1. “ Our deepest fear is not that we are inadequate, our deepest fear is that we are powerful beyond measure…” - Marianne Williamson

3. An acute or chronic inflammatory disease of the external ear canal  Clinical signs: › Head rubbing or shaking › Ear scratching › Head tilt – with the affected ear tilted down › Malodorous otic discharge (brown, greenish- yellow) › Lichenification, hyperpigmentation, crusts, erythema and excoriations may be present › Aural hematoma

4. NOTE THE EXCESS BROWN EXUDATE AURAL HEMATOMA ERYTHEMA, HYPERPIGMENTATION, LICHENIFICATION

5.  PREDISPOSING FACTORS: › Conformation  Heavy, pendulous ears  Stenotic ear canals  Ear hair › Excessive moisture  Frequent bathing or swimming › Hypersensitivities  Food allergy, atopy

6.  DIAGNOSIS: › Otoscopic exam › Clinical signs › Cytology, ear smear  Yeast, bacteria, cerumen, skin cells

7.  MALASSEZZIA OTITIS Malassezzia resemble footprints, bowling pins, or snowmen

8.  BACTERIAL OTITIS ROD-SHAPED BACTERIA AND A SKIN CELL

9.  TREATMENT › Always treat the underlying condition if present › Topical meds instilled daily  Antibacterial, antifungal, or combination products often with steroids (otomax, tresaderm, baytril otic)  Cleaning ears during treatment › Surgical intervention may be required  Aural hematoma  Chronic conditions (Total Ear Canal Ablation)

10. The anal sacs are located between the muscle layers of the anus at the 4 and 8 o’clock positions. Each sac connects to the surface through a narrow duct. Sebaceous glands produce a foul-smelling oily, brown fluid. The sacs are naturally expressed during defecation, but can sometimes overfill.

12.  IMPACTION › When the sacs overfill, the water can be reabsorbed, and the material dries out.  Sacs become a source of discomfort for the dog and are difficult to express at this time. › Impaction can lead to abscessation and rupture.  Clinical signs include: scooting rear end across the floor, painful defecation, tail chasing, perianal erythema, and/or swelling

14.  DIAGNOSIS › Palpation (rectally or externally) › Clinical signs  TREATMENT › Express contents › Flush sac › Instill antibiotic ointment › Oral antibiotics, anti-inflammatories › Surgery?

15. WEARING GLOVES, GENTLY MILK THE GLANDS IN AN UPWARD MOTION TO EXPRESS.

16. Tumors are a new growth of tissue characterized by progressive, uncontrolled proliferation of cells. Benign vs. Malignant Localized vs. Invasive Adenoma/Carcinoma vs. Sarcomas

17.  HISTIOCYTOMA: small, button-like tumors that are usually pink, hairless, and raised. They are rapidly growing Common locations include the pinnae, head, and legs

18.  HISTIOCYTOMA › Occurs almost exclusively in young dogs <4yrs old  DIAGNOSIS › Appearance › biopsy  TREATMENT › These tumors may spontaneously regress, but surgical excision is the treatment of choice ROUND CELL TUMOR

19.  LIPOMA: tumor of the subcutaneous adipocytes (fat cells) that are typically freely movable and well-circumscribed › Common in older, female, obese dogs  DIAGNOSIS: › Biopsy › Fine needle aspirate

20.  LIPOMA › TREATMENT:  Surgical excision  Benign neglect lipocytes

21.  PAPILLOMAS: wart-like growths that develop as smooth, white/pink/pigmented, elevated lesions in the oral cavity (oral papillomatosis) or on the skin (cutaneous papillomas) › These growths are caused by a papillomavirus

22.  PAPILLOMAS › DIAGNOSIS:  Appearance  Biopsy › TREATMENT  Usually spontaneous regression  Autogenous vaccine

23.  SEBACEOUS GLAND CYSTS: Slow growing, encapuslated, round, and exude a gray, cheeselike material. Caused by degenerative changes in the glandular area surrounding the follicle. › Common in cocker spaniels  DIAGNOSIS  Contents of the cyst  histology  TREATMENT › Surgical removal of entire encapsulated cyst

24. SEBACEOUS CYSTS

25.  FELINE VACCINE-INDUCED FIBROSARCOMAS: rapidly developing, highly invasive, malignant tumors that occur at the site of vaccination ~4-6 weeks later. › VACCINES MOST COMMONLY IMPLICATED ARE THOSE WITH ADJUVANTS (substance that enhances the immune response by increasing the stability of a vaccine in the body) SUCH AS FeLV AND RABIES

26.  VACCINE- ASSOCIATED SARCOMAS › DIAGNOSIS:  Biopsy of fine needle aspirate  Physical exam findings  Swelling in area of recent vaccination  Rapidly growing firm elongated mass

27.  VACCINE-ASSOCIATED SARCOMAS › TREATMENT  Radical surgical excision which may involve limb amputation is the treatment of choice › CLIENT INFORMATION  Poor prognosis if not detected early and treated aggressively  Inflammatory lumps may do develop after vaccines but usually disappear within 1-2 weeks

28. FELINE VACCINE-ASSOCIATED SARCOMAS

29.  MAST CELL TUMORS: firm nodules on the skin that may be ulcerated or edematous. Mast cells contain histamine and heparin

30. FINE NEEDLE ASPIRATE OF MAST CELL TUMOR; NOTE THE NUMEROUS GRANULES

31. IN CATS, MAST CELL TUMORS ARE USUALLY BENIGN AND MAY SPONTANEOUSLY REGRESS

32.  MAST CELL TUMOR › TREATMENT  Chemotherapy  Radiation therapy  BENADRYL  H2 blockers to treat gastric ulceration and irritation › PROGNOSIS  Depends on biopsy “grading” results

33.  MELANOMA (Benign or Malignant) › BENIGN: small, slow growing, hairless, pigmented › MALIGNANT: large, dome-shaped sessile +/- pigmentation  Ex: Tumors of the oral cavity and digits  Poor prognosis  Metastasize readily  Recurrence after surgery is common

34. TREATMENT INVOLVES SURGICAL REMOVAL AND POSSIBLY TREATMENT WITH THE VACCINE