Alopecia
T or F: Pyoderma is always a primary disease.
False! Pyoderm is always secondary to an underlying cause.
What technique is the most sensitive for fungal culture?
Mackenzie toothbrush
T or F: Malassezia pachydermatis is a commensal organism of the skin in both dogs and cats.
True!
A 3 year old dog presents for pruritus, erythema, and alopecia in the perianal area and cubital flexor region. Owner previously noted this seasonly when he was 1, but this year it has stayed past the season change. A cytology does reveal a Malassezia infection. What is the most likely diagnosis?
canine atopic dermatitis
A 4 year old Siamese cat presents for tachypnea, open-mouth breathing, and cyanosis. It is an indoor/outdoor cat and the owner just noticed these signs today. The owner did note that there was a strong bloom of pollen in the area today. What is the most likely diagnosis?
feline asthma
A dog presents with a red, exudative spot on his cheek. Owner noticed he has been scratching at it and it seemed to happen over night. What is the diagnosis?
pyotraumatic dermatitis (hot spot)
A cat presents with alopecia of the face, ears, and muzzle. A dermal nodule is found on the upper lip. There is mild pruritus present. What is the most likely diagnosis?
dermatophytosis
What systemic therapy cannot be used to treat Malassezia dermatitis in cats?
ketoconazole
What is an example of a cutaneous reaction pattern that a cat with allergies presents with?
1. eosinophilic granuloma complex
2. self-induced alopecia
3. face, head, neck pruritus
4. miliary dermatitis
An Oriental shorthair cat presents with bilaterally symmetrical alopecia. A skin cytology shows no sign of bacteria or yeast infection. The owner has noticed the cat overgrooming. What is the best treatment?
- remove stressors
- environmental enrichment
- behavior modification
- anxiolytic meds (fluoxetine, gabapentin, clomipramine, amitriptyline)
DX: psychogenic alopecia
This pyoderma presents on the ventral abdomen, between the digits, and on the ear pinnae. When a cytology is performed, bacteria is found with no signs of inflammation. What is the most likely diagnosis?
bacterial overgrowth syndrome
What are the three first-choice drugs for systemic antimicrobial therapy for pyoderma?
cephalexin, clindamycin, amoxicillin-clavulanate
A dog presents with severe pruritus. Crusts are found on the ears, elbows, and hocks. When the pinnal margin is rubbed, the animal starts to scratch. What is the most likely diagnosis?
Sarcoptic mange
What is the 4-step method to diagnosing cAD/FASS?
1. rule out ectoparasites
2. identify & treat secondary infections
3. investigate CAFR
4. diagnose atopic dermatitis
A cat that has been on steroids for a couple months presents with an ulcer on the bridge of its nose. It has also been sneezing, and has opaque nasal discharge. Its eyes have been more watery, and is more lethargic than normal. A cytology of the ulcer shows eosinophilic inflammation with bacterial overgrowth. What is the next diagnostic test that should be performed?
BONUS: What is most likely diagnosis?
PCR test to detect viral DNA in tissue
BONUS: feline herpesviral dermatosis
What is the best treatment for surface pyoderma?
topical antiseptics preferred
- chlorhex, benzoyl peroxide, sodium hypochlorite, PBM, bacitracin for local lesions
topical anti-inflammatory meds (GCCs, antipruritic)
address underlying cause
A German shepherd presents for geographic lesions consisting of thick crusts, draining tracts, and ulcers. TPR - (103.5 F, 95 bpm, 22 RR). What is the diagnosis and the most likely etiologic agent?
deep bacterial folliculitis/furunculosis (DBFF)
etiologic agent: Staphylococcus spp.
A 4 year old cat is brought in from hair loss. After taking a history, it is revealed that the owner did notice her cat overgrooming herself. The other cat in the house is affected a well. However, one cat seems a little more itchy than the other. A superficial skin scraping is done and a cigar-shaped organism is found. What is the most likely diagnosis?
Demodex gatoi
What is a limitation with the use of cyclosporine for treatment of cAD and FASS? This may not be ideal for owners.
slow onset of action, 4-6 weeks
A cat presents with lameness. On physical exam, footpads appear swollen, and superficial erosions are visualized. What is the diagnosis and treatment?
BONUS: which treatment med should be used with caution and why?
dx: plasma cell pododermatitis
tx: prednisolone, doxycycline, cyclosporine
BONUS: doxycycline, worry for stricture, esophagitis
A dog presents with a moth-eaten focal alopecia on the ventral abdomen and medial thighs. Epidermal collarettes are also visualized on physical eam. What is the most likely diagnosis?
superficial bacterial folliculitis
Give an example of an antibiotic that is reserved for treatment of MRSP.
rifampin, chloramphenicol, amikacin, gentamicin
What is the only way to diagnose a food allergy?
strict elimination diet trial (EDT) for 8 - 12 weeks
follow with provocation challenge with old diet, evaluate for CS for ~2 weeks
What antipruritic medication should not be used in puppies less than 1 years old?
(Apoquel, oclacitinib; Zenrelia, ilinocitinib; Numelvi, atinvicitinib)
Paraneoplastic alopecia is most commonly associated with what type of neoplasia?
pancreatic carcinoma