Color dilution alopecia

 

Dr Daniela Bajenaru

Dr Daniela Bajenaru

Bajenaru Daniela (Tazy-vet), Bucharest, Romania

 

 

History

Jack, metis, 5 months, adopted from a shelter and treated against Parvovirus infection.
Prinary lesions: alopecia areas on the head, no other types of lesions were observed.
Two weeks after parvovirosis episode, dermatological problem has begun to progress2

 

Physical examination

Poor quality of the hair coat, the hair was thinner and dry
Symetrical hair loss on the auricular pavilions.
Progressive, partial, patchy alopecia and stubble
Non-inflammatory lesions
Non-pruritic31

 

 

 

Investigations

Wood’s lamp examination
Microscopic examination of the skin scrapings
Hair plucks (trichoscopy)
Fungal culture
Biopsy
Histopathological examination

 

Differential diagnosis

 

Dermatophytosis
Demodicosis
Pattern baldness
Color dilution alopecia and other fololicular dysplasias

Laboratory results

Fig.1 Trichoscopy

Fig.1 Trichoscopy

Wood’s lamp examination- Negative
Microscopic examination of the skin scrapings- Negative
Trichoscopy- irregular distribution and clumping of melanin which distorts the hair shaft.
Fungal culture- Negative
Fig 1,2,3,4- Trichoscopy examination: large grains of melanin which distorts the hair shaft.

 

fig 3

fig4

fig4

fig 2

fig 2

 

 

 

 

 

 

Skin biopsy and histopathology reveal macromelanosomes, melanin clumping and follicular dysplasia.

 histopathology reveal

histopathology reveal

 

Diagnosis

COLOR DILUTION ALOPECIA

Treatment

There is no effective treatment for this disorder. The disease is progressive and incurable.
avoiding excessive brushing and shampooing
antimicrobial and keratinolytic products only when needed A high-quality DIET and essential fatty acids20170330_18223220170330_181007

Evolution

after 6 months

evolution

evolution

evolution

Erythema multiforme or TEN (toxic epidermal necrolysis – toxic shock syndrome)

stef art

Marina-Ştefania Stroe, DVM

Marina-Ştefania Stroe, DVM

Romania

History

Dog, half breed, M, intact, 4 years old, unvaccinated and without treatment for intestinal parasites, fleas and ticks, 10.2 kg.

The main concern was the ophthalmologic problem.

Three weeks ago he had problems with the hind limbs and he had difficulty in moving. Previous treatments: meloxicam, gentamicin, steroidal anti-inflammatory.

The possibility of ingestion of a toxic (plant / substance) is not excluded.

Clinical exam

-white mucous membranes, no lesions in the oral cavity;

-necroses in the auricular pavilions with a visible marginal line, foreskin necrosis, yellow crusts and areas of necrosis predominantly on the posterior limbs, tail, dry-looking fur, which is easily detached;

-after detachment, the skin is denuded, ulcerated, very painful on palpation;

-cutaneous hyperesthesia;

-minimal normal auricular secretion;

-corneal erosions, dry eyes, agglutinated secretions at this level;

-faded cardiac noise; imperceptible pulse;

-rectal examination: doughy feces consistency, normal color;

-abdomen in tension;

-blood pressure (indirect oscilometric metod): 138/102 (112 mmHg).

Picture4Picture3

TESTS

-Chest and abdomen rx and ultrasonography: free fluid; enlarged spleen.

-Ultrasound guided abdominal puncture: yellowish ascitic fluid, orange tint, after spinning small, white deposit. Protein: 1 g / 100 ml.

-Blood tests: low red blood cell counts, thrombocytopenia, leukocytosis, granulocytosis; elevated liver transaminases, bilirubin and amylase normal values, normal kidney parameters.

-Bleeding time: normal.

-Negative tests for infectious diseases.

-Abdomenocentesis: 335 ml of ascitic fluid and cytological exam: MODIFIED TRANSSUDAT WITH ERYTHROCYTE POLLUTION

Picture6

Fig 10

Picture5

Fig 9

Fig. 9: Cutaneous cytology, direct impression smear from necroses of the pinnae (Fig.10): nonsegmentated immature young neutrophils, lymphocytes, few macrophages in whose cytoplasm are found bacilli, bacterial population predominantly represented by bacilli, but also cocci, oxyphilic cell matrix

Fig. 11: Cutaneous cytology, direct impression smear from yellow scale, tail (Fig. 12): neutrophils in all stages: mature segmented, degenerative stage, but also young with eukromatic nucleus and evident nucleoli, macrophages with basophilic cytoplasm, slightly vacuolized, eucromatic nucleus, nucleic streamming, erythrocyte infiltrate.

Fig. 14: Tape prep from yellow scale, hind limb

keratinocytes on the surface of which are attached cocci, degenerate inflammatory cells

Picture7(1)

Fig 11

Picture8(1)

Fig 12

Fig. 13: Trichogram – hair with normal structure, some hair with degraded cuticle, rap A / T: 4/6, follicular cast, negative for demodex and dermatophytes.

Picture10

Fig 14

Picture9

Fig 13

Superficial and deep skin scrapes: negative.

 

 

 

 

 

 

 

 

 

 

 

 

Picture11

Fig 15

Fig. 15:

-Direct and consensual pupil reflex present;

-Reduced visual acuity;

– Schirmmer test 0 mm / min;

-Florescein test: Positive

Diagnosis: OU Corneal melting ulcer F +

Diagnosis and other differentials

Blood smear, cell morphology: moderate, hypochromic, regenerative anemia,; leukocytosis, neutrophilia, moderate non-specific cellular toxic status, eosinopenia, lymphopenia. In this case, the leukogram (neutrophilia, eosinopenia and lymphopenia) may suggest treatment with corticosteroids, stress, hyperadrenocorticism, severe inflammation (chronic) with various etiologies (viral, bacterial, fungal).

Skin biopsy: histopathological aspects advocate for hyperkeratosis with paracheratosis and chronic inflammatory response involving the epidermis, jonctional area and superficial epidermis.

Final diagnosis

Histopathological aspects may show Erythema multiforme or TEN (toxic epidermal necrolysis – toxic shock syndrome), which is a late reaction, surprised in a chronic, secondary phase due to fibroblast proliferation.

 

The toxic shock syndrome may be a reaction to drugs, chemicals or food

 

Treatment

Enrofloxacin (dose: 5 mg / kg) at 12h po;

Amoxicillin and clavulanic acid (dose: 20 mg / kg) at 12h po;

Furosemide (dose: 5 mg / kg) at 12h iv;

Tramadol (dose: 2mg / kg) at 12h iv;

Parenteral nutrition;

Bathing (chlorhexidine);

Acetylcysteine, Tobrex, Corneregel 6-7 times / day (lack of tears).

 

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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dav

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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

dav

dav

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)

Indolent ulcer reason of flea alergy case

Dr Okan Kahraman, Green Pat Veterinary Clinic

Istanbul, Turkey

conv

20 mg metilprednisoln asetat im just one time

0,5 convenia

10 day later it was okey !

Good job!

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.