3

The evolution to be continued ….

Non-epidermolytic ichthyosis in rabbit- case report

13645233_1318532268176553_6937383040185403316_n

Dr Spas Spasov

Dr Spas Spasov
United Veterinary Clinic
Bulgaria
Varna.

 

   Case presentation:

Rabbit nine months old , female  entire.She was presented  to the clinic with a history of progressive hair loss over the last two months. The rabbit came as a second opinion from another practice where she was treated for mange mites for a month with Doramectin and  a month treatment for dermatophytes without result of both treatments.
A clinical examination found:
Generalised alopecia, yellow crusty skin,pododermatitis over the pelvic limbs and  abnormal skin elasticity.

 

 Diagnostic approach.

*microscopic examination- Negative for ectoparasites
*Punch biopsy-  There is  diffuse thickening of the  epidermis characterized by laminated stratum corneum with disproportionate  thickness than the underlying nucleated epidermis. Focal parakeratosis is also present. The epidermis is mildly to moderately achantotic. The follicular infundibulum is greatly distended by keratin. The granular layer of the epidermis exhibits different sizes of keratohyalin granules (hypergranulosis). Superficial dermis  lacks  follicular and adnexal structures. Few intact sebaceous glands are present. There is  no evidence of  neoplastic cells, parasitic/mycotic/fungal or bacterial elements in the examinated sections. The histological appearace is consistent with non-epidermolytic ichthyosis.spas-1spas

 

   Treatment:

Treatment was undertaken to support body hydration, using megaderm( omega three  and six fatty acids,linolenic acid,GLA,EPA,DHA )in order to  strengthen the skin structure.  pain medication(meloxicam 0.2mg/kg ), and antibiotic therapy(Procaine penicillin 150,000 IU per mL. Benzathine penicillin 150,000 IU per mL. ) to control the bacterial infection of the feet.
There was an option for treatment microneedle therapy, but the sample for histopathological study did not showed hair follicles.

After one month of therapy the  rabbits skin had  significantly improved.  However pododermatitis had worsened and abscesses had formed  over the limbs.
Due to failure of antibiotic  therapy and deteriorationof pododermatitis, the decision was to euthanase the rabbit.

 

   Discussion

Ichthyosis is a inherited genetic disorder that occurs both in humans and in animals characterized by diffuse  keratinization  of the surface layer of the skin.  The disease develops as a result of gene mutation that is passed from generation to generation.
Ichthyosis studies are more for dogs and cats, and not so much about rabbits. There is not much information regarding the classification of rabbit Ichthyosis and details of treatment or maintenance therapy.
Affected BreedsThe West Highland White Terrier and the Golden Retriever are the breeds most predisposed to this disease

Green coat, hypothyroidism,lymphoma and carcinoma of the sebaceous glands.

13645233_1318532268176553_6937383040185403316_n

Dr Spas Spasov

Dr Spas Spasov

Unites Veterinary Clinic

City of Varna, Bulgaria

 

   Case presentation:


    A twelve year  old female, entire Labrador Retriever, presented with skin ulcers over the low lid region of the eyes, feet, face, back and legs.
According to  the owners  the animal has become more lethargic, less active  on walks and not as playful in the last twelve months.They attributed this to the age of the animal.
At referring vet took a  blood sample to do hematology and biochemistry, which did not show abnormalities. They  treated the animal with amoxicillin with clavulanic acid.123

   Diagnostic approach.


*microscopic examination- Negative for ectoparasites
* impression smear- Colonized neutrophils with cocci bacteria.
* microbiology- Staphylococcus aureus pure culture sensitive to amoxicillin with clavulanic acid* Level of TT4 in blood was Low <6 nmol/L

456
   Treatment:


   * Local therapy shampoo containing benzoyl peroxide. Name(Peroxyderm)
* Systemic antibiotic – amoxicillin with clavulanic acid.
* Levothyroxine 0.2mg / kg once daily.
  Follow up:
Two weeks after starting treatment, the owners reported that  Cleo feels much better  and has increased her exercise activity and she is playful.  There were fewer skin ulcers predominantly over the front legs and around the eyes but  ulcers were superficial.
The follow up examination showed a shiny healthy coat,  with  few skin lesions on the legs.

The only thing that worried the owners was that Cleo’s neck had turned green.
Blood was taken to test her TT4 levels and to determine whether we need to change the dose of levothyroxine.
I believe the reason for the green coat is probably heavily chlorinated water and frequent bathing at the beginning of therapy. (This is not proven by research).1112
The levels of levothyroxine were low at 11nmol/L  and so there was a need to increase the dose.
Due to personal reasons, the owners could not make a follow up consult for another month.Their next visit was actually about three months later and the situation with Cleo was extremely poor.131415
The skin ulcers were much larger and bleeding, and her lymph nodes were double the size. Ulcers on her face were approximately 5cm in diameter.
An abdominal ultrasound was performed and showed enlarged mesenteric lymph nodes. Fine needle aspirates of the enlarged lymph nodes and punch biopsies of the skin were taken at this time.
The result of the FNA revealed- The cell population is homogeneus excibiting several blastic cells, with granular cromatin and inconspicuous cytoplasm. Several mitotic figures are also present. Random, plasma cells are observed accompaniating  the neoplastic lymphoblasts.
The result of the skin punch biopsy revealed changes characteristic of Sebaceous carcinoma.
Based on the new evidence and the results, chemotherapy was recommended but the owners declined.
They agreed to a less aggressive therapy with oral prednisolone 2mg/kg , levothyroxine 0.3 mg/kg and gabanevral 10mg/kg  and local therapy with prednisolone.
Six months later, Cleo’s disease was stable, with significantly smaller lymph nodes and skin lesions.

Diagnosing the allergic patient: a practical approach.

unnamedAlberto Martin Cordero, D.V.M

VETDERM: Dermatologia Veterinaria Especializada.

                Argentina 690, Guadalajara, Mexico

                   vetderm25@gmail.com

Allergic disease in animals and humans is a common condition. In dogs and cats is considered one of the main dermatosis affecting around 10% of the population. It is a pruritic, inflammatory, chronic disease with breed predisposition (1). Understanding the physiopathology and clinical characteristics is mandatory not only for the clinician, but the owner itself, due to the fact, most of the long-term treatment and management it is done by clinician-owner collaboration.

 

First of all, one of the main characteristics we may find on an allergic patient is pruritus. Pruritus is defined as the unpleasant sensation that triggers the desire of itching, this may be manifested as chewing, biting, licking, scratching or rubbing in our patients; due to this manifestations the clinician must be aware that most owners will associate pruritus only with itching, by this matter, a correct approach for the clinical history should be done addressing this questions correctly to include most of the manifestations of pruritus.

 

We must try to obtain a complete clinical history of the patient condition.

 

The second step is to rule out the common causes of pruritus. Bacteria, yeast and scabies may enhance or be the main cause of pruritus in some patients, however, the first two, most of the time have an underlying cause.

 

The clinician must use basic tools like skin scraping and cytology in order to detect secondary infection or scabies.

 

Scabies and allergies

 

Scabies may be a “tricky” condition; is capable of emulate perfectly clinical signs associated with allergic disease, leading to a misdiagnosis and even to therapeutic mistakes. A negative skin scraping is not guarantee of absence of the Sarcoptes mite, by the other way, the chances of finding the mite or its ova are around 30% performing a correct superficial skin scraping technique.

 

Some tips we may use in order to detect scabies are: low response or non-response of pruritus to corticosteroids, positive pinnal-podal reflex, and ear margin affectation.

 

Allergic patients respond fairly well to corticosteroids administration, being one of the most used therapies for short and middle management of pruritus. Its use must be concomitant to cautions by the clinician about side effects. Nevertheless, patients with scabies normally have a poor respond to corticosteroids. The clinician must be aware of the existence of secondary infections by bacteria or yeast, due to the fact they are able to exacerbate itch.19181716

 

Pinnal podal reflex is obtained by vigorously rubbing the tip of one earflap on to the base of the ear for five seconds, and it is considered positive if the ipsilateral hind leg made a scratching movement. On a recent study the specificity of testing for scabies by the pinnal-pedal scratch reflex was 93.8 per cent, and the sensitivity was 81.8 per cent (2). This test is not pathognomonic for Scabies, however is really helpful in determining if we need to establish a therapeutic trial to diagnose scabies.20

 

In the same study ear margin affectation was evaluated 73% of the dogs with scabies had pinnal dermatitis. Crust or desquamation of the ear margin is characteristic of scabies in some pruritic patients.

 

Therapeutic trial in scabies is referred to the administration of therapy for scabies and observation of diminish of the clinical signs to confirm the disease.

 

Once scabies have been ruled out, secondary infections by bacteria or yeast must be eradicated using the respective therapy. Cytology must be performed on the affected areas of the allergic patients in order to detect microorganisms.11

 

            Clinical signs of allergic disease.

 

Dogs and cats manifest differently clinical signs related to allergy. Differentiating a patient with food allergy or atopic dermatitis only with clinical manifestations is not an exact or easy task.10

 

Dogs and cats with food allergy or environmental components of allergy react the same and may have the exact pattern of lesions.15

 

Lesions normally occurring in allergic dogs are: papules, pustules and epidermal collarets characteristics of secondary bacterial infection; ear disease: pinnal erythema, otitis externa; erythema of: periocular region, axilla, ventral neck, chest, flexor surface of the elbow, interdigital areas, inguinal region, perianal region (3).

 

If we carefully perform and examination of the ear canal we may find mild clinical signs of allergic ear disease as react of the ear canal glands, erythema or mild inflammation of the ear canal. The author recommends exploring the ears on all patients suspicious of allergic disease.14

 

Flea allergic dermatitis or a flea component in the allergic patient may show clinical sign on the dorsolumbar region; and in some cases, flea feces “flea dirt” or the flea itself may be found.

 

Some patients may develop moist acute dermatitis “hot spots” on the lateral aspect of the head (this may be related with otitis externa) or in the dorsolumbar region (related to flea allergy); however, we must recall that moist acute dermatitis is not solely related to allergic disease.698

 

Cats may be develop any of the eosinophilic granuloma complex lesions as well as military dermatitis, feline acne, excoriations of the neck and on the back of the head, alopecia by excessive grooming. Secondary bacterial infections are not common in cats as in dogs.12

 

 

 

            Otitis externa in the allergic patient.

 

Otitis externa is defined as the inflammation and subsequent infection of the external ear canal. The causes and factors of otitis externa may be divided in 4 according to a classification proposed by Griffin. Predisposing, primary, secondary and perpetuating factors of otitis externa is the most accepted classification at this moment and is currently used by the author in patient classification.

 

Predisposing factors include: anatomical characteristics of the ear canal, such as hairy or stenotic ears, excessive moisture, and overtreatment with ear cleaners or swabs.

 

Primary factors include allergies, keratinization disorders, autoimmune and immune mediated conditions, endocrine diseases, and foreign bodies. Being allergy one of the main causes for recurrent otitis externa especially in dogs (4).

 

Secondary factors are related to bacteria or yeast infection.

 

Perpetuating factors normally are related to chronic pathological changes of the structure of the ear canal as well as complications within the middle ear.45

 

 

Evaluating level of itch

 

Pruritus level must be evaluated in allergic patients, a visual analogue score published by Hill et al., allows owner to effectively assess pruritus using a scale form 0 to 10 (5). This scale may be used at the rechecks or during the administration of allergen specific immunotherapy.3

 

Favrot criteria.

 

Favrot criteria are useful as a clinical aid in the diagnosis of canine atopic dermatitis (6). Following this criteria in combination with ruling out pruritic skin disease reduce the probabilities of false diagnosis of canine atopic dermatitis. Favrot criteria include:

 

  • Age of onset < 3 years
  • Mostly indoor
  • Corticosteroid responsive pruritus
  • Chronic or recurrent yeasts infections
  • Affected front feet
  • Affected ear pinnae
  • Non affected ear margins
  • Non affected dorsolumbar area

 

Establishing allergic components in the patient.

 

Allergic patient may have an environmental component, food component or flea allergic dermatitis. We must resist temptation to separate allergic diseases in all this major three allowing a patient to be diagnosed as “allergic”. Our diagnostic goal is to identify the allergenic components in the patient, being aeroallergens, food ingredients, flea or insects; separate or altogether in order to create a control plan for each individual (7).alberto 1

 

Patients with non-seasonal pruritus must be suspicious for food allergy, especially if the have gastrointestinal signs present. Questions like number of bowel movements, form of the feces, gases and increase of intestinal noises should be asked to owners. A recent study was able to determine the average number of bowel movements per day as 1 to 3 in 96% of the dogs of the study (8).

 

A correct restrictive diet must be performed in non-seasonal pruritic patients in order to confirm or rule out food allergy. The average length of the food trial is for 6 to 8 weeks (9). During this time, clinician must use hydrolyzed diet, novel protein diet or home cooked restrictive diet with limited ingredients.

 

Hydrolyzed proteins are composed by proteins chemically and physically “broken” in small particles. The smaller the allergen, smaller the capability of the IgE to catch this proteins even if the y are allergic to them. Prescription hydrolyzed diets claim a protein size from 3,500 to 10000 Daltons; novel diets mainly composed by amino acid ingredients claim a size lower than 1000 Daltons. Some studies have evaluated that up to 21% of patients with food allergy may react to hydrolyzed proteins (10).

 

 

The principle of using a novel protein diet is to administer ingredients to which have never be exposed before. The problem with “novel proteins” especially in over the counter pet foods are that the novel ingredients shown are only part of the ingredients contained and common ingredients in pet foods are generally used as additives. The clinician must advise pet owner to read all the ingredients in the dog food in order to avoid previously ingested ingredients. Even tough, another problem is secondary contaminants particles that may be found in “selective ingredients” pet foods as a result of the manufacturing process. A recent study evaluated secondary contamination by PCR and microscopically analysis of several commercial diets used on food trials (11).

 

Home cooked diets with limited ingredients seem, to be the best choice to perform a food trial, however, owner availability to cook for their pets, acceptance by the patient or choose of the correct ingredients are important factors to consider before prescribing this choice.

 

A good, low hydrolyzed prescription diet with small particle size is commonly the best choice to diagnose food allergy in dogs and cats.

 

Pruritus may be controlled the first couple of weeks of the food trials to avoid further injures using shot term pruritic management as short length corticosteroids or oclacitinib to diminish the initial clinical signs. Anti pruritic therapy should be discontinued in order to correctly evaluate the response to the restrictive diet.

 

During the food trial, owner and clinician will observe one of three manifestations: absence, diminish or continuation of pruritus.

 

An absence of pruritus should be continued with a re exposure to the previous ingredients or pet food ingested by the patient, and during the first week, clinical signs must re appear confirming the diagnosis of food allergy.

 

Diminish of pruritus must be addressed as previously stated with a re challenge to pet food, however, in this case, possibility of aeroallergens reaction must be suspected. The patient could be diagnosed as a patient with atopic dermatitis with a food allergy component.

 

Continuation of clinical signs after or during the food trial could lead us in the direction where no food allergy exist, but aero allergens and insect allergen may be the primary allergenic cause in the patient. Re challenge to previous diets is not needed on this case.

 

Allergy testing.

 

Allergy testing is reserved for the elaboration of allergen specific immunotherapy, an effective treatment for hyposensitize patients with environmental allergies. This test may be performed by intradermal application of allergens as well as measuring specific IgE in serum. Allergy testing should not be used with the purpose of diagnosing a patient with canine atopic dermatitis, must be strictly reserved for the elaboration of “allergy vaccines”, that are mixtures of allergens to which the patient is reactive and are applied with increasing concentrations in order to decrease future sensitization.13

 

Establish allergic patient management.

 

A short term, middle and long-term control management for the patient with environmental allergies must be created once we rule out other allergies and pruritic causes (11).

 

Short-term control management of the allergic patient includes:

  • Elimination of secondary bacterial and yeast infections. (identify these by cytology)
  • Short-term control of pruritus with topical or systemic corticosteroids, or oclacitinib administration.
  • Topical therapy with shampoos to control infections or moisturize the skin and coat

 

Middle term control management includes:

 

  • Restoration and improvement of epidermal barrier with essential fatty acids (EFAs) or topical essential oils
  • Prescription diets focused in improving epidermal barrier and diminish pro inflammatory factors
  • Anti pruritic control with Oclacitinib, oral cyclosporine, or corticosteroids (evaluate side effects and monitor the patient)
  • Concomitant use of soft topical steroids like hydrocortisone aceponate (when needed)
  • Topical therapy with moisturizing and epidermal barrier improvement shampoos.

 

Long term control management include:

 

  • Anti pruritic control with Oclacitinib, oral cyclosporine, or corticosteroids (evaluate side effects and monitor the patient)
  • Concomitant use of soft topical steroids like hydrocortisone aceponate (when needed)
  • Topical therapy with moisturizing and epidermal barrier improvement shampoos.
  • Administration of allergen specific immunotherapy based on allergy testing (in vitro or intradermal)
  • Antimicrobial therapy for bacteria and/or yeast (if needed)

 

REFERENCES

 

  1. Hillier, A., & Griffin, C. E. (2001). The ACVD task force on canine atopic dermatitis (I): incidence and prevalence. Veterinary Immunology and Immunopathology, 81(3-4), 147–151.
  2. Mueller RS, Bettenay SV, Shipstone M.. Value of the pinnal-pedal reflex in the diagnosis of canine scabies. Vet Rec. 2001 May 19;148(20):621-3
  3. Griffin, C. E., & DeBoer, D. J. (2001). The ACVD task force on canine atopic dermatitis (XIV): clinical manifestations of canine atopic dermatitis. Veterinary Immunology and Immunopathology, 81(3-4), 255–269.
  4. Saridomichelakis, M. N., Farmaki, R., & al, E. (2007). Aetiology of canine otitis externa: a retrospective study of 100 cases. Veterinary ….
  5. Rybníček, J., Lau-Gillard, P. J., Harvey, R., & Hill, P. B. (2009). Further validation of a pruritus severity scale for use in dogs. Veterinary Dermatology, 20(2), 115–122. Favrot, C., Steffan, J., Seewald, W., & Picco, F. (2010). A prospective study on the clinical features of chronic canine atopic dermatitis and its diagnosis. Veterinary Dermatology, 21(1), 23–31.
  6. Hensel, P., Santoro, D., Favrot, C., Hill, P., & Griffin, C. (2015). Canine atopic dermatitis: detailed guidelines for diagnosis and allergen identification. BMC Veterinary Research, 11(1), 1–13.
  7. Stetina, K. M., Marks, S. L., & Griffin, C. E. (2015). Owner assessment of pruritus and gastrointestinal signs in apparently healthy dogs with no history of cutaneous or noncutaneous disease. Veterinary Dermatology, 26(4), 246–e54.
  8. Olivry, T., Mueller, R. S., & Prélaud, P. (2015). Critically appraised topic on adverse food reactions of companion animals (1): duration of elimination diets. BMC Veterinary Research, 11(1), 1–3
  9. Habil, F. P. G. D. M. V. D., & DVM, S. R. M. (2011). Adverse Food Reactions in Dogs and Cats. Veterinary Clinics of NA: Small Animal Practice, 41(2), 361–379
  10. Ricci, R., Granato, A., Vascellari, M., Boscarato, M., Palagiano, C., Andrighetto, I., et al. (2013). Identification of undeclared sources of animal origin in canine dry foods used in dietary elimination trials. Journal of Animal Physiology and Animal Nutrition, 97, 32–38. Olivry, T., DeBoer, D. J., Favrot, C., Jackson, H. A., Mueller, R. S., Nuttall, T., & Prélaud, P. (2015). Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA). BMC Veterinary Research, 11(1), 1–15

Dermatology – Part 1

svetlina

Dr Svetlina Alexandrova DVM, Member of ESVD

Light Vet Clinic, Bulgaria

 

 

1ST THING TO DO IS SKIN SCRAPING!!!

 

derma 14

Slide, mineral oil (lactophenol, glycerin, liquid paraffin), blunted scalpel blade and coverslip

1ST THING TO DO IS SKIN SCRAPING!!!

 

 

 

 

 

 

1.SARCOPTES SCABEI VAR. CANIS    

 

               Even if you don`t see it, treat it!

sarc

SARCOPTES SCABEI VAR. CANIS

sarc2

SARCOPTES SCABEI VAR. CANIS

Some treatment options:

Selamectin spot on 3 x every 2 weeks;

Moxidectin spot on 3 x every 2 weeks;

Ivermectin 0,2-0,4 mg/kg s.c. 4 injections every 7 days (not licensed for this use, heartworms test, MDR1 gene mutations);

Fipronil spray 3 mg/kg at 14-day intervals

 

 

2.DEMODEX SPP

 

 

Important note for all parasites search: closed diaphragm of the microscope and less light; scan the entire slide using 10X objectivederma

demo

DEMODEX SPP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.NEOTROMBICULA AUTUMNALIS (skin scrapings)

 

Clinical signs late summer and fall.

Some treatment options:

Fipronil spray

Parasiticidal dips

derma5

NEOTROMBICULA AUTUMNALIS

derma6

NEOTROMBICULA AUTUMNALIS

 

 

 

 

 

 

 

 

4. CHEYLETIELLA SPP. (skin scrapings, tape strip test)

 

Some treatment options:

Selamectin spot on every 14- to 30-day intervals

Ivermectin 0,2-0,3 mg/kg sc 2 injections at 14-day intervals

Fipronil spray

derma9

CHEYLETIELLA SPP.

derma10

CHEYLETIELLA SPP.

 

 

 

 

 

 

 

 

 

 

 

5.TRICHODECTES CANIS (coat brushing)

 

Some treatment options:

Selamectin spot on every 14- to 30-day intervals

Ivermectin 0,2-0,3 mg/kg sc 2 injections at 14-day intervals

Fipronil spray

derma11

TRICHODECTES CANIS

derma 12

TRICHODECTES CANIS

 

 

 

 

 

 

 

 

 

 

 

6.DERMATOPHYTOSIS  (tape strip test, wood lamp, fungal culture)

 

Some treatment options:

Topical therapy: enilconazole rinses, miconazole…

Systemic therapy: itraconazole, ketoconazole

derma13

DERMATOPHYTOSIS

derma 3

DERMATOPHYTOSIS