Panda mouse- case presentation

67668506_2745972975432468_1475995593221341184_nDr Spas Spasov

Veterinary Center Dr Antonov

Varna, Bulgaria

Case presentation

Whole family of Panda mice (two adults and 12 babies) were presented at the clinic with acute and severe Pruritus and progressive history of hair loss for the past two weeks.894602907_220806952540902_4939403224386895872_n

 

 

 

 

 

 

 

Clinical signs:

Severe Pruritus, Hypotrichosis, Seborrhea and secondary scratch wounds.

These symptoms are presented in all of the 14 mice.

Diagnostics:

1 4 7

Scotch tape samples from two of the babies and both adults.

All samples were positive for the parasite Myocoptes musculinus (dozens – male, female and eggs).

copro 1

Coproparazitologic sample

copro 2

Coproparazitologic sample

Fecal samples (native and flotation) were done – both were negative for endoparasites and positive for mites (adults and eggs).

32

Treatment:

Once a week – Ivermectine spot on and disinfection of the enclosure.

 

Data:

Myocoptes musculinus is the most common parasite in mice.

Typical affected areas are the neck, the head and the shoulders.

Oral Ivermectin doesn’t seem to be very effective. Environmental sanitation is vital.

There’s no data of zoonotic aspect .

REFERENCES:

Small Animal Dermatology 7th edition

The power of local therapy in superficial bacterial infections- part 2

67668506_2745972975432468_1475995593221341184_nDr Spas Spasov

Veterinary Center Dr Antonov

Varna, Bulgaria

 

Sandra is a French bulldog whose case I have been following  for 2 years.

Sandra is regularly vaccinated and with regular tick and flea treatmen and dewormig as well .

 

When we first met, Sandra  was prescribed 2 mg of Prednisolone per kg in the morning and evening.

There were already 2-3 diets with hypoallergenic food with no results .

When the dog is on Prednisolone is very good, with no symptoms.

 

Sandra has been on immunotherapy for two years and during this time there are a total of 3-4 exacerbated periods with superficial bacterial infection.86731524_2593062557606841_6481170903102128128_n 86796564_540897716551707_1088806477625294848_n

To control these infections we tried various antibacterial shampoos and the ONLY systemic antibiotic we used was amoxicillin with clavulonic acid (at least one month ingestion)86654192_3849015221805694_8360675259283668992_n 86671200_2685748064865626_3817080252207726592_n 86696362_2218223128473460_5054249941212332032_n 86697202_485388832135765_3554367668330954752_n

86648294_214183006375305_3623894315450761216_nDuring immunotherapy, Sandra takes 1/4 of Prednisolone at 5 mg every 36 hours (Sandra weights about 15 kg throughout the therapy).

For two years, Sandra was very good, and controlling the pyoderma was relatively easy without changing the doses of immunotherapy and without changing the dose of Prednisolone.

The last case of bacterial infection was the beginning of November 2019.86696316_183578386233461_4810920583397113856_n 86702696_191563688606644_4592023430513033216_n

We began the scheme with Chloroxiderm and Amoxicillin with clavulonic acid.

10 days later, it had no effect, even the opposite.

Sandra’s skin was flushed with pustules, color and intense itching.

 

We did cytology, bacteriology and antibiogram.

The results (Staph. intermedius ) were completely resistant to 15 types of antibiotic from different groups.

The only antibiotic that worked was Rifampim, which is a strategic antibiotic in human medicine and we decided not to use.

Sandra’s improvement has been much slower and in the last few months we have changed several different regimens of local therapy.

Peptive Shampoo & Foam, Duoxo tampons & duoxo spo on  (First Month Every Day)

Omega 3 and 6 fatty acids, Chloroxiderm shampoo, Duxo pyo shampoo and foam (second month every day)

Since the beginning of January, Sandra has been on Peptive again with a bath twice a week and a hermitra spray.

The itching has decreased to normal, there are no new pustules and the hair is gradually recovering.

In conclusion, every time we use an antibiotic for systemic therapy or topical therapy, we should think very carefully about all the possible options because resistance is one of the greatest problems of our future.

Diagnosis :

Atopic dermatitis

Superfitial pyodermia

The power of local therapy in superficial bacterial infections- part 1

67668506_2745972975432468_1475995593221341184_nDr Spas Spasov

Veterinary center Dr Antonov

Varna, Bulgaria

 

 

A topic not only for dermatologists.

“Recent high-profile reports warn of the dangers of not taking action. A bleak report by economist Jim O’Neill, commissioned by the British government and released in May, estimates that 700 000 deaths globally could be attributed to AMR this year and that the annual toll would climb to 10 million deaths in the next 35 years. The report projects US$ 100 trillion in losses by 2050 if nothing is done to reverse the trend.”

Aa quote from the World Health Association website.

1.Clinical case of Azar .86809005_225664251788761_2987290882698379264_n

*HISTORY

 

Azar is a 3 years old cane corso dog.

There is a regular   vaccination  and tick and flea teratments  with tablets (isoxazolines).

Case history .

A month and a half ago, the owner has taken Azar to another clinic because of the many  pustules on the dog’s chin.

Clinical symptoms include itching in the facial area, redness, and many of about 0.5 cm pustules all over the chin.86720876_1100028783670155_9119763329592590336_n
Systemic antibiotic therapy and topical once-daily chloroxidine therapy were prescribed for Azar.

Two weeks later there was no change in the condition  of the dog.

Bacteriology and antibiogram were performed( Staph. Aureus ) , a second systemic antibiotic was added after the result (the first antibiotic was discontinued).

Staphyococcus aureus is extracted from the antibiogram.

Both antibiotics show the sensitivity of the causative agent.

Two weeks after the second antibiotic, there was no change in Azar’s condition.

  1. Clinical presentation

At the initial examination, Azar was in good general condition, but there were numerous pimples throughout the chin area, which were very easily bleeding and pussing.

In addition, Azar defecates 3-5 times a day and most times the stools are not well formed.

  1. We did cytology and deep scraping of the skin.

Cytology:
Mass neutrophils, macrophages, and cocci bacteria.

84223870_659853468118050_7209325832966242304_n85199680_200298631039436_2333131612209807360_n86702132_1496491853857452_6623962133149253632_n

Skin scraping
No demodex or other parasites of deep skin scraping.

 

Initial therapy:

Local therapy with daily chloroxiderm shampoo, duxo pio tampons and duxo seb spot form and Diprogenta 0.5 mg / 1 mg / g cream

betamethasone / gentamicin for 10 days.

The effect after the first 10 days is significant and more than satisfactory, so the therapy prescribed after day 10 was changed only with shampoo with peptide.

10 days later, there were almost no signs of infection.

10 days later, Azar’s therapy was limited to once daily administration of the duxo self-tampons and once a week the duxo-seb spot form, as well as a curative diet with the Analergenic diet.

86262184_184910839401369_1308086097347084288_n86754901_594896047756071_3207263053011746816_n

There are no signs of bacterial infection now, gastrointestinal symptoms are no longer observed, and therapy is just cleansing with duxo swabs (suitable for daily use).

 

 

Diagnosis:

Chin furunculosis and suspected food allergy.

Demodicosis with secondary pioderma and fungal infection (dermatophytosis).

31218656_1929341830411951_7466975273171288064_nDr Daiana Debreczeni

Veterinaru clinic VitalVet

Oradea, Romania.

 

Information about the patient:

Name: Lala

Sex: Female

Age:10 months

Species: Canis familiaris

Breed: Mix

Medical history

The dog had been treated for 14 days at another veterinary clinic for allergy with steroidal non-inflammatory drugs and antibiotics (amoxicillin and clavulanic acid).On presentation at our clinic the owner complained about the fact that the dog was pruritic and had the lesions presented in the pictures shown below.

IMG_0997 IMG_0998

 

 

 

 

 

 

 

 

IMG_0988 IMG_0994 IMG_0987

Diagnostic tests:

Skin citology, Gram stain: Gram positive, rod shaped cocci (Staphylococcus spp.);

Wood lamp examination: positive;

Trichogram: swollen, frayed hair with irregular outline; cortex and medulla structure – abnormal;

Deep skin scraping: positive for Demodex.

 

 

Diagnostic: Demodicosis with secondary pioderma and fungal infection (dermatophytosis).

 

Treatment:

 

– Simparica (sarolaner)  1x/month, repeat until 3 consecutive negativ skin scrapings;

  • Marbofloxacin, 21 days;
  • Bathing with therapeutic shampoo (ketokonazol, clorhexidine formulation) every 3 days;
  • Every 3rd bath another therapeutic shampoo was used (benzoyl peroxide);
  • Dermoscent Pyo spot-on, 1x/week, 4 weeks;
  • FortiFlora probiotics.

Topical gel with onion extract and heparin;

Follow up after 1 month:

IMG_1146 IMG_1153 IMG_1154 IMG_1155

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

After 3 months from the initial consultation:

 

48370418_299299174033893_6871986109262331904_n 48392732_266569077305066_4483729918953259008_n 48376231_563513447463071_1721448816659398656_n 48408389_284540192407843_6492582261840412672_n

Generalised demodicosis, cahexia, pioderma with multiple purulent wounds

27657905_1767922679940615_5207571160505979701_nDr. Nadasan Giulia
VetPoint Vest
Arad, Romania

 

Patient: Ava

Species: canine
Age: 6 months old
Environment: found in a forest
Clinical findings: normal temerature, present apetite
                         weight: 7,8 kg
                         Multifocal alopecia
                         Ulcerations and crusting on the neck,head, limbs and trunk
36311521_2252347564779988_378779891753025536_n 37279743_2252347544779990_5950344865513472000_n
Skin scrapings positive for Demodex canis
Diagnosis: generalised demodicosis, cahexia, pioderma with multiple purulent wounds
Cause: malnutrition, imunosupression 37358779_2252347538113324_2271135992675041280_n
Treatment: first day: hair clipping + clorhexidine 4% bath
baths repeated 1×3 days for 2 weeks
co-amoxiclav 12.5 mg/kg, 2x/day 14 days
afloxaner+ milbemicine oxyme (nexgard spectra)
superpremium dog food 4x/day
after 4 weeks: fluralaner (bravecto)
Weight after 3 weeks: 16 kg
In the last pictures you can see how much she has improved after only 3 weeks. Case in progress37349376_2254048444609900_3767674350048641024_n 37388617_2254048884609856_663487681757446144_n

Plasma cell pododermatitis, an imune-mediated dermatosis

27657905_1767922679940615_5207571160505979701_nDr. Nadasan Giulia
VetPoint Vest
Arad, Romania 
Patient: Mufi

Species: feline
Age: 6 years
Environment: household with 15 other cats
Clinical findings: soft, scaly swelling of all the 4 paws, one of them apears with crusts.Only the footpads were afected. The lesions appear to be painful, no pruritus.
Diagnosis: plasma cell pododermatitis, an imune-mediated dermatosis
37296260_2252346914780053_1791624317373513728_n 37303145_2252346888113389_763843415149379584_n 37357272_2252346874780057_3680124293577965568_n
Frequency: rare
Cause: it is idiopatic but asociated with FIV infection
Treatment: steroids.
first 4 days prednisolon-acetate 4 mg/kg i.m, next 7 days at home metilprednisolone 2 mg/ kg

Dermatophytosis (Ringworm)

stef artMarina-Ştefania Stroe, DVM

Romania

History

Dog, yorkshire terrier, F, 6 years old, spayed, vaccinated, dewormed and with fleas and ticks treatment done, 2 kg. She has been scratched for 2 weeks. A new cat was brought home three weeks ago. The cat present areas of alopecia on the tail.

 

WhatsApp Image 2017-09-03 at 15.41.53

fig 1

Circumscribed lesions on the shoulder (Fig. 1) and on ventral cervical region (Fig. 3), areas of round shaped alopecia with erythema, scaling.

Remaining hairs may appear broken off.

WhatsApp Image 2017-09-03 at 15.41.44

fig 2

WhatsApp Image 2017-09-03 at 15.41.52

fig 3

Positive Wood’s lamp examination – apple green glow associated with the root of each hair (Fig. 2)

Matt fur examined with Wood’s lamp:

auricular pavilion (Fig. 4) and cervical ventral (Fig. 5) positive, fluorescent hairs.

WhatsApp Image 2017-09-03 at 15.41.49

fig 4

Picture1

fig 5

A true dermatophyte infection reveals an apple green fluorescence on the roots of the hair.

 

Diagnosis

Picture2

Fig. 6: Microscopic examination – hair with modified structure of medulla and cortex.

Dermatophytosis (Ringworm)

Other differentials (ex. demodicosis, superficial pyoderma).

Wood’s lamp examination: typical yellowish-green fluorescent hair shafts that can be given by Microsporum canis strains; only Microsporum canis fluoresces and in only about half of cases. The Wood’s lamp is useful in establishing a tentative diagnosis of dermatophytosis in dogs and cats but false-negative and false-positive results are common. Definitive diagnosis is established by DTM culture.

Trichogram: misshapen hair shafts infiltrated with hyphae and arthrospores.

Deep skin scraped: negative

Treatment

Topical antifungal treatment applied on whole body twice a week, for 6-8 weeks until the result of the DTM culture is negative. Bathing are recommended to be done with shampoo containing chlorhexidine and an antifungal (ex ketoconazole) after the animal has been clipped. Ointment containing clotrimazole applied locally in thin layer, daily.

Environment: Decontamination measures in the house, where the animal stood (changed and washed carpets, bedding, beds, pillows), taking all measures to remove spores.

Supplements based on Omega 3 and Omega 6, which will help reduce pruritus and inflammation.

Prognosis

The prognosis is good. However, it should not be forgotten that dermatophytosis is a contagious disease that can be transmitted to other animals and humans.

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.

 

 

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!!!

 

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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

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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

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CHEYLETIELLA SPP.

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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