3/29/2015. Lucky, Posavacki gonic, 2y, castrated male. ESVD Conference Warsaw 2015 Cases. Main complaint. Lucky s history

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history Referred to the dermatology clinic for allergic skin tests and therapy

without improvement But the vet is annoyed, since low compliance Main complaint

1 Lucky, Posavacki gonic, 2y, castrated male ESVD Conference Warsaw 2015 Cases MVDr. Lucia Panakova, DipECVD Veterinärmedizinische Universität Wien 2 Lucky s history Referred to the dermatology clinic for allergic skin tests and therapy Is on elimination diet (hypoallergenic from Royal Canin) for eight weeks without improvement But the vet is annoyed, since low compliance Main complaint Extremely chewing his feet (pawpads and nailbeds) Also itchy on his ventral abdomen 3 4 1

three times no improvement After prednisolon reduction of pruritus by 50%

2 Lucky was saved from Serbia and lives with the new family in Austria for 4 months He was found in a bad condition in a bottom Treated with Stronghold three times no improvement After prednisolon reduction of pruritus by 50% for short time Physical examination 5 6 Dermatologic examination Problem lists 7 8 2

3 Problem lists Diferential diagnoses for pedal pruritus Severe pedal pruritus Hyperkeratotic paws Maculo-papular itchy rash 9 10 Diferential diagnoses pedal pruritus Differential diagnoses for pawpad hyperkeratosis Malassezia pododermatitis Staphylococcal pododermatitis Food induced allergy Atopic dermatitis Autumn mites (Neotrombicula autumnalis) Hookworm Ancylostoma et uncinaria pododermatitis (Pedal demodicosis) Neurologic problem (acral mutilation sy)

4 Differential diagnoses for pawpad hyperkeratosis Differential diagnoses for maculopapular rash Keratinization problem (primary) Hookworm dermatitis Generic dog food dermatosis Hepatocutaneous syndrome/ Zinc responsive dermatoses PF Distemper Hepatocutaneous syndrome/ Zinc responsive dermatoses SLE, Leishmaniasis Differential diagnoses for maculopapular rash Suggested approach Pyoderma Malassezia dermatitis Scabies Contact dermatitis Parasitic dermatitis (endoparasites) (Allergy)

5 17 18 Skin scrapings negative Treatment Cefalexine 20mg/kg BID Malaseb every day

6 11 days after the beginning of the treatment- no improvement of the itch Parasitological fecal flotation Positive for eggs from Ancylostoma/ Uncinaria eggs Ancylostoma et uncinaria dermatitis Treatment with fenbendazol (Panacur ) pills Four weeks later 7 weeks later

Ancylostoma et uncinaria dermatitis Ancylostoma et uncinaria dermatitis Rare pruritic dermatitis of dogs living in kennels with poor sanitation Caused by larval migration of L3 larvae through the

7 Ancylostoma et uncinaria dermatitis Ancylostoma et uncinaria dermatitis Rare pruritic dermatitis of dogs living in kennels with poor sanitation Caused by larval migration of L3 larvae through the skin (hair follicles and keratinized epidermis) Initially pruritic papules in the area of larval penetration (contact with the ground) Later generalized erythema and thickening of the skin In a chronic disease hyperkeratotic footpads Long bristle quickly growing nails due to chronic inflammation Diagnosis is confirmed by typical history, clinical signs, positive fecal examination and treatment response Histopathology can be helpful and can sometimes prove the present of larvae/ canals of larval migration Treatment improvement of sanitation of premises Anthelmintic treatment and routine preventive anthelmintic treatment Approach to the dermatoses on the paws History Breed, age of onset, onset of clinical signs, lesions development Bara, bordercollie, 2y, f Systemic signs fever, hepatic, Ocular, renal, ophtalmic hepatocutaneous sy, PF, SEBD, Leishmaniosis, VKH, paraneoplastic, vasulitis Additional diagnostic tests Hematology, Biochemistry, Urinalysis, ANA Clinical examination Pawpads involvement Pads PF, Vasculitis SEBD Cong.Keratinization Split pawpad dis. Neoplasias Hepatocutaneos Zinc resp.dermatosis FB, endoparasites Skin biopsies Other skin lesions Interdigital Other space cutaneus Allergies, lesions Malassezia Vasculitis and bacteria Leishmaniasis FB PF Demodicosis CLE, SLE Interdigital Hepatocutane cysts ous endoparasites Allergies, demodex Cytology, scrapings, biopsy Cytology, serology, 27 scrapings, cultures, biopsy 28 7

Amoxycillin- clavulanate and Fluconazol syst. 2 t.

8 Cause of presentation History Skin disease for the last 2 months First lesions on the nipples Father of Bara was euthanised because of devastating skin disease few years ago Bara was treated with Amoxycillin- clavulanate and Fluconazol syst. 2 t., different local antiseptics Severe deterioration of the skin in the last two weeks (june) Clinical examination Dermatologic examination T40,3 C

10 Problem list Problem list Predominantly ventral symmetric ulcerative and vesicular dermatitis with confluent serpiginous areas of ulceration in the ventral abdomen, groin and medial thighs, but also ulceration and vesicles of buccal mucosa, ulceration of anal mucucutaneous involvement Fever Differential diagnoses Differential diagnoses VCLE of shelties and collies Dermatomyositis Vasculitis Drug eruption SJS (Secondary pyoderma)

11 Suggested approach Dermatohistopathology Cell poor interface dermatitis with vaculolisation of basal cells, multiple apoptoses and pigmentary incontinence

12 Diagnose Diagnose Therapy VCLE (Vesicular Cutaneous Lupus Erythematosus) Superficial pyoderma

13 Therapy Ciclosporin A 5mg/kg SID Doxycyklin 10mg/kg SID Prednisolon 2mg/kg/SID Cefalexin 25mg/kg BID Chlorhexidine Shampoo every day

Vesicular Cutaneous Lupus Erythematosus in collies and shelties Serpiginous, ulcerative to confluent ulcerated lesions of

14 53 54 Vesicular Cutaneous Lupus Erythematosus in collies and shelties Cutaneous ulcerative autoimmune disesae with predominant ventral involvement Collies and shelties Originally mistaken for dermatomyositis Middle old to old dogs Vesicular Cutaneous Lupus Erythematosus in collies and shelties Serpiginous, ulcerative to confluent ulcerated lesions of the ventral abdomen and inguinal intertriginous skin Vesicles of the oral/ buccal mucose membranes Exacerbation in the summer months

15 Vesicular Cutaneous Lupus Erythematosus in collies and shelties ANA tests are negative Sec. pyoderma Potentially life threatening cutaneous disease Diagnose: Clinical signs and histopathology Therapy: Combination of immunosupressive therapy (Ciclosporin), ako aj doxycyklin 57 15

ESVD Conference Budapest Lucky s history. Lucky s history. Lucky s history. Lucky s history. MVDr. Lucia Panakova, DipECVD

ESVD Conference Budapest Lucky s history. Lucky s history. Lucky s history. Lucky s history. MVDr. Lucia Panakova, DipECVD Lucky, Posavacki gonic, ca. 2y, castrated male ESVD Conference Budapest 2016 MVDr. Lucia Panakova, DipECVD Veterinärmedizinische Universität Wien 2 Lucky s history Lucky s history Referred to the dermatology