COMMON SKIN PROBLEMS IN THE DOG. Breed Health Symposium STRUCTURE OF THE SKIN. Rosario Cerundolo. Keratinocytes 85% vs. non-keratinocytes 15%

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John Norris
5 years ago
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COMMON SKIN PROBLEMS IN THE DOG Breed Health Symposium Rosario

Veterinary Dermatology Hon. Assoc. Prof.

Dermatology @ Dick White Referrals (Cambridge) and @ Bayswater

com STRUCTURE OF THE SKIN Keratinocytes 85% vs.

1 COMMON SKIN PROBLEMS IN THE DOG Breed Health Symposium Rosario Cerundolo Cert VD, Dipl ECVD, MRCVS European & RCVS Specialist in Veterinary Dermatology Hon. Assoc. Prof. of Veterinary Dermatology, University of Nottingham Consultant in Dick White Referrals (Cambridge) Bayswater Referral Clinic (London) roscervetderm@gmail.com STRUCTURE OF THE SKIN Keratinocytes 85% vs. non-keratinocytes 15% Collagen and elastin fibers, ground substance, adnexal structures Panniculus or subcutis Adipose tissue, blood vessels, nerves 1

EPIDERMAL APPENDAGE Hair follicle Arrector pili muscle Sebaceous

Dogs Skin allergies Ear infections Skin infections Non-cancerous

infections Dental diseases Bruise/contusion ALLERGIES Cutaneous

2 EPIDERMAL APPENDAGE Hair follicle Arrector pili muscle Sebaceous glands Apocrine glands (epitrichial) DID YOU KNOW? Dogs Skin allergies Ear infections Skin infections Non-cancerous skin growth Stomach upsets Arthritis GI-Diarrhoea Bladder infections Dental diseases Bruise/contusion ALLERGIES Cutaneous Adverse Food Reaction (food allergy) vs. Atopic Dermatitis (environmental allergy)? 2

3 CAFR vs. AD Owner s most frequent complaint Pruritus CAFR Owner s may also report: GI signs (vomiting and or diarrhoea) Neuro signs (seizures) Clinical signs: variable, unpredictable Derm lesions Erythema, papules, pustules, collarettes, urticaria, angioedema, dry skin, Chronic phase: hyperpigmentation, lichenification, acral lick granuloma Body site CAFR Ears (80%), paws (61%), abdomen (53%) face, neck, limbs, axillae, and/or perineum (22%) 3

4 DIAGNOSTIC TESTS Rule out other pruritic causes Allergy tests Unpredictable results DIAGNOSTIC TESTS Gold-standard method Individualised diet Home-cooked vs commercial diet (novel protein and carbohydrate) Hydrolysed diet Vegetarian diet HYDROLYSED DIETS 4

VEGETARIAN DIETS HYPOALLERGENIC ALSO MEANS:

5 VEGETARIAN DIETS HYPOALLERGENIC ALSO MEANS: No additives No preservatives No artificial colourings No artificial flavourings Unfortunately these are rarely the things that cause allergies AND NOTHING ELSE! What, not even a little piece of cheese with his tablets?? 5

6 ITEMS TO AVOID Flavoured: Toothpaste Worming tablets Antibiotic or NSAID Treats, chews, vitamin/mineral supplements and fish oil Other dogs/foxes faeces! Roadkill/dead birds/rabbits! ENVIRONMENTAL ALLERGY Atopic dermatitis Allergic rhinitis/sinusitis/conjunctivitis ( hay fever ) 6

7 ALLERGENS House dust mites Dermatophagoides farinae D. pteronissinus ALLERGENS Storage mites Acarus siro Thyrophagus putrescentiae POLLENS 7

8 ANIMAL EPITHELIA/FEATHERS 8

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ATOPIC DERMATITIS Multifactorial disease Genetic factors

neurological response involved ATOPIC DERMATITIS There is no

It is not a one-off treatment plan as it needs to be regularly

Treatment is complex and requires a multimodal approach

13 ATOPIC DERMATITIS Multifactorial disease Genetic factors Environmental factors Skin barrier, immune system and neurological response involved ATOPIC DERMATITIS There is no cure! We can only control the clinical signs. It is not a one-off treatment plan as it needs to be regularly reassessed and the treatment checked and maybe modified Treatment is complex and requires a multimodal approach Avoidance of allergens, when possible Ectoparasites and infections to be controlled Skin barrier repaired 13

ATOPIC DERMATITIS Allergy vaccine When allergen avoidance is not feasible, choose a drug(s) with maximum efficacy and minimum cost & side effects: Antihistamines

14 ATOPIC DERMATITIS Allergy vaccine When allergen avoidance is not feasible, choose a drug(s) with maximum efficacy and minimum cost & side effects: Antihistamines Corticosteroids Ciclosporin Chinese herbal treatment Essential fatty acids Oclacitinib Lokivetmab INFECTIONS & ECTOPARASITES Bacterial infections Fungal infections Ectoparasites 14

Avoid spreading infections from animal to animal and to people Bacterial infections Skin: pyoderma, abscess, draining tract/fistula Surface Superficial Deep Avoid

15 Avoid spreading infections from animal to animal and to people Bacterial infections Skin: pyoderma, abscess, draining tract/fistula Surface Superficial Deep Avoid spreading infections from animal to animal and to people Bacterial infections Skin: pyoderma, abscess, draining tract/fistula Ears: otitis (unilateral or bilateral) 15

16 OTITIS Colour: yellow, green (purulent) Consistency: moist, exudative Clinical findings: malodorous, painful, ulcers Avoid spreading infections from animal to animal and to people Bacterial infections Skin: pyoderma, abscess, draining tract/fistula Ears: otitis Mouth: oral cavity microflora 16

abscess, draining tract/fistula Ears: otitis

17 Avoid spreading infections from animal to animal and to people Bacterial infections Skin: pyoderma, abscess, draining tract/fistula Ears: otitis Mouth: oral cavity microflora Paws: lesions/environment 17

18 USEFUL DIAGNOSTIC TESTS Cytology Culture & sensitivity Biopsy 18

19 Cytology: Cocci Cytology: Rods 19

20 INFECTIONS & ECTOPARASITES Bacterial infections Fungal infections Ectoparasites 20

21 M. canis M. canis M. canis 21

22 M. canis T. erinacei WOOD S LAMP EXAMINATION Indications Alopecia Dermatophytosis Principle Trytophan metabolite of dermatophyte fluoresces under UV light (253.7 nm) Wavelength is temperature dependent, so allow lamp to heat up for 5-10 minutes 22

23 TECHNIQUE Examine hair coat in dark room Look for apple green fluorescence in hairs INFECTIONS & ECTOPARASITES Bacterial infections Fungal infections Ectoparasites 23

a drop of mineral oil Examine under the microscope at 4x or 10x Cover debris with a

24 COAT BRUSHING Brush the coat over a white tissue Examine debris (scales vs. black debris) COAT BRUSHING Brush the coat over a white tissue Examine debris (scales vs. flea faeces) Collect debris in the middle and put it on a slide with a drop of mineral oil Examine under the microscope at 4x or 10x Cover debris with a few drops of water 24

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26 FLEA COMB 26

27 ENVIRONMENTAL INFESTATION (indoor) Identify area of infestation 27

28 TRUE OR FALSE? The flea leaves the host to lay the eggs in the environment Fleas jump from one animal to the other The fleas spend the winter hibernating Fleas spent 95% of the life in the environment and jump on the host only for feeding 28

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30 SKIN SCRAPINGS Deep skin scrapings are performed to find Demodex mites D for Deep and Demodex Superficial skin scrapings are performed to find Sarcoptes and other superficial dwelling mites Sfor Superficial and Scabies 30

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32 D. injai D. canis D. cornei 32

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34 In Practice 38, , EAR MITES Otic pruritus with minimal discharge; mites on rump/trunk may mimic FAD 34

35 CONCLUSIONS Breeding healthy pets/working dogs should come first Screening programme for more skin diseases? I hope I did not upset. many of you! 35

CANINE DIETARY AND ENVIRONMENTAL HYPERSENSITIVITY

CANINE DIETARY AND ENVIRONMENTAL HYPERSENSITIVITY Canine allergens What are the most common canine allergens? Common canine allergens What are the most common canine allergens? Flea allergy dermatitis