1. “Change is inevitable-except from a vending machine”
LEARN TO ADAPT
“Change is inevitable-except from a vending machine”
-Robert C. Gallagher

2. DIAGRAM – SKIN LAYERS
Differences: Epidermis, apocrine glands (seal outer surface, phermones)
compound hair

3. Apocrine vs. Sebaceous Apocrine Sebaceous ~ Sweat glands
Specialized forms in eyelids, external ear canal
Hair follicle complex
Anal sacs
Sympathetic NS
Sebaceous
Hair follicles
Secrete sebum (oily)
Large glands
Dog: dorsum of tail,
Mucocutaneous junction
Cat: dorsum of tail, on lip margins and under chin

4. Skin Protects from physical, chemical and microbiological injury
Sensory organ: pain, heat, cold, touch
Storage: Electrolytes, water, proteins, fats and carbohydrates, activates Vit D by sunlight
Epidermis
Dermis
Hypodermis/ subcuticular: Stores fat for insulation and energy

5. Dermatology-skin layers

6. Basic Anatomy & Physiology
The skin is made up of three layers:
Epidermis (the most superficial layer that contains cells, but not blood vessels)
Dermis (the middle layer that is composed of blood and lymph vessels, nerve fibers, and the accessory organs of skin such as glands and hair follicles)
Hypodermis (subcutaneous - the deepest layer that is composed of connective tissue) - fat

7. Skin - Function Enclosing barrier: Water and electrolyte loss
Environment protection
Temperature regulation
Sensory perception: touch, temp. and pain
Motion and shape
Antimicrobial and antifungal
Blood pressure control: peripheral vascular bed
Secretion: apocrine and sebaceous glands
Adnexa: hair, nails, hooves, horny layer – epidermis
Storage: Electrolyte, H2O, Vit., fat, protein, Carbs and other..
Pigmentation: color and sun protection
Excretion: some
Sun > activate vit D > normal Ca absorption

8. Definitions Dermatology: study of diseases of the skin
Dermatosis: skin disease
Alopecia: hairloss
Seborrhea: Excessive secretion of sebum (oily secretion of the sebaceous glands composed of fat and epithelial debris)
Scale: Flakes of stratum corneum on the skin surface or hair coat; various colors
Erythema: increased redness
Collarette: circular arrangement of scale with central area of hyperpigmentation
Crust: accumulation of dead cells and exudate on skin surface

9. Epidermal Collarette Most likely bacterial infection
Less commonly fungal infection, immune-mediated skin disease, insect-bite reaction, or contact hypersensitivity
Scale of loose keratin flakes or "peeling" keratin arranged in a circle

10. Definitions Ectoparasites: external parasites
Skin Scraping: method of examining skin for parasites
Dermatophyte: fungi that grow on the skin
Dermatomycosis: fungal skin infection not involving pathogens below
Dermatophytosis (ringworm): a skin infection with keratinophilic fungi (e.g. Microsporum; Trichophyton, Epidermophyton)
Pyoderma: Bacterial infection of skin
Superficial
Deep
Fungal culture – lab test used to grow dermatophytes for identification
Bacterial culture and sensitivity: lab test used to grow and identify bacteria from lesions and determine antibiotic sensitivity

11. Definitions
Impetigo (not intertigo: skin fold pyoderma): Superficial bacterial skin infection seen in young dogs “puppy pyoderma” (staph)
Acne: Pores clogged with oil forming “blackheads”, esp chin
Lesion: area of altered skin
Rash: wide spread eruption of lesions
Hyperpigmentation: increased pigmentation (melanin) of skin (epidermal/dermal)
Lichenification: Thickening and hardening of skin characterized by exaggerated superficial skin markings.
Cyst: Fluctuant nodule; walled off, fluid filled nodule

12. Lichenification:
Dff: All chronic and
pruritic skin diseases
Hyperpigmentation:
Dff: endocrine dermatoses,
secondary postinflammatory
change due to a variety of
skin diseases.

13. Definitions
Macule: A focal, circumscribed, nonpalpable change in color <1 cm (when it is larger, it is termed a patch).
Papule: small, circumscribed, solid elevated lesion of the skin ~ 1cm
Wheal: A sharply circumscribed, raised, edematous lesion that appears and disappears within minutes to hours
Pustule: a small, elevated, circumscribed, pus-containing lesion of the skin within the epidermis.
Abscess: localized collection of pus; larger than a pustule
Cellulitis: swollen, tender area of skin with bacterial infection; can develop into an abscess

14. Macule: Vitiligo,
discoid lupus erythematosus,
uveodermatologic syndrome,
mucocutaneous pyoderma.
Papule: Bacterial folliculitis,
demodicosis, fungal folliculitis,
flea-bite and
mosquito-bite hypersensitivity,
scabies, contact allergy,
autoimmune skin disease,
drug eruption

15. Pustule: Bacterial infection,
fungal infection,
autoimmune skin disease
Urticaria, insect bites,
other hypersensitivities,
drug eruption

16. Definitions
Granulation tissue: new tissue in a healing wound; consists of connective tissue and capillaries
Erosion: loss of skin surface; shallow, moist, crusted does not penetrate basement membrane
Ulcer: loss of the epidermis resulting in exposure of dermis
Comedone: dilated hair follicle blocked with sebum and other cellular debris

17. Various skin diseases associated
with self trauma such as infections
or allergies
Various skin diseases associated
with trauma such as
infections and allergies, also
immune-mediated diseases.

18. Seborrhea
Seborrhea is characterized by abnormal flaking or scaling of the epidermis and may be accompanied by increased oil production (seborrhea oleasa) or not (seborrhea sicca)
Accelerated skin cell turn-over with or without excessive sebum production.

19. Seborrhea Normal skin cell turnover – 3 weeks
Time period is shortened in seborrhea. Abnormal keratinization
Accelerated (few days) => build up of keratin (dead cells) => flakes
Altered sebaceous gland secretions
Normal secretion of oil in or near hair follicles enriches skin

20. Seborrhea

21. Seborrhea Causes Types
Primary: hereditary as in Amer. Cocker Spaniel, Eng. Springer Spaniel, Westies, Basset Hounds
Secondary: disease/injury to skin from other causes
Allergies, parasites, nutritional disorders, immune-mediated, endocrine disorders (hypothyroidism)
Types
Seborrhea sicca: dry, only scaliness
Seborrhea oleosa: oily + scales

22. Seborrhea sicca
DRY and SCALY

23. Seborrhea oleosa

24. Keratolytics Keratolytics are an important group of antiseborrheics
Keratolytics remove excess keratin and promote loosening of the outer layers of the epidermis
Keratolytics break down the protein structure of the keratin layer, permitting easier removal of this material
Found in medicated shampoos to help in treatment of seborrhea

25. Seborrhea – Treatment Medicated shampoos
Sicca: Sulfur (keratolytic, antipruritic,
antibacterial, antifungal, antiparasitic);
Salicyclic acid (KL, AP, AB)
Oleaso: Coal tar: degreaser, KL;
BENZOYL PEROXIDE: Also for
Moist dermatitis, pyoderma, stud tail
Conditioners

26. Seborrhea – Treatment Clip hair so shampoo can penetrate
If secondary, treat underlying cause
Antifungal and/or antibacterial meds
Omega-3 fatty acid supplements
Anti-inflammatory, anti-pruritic properties

27. Seborrheic Fungal Dermatitis
Malassezia species
Some commensal on skin (normal)
Cause infection when skin surface
altered/abnormal or immunosuppressed
Diagnosed by cytology (stained slides)
Skin impressions:
Samples can be obtained via tape prep or impression smear
Tx:
2% miconazole/2% chlorhexidine shampoo
Selenium sulphide
Other Antifungals: ketoconazole, clotrimazole, miconazole
Oral ketoconazole x 3+ weeks (not approved in dogs and cats)

28. Seborrheic Fungal Dermatitis

29. Pyodermas
Definition: Bacterial infection of skin, superficial or deep; Primary or secondary
Occurs when:
skin surface broken
skin macerated by chronic exposure to moisture
Normal bacteria altered
Circulation impaired
Immunocompetence impaired (aka immunosuppressed)
Superficial- Lesion usually involve superficial epidermis and heal w/o scarring, short duration, rarely ill

30. Pyoderma - Causes Dogs - Staph intermedius
Cats – Pasteurella multocida
Deep pyodermas – gram-negative organisms (E. coli, proteus sp, pseudomonas sp)
Risk factors
Allergies
Fungal infections
Endocrine diseases
Immune incompetence
Seborrhea
Conformation – ex: skin folds
Trauma
Foreign body

31. Pyoderma Superficial – commonly the trunk
Deep – chin, nose, pressure points, feet, generalized, skin folds
PE may show: papules, pustules, crusts, epidermal collarettes, circular erythematous or hyperpigmented spots, alopecia, scaling, lichenification, abscess, cellulitis, etc..

32. Pyoderma
EPIDERMAL COLLARETTES ‘PEELING EDGE’

33. PYODERMA
ERYTHEMA, PUSTULES

34. Superfical Pyodermas
Acute Moist Dermatitis, Superficial pyotraumatic dermatitis (“Hot Spots”)
Clinical Signs:
red, moist, painful areas, oozing
Common in thick coated dogs (Labs, Newfoundlands, Ger. Shepherds, Chows)
Usually in hot moist summer months
Hair loss, very pruritic
Develops very fast
Dx: visual inspection of affected area TX
Clip hair around lesion until skin normal
Cleanse skin with medicated shampoo
Topical Ab’s/steroid creams or sprays (ex: Betagen Spray)
Treat original disease (fleas, allergies)
Systemic steroids, Abs

35. Superficial Pyodermas
Client Info
Gentle cleansing BID
Owner should wash hands after treatment
E-collar may be necessary

36. Superficial Pyoderma: “Hot spot”

37. Superficial Pyoderma: “Hot Spot”

38. Superficial pyoderma: “Hot Spot”

39. Superficial Pyodermas
Impetigo (aka superficial pustular dermatitis)
Signalment: young dogs secondary to malnourishment and poor hygiene
Strep and Staph occasionally cultured from lesions
Clinical Signs: non-pruritic, non-painful pustules and papules on abdomen
Dx: Physical signs
Tx: Systemic Ab, Ab shampoo q 2-3 days, +/- Topical Ab cream
Client Info: Not contagious, usually clears by 6 months

40. Impetigo

41. Skin Fold Pyoderma (aka Intertrigo)
Occurs in breeds with abundant skin
Facial folds, vulvar folds, tail folds
Spaniels, Bulldogs, Pekingese, Pugs, Bostons, obese dogs
Folds trap moisture, heat and bacteria
Usually chronic
Dx: Affected area moist, red, ulcerated
Tx: Relieve symptoms by cleaning and drying lesion
Sx reduction of skin fold may be only permanent solution
Weight loss in obese patients
Abs, chlorhexidine-containing pledgets
Antibacterial and/or benzoyl peroxide shampoos
Client Info
Require long term medical management
Keep area dry and clean
Keep hair/folds away from eyes

42. Skin Fold Pyoderma – Vaginal Folds

43. Skin Fold Pyoderma- Facial Folds

44. Skin Fold Pyoderma – Lip Folds

45. Acne Common in young short-haired dog breeds and cats - can be chronic
Clinical Signs:
Chin swollen and painful to touch, dark spots => black heads (comedones)
Dx: Appearance, r/o bite wounds, abscesses
Rx:
clip hair on chin
clean daily with human acne product (helps with follicular flushing) – benzoyl peroxide
systemic antibiotics
Topical Mupirocin ointment or cream
Client Info:
May become chronic
Daily cleaning of chin
Use only ceramic or stainless steel bowls – NO PLASTIC

46. Acne

47. Deep Pyodermas More difficult to treat than Superficial Pyodermas
Often chronic
Patients are often resistant to treatment or immunosuppressed
Frequently involves Staph intermedius, Proteus, Pseudomonas, e. Coli

48. Deep Pyodermas Client Info Clinical Signs Papules and pustules,
+/- fever
Draining fistulas
Dx: clinical signs
Tx:
Thorough cleaning
Systemic Ab’s (clavamox, baytril, cephalexin)
Client Info
Causative organism often drug resistant
Treatment may be prolonged and expensive in large breed dogs
Some animals will never fully recovery

49. Deep Pyoderma

50. DEEP PYODERMA

53. Live each moment!
“It is only possible to live happily ever after on a day to day basis.”
-Margaret Bonnano

54. Ectoparasites

55. Ear Mites Otodectes cynotis – live on skin surface in external ears
Feed on epidermal debris
Clinical Signs: Brown-black, crusty exudate
Very pruritic, may have excoriations around ears
Dx: Combine exudate w/mineral oil, observe under microscope
Sometimes otoscopic exam will reveal moving debris/mites
Tx: Clean ears prior to topical medications
Topical ear medications
Otomite, Mitaclear, topical Ivermectin, revolution, tresaderm
Client info:
Eggs hatch every 10 days; treatment must continue for 30 days
Highly contagious, treat all animals in house
No human infection

56. EAR MITES-TX OPTIONS
Mita clear applied topically to ear canal q days
Revolution applied on the back
of the neck or shoulders as directed
q 2 weeks for at least 3 treatments
Tresaderm applied AU BID x 2-3 weeks

57. Ear Mites

58. Ear Mites: Otodectes cynotis

59. Ectoparasites: Fleas

60. Flea Life Cycle (Ctenocephalides)
Adult life span: months
Female produces avg. of eggs/day (up to 50)
Egg production only after blood meal
Incubation period: days
Larval stage (needs humidity)
feed on organic material and flea waste
2 molts, then the larva pupates (spins a cocoon)
Lasts usually days
Pupal stage
Most resistant
Lasts days to months dependent on environmental factors

61. The Flea Fleas are very flat from side to
side. They have 3 pairs of legs.
The most caudal pair is designed
for jumping.

62. Flea Life Cycle

65. Fleas
Ctenocephalides felis – The cat flea is the most commonly isolated flea from dogs and cats
Flea saliva highly antigenic=> flea bite allergic dermatitis
Clinical Signs
Scratching/biting skin
Alopecia: Dog - base of tail and caudal thighs initially then generalizes
Cat- miliary dermatitis
Flea dirt (flea feces) in hair coat
Dx: Find fleas or flea dirt

66. Miliary Dermatitis
Common presentation of flea allergy dermatitis in cats

67. Flea allergy dermatitis
Common presentation of flea allergy dermatitis in the dog

68. Fleas Treatment Topicals: sprays, powders, dips, shampoos
Shampoos have no residual effect
Systemic (spot-ons, injectable, tablets)
Advantage (imidacloprid)- once a month spot-on; causes CNS paralysis and death of the flea
Program: (Lufenuron -oral in dogs; injectable in cats);
absorbed into fatty tissue and slowly distributed into bloodstream;
Interferes with production of chitin (hard shell)
Frontline (fipronil) - once a month spot-on; causes CNS paralysis or death
Sentinel (Lufenuron + milbemycin)
Once a month oral tablet (also heartworm preventive); inhibits chitin formation
Revolution (Selamectin) – once a month spot-on; causes CNS paralysis and death; effective for heartworms, sarcoptes, ear mites, intestinal parasites in dogs and cats
Comfortis (spinosad) - once a month ORAL tablet; causes CNS paralysis and death

69. Fleas Client Info Treat environment and animal
Fleas spend most of time off host
Foggers + vacuum well
Prefer animals but will feed on humans
All animals must be treated
Skin damage/dermatitis can occur

70. Ticks: Brown Dog and Deer
Brown Dog Ticks: RMSF/Ehrlichia
(Rhipicephalus sanguineus)
A engorged female
B female
C male
Deer Ticks: Lyme
(Ixodes spp)
D larvae
E Nymphs
F male
G female
H American Dog Tick (wood tick): RMSF
(Dermacentor variabilis)

71. Hard ticks

72. Tick life cycle

73. Tick life cycle
Female lays 1,000 to 10,000 eggs before dying

74. Ticks Irritation of the bite wound Vector for diseases
Neurotoxins in saliva of 12 different species
Clinical signs vary with disease
Dx: finding tick; hx of exposure to wooded and grassy areas

75. Brown Dog Tick The brown dog tick (Rhipicephalus sanguineus)
Transmits Ehrlichiosis in dogs
Brown dog ticks are found throughout the world. Dogs are the primary host for the brown dog tick for each of its life stages.

76. Ticks Client Info Rx: Manually remove ticks
Grasp head parts close to skin with forceps (NOT HANDS) and pull backwards; no gasoline, cigarettes, etc.
Topical treatments (sprays, shampoos, powder, dips)
Collars
Topical systemic products
Client Info
Routinely check pets for ticks, esp after walks in parks, etc
Do not use bare hands to remove and kill ticks – blood may be infectious
Ticks will feed on humans

77. Tick paralysis Dermacentor variabilis
Neurotoxin in saliva of gravid female
Dermacentor andersoni

78. The Mites
Large variety of life styles among mites (free living vs parasitic), skin parasites vs respiratory parasites, etc.
Life cycle involves egg, larva (6 legs), nymph and adult (8 legs).

79. Burrowing Mites Family Sarcoptidae – Small, round, live in
skin tunnels. Short
legs close to body.
Cause mange.
– Sarcoptes,
Notoedres,
Knemidocoptes
Trixacarus
Family Demodicidae
– Live in hair follicles.
– Adults cigar shaped.
– Demodex

80. Mites (Demodectic mange)

81. Demodex
Inhabits hair follicles, sebaceous glands or apocrine sweat glands
D. canis
Normal inhabitant in small numbers
Some cats are asymptomatic carriers
Spends entire life cycle on host
Immune system controls infestation
Genetic predisposition
Localized or generalized
Transmission
Have not seen dog-to-dog or dog-to-human transmission

82. Demodex
Demodex cati (right)
Demodex canis (left)

83. Demodex D. cati D. gati - 2nd most common demodex mite on cat
Similar to D. canis – lives in hair follicles
D. gati - 2nd most common demodex mite on cat
Fat (broad, blunted abdomen)
Lives more superficial in stratum corneum
More pruritic
Associated with immune suppression
Similar lesions to dogs

84. Demodex gati
EPIDERMIS

85. DEMODEX

86. Demodex Clinical Signs Dx – skin scraping - deep Localized Generalized
Young dog (3m-1 y);
Alopecia esp on face
Erythema; crusty lesions
Not pruritic unless secondary infections are present
Generalized
Often febrile
Entire body surface involved
Can result in protein loss through wounds
Secondary bacterial infection - pustules
Dx – skin scraping - deep

87. Demodex: Localized

88. Demodex: Generalized
AUG

89. Demodex: Generalized

90. Demodex Tx
Localized – Rotenone (Goodwinol) topical daily or mupiricin (Bactroban)
Generalized
Mitaban (amitraz) dips q 7 days x 3-6 treatments or 2 negative skin scrapings
Side Effects – sedation for hrs (up to 72 hrs)
Ivermectin: 0.3 mg/kg SQ repeat q 14 days OR PO SID x days extralabel use – client sign a release form – Not herding breeds
Interceptor: 1/mo x 3 mo or more
Oral antibiotics for secondary bacterial infections
Client Info
Many animals outgrow demodex as they age
Not contagious to humans
Tx does not completely remove mites
If breeding dog, then do not treat and do not breed if does not clear on its own
Strongly recommend OHE with treatment or will relapse with heat cycles
Generalized form can be fatal.

91. Demodex Rx
Approved Not FDA approved Approved
SQ or PO

92. Demodex Newer drugs and protocols Only APPROVED treatments
Ivermectin – lower initial dose due to side effects, then gradually increase dose over several days; µg/kg PO SID x 90 days
SE: ataxia, bradycardia, mydriasis, resp arrest, salivation, stupor and tremors
Milbemycin (Interceptor) – 2 mg/kg PO SID x days
Fewer SE
Expensive for large dogs
Continue for 4 weeks post 2nd negative skin scraping – may be cost prohibitive
moxidectin + Imidacloprid (Advantage Multi)
Only APPROVED treatments
Amitraz (Mitaban)
Moxidectin + imidacloprid in topical formulation (Advantage Multi)
Milbemycin oxime (Interceptor) orally

93. Mites (Sarcoptic mange [Scabies])

94. Sarcoptic Mange Species specific Adults live 4-5 weeks
Egg-larva-nymph-adult cycle
17-21 days
Entire life cycle on skin
Infective in house environment for hrs
Burrows under skin – stratum corneum (epidermis)
Hypersensitivity reaction

95. SARCOPTES

96. Sarcoptic mange Clincal Signs
Red crusty lesions on ears, elbows and trunk
Intensely pruritic
Progressively more severe
DX – skin scraping; difficult to find mite
Tx – easily killed
Amitraz dip q 14 days
Ivermectin SQ or PO q 14 days (extralabel use)
Selamectin (revolution) – topically q 2 weeks x 3 treatments
Client Info – highly contagious to other dogs and humans

97. Burrowing Mites
Sarcoptes scabei

98. Scabies: Clinical signs

99. Sarcoptes Rx
Approved Not FDA approved
SQ or PO

100. Cheyletiellosis (Nonburrowing mites)
Cheyletiella spp

101. Cheyletiellosis “walking dandruff” Dogs, cats, rabbits, humans
Live in keratin layer of skin
Feed on lymph
Eggs deposited on hair shafts
Eggs smaller than louse eggs
Life cycle completed in 5-6 weeks
Highly contagious among animals
Direct contact and fomites

102. Cheyletiellosis Clinical Signs Severity of pruritis varies
Dry scales along back => entire body
Patchy hair loss from scratching
Dx: collect scales with clear tape, flea comb, skin scraping and ID with microscope
Rx: Weekly baths with flea control products containing pyrethrins or permethrin and/or lime sulfur dip

103. Warbles (Cuterebra)
Adult fly lays eggs in soil => larvae penetrates skin of animals=>matures=> leaves animal to become an adult fly
Dx: swelling of skin behind ears with opening – can see larvae
Tx:
Surgery: open fistula and remove
larvae
Flush wound (betadine, Nolvasan)
Oral antibiotics for skin infection
Client Info: keep animals in fly-free environment

104. Warbles (Cuterebra)

105. Warbles (Cuterebra)
Botfly, family cuterebra

106. “Education is a progressive discovery of our own ignorance.”
-Will Durant

107. Myiasis (Fly maggots)

108. Botfly ( Order Diptera)

109. Myiasis
Many spp of flies lay eggs on wet, warm, damaged skin => larvae are maggots
Dx: visually seen under matted hair with foul odor
Rx: Clip hair
Flush wound, clean daily
Antibiotics
Keep indoors to prevent re-infection
Client info
Disease of neglect
More common in heavy coated animals in summer
Do not use dips to remove maggots

110. Dog Lice (Linognathus setosus)

111. Dog Lice Rx Client Info Host specific; disease of neglect
Dx: lice cause intense itching
Blood suckers => anemia if heavy infestation
Presence of lice or nits or eggs diagnostic Rx
Treat all animals in house with dip, shampoo or dust
Topical insecticides used for fleas and ticks are adequate
Wash bedding thoroughly
Ivermectin orally (extra-label use)
Client Info
Humans don’t get lice from pets

112. DOG LICE

113. Dermatophytes
Microsporum canis

114. Dermatophytosis (Ringworm)

115. Dermatophytosis Superficial cutaneous infection
3 primary dermatophytes
Microsporum canis
Trichophyton mentagrophytes
Microsporum gypseum
Cat: 90% M. canis; Dog: all 3
Transmission
Direct contact
Contact with infected hair and scale
Fomites
Spores small and easily aerosolized
Fleas
Infected hairs – infective for up to 18 months
Incubation period 1-3 weeks
M. canis – cats
Trichophyton – rodents or nests
M. gypseum – geophilic (soil)
More common in moist, warm environments

116. Dermatophytosis Clinical Signs Hair loss, scaling and crusting
+/- pruritus
Cats
Mimics other skin diseases
Kittens – facial 1st
Can form ulcerated dermal nodules
Dog
Focal or multifocal areas of hair loss
Papules, scales and crusts
Central area of hyperpigmentation

117. Dermatophytosis Dx: Wood’s Light – UV light Quick and easy screen
50% of M. canis fluoresce, rest do not
Differentiate from scale, dust, dirt
Lamp must warm up for 5 minutes prior to exam.

118. Wood’s lamp

119. Dermatophytosis Dx Tx Fungal culture – definitive
Color change to red in 1-3 weeks
Confirm with microscopic exam Tx
Usually self curing in healthy animal – may take 2-3 months, esp in kittens
3 elements
Topical – reduces contamination on hair coat
Systemic- reduces healing time
Environmental-decreases contamination and spread

120. Microsporum canis

121. Trichophyton mentagrophytes

122. Microsporum gypseum

123. Dermatophyte Test Media - DTM

124. Dermatophytosis – Treatment
Clip haircoat, particularly long hairs
Topicals
Spot treatment may predispose to subclinical infections
Whole body shampoos, dips, rinses twice weekly
Lime-sulfur at 8oz/gal (4 oz not effective)
Miconazole containing shampoos

125. Dermatophytosis-Treatment
Systemic tx
Griseofulvin (don’t use in pregnant animals: teratogenic effects)
GI absorption variable
Adverse effects
Vomiting/diarrhea, anorexia
Bone marrow suppression
Neurologic signs
Ketoconazole (Aplastic anemia in FIV + cats)
Potential liver toxicity
Intraconazole
Less Side effects
Lufenuron – inhibits chitin formation; chitin in outer wall of fungi
Being studied
Tx till resolution of signs and 2 negative cultures

126. Dermatophytosis – Treatment
Environment
Remove or discard all bedding, brushes, fabric toys, etc
Cheap vacuum to clean with, then discard
Clean all surfaces; use bleach
Vacuum daily
Disinfect weekly
Catteries – strict isolation

127. Dermatophytosis – Zoonosis
At risk populations: children, immune suppressed adults, older adults
Vaccine – reduces severity but not occurrence of disease
May not be available now
Cats can be carriers w/o clinical signs

128. Ringworm (human)

129. Atopy (Atopic dermatitis)
Def: Allergy to inhaled environmental substances and manifested through irritation of skin and ears, usually starting at 1-2 yrs of age
Allergens:
Dust mites
Pollens
Feathers
Molds
Animal and human dander
Tobacco smoke
Clinical Signs:
Pruritus
Self-trauma to skin +/- secondary bacterial infection
Staining of hair from saliva
Licking/chewing feet
Alopecia, scaling, hyperpigmentation

130. Atopy Dx Tx: No cure Accurate hx critical
R/o food allergies, flea allergy dermatitis, sarcoptic mange, contact dermatitis BEFORE diagnosis of atopy can be made
Intradermal skin testing – most accurate to identify offending allergen
Tx: No cure
ID and eliminate cause best treatmetn
ATOPICA – contains cyclosporin A (immunosuppressor), Anti-inflammatory and antipruritic
Treat any bacterial or fungal infections before using immune suppressive drugs
Medication (steroids, Abs) and allergy shots (desensitization)
Omega 3 fatty acids
Antihistamines-more effective if given before symptoms occur

131. Atopy

132. Alopecia and erythema of the periocular skin and alopecia, erythema, and hyperpigmentation of the muzzle.
Alopecia and hyperpigmentation of the muzzle.

133. Atopy: Appearance

134. Skin Testing
Skin testing is performed to identify the allergens involved in allergic disease. Under profound sedation an area of hair on the chest is shaved and small injections of substances known to be possible allergens made. After minutes the reactions are recorded

135. Food Allergies 10% of all allergies Usually starts between 2-6 yrs
Processed foods increase likelihood of reaction
Fillers, artificial colors, preservatives

136. Food allergies in dogs

137. Food Allergies Dx and Tx
Elimination diets: new source of protein for 3 mo.
If improves, reintroduce original protein to see if symptoms recur – confirmation of dx
Use new diet.
May develop allergies to new diet later

138. Treatment

139. Food allergies

140. Treatment
Foods can be obtained based on venision and potato, fish and potato, egg and rice, duck and pea, and even kangaroo. Generally recommends duck and potato based foods for dogs

141. How do you diagnose food intolerance (food allergy)?
The patient is fed a hypoallergenic diet for days. This allows the body to become desensitized to the offending allergens. When the previous diet is fed back to the pet, an acute hypersensitivity reaction may occur. This helps to identify that a food was the source of the allergic signs

142. Pruritits Algorithm
Dogs
Cats

143. Evaluating Feline Pruritus
Feline Food Allergy
Year round pruritus
Variable response to steroids
10-30% with concurrent GI symptoms
Common offending proteins
-Dairy, fish, beef, pork, chicken, rabbit, horse, lamb, eggs, clams, "commercial diets"

144. Managing Feline Pruritus
Diagnosing food allergy
10 week food trial
Home cooked meat
Potato/rice
Canned food
Innovative Veterinary Diets (IVD)
Green pea & duck/rabbit
Hills ZD???

145. Allergies

146. References Alleice Summers, Common Diseases of Companion Animals
Dr. Ralf S. Mueller, Dermatology for the Small Animal Practitioner