Rare case of Feline Progressive Histiocytic Disease (FPH) – A case report

41768527_2349628575051886_8602568388625039360_nDr Giulia Nadasan

Vet Point Vest

Arad, Romania

This is the story of Chucky, a senior 9 year old european male neutered cat. He used to live in an outdoor environment. His medical history is very long, since he was young he had different pathologies from infectious diseases, chronic urolithiasis ended with urethrostomy and a femur fracture osteosintesis.

Chucky was a well monitored patient with all his dewormings and vaccinations on time.

Chucky was presented for a clinical consult because the owner noticed something on his skin. On the first clinical presentation I found two skin lesions (papules) about 0.5 cm diameter non ulcerated on the dorsal thorax, well circumscribed that made my think of piogranulomatosis pioderma. I started a treatment with amoxicillin + clavulanic acid and asked them to come back after 7 days. At the second consult, Chucky looked exactly like in the pictures, he was suffering of a generalized nodular ulcerated dermatitis.54515532_560264067813760_3040561606883803136_n

A skin biopsy was made the next day and the sample was sent to the histopathology lab.

 

Pathology findings : the superficial and profound dermis are infiltrated with neutrophils, macrophages, histyocitic mesenchymal cells with atypical mitosis and eosinophils and also areas of necrosis and hemorrhage (histovet.ro) = piogranulomatosis pioderma with histiocytic neoplastic component

 

DIAGNOSIS : Progressive non-epiteliotropic feline histiocytic disease

 

 

Biological facts:

Histiocytes are mesenchymal cells derived from the bone marrow as stem cells. They either become macrophages or dendritic cells (antigen presenting cells APC). Dendritic cells can be also divided into Langerhan cells, interstitial dendritic cells or interdigitating dendritic cells.

Using immunophenotyping methods the histyocites were found expressing CD1a, CD1c, CD18 and MHC class 2 molecules used specific for dendritic cells and not Langerhan cells.

 

Epidemiology:

Feline Progressive Histiocytic disease is a benign skin neoplasia in humans and dogs but it is extremely rare in cats. In a 2006 study conducted by Affolter and Moore (VetPathol.43(5)646-55) it is said that except some case reports this disease has not been characterized in cats. They analysed the cases of 30 cats with FPH and summarized that there is no breed or age predilection, that females are more prone on developing this disease and that it is a fatal one with no successful treatment options.

 

Clinical findings in Chucky :54416663_265039581075898_1025659308638994432_n 55575966_692832224465879_5135189188315971584_n

  • Multiple papules with red margins, non-pruritic on the body especially on the dorsal and lateral thorax
  • Ulcerated nodules on the head and ears also non-pruritic
  • Periauricular alopecia with hyperpigmentationPrognosis:

    FPH is a slowly progressive skin neoplasia that does not cause any pain but will spread behind the skin in the terminal stage. Median surviving time is 13.5 months.

    54462802_391015891629829_546392991934185472_n

    Treatment:

    It is considered only paliative. At the time of my diagnosis I started treatment with Prednisone at a 2mg/kg/24 h but there was no evidence of improvement. Lomustine (CCNU) is an antineoplastic drug that is used for the dog’s histiocytic disease and may be used in the cat as well at a dosage of 40-60 mg/m2 every 3-6 weeks.

    According to the book Small Animal Clinical Oncology (2012) the skin lesions do not appear to respond to corticosteroid therapy and effective medical treatment as not yet been described.

     

    What happened to Chucky: Chucky was brought for humanly euthanasia after 2 months after the diagnosis because of dyspnea and anorexia. I suspect pulmonary metastasis was present at that time but the owner refused necropsy.

     

     

     

     

CONGENITAL FOLLICULAR PARAKERATOSIS IN A STRAY DOG

48260278_10156282671250432_7554491919091367936_nDVM Diana Anghelescu

Hemopet Clinic

Congenital follicular parakeratosis is a  hereditary disorder affecting females, which suggests a X-linked mode of inheritance, the particular aspect of the condition is not affecting the skin of the nose and footpads unlike other seborrheic disorders.

More about this particular condition can be found in Small Animal Dermatology 7th Edition.

 

 

 

THIS IS DEMInnn

This particular case seemed interesting as it occurs very rarely and even more so there are few cases when owners are willing to do everything they can to keep them in good shape.

Female stray dog presents to our clinic in gravely  bad shape, with serious skin scaling , waxy material clumping together most of her coat, runny eyes and greasy smell.

Comes from a litter of 3 puppies, her other brothers being already twice her weight, with normal skin condition

 

 

Name: Demi

Age: 2 months

Sex: Female, Mixed breed

 

Waxy material concentrated mostly on the edges of the pinnae and on her neck

pic 2pic 3

 

 

 

 

 

 

 

 

Waxy material covering most of her body, creating clumps of hair, general aspect of  a dirty dog

pic 4 pic 5

 

 

 

 

 

 

 

 

 

 

Due to the severity of her condition, several tests have been performed to exclude potential affections:

-Skin scraping

-Trichogram

-Citology examination

-CDV test

-Otoscopic examination

-Bloodwork

-Giardia Test

-Coproparasitological exam

 

*CDV test – negative

*Otoscopic examination: Billateral ceruminous otitis, with buildup waxy hair follicles inside the ear canal

*Skin scrapings: Negative for ectoparasites

*Cytology from different sites of  affected skin – keratinocyes, corneocytes accompanied with malassesia, no other signs of inflamation present

*Cytology from ears-  copious amounts of ceruminous debris, flourishing with malassesia

*Cytology of the conjunctiva- chains of cocci, macrophages and neutrofiles

*Trichogram revealed normal hair structure, mostly in telogen phase, but embedded in a dense brown waxy material.

*Giardia test- negative

*Moderate Toxocara infestation

pic 6

Skin cytology- Lots of corneocytes, rare cocci.

pic 7

Otic cytology- Almost 90% Mallassezia levures

After ruling out most of the possible diagnostics, Demi was reexamined closely looking for particularities.

 

-It turned out that the keratosis was affecting especially the external areas of the pinnae, the ventral side of the neck, the entire back and along the limbs and in a smaller part the abdomen.

 

-It was peculiar  that the skin on her nose was normal, as well as her footpads, which led me into thinking about this possible condition, that could only be 100% proved with a skin biopsy.

pic 16

Trichogram- Almost all hair follicles were covered in waxy material

pic 15

Trichogram- Almost all hair follicles were covered in waxy material

 

-Unfortunately the owner who rescued her did not agree with the biopsy so I had to move onto the therapy without knowing  100%, but shortly after I was sure that this was it.

TREATMENT

-Demi remained at the clinic for 2 months, giving us time to use proper treatment such as:

-Frequent bathing (2-3x/week) with Benzoyl peroxide followed by mixed shamoo (ketohexidine) and a conditioner

-High quality protein diet based on salmon

-Daily Omega 3 and 6 oral suppliments and weekly spot ons.

-Daily Vitamin complex with high ammount of vitamin A and E

-The otitis externa was treated with Clorexyderm oto and Surolan 2x/daily for 14 days

-The conjunctivits was resolved with cloramfenicol drops and daily cleansing of the ocular area – the hyperkeratosis also affected her eyelashes, constantly irritating the eyes, I had to remove each affected lash.

-She received deworming pills and sarolaner to control the endo and ectoparasites.

 

DEMI AFTER 7 DAYS OF TREATMENT

pic 9

DEMI AFTER 7 DAYS OF TREATMENT

pic 10

DEMI AFTER 7 DAYS OF TREATMENT

 

 

 

 

 

 

 

 

 

DEMI AFTER 14 DAYS OF TREATMENT

14 days 2

DEMI AFTER 14 DAYS OF TREATMENT

14 days

DEMI AFTER 14 DAYS OF TREATMENT

 

 

 

 

 

 

 

 

DEMI AFTER 1 MONTH OF TREATMENT

pic 11

DEMI AFTER 1 MONTH OF TREATMENT

pic 12

DEMI AFTER 1 MONTH OF TREATMENT

 

 

 

 

 

 

 

 

DEMI AFTER 2 MONTHS OF TREATMENT

pic 13

DEMI AFTER 2 MONTHS OF TREATMENT

pic 14

DEMI AFTER 2 MONTHS OF TREATMENT

 

 

 

 

 

 

 

 

CONCLUSIONS

As you can see, her condition can be kept under control especially if the owner understands that it’s a lifetime condition and she will require special treatment for the rest of her life

 

She had a brief period of time when I decided to see how long it takes until new keratin materials starts to form if I stop the treatment and it only took 6 days for the most affected areas to relapse.

 

It’s a rare condition, I was especially glad to be able to care for her and to see that there are people willing to do everything needed to keep her in good shape

 

I’m pretty sure most of these dogs don’t survive long if in the wild, or are discarded by breeders if not, let’s say Demi was lucky enough to be rescued at such a young age.

 

 

 

 

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

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

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.

dav

dav

dav

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.

1st Bulgarian Dermatology Congress , organised by BAVD

14612382_553114001550481_6070253379668782534_oFirst Congress of Bulgarian Association of Veterinary Dermatology held in 27-28th of April, 2017 at city of Plovdiv, Bulgaria. There were more then 120 veterinarians from Bulgaria, Macedonia, Romania, Greece and Cyprus.

18209292_640039056191308_9139044102961873525_o 18193187_640588769469670_5244865418136719896_o

Dr. Emmanuel Bensignor and Dr. Sebastian Viaud, who impressed the audience with the way information was provided, but also the way all the scientific information was presented so to be useful in every-day-practice. They   discussed which one is the best elimination diet, which medicine is effective in the control of canine atopic dermatitis and how to use them appropriately? How to do Desensibilisation therapy? How to perform biopsy from unusual places? How to recognize vasculite lesion and how to deal with it?18209350_640038969524650_2972147177502418052_o

Vets on The Balkans support BAVD submit one free ticket for 4th Latin American Congress of Veterinary Dermatology to be held in
Merida, Mexico from 13th to 16th of June 2018  and one free ticket for 4th Romanian Dermatology Congress , October, 2017. Their members are presenting clinical reports and the best one will win. All of the cases will be posted in the journal Vets on The Balkans.

18076763_640038906191323_3770134851450354649_o 18118445_640588669469680_5880784995554696396_n

Dr Ana Maria Boncea, Vetderm Therapy in Bucharest, Romania

 

“I would like to thank you one more time for this opportunity. It was great event!! Congratulations for everything! See you soon!!”

 

Dr Daniela Bajenaru, Tazy Vet Veterinary Clinic in Bucharest, Romania

 

“Dear Luba, the 1st Bulgarian Veterinary Dermatology Congress was excellent, the lecturers gave us a lot of useful information and the organization was great!”

 

Dr Adriana Cosma, Conforvet on Bucharest, Romania.

 

“ Hi Luba! I wanted to tell you that we thank you for everything…we had wonderful time. We liked very much the BAVD Congress and the city of Plovdiv!”

 

 

The team of Vets on The Balkans congratulated BAVD for the high professional level of organizing and the brilliant scientific program.

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 ….